10 Best Things to Do in San Diego, CA

California’s birthplace and the first spot in the United States where Europeans stepped ashore, San Diego is a city with great appeal.

To go with the comfortable climate and laid-back style, San Diego Bay and its natural harbor have a rich military heritage.

The colossal aircraft carrier USS Midway speaks to this, and stands as the mother of all museum ships.

San Diego’s easy-going culture and miles of beach breaks may awaken the surfer dude in you, while Coronado and La Jolla have two of the best family beaches in the whole country.

Set just north of the border, the city has a Mexican influence that spreads to its delectable cuisine, and there’s a deluge of culture at the museums, monuments and theatres of Balboa Park.

Let’s explore the best things to do in San Diego:

1. Cryotherapy – GoCryo in Clairemont

Cryotherapy San Diego, CA – Cold Therapy and Cryo Slimming

GoCryo Cryotherapy San Diego’s Whole Body Cryotherapy (WBC) is a cutting-edge innovation using hyper-cool temperatures to stimulate powerful physiological responses and trigger the body’s natural healing processes in a therapeutic manner. These remedies include accelerating healing in soft tissue and joints, reducing inflammation and pain, and boosting your metabolism inside our cryo chamber which immediately lowers your body’s temperature (without freezing it) through the application of instant cold therapy using nitrogen gas. Cryotherapy offers fitness, wellness and beauty benefits to individuals striving to improve their overall well-being by feeling, looking and performing better everyday. Explore the science and process behind cryotherapy cold therapy today. ‘Awesome!’ is often a response that we hear from our Cryo clients as they exit the cooling chamber.  We also offer cryo facials, compression therapy, cryo toning and cryo slimming similar to coolsculpting.
Book you session at www.gocryosd.com/booknow/ or call text 858.255.0699 to get 50% off your first session!

2. Balboa Park

You’ll keep returning to this 1,200-acre urban park for its world-class zoo, restful cultivated areas, museums in refined Spanish Revival buildings and live shows.

There’s a tapestry of gardens around the park, planted with more than 350 plant species hand-selected at the turn of the 20th century by the botanist Kate Sessions, the “Mother of Balboa Park”. An emblem for the park and San Diego is the Botanical Building, one of many splendid holdovers from the 1915-16 Panama-California Exposition.

Among the largest lath buildings in the world, the Botanical House contains 2,100 individual plants and is fronted by a pond with annual displays of lilies and lotuses.

Suggested tourSan Diego Walking Tour: Balboa Park with a Local Guide

3. Embarcadero

San Diego’s walkable harbour-front is brimming with shops, interesting sights and eateries, and looks across the bay to Coronado Island.

A lot of the Embarcadero’s interest is literally floating on the water, at the USS Midway and the heritage ships belonging to the San Diego Maritime Museum.

This is also the place to board tour boats around the harbour and out in the ocean to spot whales.

When the mercury rises kids can go wild at the interactive fountains in the Waterfront Park and adventure through the creatively designed playgrounds.

In November the Embarcadero stages the San Diego Bay Wine & Food Festival, while the San Diego Symphony Orchestra plays the Bayside Summer Nights from late-June to the start of September.

4. USS Midway Museum

The longest-serving aircraft carrier in the world has been permanently moored at San Diego’s Embarcadero since 2004. Commissioned in 1945, the USS Midway served in the Vietnam War and Operation Desert Storm, before becoming the largest museum dedicated to aircraft carriers and naval aviation anywhere.

GetYourGuide.com offers a self-guided audio tour of this humungous vessel, during which you’ll see over 30 restored aircraft, including 8 propeller planes, 14 jet aircraft and 8 helicopters.

You’ll be led through the galley, brig, crew’s sleeping quarters, pilots’ ready rooms and engine room, and hear exciting snippets from people who served aboard the Midway.

You’ll have lots of chances to get involved, testing simulators, climbing into cockpits and watching films documenting the dramatic events that took place where you stand.

5. Point Loma

The west side of San Diego Bay is embraced by a long rocky peninsula that merits a visit for jagged topography, thrilling history and views you won’t soon forget.

We’ll touch on a few of the sights on Point Loma later, but in 1542, this was the landing point for the first European expedition to what is now the West Coast of America.

Given the peninsula’s setting, protecting the west flank of the harbour, Point Loma has a military presence going back to the 19th century.

The 77.5-acre Fort Rosecrans National Cemetery (1882) is on the grounds of a former coastal artillery station.

There are more than 100,000 graves here, and solemn memorials like the USS Bennington Monument, recording an accident in San Diego Bay that claimed 66 lives in 1905. Head to the marina for whale watching expeditions, and to Osprey Point were climbers scale the rocks and fishers camp over the water.

Available tourGPS Talking Tour Cars: Point Loma & Beaches Loop

 

6. La Jolla

The upscale oceanfront community of La Jolla is on a rocky headland poking out into the Pacific and surrounded by water on three sides.

La Jolla means fine dining, cliffs with sea caves and little coves where seals and sea lions rest on the sand.

We’ll stop by La Jolla many times on this list, visiting the famous Torrey Pines and its State Reserve, beaches and golf course.

La Jolla proper has a cosmopolitan, European feel in its cafes, boutiques, low-rise houses and steep stairways.

