Cold for centuries: a brief history of cryotherapies to improve health, injury and post-exercise recovery

Abstract

For centuries, cold temperatures have been used by humans for therapeutic, health and sporting recovery purposes. This application of cold for therapeutic purposes is regularly referred to as cryotherapy. Cryotherapies including ice, cold-water and cold air have been popularised by an ability to remove heat, reduce core and tissue temperatures, and alter blood flow in humans. The resulting downstream effects upon human physiologies providing benefits that include a reduced perception of pain, or analgesia, and an improved sensation of well-being. Ultimately, such benefits have been translated into therapies that may assist in improving post-exercise recovery, with further investigations assessing the role that cryotherapies can play in attenuating the ensuing post-exercise inflammatory response. Whilst considerable progress has been made in our understanding of the mechanistic changes associated with adopting cryotherapies, research focus tends to look towards the future rather than to the past. It has been suggested that this might be due to the notion of progress being defined as change over time from lower to higher states of knowledge. However, a historical perspective, studying a subject in light of its earliest phase and subsequent evolution, could help sharpen one's vision of the present; helping to generate new research questions as well as look at old questions in new ways. Therefore, the aim of this brief historical perspective is to highlight the origins of the many arms of this popular recovery and treatment technique, whilst further assessing the changing face of cryotherapy. We conclude by discussing what lies ahead in the future for cold-application techniques.

Keywords: Cold air; Cold-water immersion; Historical; Ice; Phase change material.

Fig. 1

The cryotherapy umbrella and mechanisms of action. CWI; cold-water immersion, WBC; whole-body cryotherapy, other; inclusive of cryo-compression devices, phase change material

Fig. 2

Interest in cryotherapy research since 1950. Data were collected using the “europepmc” R package (Jahn and Salmon 2021) using the search term “cryotherapy” and displayed as a percentage of all publications in the given year. The year-to-year trend is displayed by overlaying a loess smoothed fit curve on the data points