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Cold treatment is the standard treatment for muscle and joint inflammation. Athletes sit on the sidelines with a bag of ice strapped to an injured leg. Your Mum might suggest holding a bag of frozen peas on a bee sting. Some athletes even immerse themselves in an ice bath after a game to reduce inflammation, reduce pain and accelerate recovery after a game (brrr).

But does cold treatment work and if so, why?

First, let’s understand why inflammation happens in the first place.

Inflammation is a protective response to various stressors.

  • When you exercise for example, you damage your muscle cells. Some muscle cells are literally ripped apart from the strain, leaking cell contents which need to be cleaned up.
  • Inflammation signals are released which increases blood flow to the damaged area to replenish oxygen, fuel muscles, and clear out waste.
  • The resulting inflammation caused by increased blood flow presses against nerve endings causing pain.
  • As your muscles burn energy, they release chemical byproducts including ‘free radicals’ which can damage other cells, but also stimulate cell growth. If free-radicals are not removed and build up though, they are linked to ageing and a range of health disorders, and cause additional inflammation (see below).

This is all a bit of a mess that has been created, just by trying to exercise and do the right thing! What your body needs is a recovery and clean up process – and it happens to have a good one.

  • White blood cells increase and clean up the damaged cells by eating them and digesting them, which means your body can make use of the building blocks to create new cells.
  • Anti-inflammatory signal chemicals are produced which causes fluid to drain away, reducing inflammation
  • In response to the damage caused by exercise, your body produces antioxidants which mop up the free radicals.
  • The remaining healthy muscle cells fuse together to form larger, stronger muscle fibres, and new muscle cells grow out from local satellite cells. This is how your muscles grow and become stronger and are less damaged by future exercise.
  • Other hormonal changes occur which we won’t go into here, that help address stress, reduce pain and cause muscle and tissue growth to accelerate
  • Over a few hours and days, the broken cell tissue is removed and recycled, the inflammation reduces, and the free-radicals are neutralised.

As a result of regular training, your muscles grow in size, your white blood cell count increases and you can cope with higher levels of training intensity as a result. But when you ‘push’ your training, your body doesn’t have time to complete the recovery process before you put more strain on the muscle system. The inflammation and pain increases and can become chronic, eventually limiting your ability to train at a high level, or results in injury from repeated damage to muscles or connective tissues. If we didn’t need time to recover, we could just train all the time and become super-human! Speed to recovery is therefore key to being able to increase training load safely, and increasing the upper level of physical performance.

 

So how does cryotherapy help?

Cryotherapy induces a number of chemical responses that mimics exercise, without the resulting stress on your muscles. This prepares your body’s natural recovery process in advance. Your body can then naturally respond to the stress response of exercise faster, limiting the damage, inflammation and resulting pain. Think of it as like putting the fire engines right next to the building right before it catches on fire. Because all the right equipment is already in place, the fire can be put out faster, limiting the damage.

 

The biochemical responses from cryotherapy include:

  • Reducing background levels of inflammation so that your body’s inflammation response starts from a lower baseline
  • Stimulating the production of chemicals which are required to signal an anti-inflammatory response when it occurs, dampening the inflammation response
  • Increasing anti-oxidant concentration in your body, to achieve faster neutralisation of free-radicals, which in turn, reduces the inflammation response and decreases muscle damage
  • There is even some evidence that cryotherapy increases the number of satellite cells in your muscles, slightly improving muscle growth responses.

So cryotherapy is a protective process that accelerates and amplifies your body’s natural ability to recovery from exercise, and deal with inflammation.

Cryotherapy can also help if you experience chronic inflammation and pain.

 

Chronic Inflammation

Inflammation is a required and healthy response to stress in your body. You want some inflammation to achieve recovery.

But the body can sometimes over-compensate for damage that occurs in your body from exercise, or infection, smoking, poor diet or obesity. These oxidative stresses (that lead to the production of free-radicals) can trigger an inflammatory response, which in turn produces more free radicals, leading to more oxidative stress that creates a negative cycle that can lead to chronic inflammation.

Chronic inflammation is painful, debilitating and can lead to conditions such as diabetes, cancer, cardiovascular diseases, fibromyalgia, chronic fatigue syndrome, arthritis and Alzheimers.

Free radicals damage affects our very DNA and is a key cause of the ageing process in humans. It is why people who smoke, who are under stress or who suffer from chronic diseases seem to age faster.

Fighting chronic inflammation is a challenge and involves having a healthy diet high in fruit and vegetables, regular exercise and reduced stress. Cryotherapy can also help. For example with fibromyalgia, which is an auto-inflammatory disease, characterized by chronic inflammation, pain and severe fatigue. A study by Bettoni et al in 2013 for example  demonstrated cryotherapy resulted in substantial clinical improvements in reducing pain and improving quality of life for patients with fibromyalgia.

 

How often to be effective

 

Cryotherapy dampens the body’s natural inflammatory response to stress. You may find it useful in gaining relief from pain, letting you train harder for longer, or just improving your overall quality of life. But it is something you need to keep doing regularly because the effects on your body’s natural inflammatory response firstly take time to ramp up and then need to be maintained. It may take 10 or 20 treatments (for some people it is less) to stimulate the protective natural response of your body. How often you then need treatment to sustain this effect will depend on the stress you are putting your body under and your body’s underlying response mechanisms.

At Recovery Jungle, we are serious about your recovery and your quality of life. We are here to work with you to design a recovery protocol that best suits your needs.


Bettoni, L., Bonomi, F. G., Zani, V., Manisco, L., Indelicato, A., Lanteri, P., et al. (2013). Effects of 15 consecutive cryotherapy sessions on the clinical output of fibromyalgic patients. Clin. Rheumatol. 32, 1337–1345. doi: 10.1007/s10067-013-2280-9

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