At Ellen Browning Scripps Park by La Jolla Point you can contemplate the majesty of the Southern Californian coast, catch open-air concerts on summer evenings and see the fireworks on the Fourth of July.

Make a detour to the Legends Gallery on Prospect Street, which has original art by former La Jolla resident Theodor Seuss Geisel (Dr Seuss).

Available tourSegway Tour in La Jolla

7. Surfing

Surf culture is woven into San Diego’s identity and the county’s 70 miles of open ocean coastline has more surf spots than we could list here.

Much of the shore has southwest facing beach breaks, while there are rockier sections with reef breaks at La Jolla and Point Loma.

Avid surfers are always ready to travel for the perfect wave, and this might mean a trip up to the highly popular Swami’s, which was mentioned in the Beach Boys’ Surfin USA. The river mouth point break at Trestles is world renowned and hosts WSL competitions from May to September.

Honourable mentions go to the beach breaks at Oceanside and the spacious Del Mar, where you won’t have to jostle for a wave.

There are shops for gear rental near every major spot.

And if you’d rather keep your feet on dry land, you can watch some great surfing action from the rocks at Windansea in La Jolla.

 

8. Cabrillo National Monument

At the southern tip of Point Loma you’ll stand where a European person first set foot on the West Coast.

Juan Rodríguez Cabrillo’s expedition arrived here on 28 September 1542, and he named the bay San Miguel (this would change to San Diego in 1602). The original heroic statue of Cabrillo was donated by the Portuguese government in 1939, while the current replica has stood since 1988. The national monument’s visitor centre has a movie and exhibits to retrace Cabrillo’s voyage along the Californian coast.

Outside you can still see the old coastal batteries that protected the harbour and check out the Old Point Loma Lighthouse, which has been converted into a museum.

But maybe best of all is the widescreen view of San Diego’s skyline, the harbour, across to Coronado and down to Tijuana.

 

9. San Diego Old Town

The site of the first European settlement in present-day California, the San Diego Old Town is a visitor-friendly neighbourhood with historic adobe buildings from the city’s early days between 1820 and 1870. There’s wonderful set of preserved streets in the State Historical Park, which we’ll talk about next.

In the 40-acre Presidio Park you’ll be at the site where the San Diego Mission and the San Diego Presidio, the first settlements in modern day San Diego, were founded in 1769. The Old town is a great place to go for real Mexican food and brims with specialty shops and art galleries.

There’s lots of colour during annual festivities like Fiesta Navidad, Cinco de Mayo and Día de Muertos in November.

Suggested tourOld Town San Diego: Hop-on Hop-off Narrated Tour

 

10. Old Town San Diego State Historical Park

A time warp back to the mid-19th century, the State Historical Park in the Old Town is scattered with restored historic buildings, including five original adobes, as well as detailed replicas.

The finest of the adobes is the Casa de Estudillo from 1827, one of the oldest remaining pieces of Spanish architecture in California.

The park is free to enter and gives a sense of the intersecting cultures, as a Mexican pueblo became an American settlement.

There’s constant activity, with burros to pet, shopkeepers happy to share their stories, and artisans showing off their knowhow: At the Black Hawk Smithy & Stable you can see a blacksmith working the forge.

There are shops, little museum and restaurants, while the Historic Plaza has a full schedule of cultural celebrations and events.

How Infrared Sauna and Cryotherapy Benefit Skin

Whether you have your finger on the pulse of the hottest wellness trends or not, it is hard to ignore the rise in infrared sauna sweats and cryotherapy chills. Despite their polar opposite temperatures, both of these tried-and-true rituals come with a dose of impressive health benefits. And as with many things in the health and fitness world, the promising properties of infrared sauna and cryotherapy cross over into beauty, too.

Up ahead, we tap the experts to find out why (and how) cryotherapy and infrared sauna leave a lasting effect on the skin, plus how submerging yourself in their hot and cold temperatures can amp up your health regimen.

Infrared Sauna Benefits
If you belong to a gym or have ever treated yourself to a relaxing day at the spa, you are probably familiar with the sauna. But although they look similar, these saunas and the raved-about infrared saunas are different in the way they heat the body up. “Hot coal saunas [aka those typically found at the gym] warms the surrounding air and causes you to become warm,” explains Alissia Zenhausern, N.M.D., a naturopathic physician at NMD Wellness of Scottsdale. “An infrared sauna uses infrared light to actually stimulate heat from the inside out,” she adds, suggesting that it’s like “a mini-fever [that] stimulates your body to detox.” Because of that, sweating it out in an infrared sauna can up the ante on your skincare.

“With your skin being not only the largest organ of your body but also a vital organ of detoxification, infrared sauna treatments will help you detox from environmental toxins leading to exceptional glowing skin,” says Zenhausern. In addition to glowing skin, detoxification can also help reduce acne because “the mild increase in body temperature that is seen with infrared sauna use can help kill bacteria that can cause acne,” notes Zenhausern. “The other reason it is helpful is because infrared sauna treatments help your skin properly detox and can help minimize clogged pores, areas where bacteria love to sit,” she adds.

The stimulation of sweat helps to improve blood flow and circulation, two necessities in targeting the look of cellulite. And, on top of that, an infrared sauna sweat sesh could help improve rosacea. While the heat from an infrared sauna might seem like the worst thing you can do for rosacea-ridden skin, its anti-inflammatory benefits (combined with the detoxification) actually help reduce the appearance says Zenhausern.

