The cold truth: the role of cryotherapy in the treatment of injury and recovery from exercise

Post-exercise Recovery: Cooling and Heating, a Periodized Approach

“…Beyond sleep, nutrition, and hydration, recent work has focused on the application of various temperature-based modalities in an attempt to accelerate recovery (McGorm et al, 2018;Kwiecien and McHugh, 2021). Indeed, among the vast array of recovery strategies commonly used by athletes, temperaturebased modalities have shown the most promise, although, still the data are inconclusive (Jakeman et al, 2009;Stanley et al, 2012;Broatch et al, 2014).…”

“…Cooling has been performed for decades in relation to injury, and intuitively, transferred to recovery from exercise in more recent times. Topical cooling, cold water immersion, whole body cryotherapy, and more recently phase change material are most commonly used in both the clinical and professional sports settings (Kwiecien and McHugh, 2021). The mechanistic response between these modalities has been shown to differ and in some circumstances provides a completely different physiological effect (Mawhinney et al, 2017;Kwiecien and McHugh, 2021).…”

“…Topical cooling, cold water immersion, whole body cryotherapy, and more recently phase change material are most commonly used in both the clinical and professional sports settings (Kwiecien and McHugh, 2021). The mechanistic response between these modalities has been shown to differ and in some circumstances provides a completely different physiological effect (Mawhinney et al, 2017;Kwiecien and McHugh, 2021). The ultimate objective for cooling is to reduce deep muscle temperature, in an attempt to favorably reduce blood flow and metabolism at the affected muscle site, in an effort to diminish the secondary damage phase (Merrick, 2002).…”

“…The ultimate objective for cooling is to reduce deep muscle temperature, in an attempt to favorably reduce blood flow and metabolism at the affected muscle site, in an effort to diminish the secondary damage phase (Merrick, 2002). A recent review suggested that repeat application or elongating cooling time would lead to the most advantageous results in reducing deep muscle temperature, in turn, the proliferation of the secondary damage phase (Kwiecien and McHugh, 2021). Importantly, local changes in muscle temperature (cooling or heating) may influence enzymatic activity and effect rates of intramuscular glycogen resynthesis (Cheng et al, 2017).…”

“…It appears that the first and most critical physiological event to attempt to mediate is the secondary damage phase shortly following mechanical damage. The latest evidence suggests that prolonged cooling is the most suitable intervention (Kwiecien and McHugh, 2021). Cooling via water immersion (in some cases multiple exposures) or local phase change material has been shown to have the most effective results in reducing tissue temperature (Mawhinney et al, 2017;Kwiecien et al, 2020b).…”