“Bring on the Cold-Water Plunge” by Guest Contributor, Jerrod Ackerman, Physical Therapy Manager at Rock and Armor Physical Therapy

“Picture this:  Sitting, soaking, relaxing in a steamy idyllic Idaho hot spring in the middle of February with friends.  Lazily gazing around, you see a flowing river with pillows of snow balanced on top of river rocks.  Do you ever get a wild hair to take a quick full body (head, shoulders, knees & toes) dip in that frigid river?  I know I do!  Bring on the cold-water plunge!  It turns out this cold plunge may actually benefit you more than just proving to your buddies that you had the courage (or stupidity…) to do it!

In the literature, this is known as Whole-Body Cryotherapy (WBCT) which is the process of briefly exposing one’s entire body to extremely cold temperatures.  Most studies show benefits are maximized when exposure duration reaches 2-3 minutes at a temperature of -160 degrees Fahrenheit (I.E., very, VERY cold).  The two most common methods are:

  1. Cold water plunge
  2. Cryotherapy chamber with circulating frigid air.

It is worth mentioning that nearly all clinical trials took place in a controlled dry cryotherapy chamber which allowed subjects to be consistently fully exposed (head to toe) for 2-3 uninterrupted minutes prior to analyzing the results.

And the results were quite stunning!

Health Benefits from WBCT

At the appropriate dosage, WBCT showed significant physiological changes (both short & long-term) in multiple systems of the body:

  • Muscular
  • Skeletal
  • Immunological
  • Cardiovascular
  • Endocrine
  • Psychological

WBCT Study Results

A study conducted by Metzger D. et al 1 showed significant improvements in pain scale ratings for individuals with fibromyalgia, rheumatoid arthritis, chronic low back pain, osteoarthritis, & ankylosing spondylitis (among other autoimmune diseases).  In this study, marked decreases of pain only lasted about 90 minutes.  Although this may be a relatively short-lasting response, it created a window of time during which more effective physiotherapy could be performed.

Another benefit is the ability to give patients with these stubborn, frustrating ailments temporary relief from discomfort.  Again, although that pain-free window may be short, it can offer the patient an opportunity to start to break ingrained patterns of pain & dysfunction.  A great example of this was demonstrated when subjects with rheumatoid arthritis showed substantial benefit when WBCT was added with concurrent physiotherapy3.

A 2017 study by Lombardi G. et al 3 compiled a multitude of multisystem effects of WBCT.

  • Lipid profiles improved – decreased triglycerides & LDLs (‘bad cholesterol’), increased HDLs (‘good cholesterol’)
  • Bone health improved – decreased inflammation-induced bone resorption & risk for osteoporosis, increased bone mineral density
  • Anti-inflammatory effects improved – reduced IL-1beta, increased IL-10 & IL-1Ra
  • Muscular enzyme changes improved – increased hypertrophy (muscle growth)
  • Endocrine changes occurred – decreased overall cortisol (chronic stress hormone) & increased testosterone
  • Endogenous antioxidants increased – these mimicked the muscular effects of physical exercise (This may serve as a powerful intervention for patient with obesity, type II diabetes, neurodegenerative diseases, congenital diseases, & mental health disorders which disrupt one’s ability to perform regular physical exercise.)
  • Qualitative outcome measurements improved such as
    • Quality of Life
    • Visual Pain Scale
    • Ability to perform daily activities
    • Global Health Status,
    • Post-exercise muscle fatigue & soreness
    • Fatigue Severity Scale (A particularly strong response was noted in patients suffering from the often-elusive diagnosis of fibromyalgia.)

One of the more impressive & surprising findings was noted in two different papers from Rymaszewska J. et al 5,6.  These papers, among others, demonstrated psychological improvements in patients with depressive & anxiety disorders.  Wellbeing & quality of life were noted to improve in these populations.  In one study, more than 40% of subjects experienced greater than 50% reduction in depression & anxiety symptoms from WBCT alone.

Who Shouldn’t Consider WBCT

Although the effects of WBCT seem to be quite useful for many, it is not for everyone.  Individuals who suffer from cryoglobulinemia, cold intolerance, Raynaud disease, hypothyroidism, acute respiratory system disorders, cardiovascular system diseases, SNS neuropathies, cachexia, & peripheral local blood flow disorders are not good candidates for WBCT.

Final Thoughts

As with any procedure affecting one’s physiology, it’s prudent to first consult with your healthcare professional.  And if you’re looking into WBCT treatments, make sure that the provider follows these researched parameters:  2-3 minutes at a temperature of -160 deg Fahrenheit.

Given the robust evidence for the benefits of WBCT for a multitude of diverse populations, maybe it’s time for you to take the plunge!”

Resources:

1. Rehabilitation (Stuttg). 2000 Apr;39(2):93-100.doi: 10.1055/s-2000-14442. Whole-body cryotherapy in rehabilitation of patients with rheumatoid diseases–pilot study. D Metzger 1C ZwingmannW ProtzW H Jäckel

3. Front Physiol. 2017; 8: 258. Whole-Body Cryotherapy in Athletes: From Therapy to Stimulation. An Updated Review of the Literature. Giovanni Lombardi, Ewa Ziemann, and Giuseppe Banfi

5. Arch Immunol Ther Exp (Warsz). 2008 Feb; 56(1): 63–68. Whole-body cryotherapy as adjunct treatment of depressive and anxiety disorders. Joanna RymaszewskaDavid Ramsey, and Sylwia Chładzińska-Kiejna

6. Front Psychiatry. 2020 Jun 9;11:522. doi: 10.3389/fpsyt.2020.00522.eCollection 2020. Efficacy of the Whole-Body Cryotherapy as Add-on Therapy to Pharmacological Treatment of Depression-A Randomized Controlled Trial. Joanna RymaszewskaKatarzyna M LionLilla Pawlik-SobeckaTomasz PawłowskiDorota SzcześniakElżbieta TrypkaJulia E RymaszewskaAgnieszka ZabłockaBartlomiej Stanczykiewicz

If you’d like to find out more about WBCT and/or chat with Jerrod about potential treatment options, feel free to email or call (208) 375-5511.

Here’s a list of past articles written by Jerrod Ackerman:

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