Whole Body Cryotherapy: Strength + Training Research

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Many of our clients participate in high-impact, high-challenge activities: CrossFit, Boot Camp, Martial Arts such as Judo, Jiu-Jitsu, Muay Thai, Wrestling, Boxing, Karate, and Kickboxing. We also see many clients who participate in traditional sports like baseball, basketball, soccer, hockey, football, and running.

There is a growing body of research examining and testing the mechanisms by which whole-body cryotherapy effectively enhances athletic performance, recovery, and injury prevention. Here is a synopsis of current academic research. The results are astounding!

Thank you, Sean Hogan, for compiling this data.

Recovery from Training/Exercise Damage

A group of researchers from Poland (Wozniak et al 2007) examined the impact of WBC on muscle damage following training with and without WBC. They used a control group, and the study, published in the peer-reviewed European Journal of Applied Physiology, showed that trained athletes experienced between 30% and 46% less muscle cell damage after training when they underwent WBC exposure. After 6 days of training and WBC exposure, the athletes, according to the authors, showed less exercise-related stress than those who did not take WBC. In simple terms, the study showed that WBC exposure was beneficial in reducing the muscle damage that typically occurs with intense training. Thus, the authors point out that WBC may reduce micro-injury to muscle fibers caused by exercise.

These findings are similar to the findings from an unpublished study by Hennessy and colleagues (2005) with trained athletes (including track and field and soccer players), where other subjective markers of fatigue, such as muscle soreness and general perception of fatigue, were lower in those players using WBC compared to those not taking WBC during a similar training period. Furthermore, energy levels and enthusiasm for training were higher among players exposed to WBC. This study on elite Rugby Union players also showed that Heart Rate Variability (HRV), as assessed using the RmSSD method (evaluating parasympathetic activity), also displayed a more stable day-to-day profile in players undertaking WBC.

In addition Hausswirth et al (2011) found that in well trained runners WBC exposure completed within the 48 hours after a damaging running exercise accelerates recovery from exercise induced muscle damage to a greater extent than other established therapies such as far infrared therapy (Note far-infrared is used to relieve pain in patients with muscular disorders and more recently has been considered as an efficient recovery strategy in sport (Mazuda et al 2005)).

Enhanced Biochemical/Hormonal profile and Antioxidant benefits

Further, Wozniak et al. (2007) showed that the stress hormone cortisol was reduced during WBC exposure. This provides further evidence that the stress of training is reduced when WBC is taken alongside intense training. Of interest to us is that the athletes were exposed to WBC before training each day.

This study by Wozniak agrees with the findings of Bialy and colleagues (2005), who reported that athletes from judo and karate sports experienced improvements in general well-being and greater training tolerance following training with WBC.

Numerous authors have also reported positive effects on the hormonal status of athletes following WBC exposure (Bialy et al 2005, Gregorowicz and Zagrobelny 2006, Strek 2006). Some of these changes relate to improved testosterone levels in male athletes following WBC. However, the changes reported in these studies have not always been statistically significant (Bialy et al 2005).

Studies on the effects of WBC on the immune system have also been presented by Jackowska and her team of researchers at the faculty of Physiotherapy in Wroclaw, Poland (2005). This team of researchers showed how healthy non-athletic subjects who were exposed to a series of WBC exposures from -110 to -180 °C over 5 days improved aspects of their immune profile. Other researchers have also reported increased levels of endorphins (the feel-good chemicals) and other neural or nerve conduction proteins following cryotherapy exposure (Bialy et al., 1999; Wawrowska, 1992).

More recently, numerous studies have highlighted beneficial effects on antioxidant status, including those following a series of 10 WBC exposures (Mila-Kierzenkowska et al., 2010; Miller et al., 2010). Recently, Lubkowska et al (2011) reported an increase in the body’s immunity, associated with a decrease in total oxidative status and inflammatory response after repeated WBC sessions (10 to 20 sessions).

Schall et al (2013) reported that HRV returns to baseline faster after WBC exposure during an intense period of training in well-trained athletes. This finding is similar to that of Hennessy et al. (2005). Sleep quality was also improved as a result of daily WBC exposure in these well-trained athletes.

