At some point in our lives, almost all of us have been able to have some therapeutic experience with the cold. We put on a cold compress when we have suffered a blow or we put our hand in the cold water if we have burned ourselves with oil. The cold seems to have restorative properties that we should take into account.
A few years ago it was striking to see how Pau Gasol put ice packs around his knees after a game. But now it is common to see Lebron James or Cristiano Ronaldo getting into a bathtub with ice as a routine after an intense workout, and sharing it on his social networks, which helps spread the benefits they can have for health and physical recovery. One of the most famous characters for his ice baths is the Dutchman Winhoff (called ice man due to his ability to tolerate the cold), who has broken several Guinness records by swimming in icy waters, diving in ice or running a half marathon on ice.
His wim hof method (or WHM) combines cold therapy with breathing and meditation techniques, with the aim of improving conditions such as rheumatoid arthritis, multiple sclerosis or Parkinson’s. However, several people who practiced his method drowned, raising doubts and suspicions about the real benefits of the method. It is always convenient to ask science about serious questions and, in this case, analyze the benefits that cold water can bring to people’s health. What history tells us is that its use is very old, and science has to be there to make that use beneficial.
Cryotherapy (from the Greek κρύο(ς)/kryo(s), cold and θεραπεία, cure) encompasses both immersion in cold water and the use of ice or cold air to cure or recover. A very recent historical review reveals how it has been used throughout history for therapeutic purposes to eliminate heat, reduce body temperature and reduce muscle inflammation, as well as to modify blood flow. And also, it is a powerful reducer of the perception of pain, an analgesic that promotes a healthy feeling of well-being.
The great physician Hippocrates already suggested cold water therapy in Ancient Greece to relieve exhaustion of strength and energy, as well as the use of ice or snow to reduce edema, being a pioneer of cryotherapy with his treatises. On air, water and places. From there, throughout history, interest in the physiological effects of cold water on body temperature, pulse, respiration, blood pressure and the nervous system grew. Consider that the application of ice was a method used by Napoleon’s surgeon, who used ice or snow to help reduce pain in amputated soldiers or during operations.
The science of cold as a recuperator
It was from the 1960s when research began on the effect of cold water baths as a recovery method after different types of exercise, with different types of athletes, examining the doses of cold and its effects. From all this research effort, a recommendation can be deduced to establish immersion protocols in cold water for 10-15 minutes at temperatures of 10-15 °C after training, which causes a drop of about 6 °C in muscle temperature and a 20-30% reduction in vascular permeability, improving recovery processes.
Cold in its different forms then began to be used in the treatment of muscle injuries due to its ability to lower the temperature of connective tissue, developing sprays, cooling gels, cold packs or ice massages to reduce skin temperature. . Lowering the temperature to 13.6 °C activates the analgesic effects of cold, which reduces the connectivity of sensory nerves. This explains what we knew from our own experience. Who has not noticed the relief that comes from putting an ice pack on the injured area after an ankle sprain?
Another of the cryotherapy methods is the application of cold air, promoted by Toshima Yamaguchi, who used it in Japan in 1978 for the treatment of rheumatoid arthritis, managing to reduce symptoms and muscle pain. It is currently applied in the sports world with temperatures below -100 °C in full-body cryotherapy chambers (which leave the head and neck outside). The patient is exposed to 2-3 minutes of extremely cold air, after a previous adaptation of 30 seconds. This reduces the sensation of muscle pain and increases parasympathetic activation and anti-inflammatory cytokines.
Due to the very low temperatures it reaches, this extreme variant allows to reduce recovery and application times compared to cold water baths, and is increasingly popular in competitive sports due to portable cameras. Finally, within cryotherapy, materials that absorb a large amount of heat at a constant temperature have also been included. They are used in vests that allow it to be between 3 and 6 hours at a temperature of 15 °C, which improves the recovery of loss of strength and reduces muscle pain.
But maybe the most popular method of post-exercise recovery be it getting into cold water, either in a pool created for it in health centers fitness or also in the bathtub at home. All of this favors psychological (reduces fatigue) and physiological changes (improves intracellular-intravascular fluid exchange, reduces muscle edema, increases cardiac output, blood flow, and the transport of nutrients and waste through the body). The three most prominent forms are:
- Cryotherapy: immersion in cold water, generally below 15°C. The athlete submerges the legs for 15-20 minutes in a bathtub with ice packs.
- Contrast therapy: alternating baths from hot to cold water, and vice versa, for 30 to 300 seconds in one type of water; and immediately after, the same time in the contrasting water. The process is repeated several times for 4 to 30 minutes.
- Thermoneutral therapy: immersion in water at room temperature, between 16 and 35°C, for 5 to 30 minutes, during which the effect of hydrostatic pressure occurs.
Paying attention to the classics, cold or warm water baths are the most beneficial, although the temperature, the immersion time and the previous exercise will condition their use. Therefore, it is necessary to consult and follow the advice of medical professionals and physical-sports educators in their employment. Everything must be considered in an individualized and planned way, depending on the type of training carried out and whether health, post-exercise recovery or rehabilitation after an injury is pursued.
It must be remembered that in some circumstances these practices are not recommended. Very cold water (below 5°C) can be harmful after high intensity exercises, with very short periods between training sessions; and also when cryotherapy is considered very frequently, it reduces the benefits of long-term muscular adaptations of resistance training. Being well informed should be a habit for all those who exercise.
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