For athletes, post-exercise cold therapy is a widely accepted recovery modality to decrease muscle soreness and muscle swelling, and facilitate a speedier recovery. Cold-water immersion (CWI) and partial-body cryotherapy (PBC) are two forms of cold therapy intended to improve muscle recovery in athletes. The authors in the study, Cold-water or partial-body cryotherapy? Comparison of physiological responses and recovery following muscle damage, compare physiological markers including muscle oxygen saturation (SmO2), cutaneous vascular conductance (CVC), mean arterial pressure (MAP), and skin temperature in participants following CWI or PBC to compare the effectiveness of both modalities.
Materials and Methods
Twenty male participants regularly involved in moderate physical endurance exercise volunteered for the study. The experiment followed a parallel group design and the participants were randomly assigned to either the CWI or PBC group. Both groups performed a muscle-damaging exercise which included five sets of 20 box jumps. Following the exercise, the participants received either CWI or PBC. The CWI involved immersing in cold water (+10 degrees Celsius) up to sternum level for ten minutes. The PBC participants entered a cryocabin for two and a half minutes (-60 degrees Celsius for 30 seconds and -135 degrees Celsius for two minutes).
Physiological parameters which include SmO2, CVC, MAP, and skin temperature were measured before and immediately following exercise as well as in ten-minute intervals up to 60 minutes post-exercise. Indirect markers of muscle damage including rating of delayed onset of muscle soreness (DOMS), anterior thigh muscle swelling, 2-leg vertical jump performance (VJP), and maximal voluntary contraction (MVC) of the knee extensors, were assessed pre-exercise and 24, 48, and 72 hours post-exercise.
SmO2: There was a greater reduction in SmO2 following CWI compared to PBC at ten minutes and 40 minutes after exposure.
CVC: CWI decreased CVC significantly 10 minutes after the treatment compared to baseline values.
MAP: A significant increase was observed in both groups only directly after the treatments compared to baseline.
Mean Skin Temperature: The mean skin temperature was significantly lower in the PBC group only immediately after the treatment compared to the CWI group. Ten minutes following treatment, the CWI group had significantly lower temperature than the PBC group.
Anterior Muscle Swelling: Compared to baseline, swelling was significantly increased in only the CWI group.
VJP: The CWI group had lower performances at 60 minutes after the treatment compared to baseline values.
MVC: MVC significantly decreased compared to baseline values at 60 minutes post-treatment in both groups. Both groups recovered their MVC within 24 hours.
DOMS: DOMS peaked at 24 hours in the PBC group and after 48 hours in the CWI group compared to baseline. Neither the PBC group nor the CWI group recovered from DOMS 72 hours after the damaging protocol and there was no significant difference for DOMS between groups.
The primary findings of the study are that the physiological impact of CWI was significantly greater than PBC. There was decreased oxygen saturation, decreased vascular conductance, increased arterial pressure, and reduced skin temperature in the CWI group as compared to the PBC group. This restriction of blood flow to the muscle helps to wash out waste products like lactic acid which cause muscle soreness, decrease metabolic activity, and reduce swelling and tissue breakdown.
There was no differences in objective and subjective recovery between CWI and PBC up to 72 hours post-exercise. This is the first study to compare the physiological responses and muscle recovery effects between CWI and PBC. The results suggest that either modality could be used for muscle recovery after exercise. The largest limitation in this study is the lack of a control group. It is important that additional studies include a control group to compare these two interventions to passive recovery.
PT First Implications
Cryotherapy in the form of CWI or PBC could be effective in promoting quicker, less painful muscle recovery after exercise. PT First’s therapists are capable of evaluating and screening athletes for exercise induced injuries and recommending various forms of cryotherapy treatment as an adjunct to skilled physical therapy.
Hohenauer, E., Costello, J., Stoop, R., Kung, U., Deliens, T., Clijsen, R (2017). Cold‐water or partial‐body cryotherapy? Comparison of physiological responses and recovery following muscle damage. Scandinavian Journal of Medicine &Science in Sports. Volume 28, Issue 3.