Written by Garett Reid | NSCA, CSCS, CISSN, M.S.E.S.S
Fact checked by Kirsten Yovino, CPT Brookbush Institute
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Foam rollers were so early 2000s.
Now it's 2023 (we guess that technically still counts as early), and recovery methods have changed. So instead of grimacing in pain as your gym partner rolls over your muscles with various sticks, you now get to use cold air or frigid water to support your recovery.
We can't explain why all recovery methods (except for sleep) must be accompanied by pain, but we do know one thing: Cryotherapy has seen a dramatic rise in popularity over the years. And along with that popularity, there has been a flood of good and not-so-good information.
Discerning the information is even harder because there are several forms of cryotherapy treatment. As a result, research from one form of cryotherapy can be wrongly applied to another.
But don't worry! If you're interested in cryotherapy, after reading this article, you'll know everything you need to use it effectively.
Table of Contents:
- What Is Cryotherapy?
- A Brief History of Cryotherapy
- How Does Cryotherapy Work?
- Cryotherapy vs. Cold Water Therapy: What Are The Differences?
- Different Types of Cryotherapy
- Cryotherapy Uses
- Who Should & Shouldn't Use Cryotherapy
- Benefits of Cryotherapy
- Downsides of Cryotherapy
- Is Cryotherapy Safe?
- What to Expect Before, During, & After Cryotherapy
- Best Tips For Getting The Most Out Of Cryotherapy
- Common Cryotherapy Mistakes
- Where Can You Do Cryotherapy?
- What To Do After A Cryotherapy Session
- FAQs
What is Cryotherapy?
Cryotherapy involves exposing your body to very cold temperatures in the form of air. Liquid nitrogen can also be used in more sophisticated machines. Depending on your specific goals and intent, the temperature may be directed toward your entire body or just one area.
In addition to being used as a recovery method, cryotherapy is also used to destroy abnormal cells, as seen with skin cancer, or even freeze warts. In this instance, below-freezing temperatures are used. Other times it may be used to alter hormonal profiles. For this situation, slightly warmer (but still very cold) temps might be used.
What else should you know about cryotherapy? Well, some of the top athletes in the world swear by, or have sworn by, cryotherapy, including Stephen Curry, Lebron James, the late Kobe Bryant, and the fastest man in the world, Usain Bolt.
In addition, the cryotherapy total market share in 2021 was just under $7 billion. Analysts project this to grow by 7% every year until 2030¹.
A Brief History of Cryotherapy
The use of very cold temperatures both for medicinal purposes and therapy date back to the early Egyptians. In fact, even Hippocrates noted that cold temps can be used as a treatment for swelling and pain².
But as the medical practice we know today, cryotherapy is actually quite new. The first time it was used professionally in the medical field was in 1978 by a Japanese rheumatologist named Toshima Yamaguchi.
As he was mainly interested in non-invasive methods to reduce pain, he examined the use of freezing cold therapy to mitigate the symptoms of arthritis. He concluded that cold therapy effectively decreases pain and provides relief due to the body being flooded with endorphins.
The use of cold therapy grew due to its effectiveness, and various cold chambers were invented to expose the entire body to cold temperatures.
How Does Cryotherapy Work?
Cryotherapy involves placing your body in an extreme environment, usually only for a few minutes. Therefore, it should be no surprise that it invokes several physiological adaptations.
The first major response is the narrowing of your blood vessels called vasodilation, which slows down blood flow, potentially reducing inflammation and swelling.
Due to the extreme cold, everything will move slower, including the rate at which your cells produce energy. At the same time, your body will have to produce more energy to keep itself warm, which is why we shiver. It's a mechanism that causes us to produce heat internally, similar to working out.
The last major response involves your body being flooded with various chemicals. The primary chemicals secreted are dopamine and norepinephrine, both of which are responsible for the "feel-good" sensation and decrease in pain and discomfort.
Cryotherapy vs Cold Water Therapy: What Are The Differences?
Even though cryotherapy is sometimes used as a universal term for cold treatment, it is distinctively different from cold water therapy. The main difference is that cold water therapy uses, well, water!
In addition, the term cold therapy can refer to a host of treatments, including cold water immersion, cold showers, ice baths, and even an ice pack.
During cold therapy with water, the temperatures are generally significantly warmer than with cryotherapy. This is because the water would freeze if it reached the low temperatures of cryotherapy.
As a result, cold water therapy is more commonly used for muscle & workout recovery and other therapeutic uses.
Different Types of Cryotherapy
As mentioned above, there are various forms of cryotherapy treatment to choose from. We are going to focus on the two most common types used for workout and muscle recovery and then will mention the other types briefly, which are used more for medicinal purposes³.
