Chill Out: Cryotherapy for Strongman and Sport Recovery

The first time you take the plunge into an ice bath, the breath is sapped from your lungs as if you’d just had the wind knocked out of you by Thor himself. But then, the next time you dive in is a little easier, and the time after that even more so. Soon you come to crave the mood boost and energized feeling you get from your daily dose of cold. And just as soon, you realize your athletic performance and strength has benefitted from the recovery enhancing effects of cryotherapy... 

Cryotherapy takes advantage of evolutionary mechanisms that have been around longer than human existence. 

There are many excellent resources for information on cryotherapy for general health that I shall refer you to. In particular, Dr. Rhonda Patrick of FoundMyFitness has several podcasts and a free research review all about cryotherapy. I will briefly touch on the most significant benefits of whole body cryotherapy (WBC) or cold water and then will focus on how any type of cryotherapy can be used to improve athletic performance and recovery, specifically for strongman. If you train hard for strongman or whatever your sport may be, you will want to take note. Implementing cold exposure into your recovery practice will do incredible things for improving your recovery between training sessions.

Note: In general I will use cryotherapy, cold shock, or cold stress interchangeably in the article. Specific modalities will be referred to appropriately. For example:

• WBC or Whole Body Cryotherapy refers to cryotherapy chambers that use super cold air or liquid nitrogen that expose you to -150° C or lower for under three minutes at a time. 
• Ice baths refer to cold water immersion in which the temperature of the water is cooled to below 10°C. 

I will also preface this discussion of cryotherapy methods by saying that you should always consult your doctor prior to any extreme conditions exposure and especially if doing any contrast therapy. 

Cold Stress and Norepinephrine

Cold stress is an extreme shock on your system, which is a big part of the mechanism behind how it works for improving health and recovery. 

Cold stress and cryotherapy methods blast your central nervous system, activating your sympathetic nervous system, which is your evolutionary response to fight or flight situations. This creates a huge release of norepinephrine in your body, which is responsible for many of the effects people will first notice and link with cold therapies. Norepinephrine heightens attention and focus and also boosts mood, as these all help to keep you alive in dire situations. While the cold is unpleasant at first, the mood boosting effects of norepinephrine keep people wanting to come back for more cold exposure, whether it be ice baths, cold showers, or whole body cryotherapy. To futher this boost in mood and the reason why, if you choose to try this out for any period of time, you'll come to crave it, dopamine also gets released when exposed to water below 50 degrees Farenheit (Šrámek, et al., 2000). 

Fat Loss and Cold Stress

Cryotherapy has also been shown to enhance lipid metabolism, which can benefit fat loss goals and energy requirements for athletes. Because norepinephrine is released to prime your body for survival, it acts on fat cells to mobilize lipids to be burned for energy, which makes sense when you are running for your life, but we can take advantage of this to also help with fat loss goals, or to provide energy for fasting or ketogenic athletes. 

Cold shock also works with the second part of the equation as your body will increase its metabolism to maintain homeostasis against the cold. This is known as cold thermogenesis. So not only are you freeing up lipids to be burned through cold shock, but by enduring the cold for an extended period of time, you'll be burning that fat to stay warm as well and increasing the amount of the more metabolically active brown adipose tissue (BAT) in your body (van der Lans et al., 2013). 

Some other interesting effects found with cryotherapy:

• Cryotherapy promotes synapse regeneration during the process of warming back up following treatment. This may prove useful for preventing neurodegeneration with aging. 

• Cold stress increases white blood cell count, which helps to fight off infection, illness, and even some types of cancer (Brenner et al., 1999). It will be interesting to see more research being done on whether this immune response can reduce the risk of some types of cancer.
• Cold stress is what is known as a hormetic stressor. Hormesis is the state of the body responding to small doses of stressors in a way that further bolsters your resistance against greater stressors in the future. Cold stress activates powerful antioxidant systems and antioxidants contribute to everything from fighting off infection to reducing inflammation following exercise (Wozniak et al., 2007). 
• To further the effects of reducing inflamation with cold stress, norepinephrine reduces systemic inflammation by directly reducing the inflammatory cytokines TNF-alpha and the E2 prostaglandins (Hu et al., 1991). 