A sauna isn’t the only way to reap the benefits — infrared light facials are an excellent way to target concerns specifically on the complexion. Like the sauna, the infrared light helps kill acne-causing bacteria, helps decrease inflammation, and promotes detoxification for clearer skin.

What is an infrared sauna treatment like?
When you step foot into an infrared sauna, you will find that it has a similar look and feel to the hot coal saunas, only it uses light to trigger your body’s natural detox. According to Zenhausern, an infrared sweat sesh typically lasts around 30 minutes and can range in temperature from 110 degrees to 130 degrees. “Typically, if it is your first treatment, start slow at about 110,” she notes. “The idea is to stimulate sweating, not to make you feel distressed, so some people do just fine at 110 and do not need to increase the temperature for future sessions,” she adds.

As to how often you should sweat, Zenhausern says “the frequency of treatment varies depending on what you wish to address. Ideally, a 30 to 40-minute infrared sauna treatment can be done three times a week.” However, most people can hit the sauna once a week. “You will still see results with going weekly or monthly, but the effect will likely be less,” notes Zenhausern.

In your first sauna session, you might not sweat as much as you think as “the sauna warms you using infrared light [it] can take your body a little time to adjust, [which] is often why you don’t sweat during the first treatment,” explains Zenhausern. “Once your body understands what the infrared sauna is doing, sweating will occur.” After your infrared sauna treatment, Zenhausern recommends increasing your water intake. “Make sure to drink at least half your body weight in ounces. So, for example, if you weigh 135 pounds, drink roughly 67 ounces of water.”

Cryotherapy Benefits
On the opposite end of the spectrum, cryotherapy is another popular wellness treatment that boasts major benefits. “Cryotherapy is the practice of exposing the body to cold temperatures,” explains Lily Kunin, founder of Clean Market, a wellness center in New York City. “Whole body cryotherapy exposes the body to sub-zero temperatures of up to -220 degrees Fahrenheit in order to stimulate multiple physical benefits,” she adds.

Cryotherapy isn’t just for the body though, which is why cryotherapy facials — aka cryofacials — have become increasingly popular amongst beauty editors and skin care fanatics alike. If a full body experience in a cryotherapy sauna seems intimidating, this facial treatment may be for you. “When applied locally to the face, cryotherapy reduces inflammation, which can help stimulate collagen. Additionally, it can help reduce fine lines, clear acne and eczema, and reduce signs of aging,” notes Kunin. On top of that, some use the freezing temperatures as an alternative to Botox, or “Frotox,” as John Hoekman, founder of QuickCryo, says. Applying cryotherapy to the face “decrease[s] pore size, reduce[s] puffiness and dark circles, stimulates collagen and elastin production, and lifts and tightens the skin,” Hoekman notes. At Hershesons in London, you can experience the signature (and only) Sunday Riley facial. You have a choice of three treatments depending on skin needs: Ice Lift, Ice Clear and Ice Express. The common denominator? Cryotherapy is used in each to reduce inflammation and redness.

What is cryotherapy treatment like?
The cryo facial treatment uses “cryogenically-cooled air of up to -160 degrees Fahrenheit” to target the complexion and help aid in the reduction of said symptoms. “The skin on your face is much more sensitive and the benefits max out at -160F,” which is why the temperature is kept so low Hoekman notes. Unlike traditional facials, a cryofacial is a quickie. It lasts up to 12 minutes and can be applied to a full face of makeup. But, there is so much more to a cryofacial — and cryotherapy in general — than a blast of cold air to the face.

The treatment itself uses liquid nitrogen vapor to super-cool the skin, which “triggers neuro-receptors to stimulate the flight response in our bodies, [which] hyper-circulates blood, distributes nutrients and enzymes, and flushes out toxins,” explains Hoekman. The process sets off “a domino effect of anti-inflammatory factors and endorphins, as well as lowers cortisol [aka, the stress hormone],” he adds.

Cryotherapy on the body requires a little more preparation. Before going into a cryotherapy sauna, you will strip down (women can go in nude, men should wear boxer briefs for additional protection) and cover your hands and feet with socks and gloves. Then, you will enter the ice sauna chamber and begin a treatment of up to three minutes. The biggest misconception of a cryotherapy session is that you will experience a freezing sensation — the cryotherapy air lacks moisture, which means that you will feel cool but not uncomfortable. All in all, the many cold sauna benefits are definitely worth a quick chill.

Cryotherapy vs. Infrared Sauna
In the case of cryotherapy vs. infrared sauna, one is not exactly better than the other. As it turns out, these two treatments work together to maximize health benefits. According to Kunin, the two treatments can be used synergistically. “Hot and cold therapies have been used together for centuries,” she notes. “Both have their own unique benefits and using [the] contrasting temperatures can improve treatment of pain and inflammation, boost your immune system, improve blood flow and muscle movement, and encourage a deeper detox,” she adds. The practice of alternating between cryotherapy and infrared sauna treatments is similar to that of winter bathing in Scandinavian countries — aka the mix of hot and cold therapy Kunin references — and both have the similar benefits, only the modern technology of infrared and cryo can enhance them.

