EXERCISE trends come and go quicker than you can say ‘cardio burn'. First came aerobics back in the 1970s, which, lets face it, did not cross the gender divide, predominantly being practised by women. Core stability appeared as the new way forward in the early 1990s and functional training was the buzz word at the end of that decade. Some have proved to have longevity, rather than being simple fads, others have faded into obscurity (Tae Bo, anyone?), but the list keeps growing.The latest on the scene to be hyped up is Whole Body Cryotherapy (WBC), which, on initial inspection, seems like a hare-brained idea if ever there was one as it involves exposing the body to temperatures cold enough to freeze the balls off a brass monkey.
It is not a new form of exercise, so to speak, but a treatment that supposedly will allow an athlete's body to recover from high intensity training more quickly, also improving their performance, as well as providing therapeutic qualities for the healing of acute and chronic injuries.
Cryotherapy involves entering a cryo-chamber and being subjected to intense cold, from minus 100 to 175 degrees Celsius, for short periods of time. It might be wondered whether this is actually dangerous, but since air is a poor conductor of cold it will only chill the outside layers of your body, because an individual is only exposed for a couple of minutes, and not your internal organs. Also, your body's important ‘bits' won't drop off as they are covered by protective clothing.
For those brave enough to undergo it, the treatment shrinks the body's cells which subsequently expand after you emerge from the chamber, thus increasing blood flow, easing pain, swelling and reducing inflammation. This novel method of cooling the body has arrived in Ireland with much fanfare. The cryotherapy chamber in Whites Hotel, Wexford, is the only facility of its kind on the island and Tyrone full-back Cormac McGinley made full use of it during the summer months as he battled injury. But this treatment has caused much debate as there are unsupported claims about its perceived benefits.
For example, one leading Irish Sunday newspaper hailed WBC as ‘a miracle cure' in an article printed last year. Unfortunately, unless there is actual divine intervention from the Big Man Above, we can confidently state that there are no miracle cures. But what is it about this process? Why has it created such excitement?
In 1979, Japanese professor Toshiro Yamauchi built the first whole body cryotherapy unit, but this does not mean that extreme cold was not used on the body before then. The therapeutic use of cold is, surprisingly, as old as mankind and medicine. Such treatments were, amazingly, performed by ancient Egyptians about 2500BC, but since they managed to build the pyramids we shouldn't be surprised at their ingenuity.
The old favourite, the ice pack, is also a form of localised cryotherapy and is highly effective in reducing swelling following a blow, contusion, strain or sprain. Every player has experienced this form of cold treatment but WBC, it should be stressed, is nothing like simply applying ice to an injured body part. It doesn't even come close, as we are talking about extreme cold, minus 100 degrees Celsius at least. The difference between cold application to the skin and WBC is enormous and so are the physiological, physical and psychological effects.
The whole body form of cryotherapy, developed by Yamauchi in the late 1970s and early '80s, used this extreme form of cooling the body to assist in the treatment of rheumatoid arthritis. Since then, WBC has been used to treat many different medical conditions, but the possibilities of WBC have grown and are now applicable to sportspeople.
Without doubt, the most experienced users of WBC in our neck of the woods are the Irish rugby team. Rugby is a high impact, high intensity sport, and in the professional era, players have to face a greater volume of games, so Irish rugby players, since 2001, have been travelling to a training camp in Spala, Poland, where cryotherapy has taken hold as a method of rejuvenating the body. Since then, over 2000 hours of WBC exposure have been completed during the Irish team's very intensive pre-season physical training programme. WBC has been used as part of it to assist in recovery between the very demanding training units that they engage in. Indeed, several other athletes and teams have since used the centre and all report very positive benefits as a result of using cryotherapy as a key recovery modality during intense training.
But does WBC really deliver? Can it really aid the modern sportsperson to such a great extent? Research into its effects is really in its infancy. Last year, at a British Association of Sport and Exercise Medicine meeting, only limited research was presented to outline possible benefits. Since the original WBC unit of Yamauchi, however, research has been mainly conducted in Eastern Europe and, as such, Western scientists tend to be sceptical of their papers and their approach.
Nevertheless, several centres in Poland and Germany, in particular, have completed interesting research in the area. Unfortunately, many of the studies have not featured control groups, a major flaw in the research design, and a reason for some of the scepticism here. Many of the studies present case reports of individual responses to WBC treatment and these are not regarded as strong scientifically.