Harnessing the Cold For Increasing Performance and Recovery in Strongman and Other Sports

Now that you’ve seen some of the cool things that research has demonstrated regular or even single bouts of cryotherapy can do for you, let’s look at the good stuff: how can cold stress improve your strength, endurance, and recovery?

Since most of you reading this are coming from a strongman or strength sports background, I will focus my efforts around how strength athletes can potentially improve their recoverability between training sessions to lead to greater gains in strength and endurance. 

There are two opposing ways that ice baths and cryotherapy have been studied when it comes to training and the end up with massively different results:

1.  Studying the effects of ice baths or cryotherapy immediately post-training.
2.  Waiting an hour or longer post-training before applying any type of cold stress to the body of the athlete. 

Immediately post-training the body actually requires an inflammatory response, as inflammation triggers macrophages, which release the highly anabolic hormone IGF-1, and also triggers satellite cell response leading to muscle growth. Inflammation helps to clear out the damaged junk that builds up from hard training. As has already been discussed, cold therapy is anti-inflammatory, which makes sense since the Latin root word of inflammation means fire. When cryotherapy of any sort (even an ice pack to a single body part) is applied immediately post-training it blunts the recovery response to training. This has been demonstrated as a reduction in the hypertrophy response to training when athletes were exposed to cold water immediately following training (Roberts et al., 2015). Clearly, post-training is not the best time to try cryotherapy, unless you don't want to adapt to your training and improve. 

The body naturally starts to produce an anti-inflammatory response to training 1 hour after exercise ends. It still hasn’t been studied in great detail on exactly when cold should be used as a recovery modality for training, but waiting at least 1 hour before any cold immersion seems to be an appropriate method for boosting the natural anti-inflammatory response to training and helping to further clear away the cell damage. Improving the anti-inflammatory response of your body at the right time means you'll be able to recover faster between training sessions, and can therefore (in a perfect scenario) train again sooner and make progress at a faster rate.

Because of the increased thermogenic demand of cold stress, mitochondria biogenesis takes place. Meaning that new mitochondria are created in the muscles, which has been demonstrated to enhance endurance capacity (Ihsan et al, 2014). So endurance in subsequent training will be further enhanced by implementing cryotherapy in the recovery phase compared to just endurance training alone.  This is an exciting potential use of cryotherapy for strength athletes, especially strongman competitors, because improving endurance is extremely important for being the best strongman you can be. Combining cold stress with endurance and cardiovascular work may be better than just doing cardio alone and so as a strongman valuing cardiovascular work, you can get more out of endurance training. 

If you want to play it safe until further research shows whether 1 hour post-training is still too soon, you can keep your cryotherapy or cold water treatments as far away from training as possible, which is what many top level athletes and coaches suggest. So if you work out in the morning, only do your cold shocks at night or on off-days. 

Cold-Water / Ice Baths vs. WBC? Which one is better? 

 

Both robustly release norepinephrine from brain and body, so either is going to have similar benefits and positive health and recovery effects. WBC isn’t financially feasible for everyone, so it is reassuring to know that cold water and ice baths may work just as well. 

Personal Experience and Suggestions

 

It’s a struggle to get used to ice baths or cold showers the first couple of times you try it out. I have found it to be worth the effort though, as I have come to love the feeling of ice baths and also contrast showers. As I train in the morning and try to keep the more lengthy ice baths to off days or night time. I soon came to find that ice baths at night were a bad idea, as they affect my sleep. Brief cold showers or contrast showers before bed can help to lower your body temperature a little bit to promote a better sleep, but ice baths take it too far and cause too much of a sympathetic response which I find creates too much alertness. I also found that it lowered my core temperature too much and I was struggling to get warm for many hours, which needless to say affected my sleep. 

