Cold therapy: Fact or fad?

Cold therapy involves the application of cold temperatures to the body for therapeutic purposes; inducing a controlled physiological response that triggers healing and recovery processes within the body. In this article, we'll delve into the science behind cold therapy, exploring its physiological effects, proven benefits, and practical applications.

Benefits of cold therapy

Sports recovery and injury management

The physiological effects of cold therapy include reductions in pain, blood flow, edema, inflammation, and muscle spasms (Malanga et al., 2015). Cold therapy exposure can be a highly effective recovery tool after high-intensity exercise or endurance training to accelerate post-exercise recovery, reduce muscle soreness, and enhance performance (Moore et al., 2022; Hohenauer et al., 2015). Cold therapy is effective in managing acute injuries such as sprains, strains, and bruises by reducing pain and inflammation (Wang & Ni, 2021). It should be noted that cold water immersion (but not cold showers) can limit some of the gains in muscle growth, strength, or endurance if done in the 4 hours or so after training (Huberman Lab, 2022). If any of these are your goals, it is recommended to wait 6 to 8 or more hours until after training.

Increased metabolism

In the long term, cold exposure increases the conversion of white fat (energy storage) to beige or brown fat (which are highly metabolically active) (Huo et al., 2022). This causes a sustained increase in a person’s metabolic rate. Additionally, the shivering action may further enhance metabolic increases from the cold by activating brown fat thermogenesis.

Increased energy and focus

Cold exposure causes an increase in adrenaline and noradrenaline and their level in the brain and body stay elevated for some time. This has the effect of increasing a person’s energy and focus (Huberman Lab, 2022).

Builds mental resilience

Pushing yourself to tolerate cold exposure can build mental resilience (Huberman Lab, 2022). When you choose to take a cold shower or an ice bath the planning and self-control part of your brain overrides deeper centres that react to the cold. This strengthens your ability in challenging situations to stay calm and focused. With practice, the mental stamina gained from cold training transfers over to handling real-life pressures and adversity.

Enhanced mood

Exposure to cold temperatures triggers the release of dopamine in the brain. Dopamine is a neurotransmitter that plays a role in mood, focus, motivation and feelings of pleasure.

Research shows that brief cold exposure can lead to prolonged elevation of dopamine levels. This surge of dopamine has been linked to improvements in overall mood, energy, concentration, and drive (Yankouskaya et al, 2023).

Skin health

The research surrounding cold therapy and cosmetic benefits is not well-established and often inconclusive. However, research shows that cold exposure can lower inflammation and oxidative stress in the body. Oxidative stress and inflammation are tied to accelerated aging. By reducing these processes, cold therapy may help slow aspects of aging in the skin and improve its look over time (Dzidek & Piotrowska, 2022). One study also found that focused cold therapy seems to be an effective, safe nontoxic alternative to popular wrinkle-reducing treatments (Palmer et al., 2015)

 Practical suggestions for cold therapy

Ice packs and cold compresses:

Apply ice packs to sore muscles or injured areas for 15-20 minutes at a time to reduce pain and inflammation.

Cold water immersion:

While ice baths or cold water­­­ immersion to the neck are best, cold showers can work and are often more accessible. There is no optimal temperature for this, as each person’s tolerance for cold is different. The general rule is that the temperature should feel uncomfortable, but safe to stay in for a few minutes. By practicing deliberate cold exposure more often, you will be more comfortable in the cold and can start to use colder temperatures. The recommendation is that this is done in 2-4 sessions throughout the week, each session lasting 1-5 mins (Huberman Lab, 2022).

Cryo chambers:

Visit cryo chambers, where you're exposed to extremely cold temperatures for a short duration, to experience whole-body cryotherapy. This is a valid option however, these treatments can be extremely pricey to do regularly.

Cold therapy offers a range of potential benefits for physical recovery, pain management, and overall well-being. By understanding the science behind cold therapy and incorporating it into your lifestyle, you can harness its therapeutic effects to support your health and performance goals.

References:

Dzidek, A., & Piotrowska, A. (2022). The use of cryotherapy in cosmetology and the influence of cryogenic temperatures on selected skin parameters: A review of the literature. Cosmetics, 9(5), 100. https://doi.org/10.3390/cosmetics9050100

Hohenauer, E., Taeymans, J., Baeyens, J. P., Clarys, P., & Clijsen, R. (2015). The effect of post-exercise cryotherapy on recovery characteristics: a systematic review and meta-analysis. PloS One, 10(9), e0139028.

Huberman Lab. (2022, May 1). The science & use of cold exposure for health and performance. https://www.hubermanlab.com/newsletter/the-science-and-use-of-cold-exposure-for-health-and-performance

Huo, C., Song, Z., Yin, J., Zhu, Y., Miao, X., Qian, H., Wang, J., Ye, L., & Zhou, L. (2022). Effect of acute cold exposure on energy metabolism and activity of brown adipose tissue in humans: A systematic review and meta-analysis. Frontiers in Physiology, 13, 917084. https://doi.org/10.3389/fphys.2022.917084

Malanga, G. A., Yan, N., & Stark, J. (2015). Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgraduate Medicine, 127(1), 57–65. https://doi.org/10.1080/00325481.2015.992719

Moore, E., Fuller, J.T., Buckley, J.D. et al. (2022). Impact of cold-water immersion compared with passive recovery following a single bout of strenuous exercise on athletic performance in physically active participants: A systematic review with meta-analysis and meta-regression. Sports Medicine, 52, 1667–1688. https://doi.org/10.1007/s40279-022-01644-9

Palmer, F. R., 3rd, Hsu, M., Narurkar, V., Munyon, T., Day, D., Karnik, J., & Tatsutani, K. (2015). Safety and effectiveness of focused cold therapy for the treatment of hyperdynamic forehead wrinkles. Dermatologic Surgery: Official publication for American Society for Dermatologic Surgery [et al.], 41(2), 232–241. https://doi.org/10.1097/DSS.0000000000000155

Wang, Z. R., & Ni, G. X. (2021). Is it time to put traditional cold therapy in rehabilitation of soft-tissue injuries out to pasture? World Journal of Clinical Cases, 9(17), 4116–4122. https://doi.org/10.12998/wjcc.v9.i17.4116

Yankouskaya, A., Williamson, R., Stacey, C., Totman, J. J., & Massey, H. (2023). Short-term head-out whole-body cold-water immersion facilitates positive affect and increases interaction between large-scale brain networks. Biology, 12(2), 211. https://doi.org/10.3390/biology12020211