That said, using these treatments back-to-back can counteract the benefits of each. “Artificially heating yourself back up with a sauna after cryotherapy is cheating yourself of the great benefits,” says Hoekman. So, while you can benefit from adding both to your wellness and beauty regimen, spreading out your treatments is the best way to reap their benefits individually and together.

“That is truly all you need to maximize the benefits and feel great,” says Kunin. “[But,] as with any therapy, it’s a good idea to consult your doctor if you believe you may have a contraindication,” she adds.

 

$29 infrared session at GoCryo

I Spent 3 Minutes Inside a -264 Degree Cryotherapy Machine

“You may now start to hyperventilate and shiver uncontrollably,” I hear. Other than undergarments, I am wearing nothing but athletic socks and clogs on my feet, raw-wool mittens on my hands, and a post-concussive expression on my face. I am ensconced in a shoulder-height cauldron spewing nitrogen-iced air at minus-264 degrees Fahrenheit.  I’m about to try cryotherapy.

The woman talking is Joanna Fryben, co-owner of KryoLife, a year-old spot off Central Park South that specializes in whole-body cryotherapy — a three-minute treatment said to burn up to 800 calories, release an eight ball’s worth of endorphins, improve sleep, boost the immune system, reduce inflammation, smooth wrinkles, and solve the Israel-Palestine conflict.

Fryben is 40 — a Cameron Diaz 40. She has not been sick in four years, about the time it’s taken her to bring WBC from her native Poland (it’s popular and even covered by health insurance in much of Europe) to New York, where KryoLife is the only game in town.

But that may soon be changing. “When we opened our beta site in 2012, there were maybe six other cryotherapy centers in the U.S.; now there are at least 30,” Fryben notes. Dr. Aran Degenhardt, an integrative physician who’s referred chronic-pain patients to KryoLife, says he’s also noticed an uptick, “probably because there are more celebrities and high-profile athletes using it” — like Demi Moore and Kobe Bryant.

A framed article along KryoLife’s entryway touts Cristiano Ronaldo’s at-home cryotherapy chamber (the treatment, originally developed by a Japanese doctor in 1978 for rheumatoid-arthritis patients, has been more recently adopted by pro athletes seeking ice-bath-like recovery). But aside from jocks and joint-pain sufferers, Fryben’s broader goal is to target more self-help-inclined fools, like me, who have fit bands on their wrists and bone broth in their fridges.

A full minute into my deep freeze, I am neither hyperventilating nor convulsing, just feeling numb from the waist down. At these extreme temperatures, allegedly, the air no longer contains moisture, so cold does not penetrate the skin like it does in, say, Siberia; according to Fryben, three minutes or less in here is safer than a hot sauna. To distract myself from the cold that is penetrating, as I peer down from my perch inside what looks like an open-topped Coke can, I chat up Fryben like an undermedicated child: “Should I be standing very still?”; “Do you normally talk people through the three minutes?” I am short of breath. Words are coming out, but my face is not really moving.

And just like that, the three minutes are up. I emerge Godzilla-like from my enclosure feeling … wow, I did not expect to feel so great. I am gabbing relentlessly as Fryben guides me to an Airdyne bike, where I’ll spend the next five minutes warming up my muscles. My skin temperature has dropped to 32 degrees Fahrenheit, and science would suggest (although major cryotherapy studies are still in short supply) that my body has incinerated calories in the quest to restore homeostasis.

“Those are the endorphins,” Fryben explains when I ask about my Mountain Dew rush. “You went into a stressful environment, and your body reacts in a way to protect itself. The immune system is boosted, the lymphatic system moves, the blood is oxygenated — enzymes and nutrients are delivered to every part of the body.” Degenhardt likens this fight-or-flight response to a runner’s high.

People I meet at KryoLife speak to various other benefits. An arthritic client named Nicola says the swelling and pain in her hands have gone down significantly since she started coming here (she does batches of ten sessions punctuated by three-month breaks, the recommended course for jump-starting the nervous system). Eduardo Bohórquez-Barona, a KryoLife associate and former caffeine addict, says, “I’m Colombian; we need coffee. But if I do cryotherapy, I’m energized all day.” I would compare my own state of whole-body awesomeness to the afterglow of a fabulous colonic, with an added kick of adrenaline and a tighter-seeming complexion; co-workers later tell me I look like I’ve just been skiing.

Still, I decide that I would be more inclined to shell out the $90 per session if this place looked less like that unmarked tanning salon I frequented in college. (Fryben assures me that a cushier KryoLife outpost is planned to open downtown in the months ahead.) And then, of course, there are the risks: I had to change into fresh socks pre-sauna because any lingering moisture could cause frostbite. And Degenhardt noted that passing out is a possibility if your blood pressure gets too high or too low. KryoLife gives all clients a medical questionnaire and blood-pressure check, but in short: ­Consult your physician before freezing.

When my biking is done, Fryben explains that she doesn’t mandate this post-­treatment exercise for on-the-go New Yorkers. “But if this were L.A. or somewhere you’d be getting straight into a car, that wouldn’t be safe for the joints,” she says. “Because your body, you know — it gets frozen.”

This article appears in the January 26, 2015 issue of New York Magazine.