Needing an alternative to straight up ice baths is when I started to look at contrast showers more as a better way to get “the best of both worlds” with hot and cold. Contrast showers go back and forth from as hot as you can handle on your tap to as cold as your tap goes.  Heat stress has a multitude of amazing benefits just like cold stress, but I won’t be going into detail on that today. You can read some of the research reviews that Dr. Rhonda Patrick has put together on heat if you are more interested in hot rather than cold for recovery.

The reason I like contrast showers as an introduction to cold stress is because it doesn’t feel as bad as just plunging in to an ice bath without any experience. After a few days of getting used to cold water exposure the cold of an ice bath won’t feel as bad, meaning you’ll be able to withstand it longer and with less mental duress and get a better experience out of it. 

The protocol that I use for contrast showers is 10 seconds of hot followed by 20 seconds of cold for 10 rounds ending on cold for 2 minutes. I set up an interval timer on my phone to listen to so I don’t have to continuously think about or count out the time and gave myself 4 extra seconds on each interval to allow for the temperature to adjust accordingly for the full interval (so I actually do 14 seconds hot and 24 seconds cold). 

The other reason why I prefer contrast showers is that I’ve found the recovery effects greater with the contrasting temperatures, rather than just doing ice baths all the time. Cold constricts your blood vessels and heat dilates your blood vessels so when you do contrast showers, or baths if you have access to a cold plunge and hot tub, you get a circulatory effect to help clear away metabolites of training and promote nutrient delivery to the tissues. While I usually just rotate to cover my entire body during contrast showers you can also emphasize whatever is most sore from training, although I don’t know if there is any significant difference. 

If I have the time available I will also combine an ice bath with the contrast shower, which I have found to be the best method so far to do a full ice bath without the extended time afterwards it sometimes takes to warm back up. I simply fill the ice bath up and do 5-6 minutes or so and then pull the plug and start a contrast shower as normal. 

Try it out for yourself and let me know what works best for you. 

Fortissimus

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References:

Brenner, I. K. M., Castellani, J. W., Gabaree, C., Young, A. J., Zamecnik, J., Shephard, R. J., & Shek, P. N. (1999). Immune changes in humans during cold exposure: effects of prior heating and exercise. Journal of Applied Physiology, 87(2), 699-710.

Hu, X., Goldmuntz, E. A., & Brosnan, C. F. (1991). The effect of norepinephrine on endotoxin-mediated macrophage activation. Journal of neuroimmunology, 31(1), 35-42.

Ihsan, M., Watson, G., Choo, H. C., Lewandowski, P., Papazzo, A., Cameron-Smith, D., & Abbiss, C. R. (2014). Postexercise muscle cooling enhances gene expression of PGC-1. Med Sci Sports Exerc,46, 1900-1907.

Jedema, H. P., Gold, S. J., Gonzalez-Burgos, G., Sved, A. F., Tobe, B. J., Wensel, T. G. and Grace, A. A. (2008), Chronic cold exposure increases RGS7 expression and decreases α2-autoreceptor-mediated inhibition of noradrenergic locus coeruleus neurons. European Journal of Neuroscience, 27: 2433–2443. 

Roberts, L. A., Raastad, T., Markworth, J. F., Figueiredo, V. C., Egner, I. M., Shield, A., ... & Peake, J. M. (2015). Post‐exercise cold water immersion attenuates acute anabolic signalling and long‐term adaptations in muscle to strength training. The Journal of physiology, 593(18), 4285-4301.

Šrámek, P., Šimečková, M., Janský, L. et al. (2000). Human physiological responses to immersion into water of different temperatures. Eur J Appl Physiol 81: 436.

van der Lans, A. A., Hoeks, J., Brans, B., Vijgen, G. H., Visser, M. G., Vosselman, M. J., ... & Schrauwen, P. (2013). Cold acclimation recruits human brown fat and increases nonshivering thermogenesis. The Journal of clinical investigation, 123(8), 3395-3403.

 Wozniak, A., Wozniak, B., Drewa, G., & Mila-Kierzenkowska, C. (2007). The effect of whole-body cryostimulation on the prooxidant–antioxidant balance in blood of elite kayakers after training.European Journal of Applied Physiology, 101(5), 533-537.