A recent study, however, did use a control group and the study, which was published in the eminent peer-reviewed European Journal of Applied Physiology, showed that trained athletes (kayakers) experienced 30 per cent less muscle cell damage after training when they underwent one WBC exposure compared to having no WBC exposure. After six days of training and WBC exposure, the athletes showed less exertional stress compared to those athletes who did not take WBC. This study agrees with findings from 2005 which found that athletes from judo and karate sports experienced improvements of general well-being and greater training tolerance following WBC treatment. Unfortunately, the authors did not have a control group for comparison with these self-reported findings.
There have also been reports of positive effects on hormonal status of athletes following WBC exposure, improving testosterone levels in male athletes. However, the changes have not always been statistically significant.
Studies on the effects of WBC on the immune system have also been done in Poland. Researchers showed how healthy non-athletic subjects who were exposed to a series of WBC exposures from -110 to -180 degrees C over five days improved aspects of their immune profile. Other research has also shown improved levels of endorphins (the proteins associated with feeling good) and other neural proteins following cryotherapy exposure.
If these studies are to be believed, it becomes clear why WBC has been talked up as such a ‘miracle-worker', as it can reduce muscle damage during training; provide greater tolerance to training; improve testosterone levels in male athletes; increase an athlete's immune profile following WBC; raise endorphin levels.
The above list is quite impressive and while the evidence to support these claims is only limited, there is actually no evidence to refute the above claims. Of course, more research needs to be done to copper-fasten these assertions.
As for improved performance, the only published study shows how rugby players showed greater improvement in speed, strength and power following cryotherapy treatment compared to players who did not over the same period of time. However, the authors did report that separate training environments were used for the two groups, a limitation in the study design. The greater gains made by those using the WBC-assisted physical training programme were impressive and included more muscle mass gain, improved body fat reduction, higher power gains, improved speed and better anaerobic endurance.
WBC, used during pre-season training, does offer the opportunity to complete a greater volume of high intensity training, so leading professional rugby teams use it in pre-season where speedy recovery from intense training is required. Again, more training studies are needed to establish with confidence that WBC can produce similar benefits for athletes and players from other sports, including Gaelic games.
Since cryotherapy was developed initially to alleviate the painful symptoms of rheumatoid arthritis, it makes sense that it could be used as an adjunct to the rehabilitation programme following injury. Research has also indicated the effectiveness of WBC in reducing injury-related ‘ailments' during intense training. There is evidence that the recovery time following knee injury (patella thigh syndrome) is shortened when rehabilitation includes WBC.
However, there is a lack of well designed control group studies when it comes to examining the effectiveness of WBC in the rehabilitation process following injury, but at least there is strong anecdotal evidence.
So, it seems the jury is still out on WBC and its true effectiveness, but at least there is nothing to say that it is harmful. Quite the contrary, this unusual technique seems to have some very interesting side-effects that can aid a sportsperson, in numerous disciplines, improving the body's endurance levels and aiding recovery. Proof is in the pudding.
Whole Body Cryotherapy - what is it?
Whole body cryotherapy (WBC) is a short-term therapy where the unprotected body surface (wearing only shorts, socks, body top (for females) gloves and face mask) is exposed for between two and three minutes to ambient temperatures of less than -100 degress C. The skin surface temperature can reduce to a temperature of 5 degrees C in this short period with core temperature remaining around its normal 36 - 37.2 degrees C. The individual enters a small cabin like structure which can hold between 2 and 6 individuals (at any one occasion) where the air is cooled by any one of the following methods:
1. Liquid nitrogen
2. Liquid air
3. Cooled air
Following this WBC exposure the players then complete a short exercise routine which is intended to re-establish a normal physical condition.
Proposed benefits
- Pain relief
- Inflammation reduction
- Muscle strengthening
- Muscle relaxation
- Greater muscular resistance to fatigue
- Faster muscle recovery following exercise
- Greater muscular performance
- Conservation of energy for muscular efforts
- Improved hormonal profile
References
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Hennessy et al. The impact of extreme cryotherapy on pre-season fitness development in professional rugby players. 2nd Annual Scientific meeting programme. RCPI & RCSI. 2005.
Ireland on Sunday. ‘Stars queue up for a death defying spell at minus 110 C. August 13th 2006.
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