Cold Therapy

LOTS OF BRR WITH BENEFITS

Cold hydrotherapy, also known as cold therapy, cold water therapy, and cryotherapy, is the general or localised use of cold water, around 15°C, in the treatment of inflammation and swelling. Cold therapy is also believed to stimulate a few health benefits. Remember the time you pressed a bag of frozen peas on that bump on your head or swollen ankle?

Well, you probably weren’t aware of it, but you were simply treating your pain with a basic form of cold therapy.

There are numerous ways of adding cold therapy into our everyday life: ice baths, cold showers, outdoor cold water swimming, whirlpools, cold water immersion, exposure to the cold air outside, ice bucket challenge, ice massage therapy, coolant sprays, ice packs, etc.

UNFREEZING RESEARCH ON HOW COLD THERAPY BRINGS BENEFITS: THE SCIENCE AND BELIEFS BEHIND IT

1. Cold therapy brings your core temperature down and leads to cardiovascular and endocrine changes. Cold therapy increases adequate volumes of blood being brought back to the heart, increases its pumping action and electrical activity, and increases the amount of blood going to vital organs. Your body perceives cold as a form of stress, like inflammation and exercise. As a consequence, stress alters the secretion of hormones that regulate heart rate, fluid balance in your body, blood flow to your organs, and breathing. These physiologic responses to cold therapy were documented in a study published in the Extreme Physiology and Medicine journal in 2013.


2. Exposure to cold environments has been shown to increase the activity of brown fat tissue. Brown fat or brown adipose tissue (BAT) is responsible for burning calories and utilising that energy to generate heat or warmth in your body. A study from the Journal of Clinical Investigation noted that frequent exposure to cold environments increased BAT activity, which can lead to more calorie expenditure, suggesting that it may be used as a supplementary method in losing weight.


3. The Lewis Hunting Reaction is a physiologic process of alternating vasoconstriction* and vasodilation** in limbs exposed to cold. It may be a possible explanation of how cold therapy promotes its benefits. On exposure to cold, the blood vessels on your skin constrict to minimise blood flow and decrease heat loss. After a few minutes of vasoconstriction, vasodilation occurs and can last for 15 minutes before another bout of vasoconstriction. This alternating response is called the Lewis Hunting Reaction. This type of reaction or response has the benefit of suppressing inflammatory states like rheumatological conditions, post-exercise period, and soft tissue injuries (like ankle sprain).




*vasoconstriction – narrowing of blood vessels in response to cold temperature.

**vasodilation – widening/increase in the calibre of blood vessels in response to cold temperature.



4. An article published in the Journal of Athletic Training in April 2020 provided possible explanations on how cold therapy could decrease exercise-induced muscle damage in runners and provide other benefits. Cold therapy lowers body temperature and signals the autonomic nervous system to increase the production and release of epinephrine and norepinephrine. The release of these substances boosts the anti-inflammatory system of your body and reduces inflammatory factors in your system.


5. The Wim Hof Method (WHM for short) has an interesting take and use of cold therapy. WHM was formulated by a Dutch extreme athlete named Wim Hof. He’s famous for his ability to withstand freezing temperatures and consequently, has claimed 26 Guinness World Records including one for longest ice bath (almost two hours). All of his feats, he attributes to his method, which is a mixture of cold therapy or exposure, breathing techniques, and meditation. We’ll briefly focus on how his practice of cold therapy brings benefits.



6. According to WHM, extreme cold, like immersion in ice cold water, leads to vasoconstriction. It increases anti-inflammatory and decreases pro-inflammatory factors in the body. This primarily benefits people with autoimmune disorders (rheumatoid arthritis, IBD, Parkinson’s disease). A study published in the PNAS* Journal in 2014 found possible support for WHM. They confirmed that cold therapy constricts blood vessels and found that it increases the release of epinephrine which promotes the production of anti-inflammatory substances. These substances inhibit cytokine response which is pro-inflammatory. They accomplished this by measuring blood levels of critical biochemical substances before and after trying out WHM of cold therapy.

