Head, Face and Neck Cooling as Per-cooling (Cooling During Exercise) Modalities to Improve Exercise Performance in the Heat: A Narrative Review and Practical Applications

Abstract

It is well known that uncompensable heat stress greatly impairs endurance and team sport-related performance because an increase in the core temperature directly induces a greater magnitude of the central fatigue in the heat than in thermal neutral environments. Numerous studies have been conducted in an attempt to discover reliable cooling strategies for improving endurance performance and repeated sprint ability while exercising in the heat. Whole-body pre-cooling has been shown to improve endurance performance in both dry and humid heat. Despite this, the reduction in thermal perceptions associated with pre-cooling gradually narrows during intense exercise. Hence, effective per-cooling strategies to improve athletic performance in the heat are required. Unfortunately, due to practical issues, adopting pre-cooling approaches as a per-cooling (cooling during exercise) modality to improve athletic performance is impractical. Thus, we sought to examine the impact of head, neck and face cooling on athletic performance in heat. According to current evidence, cooling the head, neck and face reduced local skin temperature in the areas where cooling was applied, resulting in improved local perceptual sensations. In the heat, neck cooling during exercise improves athletic performance in both endurance and team sports athletes. Furthermore, from a practical standpoint, neck cooling is preferred over head, face and combined head/face and neck cooling for both endurance and team sport athletes in the heat. Nonetheless, for all athletes who have access to water, face cooling is a recommended cooling strategy. There is a lack of research on the systematic selection of per-cooling modalities to improve athletic performance based on environmental conditions and the nature of sports. In addition, powerful but portable head, neck and face cooling systems are urgently needed to assist athletes in improving their performance in hot conditions.

Effects of different external cooling placements prior to and during exercise on athletic performance in the heat: A systematic review and meta-analysis

“…Mitigation of competition pressure between the skin and muscles, possibly allowing better maintenance of venous return, cardiac output and mean arterial pressure, and greater blood flow perfusion of the active muscle, thereby boosting oxygen delivery or metabolite removal, and increasing the contribution of aerobic metabolism to ATP re-phosphorylation ( Marsh and Sleivert, 1999 ; Cotter et al, 2001 ). On the other hand, as neck and head are adjacent to the temperature-regulating centers and high sensory thermoreceptor, which dominate whole-body temperature perception ( Cotter and Taylor, 2005 ; Kim et al, 2019 ), neck and head cooling could alter the sensory feedback and attenuate the inhibitory effect on neural drive ( Watkins et al, 2018 ), thereby changing thermal sensation, mitigating central fatigue and improving exercise performance in the heat ( Chaen et al, 2019 ; Cao et al, 2022 ). However, central cooling seems not to be able to significantly alter the physiological or peripheral neuroendocrinological responses to the exercise in the heat ( Tyler et al, 2010 ).…”

Stratégies de gestion de la chaleur et performances sportives de haut niveau : éclairage psychophysiologique et recommandations appliquées

“…Des facteurs exogènes comme la chaleur peuvent influencer négativement l'activité physiologique en imposant des contraintes aux systèmes cardiovasculaire et ventilatoire, se traduisant notamment par une augmentation des fréquences cardiaque et respiratoire, liées au maintien de l'homéostasie [6, [14][15]. La TE engendre ainsi des difficultés de dissipation de chaleur corporelle pouvant augmenter la température centrale, occasionner des dysfonctionnements physiologiques [2] ainsi qu'un épuisement cognitif précoce [16,17].…”

Case Report: Countermeasures Against Heat and Coronavirus for Japanese Athletes at the Tokyo 2020 Olympics and Paralympic Games

“…In 2019, we conducted a practical study applying evidence-based body cooling methods (Jay and Morris, 2018 ; Cao et al, 2022 ) and planned hydration for elite sailors (Nakamura et al, 2019 ), elite beach volleyball athletes, elite cyclists, elite fencing athletes, and the Japan national soccer team (Japan Institute of Sports Sciences, 2020 ). The results of the laboratory and practical studies obtained were summarized in a guidebook (Japan Institute of Sports Sciences, 2020 ) and provided to athletes and coaches, with pre, per, and post cooling strategies that could be implemented at the Tokyo 2020 Games.…”

“…For body cooling, it is important to consider the combination of internal and external cooling (Racinais et al, 2015 ; Bongers et al, 2017 ; Jay and Morris, 2018 ; Gibson et al, 2020 ; Cao et al, 2022 ) and the timing of implementation (Jay and Morris, 2018 ; Bongers et al, 2020 ; Gibson et al, 2020 ). However, there are a number of constraints when performing body cooling during actual competitions, including individuality considerations, limitations in cooling methods and cooling times, challenges related to freezing and delivery methods of cooling devices, and venue regulation (Japan Institute of Sports Sciences, 2020 ; Naito et al, 2020 ).…”