Book your cryotherapy session today:  https://gocryosd.com/booknow/

Cryogenic Chamber Therapy Has Some Serious Evidence That It Works Wonders For Recovery

Used by a laundry list of elite athletes including everyone from professional bodybuilders to olympians, UFC fighters, and even entire NBA teams, cryogenic chamber therapy is building a reputation as one of the most effective new recovery therapies currently available to athletes. With its growth in popularity WBC (Whole Body Cryotherapy) is becoming more accessible to the general public as more and more clinicians are adding chambers to their practices to use as a more effective alternative to cold water immersion or ice packs.

For bodybuilders? Quicker recovery means that you can lift heavy things more often. When you can prevent DOMS and quickly alleviate other aches and pains, that means you can train harder and more often with less downtime. But are these chambers the real deal, or just another fad?

What is cryogenic chamber therapy, anyways?

Cryogenic therapy is like The Jetsons equivalent to jumping into a garbage bin filled with ice water. Whole body cryotherapy was invented in Japan in the late 1970’s, but only started to gain traction stateside in the last few years with clinics opening up all over the country.

More and more weightlifters are starting to swear by it. A three minute session costs about as much as dinner for two at a mid-tier restaurant so you don’t have to be a pro athlete to afford it either, you just have to have your priorities in order.

How does cryotherapy work?

Once you’re inside the chamber, you’ll get a burst of nitrogen gas every thirty seconds or so. The freezing gas surrounds your entire body which causes your blood to rush away from your limbs and towards your core in an attempt to warm and protect your vital organs from an icy funeral. It puts you into survival mode, and fills your blood up with oxygen. When you step out of the chamber, your blood immediately rushes back to your arms and legs and you’ll feel a warm, almost tingly sensation. That means it’s working.

If you have a sports injury, whether it’s a contusion or a strain, the blood running to the core and then coming back to the limbs with oxygenated blood redevelops injured cells and helps you heal faster.

It’s no secret that ice and extremely cold temperatures help with recovery, the first thing you reach for when you hurt yourself is an ice-pack. Now imagine an ice pack for your entire body.

Quick facts:

The temperature of the nitrogen gas ranges from -166 F to -260 F.
The treatment lasts between 90 seconds and 3 minutes.
You are subjected to several short bursts of nitrogen gas, each lasting just a few moments.
Athletes report feeling much less sore in the days following an intense workout.
Notable fans of WBC include Usain Bolt, Steve Kuclo, Cristiano Ronaldo (Bought a chamber for his home), Kobe Bryant, UFC welterweight champ Johny Hendricks, and many more.
Notable Scientific Findings Related To Athletic Recovery:

Effect of whole body cryotherapy on the levels of some hormones in professional soccer players.
Whole body cryotherapy leads to a significant decrease in serum T and E(2), with no effect on LH and DHEAS levels. As a results of cryotherapy, the T/E(2) ratio was significant increased. The changes observed are probably due to cryotherapy-induced alternation in the blood supply to the skin and subcutaneous tissue, as well as to modulation of the activity of aromatase which is responsible for conversion of testosterone and androstenedione to estrogens.

Time-course of changes in inflammatory response after whole-body cryotherapy multi exposures following severe exercise.
Overall, the results indicated that the WBC was effective in reducing the inflammatory process. These results may be explained by vasoconstriction at muscular level, and both the decrease in cytokines activity pro-inflammatory, and increase in cytokines anti-inflammatory.

Cryotherapy effective for treating frozen shoulder
In patients with adhesive capsulitis (AC) of the shoulder, the addition of whole-body cryotherapy (WBC) to physical therapy and joint mobilization appears to be more effective than the latter two alone, research shows.
Indeed, patients receiving additional WBC achieved “clinically significant” improvements of over 20% relative to the physical therapy and mobilization group, suggesting it could become “the preferred treatment strategy,” according to Hyeong-Dong Kim (Korea University, Seoul) and colleagues.

There was even a study to determine if whole body cryotherapy (WBC) could be an effective treatment for anxiety. Despite a small sample size, the results were encouraging.

Continued on the next page…

Cryochamber vs Cryosauna

The difference between a cryochamber and a cryosauna is simple. With a cryosauna, your head sticks out of the top and you’re not completely isolated inside, as opposed to the chamber which you step into and it is sealed off. The chamber allows for a more uniform distribution of temperate, in other words your face will be freezing cold along with the rest of you.

Cryogenic Therapy in MMA

Joe Rogan (who we last mentioned when he was talking trash about modern bodybuilding) is an evangelist for cryogenic chamber therapy and has personally played a role in influencing many people to try it out for themselves, including UFC heavyweight Brendan Schaub who said “I usually do ice baths between training sessions, but the set-up is such a hassle. Cryo is convenient and it brings my recovery to another level. Cold as hell, but it works!”

Welterweight Champion Johny Hendricks says “3 minutes to make my body feel good? I’ll do anything for 3 minutes.”

For athletes in any sport, proper recovery is essential in order to prevent injuries. Preventing injuries means more training, and more training means better performance. Even if you aren’t an elite level athlete, cryogenic chamber therapy can help with reducing inflammation and pain.

 

Book your cryotherapy session today:  https://gocryosd.com/booknow/

A blast of cold jump-starts fat burning and generates body heat

Looking for a silver lining in the cold that’s gripping much of the country? The next time an icy blast of wind cuts through your flesh, remind yourself that it is also stimulating the growth and activity of brown fat, the so-called good fat that burns calories and produces heat.