Performance-related benefits

Is there any evidence for improved athletic performance as a result of using WBC? Hennessy et al. (2005) reported that elite Rugby players showed greater improvements in speed, strength, and power following training with WBC than players who trained without WBC over the same training period. However, the authors reported that the separate training environments used by the two groups were a limitation of the study design. The greater gains made by players using the WBC-assisted physical training program included:

  • Greater muscle mass gain
  • Greater body fat reduction
  • Higher power gains
  • Improved speed and
  • Better anaerobic endurance

Klimek et al. (2010) have also shown an improvement in anaerobic capacity after 10 WBC sessions, primarily explained by metabolic changes (i.e., increased activity of anaerobic glycolytic enzymes) and improved pain tolerance, as evidenced by an increase in blood lactate concentration. In practice, it seems that a sufficient number of WBC sessions (at least 10) is necessary to stimulate an immunological response, whereas antioxidant and anti-inflammatory effects can be observed from the first session.

Functional Overreaching augmented

The use of WBC during pre-season training allows for a greater volume of high-intensity training and, as stated, several leading professional Rugby teams use it in their pre-season programs.

This is typically referred to as Functional overreaching, in which a deliberate increase in work volume and intensity is performed, with an augmented recovery period built into the post-training period.

Combining functional overreaching with WBC does seem to provide a greater training effect, and this evidence alone is strong support for its use, especially as part of a well-planned training program during critical periods where speedy recovery from intense training is required for swimmers, elite team sport players, and well-trained athletes (Al Haddad et al 2012, Schaal et al 2013, Hennessy et al 2005).

Nevertheless, more training studies are needed to establish more precise protocols of WBC use and training volumes during such deliberate Functional Overreaching periods.

Enhanced Mood and Sleep quality

As noted earlier a number of studies have shown that WBC induced a reduction of depressive symptoms by enhancing well-being, sleep and relaxation (Gregorowitcz et al 1998, Rymaszewska et al 2008). In particular, Al Haddad et al (2012) reported that daily use of WBC whole body cryotherapy increased resting parasympathetic tone (i.e., improved HRV profile) and sleep quality in swimmers. Further, Schaal and colleagues (2013) studied the effects of daily WBC during an intense training period in well-trained athletes. Sleep quality improved, and HRV returned to baseline faster after WBC exposure. In addition, the following positive benefits were also reported following daily WBC exposure during intense training:

Decreased tension, depression, anger, fatigue, and confusion. Greater somatic and cognitive states were observed among those undergoing daily WBC exposure compared with the control group, which did not experience WBC.

In addition, several studies highlight the impact of daily use of WBC in the medical domain. Symptoms of depression seem to be positively affected, whereby improvement of mood and deep relaxation have been reported after ending a cycle of WBC (Rymaszewska et al 2000).

Summary of benefits

So, let us summarise. To date, there is evidence for:

  • Less muscle damage during training when WBC is used
  • Greater tolerance to training over several days when WBC is used
  • Greater anaerobic power and adaptation to training
  • Improved testosterone levels in male athletes
  • Better immune profile following WBC exposure
  • Improved endorphin levels when WBC is used.
  • Greater antioxidative status
  • Enhanced mood and relaxation
  • Better sleep quality

The above list of benefits is quite impressive and is likely to facilitate the sports person’s recovery and adaptation to intense exercise. If better sleep quality can be achieved with cryotherapy exposure and if less muscle damage occurs in response to training, then it is likely that WBC and PBC may be seen as a positive adjunct to the training program. In addition, if repeated cryotherapy exposure can enhance or mitigate the detrimental effects of intense training on immune markers, then the recovery strategy offers significant long-term benefits to the hard-training athlete.

Sports Injuries – Is cryotherapy beneficial?

Papenfus (2006) provides evidence supporting the use of WBC as an adjunct to the rehabilitation program following injury. Indirectly, Bialy et al (2005) also note the effectiveness of WBC in reducing the reporting of injury-related ‘ailments’ when WBC is used during intense training. Zimmer and colleagues (2005), from the Physiotherapy faculty at the Academy of Physical Education in Wroclaw, provide evidence that the recovery time following knee injury (patella thigh syndrome) is shortened when rehabilitation treatment includes WBC. However, there is a lack of well-designed controlled studies examining the effectiveness of WBC as an adjunct to standard rehabilitation following injury. This is an obvious area for research, and until there is more substantive research, the effectiveness of WBC in accelerating recovery from sporting injuries and returning to participation remains unclear.

Summary

There is a growing body of research supporting the benefits of using WBC as a recovery strategy and an adjunct to physical training for athletes across several sports. In addition, there is strong support from leading professional sports teams that WBC indeed provides superior gains during intensive physical training, beyond what is possible without it. Several studies support these benefits while highlighting the need for more detailed research.

