The Efficacy of Cryotherapy: A Deep Dive into Cold Treatments for Recovery

Cold exposure reduces soreness — but 36 studies and a 12-week trial suggest it may blunt the very adaptations you trained for. Here's what the evidence actually supports.

The Efficacy of Cryotherapy: A Deep Dive into Cold Treatments for Recovery

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thanks to Squarespace for sponsoring this video [Music] all right what is going on everyone I want to welcome you all to a new episode of myth-busting where every Monday we're gonna take a look at some common fitness or nutrition idea look at where that idea came from and then figure out whether it's true or false based on the most recent scientific evidence so this week we're gonna be looking at the idea that cryotherapy improves recovery from training and just to be clear we're gonna be using cryotherapy in its etymological context which derives from the Greek cryo meaning cold and therapy a' meaning to cure so basically any form of therapy that involves cold treatment and just to differentiate here modern whole body cryotherapy is when you just sit in a really cold room set at negative 100 to about negative 200

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degrees celsius for 3 or 4 minutes and a related form of cryotherapy is cold water immersion therapy which is when you just sit in a cold water bath for 10 minutes or so um so these are both technically cryo therapies however when people use the term cryotherapy they're usually referring to whole body cryotherapy where you'll sit in a chamber or some cold room but regardless we're gonna cover both of these so first where did the idea that these cryotherapy treatments that can improve recovery come from well it probably dates back to at least 2500 BC when ancient Egyptians would use cold compression treatments for wounds and inflamed injuries there's also record of Napoleon's surgeon using extreme cold as an anesthetic in the late 1700s and through the 19th and 20th centuries cold treatments remained popular and medical practice with applications and treatments of headaches neuralgia and specific cancers however it wasn't until 2002 that ice baths became all the hype and sport circles when English long-distance runner Paula Radcliffe attributed her gold medal in the 2002

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European Championships to ice treatment and she claimed that it's absolute agony and I dread it but it allows my body to recover so much more quickly and then the mainstream popularity of the more modern whole body cryotherapy has even more recent than that although the first cryotherapy chamber was built in Japan in the late 1970s it's only been widely available in the United States for the last decade or so and since then it's really just blown up in mainstream fitness circles but if the real question is is all of that hype justified and I think in order to answer that question we need to have a look at what the scientific evidence has to say now I actually covered this study in another video but very quickly a 2016 study comparing the recovery effects of whole body cryotherapy and cold water immersion therapy in ten subjects after performing five sets of 15 reps on the leg curl found that at 0 24 48 and 72 hours after training cold water immersion was better at improving recovery than whole body cryotherapy and

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that was measured by a muscle soreness counter movement jump height and creatine kinase levels which is a marker for muscle damage and while whole body cryotherapy is a newer methodology all of the research that we currently have comparing it to cold water immersion basically shows it to be worse including a 2013 meta-analysis comparing the two so cold water immersion definitely seems to be better than whole body cryotherapy but for all that is it actually worth doing still so I'd like to first look at its effect on muscle soreness and a very comprehensive 2015 systematic review and meta-analysis looking at 36 articles found that overall cooling treatments did significantly lower the symptoms of delayed onset muscle soreness at the 24 hour mark compared to the control condition which basically just involves sitting or standing in a room set at a comfortable temperature and this soreness reduction continued for up to 96 hours and all the studies included that looked at that however muscle soreness may not be the best gauge of recovery especially given how subjective its measurement is and

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the authors noted that cooling didn't affect objective recovery variables such as lactate levels creatine kinase levels or interleukin 6 levels and I think there are also a number of other limitations with this research probably the main one is that it's virtually impossible to blind the subjects in this case so they're fully aware of whether they're in the treatment group that's getting the ice bath or the control group that isn't getting the ice baths and I think that that leaves them very susceptible to the placebo effect and it could very well be the case that since there is such a widespread belief that this cold treatment therapy is effective at reducing soreness that could sort of be playing into the subjective reports of these subjects in terms of their own perceived levels of muscle soreness after training and in the days after the ice bath and of course I think all that we think we know from this present analysis is that some sort of cryotherapy seems to be better than just sitting there basically doing nothing at reducing delayed onset muscle soreness however that doesn't