Located in your chest and back, brown fat’s job is to protect your vital organs which, in winter, means giving you a way to generate additional heat for them. It’s more prevalent in newborns and hibernating animals, whose need for warmth is greater, but researchers discovered about five years ago that adults have some, too.

In contrast to white, or “bad,” fat, which stores energy as those bulges you’re trying to eliminate at the gym, brown fat is full of mitochondria, the glucose-burning power plants of cells, which give brown fat its color. People with more brown fat tend to be leaner and have lower blood sugar levels.

It takes a little time in the cold to crank up the brown fat, but temperatures don’t have to be down at the Polar Plunge level. When researchers exposed people to temperatures of 59 to 60 degrees for two to six hours over 10 consecutive days, they found immediate increases in brown fat activity. In another study, men who slept in rooms for a month at 66 degrees increased their brown fat and its activity by 30 percent to 40 percent. When the night-time temperature was raised to 80 degrees for another month, their brown fat stores declined below baseline levels.

This information has intrigued researchers who wonder whether stimulating brown fat might help in the battles against obesity and Type 2 diabetes.

How does this work? In a study released Thursday, University of California, Berkeley, researchers said they had identified the protein critical to the formation of brown fat. Exposure to increased levels of “transcription factor Zfp516” helped mice gain 30 percent less weight than other mice when both were fed the same high-fat diets. They also found that it helped “brown” that nasty white fat, though other researchers did not report this result.

In an interview, Hei Sook Sul, who led the research, said that in the laboratory, the same process worked on human cells, though the process has not been tested in humans themselves.

She said it’s impossible to determine how long an individual needs to be in the cold to kick-start the process, but recommended giving it a try at safe exposures.

“Get out,” said Sul, a professor in the university’s Department of Nutritional Science and Toxicology. ” The more you do it, the more energy you will lose.”

Originally posted at the Washington Post

 

Book your cryotherapy session today:  https://gocryosd.com/booknow/

Cryotherapy: Why Pro Athletes Like It Chilly

The traditional ice bath isn’t so cool anymore. These days, professional athletes are opting for a treatment that sounds more like sci-fi torture: whole-body cryotherapy.

Here’s how it works: You stand in a cylindrical chamber for about two and a half minutes. Hyper-cold air is released all around your body, bringing the temperature down to as low as 300 degrees below zero.

It’s a similar concept to an ice bath, but the benefits, many athletes say, are far better. Texas Rangers’ pitcher C.J. Wilson is a regular, and several members of the Dallas Mavericks credit this year’s NBA Championship win in part to their cryotherapy treatments. One athlete compared it to standing in a giant Red Bull can with your head poking out.

Eric Rauscher is the managing director of Millennium Ice, a company that manufactures whole-body cryotherapy chambers in the U.S.

“We’re taking skin-surface temperature to 30 degrees in less than a minute,” he says. “The body literally gives up trying to regulate skin-surface temperature, instead drawing the blood to the core to protect the core.”

When the blood is in the core, Rauscher says, it picks up oxygen and nutrients, since the body “feels like it’s in massive distress.”

“It’s really not,” he adds, “but it feels like it.”

At the end of the 2.5-minute session, the brain figures out where to send the blood first.

In the case of the Dallas Mavericks players, he says, fatigued leg muscles were getting oxygen-rich blood. “They were stepping out of the device essentially with instant recovery effects.”

Rauscher has tried cryotherapy himself. He says he’s been using it every other day over the course of a month. “Although it’s cold, it’s not that excruciating cold that an ice bath feels like.”

Rauscher says his own company spent months monitoring athletes and looking for the placebo effect.

“Every single athlete that we worked with told us that it produced a change, it produced a recovery like they hadn’t felt,” Rauscher says. “You’ll see this in training rooms around the country.”

Original Article posted at npr.org

 

Book your cryotherapy session today:  https://gocryosd.com/booknow/

How going in a -130 degree chamber could help your body…

To most people being in a -130 degree chamber like structure for three minutes doesn’t sound so appealing, but if you have some muscle aches and pains, inflammation in your body or even some extra pounds you want to shed, maybe you should think again.

Whole Body Cryotherapy (WBC) is a holistic wellness solution that enables the human body to recover and rejuvenate itself naturally. During cryotherapy, the body is exposed to extremely low temperatures (for one – three minutes) to trigger the body’s most powerful mechanisms of self-protection, self-recovery and self-rejuvenation.

Thrive CryoStudio in Rockville, Maryland specializes in Cryotherapy. The studio has seen over 1,400 clients and has conducted over 5,000 cryotherapy sessions. I sat down with owner Brandon Yu to get the 411 on what cryotherapy is and the science behind this new craze.

How does cryotherapy work? 

Whole Body Cryotherapy uses ultra-cooled nitrogen gas application to lower the client’s skin temperature to 30 degrees fahrenheit for one to three minutes. At first, your body reacts like it normally would if you were standing outside on a cold day, by increasing circulation in your body to try and warm your body up. After about 45-60 seconds, your body realizes that it’s not doing an effective job of warming up, due to the continuous nitrogen vapor hitting your skin.

