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By Sergio Mesas, Bewolfish physiotherapist, graduated in Physiotherapy by EUSES and finishing the CAFD studies.

There has been a lot of debate about the use of cryotherapy. In addition, we have seen many athletes using ice baths after the Mutua Madrid Open matches in the last week. But, is cryotherapy really useful in sports? In that case, when should we use it? And, moreover, what effects has it in our body? These are some of the issues that we will address in this article.

“Cryotherapy is not only useful

to prevent swelling,

but also to relieve pain”

First of all, cryotherapy is the application of low temperature around an area to, for example, reduce inflammation or mitigate pain at a localized point, among other uses. Traditionally, cryotherapy has been used in bruises to prevent swelling from appearing.

It is known that the applied cold penetrates through the skin causing a decrease in the enzymatic function (affecting, for example, the ATP, a fundamental molecule for obtaining energy) and a vasoconstriction (narrowing of the blood vessels). Which means that, when we apply cold, we achieve a lower blood flow in the area, responsible for transporting fundamental factors such as nutrients and oxygen (among others), thus reducing inflammation.

However, cryotherapy is not only useful to prevent swelling, but also to relieve pain. In our body, we have various nerve pathways, each one responsible for transporting a type of information. The A-d pathway is responsible for transporting temperature information. Therefore, if we inhibit this route saturating it by using cold, it will not be able to carry pain information and it will have an analgesic effect (inhibition of local pain while using it).

Cryotherapy is also used in the acute phase after an injury to prevent or reduce inflammation. It has especially been used the RICE method. It consists of rest, ice, compression and elevation. But, is it convenient to use this method when suffering injuries? If we review the scientific evidence, there are no relevant studies that support its use.

“Cryotherapy is also used in

the acute phase after an injury

to prevent or reduce inflammation”

Let’s examine why. The blood supply is what provides oxygen and nutrients to the tissues of our body and, when there is an injury, it acts as a repairing effect. As mentioned earlier, cryotherapy causes vasoconstriction, that is, reduces local blood flow and, therefore, decreases the supply of oxygen and nutrients to tissues. So, if applying cold in an area we suppress these factors completely, we will attenuate the repair of the affected tissue, therefore, we will reduce the repairing effect.

To obtain the benefits of cryotherapy without losing the repairing effect, contrast water therapy can be used, that is, combining hot water baths with cold water baths. With it, we achieve a kind of “vascular training” that causes, on the one hand, an effect of vasoconstriction (narrowing of the blood vessels and therefore less flow) and, on the other, a vasodilation (enlargement of the blood vessels and therefore much more flow). The combination of both effects can improve blood circulation, reducing swelling while still providing blood to the affected tissue and thus respecting the biological healing process.

“Ice baths are not the most recommended

method for post-exercise recovery.

The most recommendable is the

active recovery at low intensity”

We have already analysed the convenience of ice baths or cold water when suffering injuries but, is it convenient for post-exercise recovery? It is known that the application of ice baths immediately after exercise suppresses muscle inflammation, but also delays the growth of muscle fibres and their post-exercise recovery. Therefore, it is not recommended.

On the other hand, there is also no clear evidence that ice baths reduce the risk of delayed onset muscle soreness (DOMS). The majority of studies carried out are inconclusive since the samples used are not similar. However, in a study conducted with a homogenous sample of untrained people, it was found that the use of post-exercise ice baths had no effect on subsequent DOMS.

Based on these statements, we can conclude that ice baths are not the most recommended method for post-exercise recovery. The most recommendable is the active recovery at low intensity, that is, not stopping the sports activity in a sudden but continuing with a little effort activity. For example, using the roller (static bicycle) in order to help the body to eliminate waste substances such as lactic acid, a substance that is produced due to high-intensity efforts.

In short, cryotherapy is useful to reduce inflammation in the acute phase and to mitigate pain when we suffer bruises. In an inflammatory process due to an injury, it is recommended to use contrast water therapy in order to improve circulation in the area while still providing blood to the tissue, respecting the process of biological recovery (follow always the advice of professionals). On the contrary, if what is sought is a good post-workout recovery, the best option is an active recovery at low intensity, such as using the stationary bike, the elliptical or stretching.

 

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