whole-body cryotherapy

The most difficult experience to endure as a massage therapist is to watch a client who, despite your skill set and best efforts, remains in pain. We have all had clients who are desperate for relief and searching for answers apart from taking medicine.

You may have had a similar experience yourself, as the client. When it comes to being in pain, there is nothing you wouldn’t do to alleviate the symptoms. If you happen to suffer from chronic pain, your life becomes dictated by the limitations that pain has created. You are willing to try anything, literally anything, right?

Standing in a cryosauna surrounded by hyper-cooled air that ranges from temperatures as cold as -225 to -275 degrees Fahrenheit in nothing but socks, gloves and your skivvies might sound a little too far-fetched—but, that is exactly what you will do when you decide to try whole-body cryotherapy.

Quickly adopted by professional athletes and training teams in the U.S., the cryosauna is finding its way into massage and integrative clinics, spas and stand-alone cryotherapy practices.


The Problem

Originally developed in Japan in the 1970s for the treatment of rheumatoid arthritis, whole-body cryotherapy—cryo meaning cold and therapy meaning cure—has been circulating the globe and gaining notoriety for its ability to aid in speeding up the recovery process due to its ability to ease inflammation.

As we all understand, inflammation can be due to any number of triggers, and therein lies the problem. The body cannot distinguish the intent behind the necessary scalpel of a surgeon as compared to the violence of a knife wound, the difference between an external allergen and an internal autoimmune response. Even daily exercise, which is a good stressor for the body, creates inflammation. The body will initiate an inflammatory response despite the cause, and will begin to address the area of insult with the release of inflammatory proteins.

So, if we know inflammation is the problem, how does the use of a cryosauna become the solution?



The Physiology

The temperature of the body’s core must be constant, as even the slightest changes will trigger a protective response to avoid the possibility of death. So when the skin’s cold sensors are exposed to the extreme temperatures inside the cryosauna, a clear warning is sent to the brain that maintaining its core temperature will be impossible if circulation continues to the outer layers of tissue.

The body’s survival resources are mobilized and the blood flow is pulled from the periphery to the core to protect the vital organs. This internal cycle allows for the blood to become oxygen-rich with necessary enzymes and nutrients, all the while nourishing the organs, aiding in the acceleration of crucial processes such as elimination of dead cells through the lymph system, expelling toxins from the subcutaneous layers, and cellular regeneration.

What areas the body does not perceive as deficient in its normal state, now in survival mode identifies and addresses as not functioning at full capacity. Simply put, we force the body to wake up and pay attention to its issues as we put it in the best position to heal itself.


The Periphery’s Response

The beauty of the human body and its ability to invest in its own restoration is what brings about the second stage of the process. The cold caused vasoconstriction that allowed toxins to be removed from the periphery and brought into the core to be filtered out; now out of the cryosauna and returning to the ambient environment, the body no longer senses the risk of freezing.

This realization creates rapid vasodilation, allowing blood flow to return to the subcutaneous layers, muscles and entire periphery of the body. It is this blood flow loaded with oxygen, endorphins, and a release of norepinephrine, which aids in producing the analgesic effect.

These effects will last between six and eight hours. The body will rebound from the sympathetic response by raising the core temperature, resulting in a boosted metabolism, increased energy and an excess of 500 calories burned. A person will feel warm, relaxed and simultaneously energized and refreshed.


The Physiological Effects

As with many complementary and integrative therapies, research that supports the benefits of whole-body cryotherapy is lacking. One study conducted in May of this year, “The effects of a single whole body cryotherapy exposure on physiological, performance and perceptual responses of professional academy soccer players following repeated sprint exercise,” measured the physiological, performance and perceptual effects of a single whole body cryotherapy session. Professional youth soccer players sat for 30 seconds in a -76 Fahrenheit degree chamber, and then sat for 120 seconds in a -211 Fahrenheit degree chamber. “A single session of [whole body cryotherapy] performed within 20 minutes of repeated sprint exercise elevated testosterone concentrations for 24 hours, but did not affect any other performance, physiological or perceptual measurements taken,” the investigators noted. More research is needed.

Until that time, anecdotal evidence indicates that the cryosauna can help with stress relief, pain relief, improved circulation, better sleep and faster recovery. Clients who experience daily pain will start to see the benefits within minutes of using the cryosauna. So what does a client have to do to get these results?


The Perception

So often we hear the no pain, no gain theory in response to changes we make in our health, from changing an eating habit to starting a new exercise routine. When it comes to your recovery, this does not need to be the case. Despite the extreme-sounding temperatures, the cold of a cryosauna is very tolerable. The hyper-cooled air circulates around your body and never penetrates deeper than a millimeter of your skin.

This is drastically different from when you submerge in an ice bath or apply ice to an area of injury. The application of a cold pack or ice bath can be excruciating and last 15 to 20 minutes. In those cases, you are using the thermal effects of the ice to cool the skin, subcutaneous layers and potentially even muscles.

Because whole-body cryotherapy is not a penetrating cold, it is safe for clients who have had surgical repairs that left them with internal hardware, such as a total knee replacement.


cryosauna in use

The Process

As you stand in the upright cryosauna, liquid nitrogen, which is converted via the sauna into vapor, swirls around your body and fills the sauna from the bottom up. Your head and neck are raised above the level of the cryosauna so you continue to breathe room-temperature air.

As the sauna fills, you become “submerged” in nitrogen, your skin is exposed, and you may see goose bumps. However, surprisingly, most clients do not even shiver. Since the duration is brief and intense (yet tolerable), it is safe to use on teenage athletes as well as the elderly.

However, as with all modalities, there are precautions. Most cryosauna businesses will measure your blood pressure before your session, especially if you have a history of hypertension, to ensure that you are not at risk of increasing your blood pressure to an unsafe range while the blood is pulled in to the vital organs.

At the end of the three minutes, you simply step out of the sauna.


The Product

As a result of the increased blood flow caused by vasodilation, most clients report a sense of warmth and relaxation. The release of endorphins, our feel-good hormones, aid in our ability to relax. The norepinephrine released aids to increase energy, boost mood, decrease inflammation and improve focus. The hyper-oxygenated blood produces better perfusion of the muscle tissues that leads to improved performance, including the ability to allow for elongation of the muscles.


The Practice

As a massage therapist, I request that my clients complete a cryosauna prior to their massage. They are simply given a robe and move from the cryosauna to the heated massage table. This allows me, as a therapist who deals primarily with repetitive use, postural and chronic pain patients, to capitalize on the increased oxygen being delivered to the muscles to aid in the client’s relaxation.

Imagine how those clients who have trouble getting into a position of comfort or who constantly seem to guard due to pain can now, with the presence of endorphins and the analgesic effect created from the cryosauna, ensure that they are in the best possible position to receive bodywork both at a physiological level and from a perceived pain aspect.

The results that I can achieve in pain relief, increased range of motion, and structural changes of the muscles cannot be duplicated with the simple application of heat or ice. The value of being a part of a client’s answer to pain is priceless.


About the Author

Megan Sanders, L.M.T., N.C.T.M.B., holds a master’s degree in physical therapy. She is an instructor of The Muscle Release Techniquesm and treats clients at SubZero Cryotherapy (subzerocryotherapy.com) in Chesterfield, Missouri, where she lives with her family. Sanders is a National Certification Board for Therapeutic Massage & Bodywork-approved provider of continuing education.