A view from professional football
There has been plenty of topical discussion about Cryotherapy within the media and medical discussion boards recently. I would love to tell you that this is a fairly new argument but I would be wrong in saying that as this debate has been going on for decades. Having worked in professional sport for over 5 years it is arguably one of the most heated debates between staff members from Physio’s to sports scientists and coaches on a near daily basis, particularly in the pre-season. The majority of “old school” coaching staff still religiously believe that players and sportsman should take a cold ice bath after every training session. Now let me assure you, cryotherapy for the majority is never nice and from experience, all I ever received was abuse from football players when informing them they have to spend time in freezing cold water for minutes on end! Overseeing players standing or sitting in ice baths, often gives time for player reflection and at that moment one of two questions nearly every player asks is if it will freeze their manhood and more importantly what do ice baths actually do?
Therefore, in this blog I will go over what the recent evidence proposes happens during the time you are freezing cold standing in arctic cold water or a futuristic ice chamber and is it actually worth your time, or would you be better leaving out the cold treatment altogether.
Traditionally, ice baths/cryotherapy were and are seen as a way to reduce swelling/ DOMs/ inflammation after a hard training session. The word tradition is key in the previous sentence as the majority of cryotherapy treatment is done because of the argument “we have always done it so it must work”. Fortunately, in my time within elite sport, the tradition was never the main reason for the use of anything in relation to player welfare. We always clinically discussed the best option for best practice. During the off-season (June), the medico-sport science team rationalised the use of ice baths particularly during the upcoming pre-season (July/August) period and discussed the disadvantages and advantages of using ice baths as a recovery method for football players. The advantages and disadvantages were:
- The positive psychological response following ice bath use.
- Build team morale. (This sounds odd, as above I have stated that the players used to complain about going in ice baths, however, once we convinced the players to go in, they used to joke and make fun of the staff and players.
- Typically players didn’t like being told what to do.
- Filling up the ice baths was a lengthy process and very time-consuming.
- Contrasting literature around ice baths and their positive influence on recovery
- The supportive evidence suggesting ice baths are a good recovery tool has also stated that they potentially inhibit muscle adaptation (which during the pre-season is what we were after).
As it is a blog, I will give my opinion on whether ice baths work. I do believe they have a place in professional sport/training, and professional sport/training only. You may be asking why I have this viewpoint? My rationale for this stance is that an ice baths’ aim is to enhance recovery and inhibit muscle damage, therefore, giving professional sports people the ability to train/play harder, faster and longer the next day/day after that. A great example of this is seen when a football team plays a match on a Saturday and then again on a Tuesday. Now if you’re not a professional sportsperson and you don’t train every day for 48 weeks of the year you may need to ask yourself if an ice bath is what you’re after. Several articles have reported that ice baths as a recovery tool actually have detrimental effects on training (1)
I will use myself as an example. On a good week, I try and get myself to the gym or partake in physical activity 5 times a week. My goals are unfortunately to look great in the mirror and on holiday and obtain some level of fitness so I can run for 3 to 5 miles twice a week. Getting big muscles and looking “shredded” is referred to as muscle adaptation in the professional world, if I want to look “hench or ripped” I don’t want to be submerging myself in sub 15-degree temperatures every week. The latest literature states that we want the inflammatory response within our muscles for them to grow and adapt and therefore I will be preventing the good work I am achieving in the gym completing weight after weight session (2,3).
- Higgins, T R, Heazlewood, I T, Climstein, M. (2011) A Random Control Trial of Contrast Baths and Ice Baths for Recovery during Competition in U/20 Rugby Union. Journal of Strength & Conditioning Research, 25, 4: 1046-1051.
- Giraldo E, Garcia JJ, Hinchado MD, Ortega E (2009) Exercise intensity-dependent changes in the inflammatory response in sedentary women: role of neuroendocrine parameters in the neutrophil phagocytic process and the pro-/anti-inflammatory cytokine balance. NeuroImmunoModulation 16(4):237–244
- Lateef, F. (2010) Post-exercise ice water immersion: Is it a form of active recovery? J Emerg Trauma Shock. 3 (3): 302.
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