1) Whole-body cryotherapy:
Whole-body cryotherapy (WBC) is a form of cryotherapy in which a person fully enters an enclosed cryotherapy chamber. Once inside, the door is closed to create a tight room.
From here, electricity is used to drop the temperature inside.
2) Partial-body cryotherapy:
Partial-body cryotherapy is much more common than whole-body cryotherapy. And even though it's called partial, it should really be called "everything but the head," as it's basically a cryotherapy chamber in which your head sticks out.
Partial-body cryotherapy uses liquid nitrogen to drop the temperature in a partially closed system. Aside from your head, everything else is exposed to freezing temperatures.
This is generally the most common form of cryotherapy treatment, especially for supporting muscle recovery and treating muscle pain.
3) Other Forms of Cryotherapy:
There are multiple other forms of cryotherapy used for medicinal purposes. Here's a brief overview.
Cryoblation, also known as cryosurgery, is a form of cryotherapy treatment that uses extremely cold air that is localized to a smaller point. It is used to kill damaged or diseased tissue. One of the most common examples of this is the freezing of warts.
In addition, a local cryo-stimulation device is one of the forms of cryotherapy that attacks a localized area. It uses a device to deliver liquid nitrous oxide to a small location and bring the temperatures down to 25° to -40° F. This is what's commonly used to treat diseased tissue such as skin tags.
Technology in cold therapy has advanced so far that doctors can now treat areas of the body underneath the skin. This is done through a device called a cryoprobe, a probe that's placed into an incision in the body and capable of generating very low temperatures. The immune system then clears any the abornmal cells that were frozen as part of the internal cryotherapy process.
Cryoneurolysis is a procedure that uses a small probe that's placed below the skin next to a peripheral nerve. The probe then cools the nerve using nitrous oxide, which effectively "freezes" it for a period of time. Studies have shown that it may be an effective method to help numb and mitigate pain, such as back pain.
Cryotherapy Uses
Over the years, the use of cryotherapy has expanded and is now used for a variety of conditions.
Again, we're going to focus on health and wellness benefits here, but it's important to note that cryotherapy is also used for removing diseased tissue, like warts, or cancerous cells, like basal cell carcinoma. In addition, it's used to destroy abnormal tissue and treat low-risk cancer, like pancreatic cancer, improve skin health, and treat mood disorders.
With that, here's a look at three ways it's used by athletes and gym goers.
1) Improve Muscle Recovery:
Cryotherapy has become so popular in the past few years due to its prevalent use among athletes for recovery. One of the mechanisms that is believed to improve recovery is the vasoconstriction of blood vessels.
When the body experiences extremely cold temperatures, the blood vessels constrict or get narrower. This results in less blood circulation and blood supply to the affected area, resulting in the area seeing less inflammation and swelling.
As an added bonus, this improvement in recovery may be accompanied by improvements in work capacity and performance⁴.
2) Mitigate Muscle Pain:
Another variable similar to muscle recovery is muscle pain. Note that these two variables may be related but are, in fact, distinct attributes. And the evidence for reducing muscle pain appears to be smaller than that of recovery.
Take these two meta-analyses, for example, which concluded that there is little evidence to suggest cryotherapy reduces muscle pain, specifically discomfort that occurs with DOMS (delayed onset muscle soreness)5,6.
It is important to note that regular use of cryotherapy has been shown to numb the nerves and sensations around local points, temporarily relieving pain, so this may help those with chronic pain or even those looking for brief relief from muscle pain post-workout.
It's just not going to be a long-term solution.
3) Weight Loss:
Many people will attempt to use cryotherapy to help them shiver off the fat. When the body is placed in a cold environment, it must generate its own heat in a process known as cryo-thermogenesis. This event is factual and an acknowledged phenomenon.
However, true cryotherapy is not likely to be effective for weight loss due to its short duration. Remember that cryotherapy only lasts 3-5 minutes. Therefore, you'd need to be burning 2,000 calories an hour just to burn 100 during that time frame.
The point is that any extra calories burned should be seen as one of the extra (and smaller) benefits of cryotherapy, and cold water therapy in general, not the main reason for doing it. You can learn more about this in our article: Do Cold Showers Burn Fat?
Again, all signs point back to using it for muscle recovery for best results.
For those trying to lose weight, you're much better off following a workout split and proper diet.
Who Should Use Cryotherapy?
The list of who should use cryotherapy is extensive. Cancer patients, those with nerve damage, and those with chronic muscle pain may all want to consider using cryotherapy.