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speak to how it might stack up against other recovery modalities such as doing a 10 minute post-workout cooldown and in fact a recent issue of the mass research review highlights some newer research showing that Coldwater immersion therapy doesn't improve recovery better than a simple 10-minute low intensity bout of cycling now some people may note the time-tested efficacy of cold or ice based treatments at reducing inflammation and while this has been shown to be effective in animal models especially following injury at 2017 study in the Journal of physiology notes that no research has examined whether Coldwater immersion reduces local inflammation in human skeletal muscle after a resistance training and it also points out that the repair of skeletal muscle tissue following injury is complex and involves interactions of a ton of different mediators and pathways and it's not even clear that reducing inflammation is the best way to recover from exercise in fact some research shows that reducing inflammation and muscle after injury often in kids muscle repair and while their overall

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conclusion had a very skeptical toned authors do acknowledge that less muscle soreness after intense exercise may be the most consistent effect of cold water immersion but still as of 2017 the mechanisms through which cold water immersion reduces soreness is still unknown but it may have something to do with no Chi scepter or pain receptor activity and I think it's worth pointing out here that delayed onset muscle soreness or Dom's probably not caused by inflammation and this is a common misconception and I think it's led a lot of people to seek out treatments that reduce inflammation as a way of reducing delayed onset muscle soreness also things like anti-inflammatory medications or ice treatments but it stands to reason that even if these treatments did reduce inflammation locally and muscle that doesn't imply that it'll actually effectively reduce muscle soreness but with that out of the way it does really seem to be the case that certain therapy's due reduce muscle soreness after training but for all that it may not be linked to their reduction in inflammation which I don't think they've been strongly shown to do and even still

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this potential reduction in soreness may come at a cost in 2015 Roberts and colleagues split 21 trained men into two groups both groups trained lower body only twice per week for 12 weeks but one group underwent ten minutes of Coldwater immersion after every training session and the other group did 10 minutes of low intensity cycling after every session and after the 12 weeks the simple cycling group saw improved muscle mass and improved strength more so than the Coldwater group for every measure that they tested and in a follow-up study the same research group determined that the muscular and performance detriments from the Coldwater therapy was likely due to a dampened anabolic signal and from decreased satellite cell activity and the authors concluded that the present findings contribute to an emerging theme that cold water immersion and other strategies that are intended to mitigate and improve resilience to physiological stress associated with exercise may actually be counterproductive to muscle adaptation okay so in conclusion I would say that cryo therapies including whole body cryotherapy and cold water immersion

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improve recovery from training is pretty much busted doesn't seem to be the case that some of these cryo therapies do reduce muscle soreness following training however all of the other measurements of recovery don't seem to be too much in favor of the cryotherapy camp and in fact they make on that quite a cost when it comes to muscle hypertrophy and performance adaptations it does seem to be the case that they might reduce muscle soreness in the days following training however I think there are methodological flaws with that body of research and I would also point out that there are other recovery modalities things like just having a simple ten-minute cooldown on the bike following training or doing some foam rolling may also be an easy way to sort of reduce that muscle soreness and in my opinion it might be a cheaper and perhaps more bearable way to reduce soreness and dunking yourself in a tub of cold water after training furthermore whole body cryotherapy seems to be worse than cold water immersion therapy so if

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you're gonna pick between one or the other the ice bath is the way to go however it isn't perfectly clear that even the ice bath is really any better than just doing a simple 10-minute cooldown and in fact these cryo therapies may be coming at a cost as some of the more recent literature has shown that it may not be that great in terms of muscle hypertrophy and strength performance it may actually dampen some of the anabolic signals associated with training um so all things considered and bringing this full circle I would say that there does seem to be more of a potential cost than a potential benefit when it comes to these recovery treatment modalities especially when there are other options available that seem to be just as effective use it at your own discretion is what I would say so that's going to conclude this one guys thank you so much for watching the video before we go I have to thank Squarespace for sponsoring another mythbuster I really do appreciate their support on the channel and in particular with this series and if you guys aren't aware Squarespace is the website creator

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Transcript auto-generated by YouTube. Verbatim — duplicates intentionally preserved.