*PNAS – Proceedings of the National Academy of Sciences of the United States of America

Note: The WHM’s explanation on how cold therapy brings benefits to your body is mostly based on Wim Hof’s explanation and a handful of scientific studies. If you’re interested in trying out his methods, we recommend consulting with your primary healthcare giver first.

It’s essential to point out at the end of this section that there are several ways, methods, and scientific explanations on how cold therapy helps your body. There’s still a lot of work and explaining to be done. In spite of this, cold therapy has some potential benefits. Read on to the next section.

BENEFITS OF COLD THERAPY

1. Heightened alertness. When was the last time you took a cold shower in the morning because the heater was broken? Well, we all know how that feels to your entire body. Cold showers will make you feel more alert, energised, and awake. It also increases your blood pressure (in a good way and briefly), respiratory rate, and heart rate. These findings have been validated by a research study published in the British Journal of Medicine.
2. Decreased muscle pain. A research study done in 2016 demonstrated decreased muscle pain among participants who just finished intense training sessions (repeated knee extension and flexion), after they underwent cold therapy for 10 minutes. Cold therapy constricts arteries and reduces blood flow to painful areas. Reduced blood flow means less swelling and inflammation.
3. Faster cooling after heat builds up in your system. It’s a well-known fact that your body heats up after intense physical activity (exertional hyperthermia). Cold water immersion therapy or a cold shower enables your body to cool down faster. Cold water immersion is far better than a cold shower in generating body heat.
4. Elevates your mood. A research study that appeared in the Medical Hypotheses Journal stated that cold showers increase endorphin and norepinephrine release in your body. The cold temperature excites your sympathetic nervous system to increase the production and release of neurotransmitters, resulting in feelings of elation. After a cold shower, you should expect at least a shift in your mood from bad to good. Try it and let us know.
5. Stimulates your immune system. A stimulated immune system increases the number of disease-fighting white blood cells in your body capable of fighting illness. Unfortunately, more studies are needed to verify this claim. But a lot of people who try cold therapy swear that they have boosted their immune systems because they experienced fewer episodes of upper respiratory tract infections.
6. Increases metabolism. Yes, cold therapy increases your metabolism, but not enough to promote significant weight loss. So, don’t expect to lose weight after floating in a tub of ice for several months. You’ll still need to exercise and eat a well-balanced diet.
7. A recent study published in the Journal Diabetologia (2016), suggested that cold therapy could have some therapeutic value in Type 2 diabetes mellitus, by lowering blood glucose levels. Researchers proposed that being exposed to cold temperatures like cold water immersion or cold shower, can increase consumption of glucose in cells, thereby lowering glucose levels in the blood. Your body creates energy and produces heat to warm you up from the cold. More follow-up studies are needed to replicate these findings.

BELOW ARE SOME TIPS ON HOW YOU CAN GET STARTED ON COLD THERAPY:

1. For cold water immersions, keep them brief. A few minutes will suffice. Staying in there longer can bring more harm than good.


2. Cold showers are best after an intense training session at the gym.
3. Take a friend with you for outdoor cold water swimming.
4. It’s essential to note that you should stop cold therapy, whatever variation it may be, if you lose sensation or feeling on your skin when applying it, you no longer feel it’s beneficial or it becomes painful.
5. We all have our perceptions of cold water. What you can tolerate as cold water, another person may have difficulty doing so. Most research studies suggest 15 to 20°C for a 5 to 10 minute cold shower. But still, you’re the captain of your ship, so you decide.
6. Make sure you warm up immediately after a cold water immersion (tub of ice) or cold shower. Have a towel or robe and a light meal ready.

COLD THERAPY MAY OR MAY NOT BE FOR YOU

There’s a lot to think about in regards to the benefits of cold water therapy. It can benefit your overall health in different ways, however certain medical conditions may prohibit you from trying cold therapy as a form of treatment such as diabetes, Raynaud disease cold urticaria, a previous injury that was cold-induced at that limb or site or cryoglobulinemia. To date, there have been no randomised controlled trials on the benefits of cold therapy, with scientific evidence based on preliminary studies with small numbers of volunteers and test subjects. Despite the lack of randomised controlled trials, numerous people still believe in its benefits. Consult with your primary healthcare provider if you have any questions or concerns regarding cold therapy.