And relevant to this article, the benefits of cryotherapy can be very advantageous for athletes, especially those with demanding schedules, as it's vital that they recover from training or a game as quickly as possible.
Athletes aren't going to have 2-3 days to fully recover as they will play daily, sometimes even twice a day! If they can recover faster, they will have the advantage.
You can learn more about how athletes utilize cold water therapy in our article: Why Do Athletes Take Ice Baths?
Who Should Avoid Cryotherapy?
While cryotherapy is generally safe, there are some groups who should avoid it. Here's a look.
1) Advanced Diabetic Patients:
Even though cryotherapy can help diabetic patients by improving nerve function and circulation, it can be detrimental to advanced patients7. This is due to having very poor circulation and an inability to feel.
If you have diabetes, speak with your doctor before trying cryotherapy.
2) Those With Low Blood Pressure Or Blood Circulation Problems:
Due to the vasoconstriction of the blood vessels, there will automatically be less blood flow. In healthy individuals, this isn't really an issue.
However, if you already suffer from issues with blood circulation, further decreasing the body's ability to pump blood can amount to various health issues such as low blood pressure, dizziness, and loss of consciousness8.
3) Lifters Interested In Muscle Gain:
One of the interesting adverse effects of cryotherapy is that it seems to mitigate the anabolic process and muscle growth. This is believed to be due to the disruption in the inflammation process, as this is a critical part of the process of muscle hypertrophy.
To be clear, muscle growth and muscle recovery are two distinct phenomena9. So, while an athlete may be able to recover from a workout faster using cryotherapy, it will not be accompanied by greater muscle gains.
Therefore, anyone who is training with the sole intent of building muscle should avoid using cryotherapy for post-workout recovery.
Benefits of Cryotherapy
The benefits of cryotherapy are vast. As we went over above, cryotherapy can be used as a treatment for:
- Low-risk cancer
- Removal of abnormal tissue
- Skin conditions
- Mental state
In addition to their unique applications, as a whole, cryotherapy offers a cost-effective, non-invasive therapy that has potentially high benefits.
And, over the last decade or so, there has been a resurgence of cryotherapy use due to gym-goers utilizing it as a form of post-training recovery.
Most of the benefits of cryotherapy for muscle recovery come from vasodilation, numbing of the area, and the release of chemicals. Combined, these are able to provide acute pain relief while decreasing inflammation and swelling for long-term relief.
Cryotherapy Risks & Side Effects
Cryotherapy is generally safe but can have several downsides, especially if you don't follow the guidelines.
Here are the most common side effects:
- Pain at the site of therapy
- Redness of the affected area
- Fainting
- Blistering
- Frostbite
One area that is of special concern is nerve damage. When the body is consistently exposed to extreme cold, the lipids in the myelin sheath of a nerve can solidify. This can lead to the arrest of the nerve motor, resulting in no sensation. If a cold application is continued, it can eventually lead to the permanent loss of sensation from that nerve.
Again, many of these risks can be mitigated, if not eliminated altogether, by simply following the guidelines concerning the ideal cryotherapy time frame.
Is Cryotherapy Safe?
Yes, cryotherapy is generally safe as long as you follow the established guidelines. Remember that you are placing your body in an extreme environment. Therefore, you can put yourself at risk once you start going past the recommendations.
Cryotherapy Safety Tips
Follow these safety tips to optimize your cryotherapy sessions.
- Never stay in for longer than the prescribed time.
- Do not use cryotherapy daily for an extended period of time. This is especially true for localized cryotherapy.
- Use the proper safety gear and protocols depending on the method used. This includes keeping your extremities covered and using a barrier to avoid direct application.
What to Expect Before, During, & After Cryotherapy
Interested in cryotherapy but want an idea of what to expect? Here's what to know before, during, and after a cryotherapy session.
Before Your Session:
There's not much for you to do before your session. Apart from getting prepared, you just need to show up! You'll likely feel a bit anxious or even excited. This isn't bad but try to mitigate it as much as possible, as it can exacerbate any shock.
During Your Session:
Once inside the cryotherapy chamber, your session will begin. Remember that once it begins, it only lasts 3 minutes. During this time, you will experience a rush of extreme cold temperatures.
This may be more or less uncomfortable, depending on the individual, and is sometimes considered painful. It's important that you try to remain as calm as possible during this time. We recommend you focus on breathing exercises to keep your vitals at appropriate levels.
After Your Session:
Once your session is done, you will warm up, and your discomfort should begin to subside. You may be offered a pain reliever if your discomfort is significant or doesn't go away.
If you received a direct or local application, you may need to follow some basic aftercare. Check with your provider on this.