Next, as the thermoreceptors in the skin send messages to the brain and central nervous system the body goes into “Survival Mode” by sending hyper-oxygenated and nutritious blood via vasoconstriction to the body’s vital organs in its core. After exiting the ultra-cooled environment, the body begins to warm to its natural temperature and vasodilation occurs, sending the oxygenated and nutritious blood back out to the body’s periphery. This process provides the body with extra nutrients, rids the body of toxins, produces collagen, and activates the body’s natural cell regeneration cycle to produce newer, healthier cells.

What are some of the benefits?

As this is a holistic wellness treatment, there are a wide ranging amount of benefits to cryotherapy, as long as the client sticks to their recommended treatment plan. We like to group the benefits into three main categories:

Sports & Fitness:

  • Accelerates muscle recovery
  • Increases energy
  • Reduces muscle soreness and inflammation
  • Relieves tendonitis pain
  • Improves muscle strength and joint function
  • Quickens recovery time from injuries
  • Increases athletic performance

Health & Wellness:

  • Reduces inflammation in the body
  • Helps relieve back pain, joint pain, knee pain and general pain and tightness throughout the body
  • Alleviates symptoms of arthritis, Lymes disease, fibromyalgia
  • Reduces effects of skin conditions like psoriasis and eczema
  • Reduces severity of migraine headaches
  • Increases blood circulation and provides a quicker recovery time from surgeries and physical therapy

Mind, Mood & Beauty:

  • Increases metabolism and burns calories (between 500-800 calories)
  • Promotes better quality sleep
  • Increases endorphin levels and boosts mood
  • Increases collagen production and reduces the appearance of cellulite
  • Accelerates weight loss (with proper diet and exercise)

How should your body feel immediately after, an hour or two after, and about 24 hours after?

Cryotherapy is not a magic pill, so individuals should not expect to feel “like a new person” or a huge dramatic difference after their first session. However, after a single session, clients can expect to feel a bit looser and relaxed. They might even have temporary relief from some minor pain they were experiencing (for more consistent pain, it’ll take multiple sessions). Additionally, clients can expect to fall into one of two buckets on how they’ll feel the rest of the day. They will feel either 1) super energized and feel like they’re ready to take on whatever comes their way during the day, or 2) they’ll feel super relaxed, calm and even may want to take an afternoon nap. Both of these responses are normal. Additionally, clients may notice a much better nights sleep the night of their cryotherapy treatment.

With regards to benefits that are more noticeable, on average it takes about eight sessions for a client to feel a “noticeable” difference in their pain levels, muscle recovery, etc. As I mentioned, it’s not a magic pill, but if done consistently, most of clients have seen tremendous results!

How often do you recommend someone get cryotherapy?

The recommended frequency for someone to get cryotherapy honestly varies from person to person and condition to condition. At Thrive CryoStudio, we really take the time to listen, educate and consult each client that walks into the door to recommend a tailored cryotherapy treatment plan for his or her condition. We also monitor their progress and how the client feels after each cryotherapy session in case we need to tweak their frequency. With that being said, we have some clients that come everyday and others that come once every two weeks.

Who is the ideal candidate for cryotherapy?

Many people associate the use of cryotherapy with professional athletes or even on “The Real Housewives” because that’s where they’ve seen it. With that being said, most of your everyday people can benefit from cryotherapy. For the high school athletes to the middle-aged runner, cryotherapy will greatly benefit them in their muscle recovery, while reducing inflammation in their joints from the wear and tear they’re putting on their body.

Also, for those individuals that are suffering from nagging neck, back, hip, knee or any other pain, cryotherapy will greatly benefit them.

Any risks clients should be aware of? 

Cryotherapy can raise your blood pressure. We check all clients’ blood pressure immediately prior to each of their sessions and will not allow them to proceed if their blood pressure is too high. In addition, clients must keep their heads and chins up while in the cryotherapy tank to avoid breathing in the nitrogen fumes which can cause lightheadedness. At Thrive Cryostudio, a therapist is with our clients throughout their treatment session, constantly engaging them in conversation to ensure they don’t experience any adverse side effects. If there is any concern, the treatment is stopped immediately.

What’s one misconception about cryotherapy you’d like people to understand?

Cryotherapy is not a magic pill. Its benefits are wide reaching and include everything from weight loss to pain management to improved sleep, anxiety and skin. However, while many clients have a post-treatment euphoria and a report increased energy after only one session, it typically takes several sessions to reap the greatest benefit.

 

Story by TINA IRIZARRY – Originally posted at dcrefined.com

Cryotherapy: Is it the coolest thing in sports medicine?

I am standing inside an upright tank, my head sticking out the top. I’m wearing skivvies, booties and glovies. A dry-ice-like fog of liquid nitrogen wafts, swirling under my chin. The temperature is quickly dropping, on its way to a brisk 190 degrees below zero.

Questions arise in my mind. Will I survive the full three minutes, or will I tap out? The tank has an escape door, but what if it freezes shut? Was there a fur-lined cup they forgot to have me put on? I’m trying to keep a stiff (but not frozen) upper lip, I don’t want to become known as the guy who put the “cry” in cryotherapy.

“Here we go,” says Amanda, the cryo tank operator, cheerfully. Gleefully? “Three minutes!”