The message is clear: athletes and players who use WBC as an adjunct to their training can expect to feel better and recover faster from training. In addition, the effectiveness of using WBC between dense periods of competition may be of great value; specific studies examining its effectiveness during such periods have yet to be conducted. As is normal, we await well-prosecuted research in examining the potential of WBC as an ergogenic aid; however, many professional teams are not waiting. They are taking the cold exposure regardless.

References

Al Haddan et al. IJSPP. 2012 (cited in Hauswirth and Mujika’s Recovery for Performance in Sport (2013)).

Bialy et al. The application of whole body cryotherapy in sport. Biomed Engineering Acta. 86-91, 2006.

Bialy et al. Krioterapia ogólnoustrojowa w sporcie. Medycyna Sportowa. 94, 21-24, 1999.

Bieuzen et al. Cold water therapy and exercise-induced muscle damage: a systematic review and meta-analysis. PLoS One. 2013 Apr 23;8(4):e62356. doi: 10.1371/journal.pone.0062356. Print 2013.

Bleakley et al. Cold water immersion (cryotherapy) for preventing and treating post-exercise muscle soreness. Cochrane Database Syst Rev. 2012 Feb 15;2:CD008262. doi: 10.1002/14651858.CD008262.pub2.

Braun et al Whole-body cryotherapy in patients with inflammatory rheumatic disease. A prospective study. Med Klin (Munich). Mar 15; 104(3):192-6.2009.

Casa et al. Cold water immersion: the gold standard for the treatment of exertional heatstroke. Exerc Sport Sci Rev 35(3), 141-149. 2007.

Gregorwicz & Zagrobelny. Stetematic cryotherapy. Indications and contraindications, process of treatment, and its physiological and clinical results. Biomed Eng Acta. 9-21, 2006.

Gregorowitcz et al. Whole-body cryotherapy indications and contraindications, the procedure, and its clinical and physiological effects. Acta Bio-Optica Informatica Med. 1998;4:119–131. 1998.
Hennessy et al. The impact of extreme WBC on pre-season fitness development in professional rugby players. 2nd Annual Scientific Meeting. RCPI & RCSI, 2005.

Ireland on Sunday. Stars queue up for a death-defying spell at minus 110 C’. August 13th 2006.

Jackowska et al. Chenages of level of immunoglobulins and C3 and C4 proteins in serum during WBC. Biomed Eng Acta. 47-51, 2006.

Klimek et al. Influence of the ten sessions of the whole body cryostimulation on aerobic and anaerobic capacity. Int J Occup Med Environ Health. 23:181–189, 2010.

Lubkowska et al. The effect of prolonged whole-body cryostimulation treatment with different amounts of sessions on chosen pro- and anti-inflammatory cytokine levels in healthy men. Scand J Clin Lab Invest. 71:419, 2011.

Masuda et al. The effects of repeated thermal therapy for patients with chronic pain. Psychother Psychosom. 74:288–294. 2005.

Mila-Kierzenkowska et al. Whole-body cryostimulation in kayaker women: a study of the effect of cryogenic temperatures on oxidative stress after the exercise. J Sports Med Phys Fitness. Jun; 49 (2):201-7.2009.

Miller et al. Effect of short-term cryostimulation on antioxidative status and its clinical applications in humans. Eur J Appl Physiol. May; 112(5):1645-52. 2012.

Papenfus W. Power from the Cold. Regensburg, Germany. 2006.

Rymaszewska et al. The influence of whole body cryotherapy on mental health. Psychiatr Pol. Jul-Aug;34(4):649-53. 2000.

Rymaszewska et al. Whole-body cryotherapy as an adjunct treatment of depressive and anxiety disorders. Arch Immunol Ther Exp (Warsz); 56:63, 2008.

Schall et al 2013.

Strek W. Cryo chamber treatment. Summary of BASES. Spring meeting 26-27 April 2006.

Skrzek et al. Application of cruptherapy in fibromyalgia (FMS) treatment. Biomed Eng Acta. 52-55, 2006.

Wawrowska A. Wpływ ogólnoustrojowej krioterapii na organizm osób. Praca doktorska. AWF Wroclaw, 1992.

Wozniak et al., the effect of WBC on lysosomal enzyme activity in kayakers during training. Eur J Appl Physiol. 100 (2) 2007.

Yamauchi T. WBC is a method of extreme cold (-175 °C) treatment, initially used for Rheumatoid Arthritis. Z Phys. Med Balneol Med Klimatol. 15 p 311, 1986.

Zimmer et al. Application of cryotherapy in the treatment of patella-thigh syndrome. Biomed Eng Acta. 73-76. 2006.

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