Tips For Getting The Most Out Of Cryotherapy
Cryotherapy sessions are pretty straightforward. However, here are some tips to help you make the most out of your sessions.
- Wear appropriate clothing. Depending on what type of cryotherapy you perform, you'll have different guidelines for clothing. For example, whole-body cryotherapy generally allows loose-fitting clothing while half-body cryotherapy has you wear as little as possible apart from underwear, socks, and gloves. Be sure to check before you go.
- Be as dry as possible! Do not come to your session sweaty or wet. We mentioned this above but it's worth repeating. Any water on your body will freeze and can present problems.
- Don't wear jewelry. You should take off all jewelry before you go to your cryotherapy session. If metal contacts your skin, it can freeze to your body and create serious cold burns.
- Don't use any lotions or oils. The reasoning for this is similar to why you should be totally dry. Lotion or oil can freeze and crystalize on your skin, increasing the probability of getting frostbite or serious cold burns.
5 Common Cryotherapy Mistakes To Avoid
Cryotherapy uses extreme cold, and these temperatures are actually dangerous for a person if they're exposed for too long.
Here are the top things you can do to make this generally safe treatment unsafe.
1) You're not dry:
Never start a cryotherapy session wet, which includes being sweaty from a workout. Being wet can cause the water to freeze on your body and cause frostbite, similar to if you place ice directly onto the skin.
So, stay dry! If you do use cryotherapy following your workout, give yourself enough time to cool down and dry off.
2) You Fall Asleep:
The duration one stays in cryotherapy is very short, 2-5 minutes. This is due to the extremely cold temperatures used and the damage it does to your healthy skin if exposed for too long.
I can't imagine how you would be able to fall asleep while being blasted with cold air, but heed my warning! This is not the time to relax and drift off.
3) You Perform Cryotherapy Alone:
Again, this is another health hazard.
Cryotherapy treatment uses extreme colds that can either put a person in shock or cause serious injury. Therefore, never perform cryotherapy on yourself. You must have another person present to help in case of an emergency.
4) You Go For Too Long Or Too Often:
You must listen to the safety protocols regarding time. These safety measures are set in place to protect the body from these extreme temperatures. If ignored, temperature injuries such as frostbite can occur.
For example, this case study examined the events surrounding two cases of feet frostbite. Both patients had prolonged and uninterrupted application of cryotherapy for 4 to 7 days10. While both patients were eventually treated successfully without loss of limb, this could have been easily avoided.
5) You don't Use Proper Padding When Required:
Some forms of cryotherapy require using a barrier to protect unexposed skin from extreme cold. For example, when using a direct application like ice packs, the recommendation is that you use a sufficient amount of padding to protect your skin from direct contact.
In addition, it's also common practice for patients to wear gloves when using methods such as partial body cryotherapy.
These extra layers are present as these areas are susceptible to injury if unprotected. Cases of frostbite have been reported when these precautions are ignored. But I haven't seen this occur anywhere in which the proper protocols were carried out.
Where Can You Do Cryotherapy?
Options for how and where you do cryotherapy are growing every day.
Here are some of your options:
- At Home: Some forms of cryotherapy can be performed in the comfort of your home. This primarily consists of things such as using ice packs and cold therapy machines.
- Fitness Centers: Many fitness centers have begun to offer cryotherapy, either directly or through a partnership with a company. If this option is available, I recommend confirming that the practitioner has the appropriate experience and skills.
- Specialized Recovery Centers: There has been a dramatic increase in specialized recovery centers. These are health facilities that specialize in the recovery and rejuvenation of the body. They may offer services such as IV, compression suits, and cryotherapy.
- Hospitals: You must go to a hospital if you seek cryotherapy to treat medical conditions, such as removing skin tags and other growths.
What To Do After A Cryotherapy Session
After your cryotherapy session, you will likely feel a rush of endorphins and "feel-good chemicals." Generally, when one uses partial-body cryotherapy or whole-body cryotherapy, there is a minimal amount of aftercare you must take.
However, for extreme examples or those that use direct application, aftercare may be more important. For those using liquid nitrogen, temperatures can reach 200 degrees below zero. This is cold enough to actually cause cold burns, which can result in the area swelling as well as the appearance of blisters.
The swelling should go down by itself, however, blisters can stick around for a few days. If you experience a blister, you can let it break on its own or use a sterilized needle to puncture it. This should be done after the blister has stopped enlarging. You should then clean the area and use an antiseptic to cover the area and prevent infection.
In addition, stay well hydrated to ensure skin health. If you are sensitive, you may use sunscreen to prevent irritation from the sun.