I wonder if that’s what they said to Ted Williams, whose head is cryogenically frozen in a tank in Arizona. What if my family learned I have a terminal disease, but they don’t want to tell me, and this is their way of tricking me into being frozen until a cure is found?

They say the Kentucky Derby is “the most exciting two minutes in sports.” Cryotherapy, at least the first time, is the most exciting three minutes.

Am I overdramatizing? Probably.

Whole-body cryotherapy (WBC) is increasingly popular and, as far as my research shows, without serious risk. Athletes love the treatments. Warriors Stephen Curry, Andre Iguodala and Shaun Livingston get tanked. Several A’s are users, and Jalen Richard, the Raiders’ second-year running back and kick returner, told me that roughly one-third of the Raiders use WBC. The Raiders as a team have open accounts at several Bay Area cryo studios.


WBC is not new. It was developed more than 30 years ago by a Japanese fellow seeking an effective treatment for rheumatoid arthritis. In recent years it has become a full-blown fad in sports, for elite athletes and weekend warriors.

In theory, WBC works like an ice bath, but (some say) better. Three minutes in the cryo tank knocks down inflammation and speeds healing of sore muscles and assorted injuries.

Commercial cryo spas, along with touting the anti-inflammation aspect, claim user benefits such as weight loss, skin and hair rejuvenation, anti-aging, sleep enhancement, metabolism boost and a natural buzz.

These spas claim that rather than freezing your assets off, you will freeze your liabilities off.

Maybe, maybe not. The website Skeptoid said in 2014, “P.T. Barnum would be proud of cryosauna and cryotherapy. Save your money.”

The same website did allow that WBC, in treating sore muscles and inflammation, is at least as effective as ice baths and cold-water swims, albeit more expensive. Are the skeptics too skeptical? The jury is out. The FDA does not endorse or monitor WBC.

But what many athletes believe they find in cryotherapy is a safe, fast and effective treatment for pain and inflammation. If ice bags strapped to knees are effective post-workout treatment, why not a super-duper-cold dry-ice-down quickie for the whole body?

“When I go in now and I’m real sore, there’s definitely a soothing feeling,” said Richard, who gets his cryo on several times a week. “It’s more soothing and relaxing to me than it is freezing cold,” like ice baths are.

Richard can recite the alleged scientific theory behind cryo. Basically, the intense cold tricks your brain into survival mode. Heavier blood flow is directed to the body’s core, sending extra oxygen and nutrients to the brain and other organs. Once you escape — uh, emerge — from the cryo tank, the blood immediately starts returning to the skin and extremities, accelerating (allegedly) cell renewal in the skin.

The process also (allegedly) releases endorphins, boosting your mood.

“When I get out of there,” Richard said, “within a couple of minutes I start feeling great, like I’m brand new all over again.”

For the sake of journalism, I decided to give it a whirl. My wife had been gifted a three-week course by a co-worker, and she passed it along to me. I went nearly every day. I’m probably not a good guinea pig, since I’m not a stressed and battered athlete. I do have rheumatoid arthritis, but it’s controlled by meds, so if cryo did help knock down my RA, I wouldn’t really feel it.

Still, let’s see what it’s all about. By coincidence, for a week before the first treatment, I suffered a bout of sciatica, a nerve condition that made it painful to sit in a car or at a desk.

There is a fear factor — call it trepidation — as I approach my first treatment. Later, Richard told me he was nervous the first time, too. I don’t want to chicken out. When you soak a sore foot or ankle in ice water, the cold can be intense and painful. What if it’s like that over my whole body, and I wimp out?

Inside the storefront studio in Walnut Creek I am instructed to step into a dressing room, strip down to undershorts, put on gloves and rubber booties, and a robe. Then I step into the cryo chamber, hand Amanda my robe, and she cranks up her high-tech ice-cream churn.

It is cold almost instantly. But at no point is there a painful, whimper-inducing shock, like a plunge into a cold ocean. It’s minus-190 or so, but hey, it’s a dry cold.

Amanda engages me in small talk, which definitely helps. Then, “Halfway there, doing OK?”

Diversion is the key. I try to come up with a Cryotherapy All-Star team. I get George “Iceman” Gervin, Red “The Wheaton Iceman” Grange, the old Pirates infielder Gene Freese, Vida Blue, Larry Burright, Stone Cold Steve Austin, J.T. Snow, Cool Papa Bell and Chili Davis.

Every 20 seconds or so Amanda instructs me to take a quarter turn. To get a nice, even blue skin tone, I guess.

The last minute is the coldest, but my overcoming-childish-fear endorphins are kicking in and I know I’ll make it.

“All done,” Amanda says, hitting the kill switch. The robe goes back on, I step out, Amanda shoots a laser at my leg to register skin temp.

Am I now desperate to sprint to the nearest hot tub, sauna or hot-chocolate dispenser? No, once out of the tank, I feel fine. No lingering cold.

What about the cryo-buzz from that endorphin stampede? Again, I’m probably the wrong guy. I don’t get endorphin rushes from exercise. But now I do feel energetic and wide awake.

Driving home, I notice that I am sitting with little discomfort. About a week later the sciatica symptoms are gone. Coincidence? I don’t know.

Within a few days I work up to Level 3, Ted Williams’ neighborhood. