Whole Body Cryotherapy: Where We’re Going, We Don’t Need Clothes
A deeper look at the health and recovery trend that athletes like LeBron, Ronaldo and Kobe swear by.
Whole body cryotherapy has been advertised as accelerating recovery, reducing inflammation, improving sleep, reducing wrinkles, and a whole bunch of other purported benefits. It might even solve world hunger.
This concept of using the cold as a therapeutic technique (known as “cryotherapy”) has been around for eons. It was used as early as 3000 BCE by the Egyptians to treat injuries and inflammation, Napoleon’s surgeon Dominique-Jean Larrey facilitated amputations with it, and it’s use grew widespread once liquid nitrogen became commercially available after World War II.
We’ve seen cryotherapy (cold therapy) used in a litany of ways in the modern age, from ice bags to ice baths to body-part specific gadgets:
Whole body cryotherapy takes it to the next level. You get into your unmentionables, put some gloves and socks on, then enter this cauldron:
Once inside, a trained employee presses a button and the temperature drops below -100°C (-148°F) for about 2 to 4 minutes.
It was first adopted by elite athletes looking for a competitive edge in recovery. Kobe and Lebron were two of the early adopters, and it became an increasingly popular technique amongst all athletes:
As tends to happen when athletes adopt something, the general population follows (other than kneeling and protesting police brutality). In recent years, whole body cryotherapy shops have popped up across the fitness wasteland.
However, like with any emerging technology, comes a slew of questions:
- What is whole body cryotherapy?
- What’s the rationale behind cryotherapy?
- Is cryotherapy actually effective?
- Is it safe?
- How does it stack up against other cold-based techniques?
I’ll take you through these questions using the most recent evidence as my guide. Let’s start with the rationale of whole body cryotherapy.
I. What is Whole Body Cryotherapy
Whole body cryotherapy chambers were first invented and used in Japan in the 1970’s to help patients who had Multiple Sclerosis (MS) and Rheumatoid Arthritis (RA) (click here and here for more info). It’s use migrated to Europe and the USSR in the 1980’s, then to Australia and the US in the past decade.
The process involves, as I mentioned in the intro, stepping into a chamber in minimal clothing and then the chamber is cooled to below -100°C (-148°F) for about two to four minutes.
More recently,a new method called partial body cryotherapy (PBC) has emerged which uses a portable cryo-cabin to expose the body (other than the head and neck) to below -100°C (-148°F) temperatures.
Here’s a video of the process:
The theoretical intent is to reduce exercise induced muscle damage (EIMD), decrease delayed onset muscle soreness (DOMS), reduce fatigue, boost recovery and generally gain a competitive advantage (plus Instagram followers).
I’m pretty sure these guys (and gal) used it religiously:
So what’s the theory behind whole body cryotherapy?
II. The Physiological Rationale for Whole Body Cryotherapy
The physical underpinning of whole body cryotherapy is that the freezing temperatures will:
- Tighten your arteries and veins (known as “vasoconstriction”) which reduces blood flow to the muscles and tissues (click here, here, and here for more info)
- Decrease sensitivity of receptors in the muscles and tissues (click here and here for more info)
- Decrease nerve conduction velocity (aka how fast signals travels through your nerves) to your muscles and tissues (click here and here for more info)
This trident of effects is supposed to help relieve soreness, reduce fatigue, and accelerate recovery.
Additionally, there’s the potential for positive psychological benefits as other cold exposure techniques (like cold water immersion) have been shown to decrease the subjective feeling of delayed onset muscle soreness (DOMS) after exercise (click here and here for more info on that).
Ok cool — so there are always plenty of theoretical gadgets floating around (Reebok Pumps were supposed to make me dunk but that never happened…still bitter), but does whole body cryotherapy actually work and is it safe?
We could ask these two…
Or we could take a look at the cold hard facts.
III. The Evidence
Let me start with this — for any new or emerging technology, it takes some time for research to come to a definitive outlook on its effectiveness and efficacy.
The evidence still hasn’t painted a definitive picture on whole body cryotherapy. For example, a Cochrane Review in 2015 (a Cochrane Review is considered the gold-standard of research. It takes all the relevant research on a topic, stringently filters out the noise, and then comes to a conclusion) found that whole body cryotherapy results in no physical changes and might have a slight psychological benefit (decreases pain perception).
However, in the last couple years, there have been reviews (click here and here for more info), albeit not the level of a Cochrane review, that found whole body cryotherapy creates some measurable & useful benefits.
These benefits of whole body cryotherapy included:
- Enhancing maximal muscle contraction and quicker return to pre-exercise levels of strength.
- A reported pain reduction after whole body cryotherapy (more likely due to psychological factors rather than physical changes). In some cases, people have reported up to a 30% pain reduction (individuals self-reporting a percent change in pain always need to be taken with a grain of salt, it’s rife with inaccuracy).
- A decrease in markers (inflammatory markers, cortisol, creatine kinase — I might have just made those words up) that are indicative of inflammation. This could reduce secondary tissue damage after exercise and activities, and therefore accelerate the regeneration and recovery process.