FAQs
Remaining cryotherapy questions? Let's answer them here.
What Does Cryotherapy Do To Your Body?
Exposing yourself to cold temperatures can cause several physiological reactions. This can include restricting your blood vessels, your cells producing energy at a slower rate, producing chemicals such as norepinephrine and dopamine, and increasing your metabolism to warm the body.
Does cryotherapy help you lose weight?
When your body is placed in extreme cold, you must combat these cold temperatures by using energy to produce heat. This heat will then warm up the inner body temperature. The evidence is mixed on this. While studies indicate a trend toward improved body composition, it is quite small compared to other weight loss methods, such as controlling your diet11.
What Are The Side Effects of Cryotherapy?
Luckily, the adverse effects of cryotherapy are relatively small and benign and can include things such as skin redness and unpleasant cold sensations. More serious issues can also occur, such as bleeding, ulcers, infection, nerve damage, and frostbite. However, these more serious effects only occur once you start to operate out of the suggested protocol.
Interested in trying cryotherapy at home? Check out these 5 Best Cold Therapy Machines to find the best fit for you! Or, if you'd like to take advantage of cold water therapy's benefits, check out these Best Ice Bath Tubs!
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References:
- Cryotherapy Market Size, Trends & Analysis Report, 2022-2030. www.grandviewresearch.com. Accessed April 4, 2023. https://www.grandviewresearch.com/industry-analysis/cryotherapy-market
- Korpan, Nikolai N. MD, PhD, FICS*. A History of Cryosurgery: Its Development and Future. Journal of the American College of Surgeons 204(2):p 314-324, February 2007. | DOI: 10.1016/j.jamcollsurg.2006.11.006
- Bettany-Saltikov J, Paz-Lourido B. Physical Therapy Perspectives in the 21st Century: Challenges and Possibilities. BoD – Books on Demand; 2012. Accessed April 4, 2023. https://books.google.com.ph/books?hl=en&lr=&id=hcqgDwAAQBAJ&oi=fnd&pg=PA155&dq=types+of+cryotherapy&ots=TrFW2Yk1db&sig=nbSYyKMRFKg_8pXwtdSS-DGRusI&redir_esc=y#v=onepage&q=types%20of%20cryotherapy&f=false
- Rose, C., Edwards, K. M., Siegler, J., Graham, K., & Caillaud, C. (2017). Whole-body Cryotherapy as a Recovery Technique after Exercise: A Review of the Literature. International journal of sports medicine, 38(14), 1049–1060. https://doi.org/10.1055/s-0043-114861
- Bleakley, C., McDonough, S., Gardner, E., Baxter, G. D., Hopkins, J. T., & Davison, G. W. (2012). Cold-water immersion (cryotherapy) for preventing and treating muscle soreness after exercise. The Cochrane database of systematic reviews, 2012(2), CD008262. https://doi.org/10.1002/14651858.CD008262.pub2
- Costello, J. T., Baker, P. R., Minett, G. M., Bieuzen, F., Stewart, I. B., & Bleakley, C. (2015). Whole-body cryotherapy (extreme cold air exposure) for preventing and treating muscle soreness after exercise in adults. The Cochrane database of systematic reviews, 2015(9), CD010789. https://doi.org/10.1002/14651858.CD010789.pub2
- Nadler, S. F., Weingand, K., & Kruse, R. J. (2004). The physiologic basis and clinical applications of cryotherapy and thermotherapy for the pain practitioner. Pain physician, 7(3), 395–399.
- Allan R, Mawhinney C. Is the ice bath finally melting? Cold water immersion is no greater than active recovery upon local and systemic inflammatory cellular stress in humans. The Journal of Physiology. doi:10.1113/jp273796
- Hooshmand H, Hashmi M, Phillips E. CRYOTHERAPY CAN CAUSE PERMANENT NERVE DAMAGE: A CASE REPORT. Published 2014. Accessed April 4, 2023. https://www.semanticscholar.org/paper/CRYOTHERAPY-CAN-CAUSE-PERMANENT-NERVE-DAMAGE%3A-A-Hooshmand-Hashmi/1e8719edec37e9ff54b8216115d221480184e134
- Brown, W. C., & Hahn, D. B. (2009). Frostbite of the feet after cryotherapy: a report of two cases. The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons, 48(5), 577–580. https://doi.org/10.1053/j.jfas.2009.06.003
- Filliard J, Faria FC, Bieuzen F, et al. (2016). P-12The effects of the whole body cryotherapy on the body composition: British Journal of Sports Medicine;50:A38.
Garett Reid
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