Cryotherapy: Myth or Magic

Recently I was invited along to a new company offering cryotherapy services to individuals, based in central London.

Cryotherapy:A definition

For those who havent heard if this before; Cryotherapy is the exposure of low temperatures to humans for medical benefit. 

The term “cryotherapy” comes from the Greek cryo (κρύο) meaning cold, and therapy (θεραπεία) meaning cure.

The Cryotherapy Experience
London Cryo have a great, clean fuss-free facility and a great team behind them which make me have no doubt they will succeed. But before we get distracted by all of that, what exactly are we talking about here? 

I am asked to change into my underwear and put on gloves and socks with some rather attractive clog type shoes. The chamber is cooled as I'm changing and it's opened for you to step into with your head poking out the top towards the ceiling. I'm then asked to remove the dressing gown (once inside) and pass it over the top to Maria, who stays with me for the experience 

The temperature drops, I have 3 minutes total time in the chamber and the temperature goes to -140. I start getting that prickly goosebumps sensation all over  i do calf raises and wiggle my fingers and toes, as Maria tells me to keep moving. It's harder than I thought it would be to stay in here for 3 minutes! The time is finally up and the chamber is opened and my dressing gown is given back to change back into.
I'm given a glass of water and go to get dressed. We part our ways, and I have to honestly say I feel on top of the world. It's the same feeling I experience when I finish a sports race, that adrenaline and endorphin mixed rush. This takes me somewhat by surprise as I'm expecting nothing. It is a pleasant experience in all honesty, and I can see why people would buy in to this.

Then I come back down to Earth and do some reading. Where's the evidence for this? Elite sports clubs have been using ice baths for years, conditioning coaches recommend icing post-exercise to assist with muscle recovery but where is the evidence behind this? 

Cryotherapy has been widely used mainly because it has some satisfactory result with little to no harm (RefRef). However there are warnings about prolonged exposure to very cold temperatures ( -100 degrees and below) due to the risk of frost bite and nerve damage.

A study comparing whole body cryotherapy (WBC), with far infrared (FIR) and passive modality (PAS) on a group of runners and the amount of exercise induced muscles damage (EIMD) once they had completed a 48 min trail run. Results found a WBC session 1 hour after the event lowered perceived muscle sensation and maximal muscle strength testing had recovered. When comparing the FIR recovery took 24 hours, and there was No effect at 24 hours for PAS. 

The results also found that by completing three sessions of WBC 48 hours post event, this reduced EIMD to a greater extent when compared to FIR and PAS. Seems pretty good right? These authors took their research further to develop another study looking at the effect of multiple exposures of WBC following severe exercise - again in a group of runners. The results here found that using WBC repeatedly could reduce inflammatory aspects of muscles when compared to PAS treatment. It seems this type of recovery would work well for multidisciplinary sports (such as triathlon) or the ever-growing multi stage event races.

But what about any reviews or cohort studies? Well Bleakley at al reviewed 10 studies relevant to this field. They reported that each study used small numbers and young participants (less than 35 years old).

They state "WBC produces a large temperature gradient for tissue cooling' and found weak evidence to suggest WBC enhances antioxidant capacity and parasympathetic pathways on relation to sports recovery. 

Within this study a small number of journals found subjective recovery following muscles overload, however this was of little benefit to functional recovery for the subjects involved.

As with many aspects of research in Physiotherapy, there seems to be no distinctive amount of research significantly promoting WBC. Bleakley at al do go so far as to say that WBC although accessible is an expensive treatment modality, and alternatives at this stage could be adequate on producing similar results on muscle tissues recovery.

So, in essence Cryotherapy works, and it feels good! But the research points towards using cheaper alternatives as they may be just as effective for muscle tissue recovery.

Better get in that ice bath then!

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