Additionally, there’s some evidence of an additive effect when whole body cryotherapy is done multiple times. The purported benefits are more likely to occur when you do it for three or more sessions. The first immediately after exercise/activity and then two+ sessions in the 2 to 3 days post exercise/activity.
The research is definitely ongoing but it’s gradually gaining more structure and clarity, like moving from a Picasso (beautiful in its own right)…
To a classic Monet…
Now that I’ve satisfied my art fix, there’s one last question…
III. “Is whole body cryotherapy safe?”
The thought of getting blasted by temperatures less than 110 degrees is not a welcoming one. Even though I’ve lived in cold weather areas like Manhattan and Flagstaff, I still start questioning existence when my weather app reads 55°F or less.
With whole body cryotherapy becoming more widespread and more easily accessible, it’s critical to determine if exposing yourself to these frigid temperatures is safe. Theoretical hazards and question marks certainly exist but, thus far, research hasn’t found any negative consequences.
In practice, the dangers of whole body cryotherapy thus far have each been associated with irresponsible use. For example, one person died from asphyxiation and was found “frozen” after using the chamber by herself late at night without anyone else to assist her. Don’t do that.
Additionally, there have been incidents of frostbite when people went into the chamber with wet clothes on or didn’t cover up their extremities, like they’re supposed to. Don’t do that either.
These problems could have been avoided by using the cryotherapy chamber with a trained employee at a reputable site and following the indicated procedures.
In general, the jury’s still out on whole body cryotherapy but it’s relatively promising considering how early we are in the research game. A game that is constantly evolving, changing, and spitting out new drops into the bucket.
So we’ve covered the theoretical rationale for whole body cryotherapy and what the evidence says about it’s effectiveness and safety. But how does it stack up against more well-established and well-researched cold modalities such as icing and cold water immersion (ice baths)?
IV. Cryotherapy vs Cold Water Immersion vs Icing
Cold water immersion (ice bath) has been found to be the most effective icing technique.
It has solid evidence behind it (both a gold-standard Cochrane review and other reviews) which show it can decrease muscle soreness (DOMS) up to 4 days following exercise/activity (especially when that activity involves running), reduce perceived fatigue for up to 24 hours after activity, and potentially accelerate physical recovery.
These ice bath benefits result more from psychological indicators (less perceived soreness, perceived fatigue) than physiological changes. But hey, perception is reality.
Further, there’s the question of ice packs — like those constantly adorned by Kobe during his twilight years:
Damn, I really tried to block out the Robert Sacre years.
Ice packs have been found to help reduce pain (“an analgesic effect”) but not help with soreness or quicker recovery.
In sum, the evidence shows that ice baths provide the most tangible benefits — physical and psychological. So with that in mind….
V. Practical Recommendations
When it comes to cold therapy, the ice bath is king.
It’s shown to have the most benefits, is cheap, and pretty easy to assemble. However, sitting waist or neck high in ice water for up to 10 minutes isn’t for everyone.
In that case, the next step really depends on you. Ice packs need to be applied in 20 minute doses (10 mins on, 10 mins off) on larger areas which can be quite uncomfortable for some and not practical for others but they will help with pain, are cheap and accessible.
On the other hand, whole body cryotherapy isn’t cheap nor as accessible as ice packs. If you do have access to a reputable site with a trained operator and appropriate covering of extremities with dry clothes, the risks look to be minimal. In terms of benefits, you may feel some pain reduction, decreased soreness, and accelerated recovery (plus it only takes two to four minutes), especially if done three+ times.
I hear this dude swears by it…
If you don’t feel any different, then oh well.
That being said, there are some conditions under which you absolutely shouldn’t use whole body cryotherapy (the following list isn’t all exclusive so definitely research it more yourself and ask the employees for a list of contraindications):
- Pregnancy
- High blood pressure (arteries & veins constricting in response to cold can & likely will shoot up the blood pressure higher)
- Any heart problems
- Pacemaker
- Any peripheral artery or venous disease, conditions
- Stroke, head trauma, or internal bleeding
- Siezures
- Raynaud’s Syndrome
- Rheumatoid Arthritis
- Any tumor related condition
- Anemia
- Infection or Fever
- Kidney or urinary tract problems
- Bleeding disorders
VI. All in All
The research is still torn on whether whole body cryotherapy provides tangible benefits but it’s also not going to harm you (when done correctly). Therefore, if ice baths aren’t your thing for whatever reason and you have the means and access to a reputable whole body cryotherapy shop, give it a try and see how you feel.
At the least, you’ll feel really….chill (I’ll be here all week).
Dr. Rajpal Brar, DPT, is writer for Grandstand Central, Stack.com, and founder of his own sports blog/resource TheInjuryInsight . He’s also the founder & owner of 3CB Performance, a health and wellness clinic in West Los Angeles. You can follow him on IG here, Twitter here, and on Facebook here and here.