In the quest for enhanced recovery and performance, many athletes and fitness enthusiasts have turned to cryotherapy. This cold treatment, which includes both whole body cryotherapy and cold water immersion, has gained popularity over the years, promising to alleviate muscle soreness and expedite recovery. But does the science support these claims?

Cryotherapy has roots that trace back to ancient Egypt, where cold treatments were used for healing wounds. Fast forward to today, and the landscape of recovery methods has evolved significantly. With various protocols available, understanding the effectiveness of cryotherapy is essential for anyone interested in optimizing their health and performance.

It's absolute agony and I dread it but it allows my body to recover so much more quickly.

2500 years since cold treatments were used in ancient Egypt 36 articles reviewed in a 2015 systematic review on cooling treatments 12 weeks of training in a study comparing cold water immersion and cycling

Introduction to Cryotherapy

Cryotherapy, derived from the Greek words for cold and therapy, encompasses various cold treatments designed to promote healing and recovery. Modern applications include whole body cryotherapy, where individuals are exposed to extremely low temperatures for a few minutes, and cold water immersion, which typically involves submerging the body in ice-cold water for a set duration.

Historically, the use of cold treatments dates back over 2500 years, with ancient Egyptians employing cold compresses for injuries. This practice has persisted through the ages, evolving into the methods we see today. The modern popularity of cryotherapy surged in the early 2000s, particularly after athletes like Paula Radcliffe attributed their recovery to ice baths. However, as the trend has grown, so too has the need for a closer examination of its actual benefits.

"It does seem to be the case that they might reduce muscle soreness in the days following training." — Speaker

Scientific Evidence on Cryotherapy

A comprehensive review of the scientific literature reveals a complex picture regarding the efficacy of cryotherapy. A 2015 systematic review analyzed 36 articles on cooling treatments, concluding that while cold therapies can reduce delayed onset muscle soreness (DOMS), they do not significantly impact other recovery metrics such as lactate levels or muscle damage markers.

For instance, a study comparing cold water immersion to whole body cryotherapy found that cold water immersion was superior in improving recovery metrics at 24, 48, and 72 hours post-exercise. This suggests that while cryotherapy may alleviate some soreness, it might not be the optimal choice for overall recovery. As noted in the review, "If you're gonna pick between one or the other, the ice bath protocols is the way to go."

Effects on Muscle Soreness and Recovery

The primary benefit often attributed to cryotherapy is its ability to reduce muscle soreness. A systematic review indicated that cooling treatments could significantly lower symptoms of DOMS compared to control conditions. However, the subjective nature of soreness measurement raises questions about the reliability of these findings.

Moreover, while cold treatments may provide a temporary reduction in soreness, they do not necessarily correlate with improved recovery outcomes. The authors of the review cautioned against relying solely on muscle soreness as a recovery metric, as it may not reflect actual physiological recovery. As one expert stated, "Cryotherapy may actually be counterproductive to muscle adaptation," highlighting the potential drawbacks of relying on cold treatments for recovery.

Alternative Recovery Methods

Given the mixed evidence surrounding cryotherapy, it is essential to explore alternative recovery methods. Recent research suggests that low-intensity cycling may be just as effective, if not more so, than cold water immersion for recovery. A study found that participants who engaged in low-intensity cycling after workouts experienced better recovery outcomes than those who underwent cold water immersion.

This raises an important consideration for those seeking effective recovery strategies. Simple cooldowns or low-intensity activities may offer similar benefits without the discomfort and potential drawbacks associated with cold treatments. As the research suggests, there may be more effective and enjoyable ways to promote recovery and resilience.

Words Worth Hearing

"If you're gonna pick between one or the other, the ice bath is the way to go." — Speaker

It's not even clear that reducing inflammation is the best way to recover from exercise.

Practical Takeaways

  1. Consider cold water immersion over whole body cryotherapy for muscle recovery.

  2. Explore alternative recovery methods like low-intensity cycling for effective results.

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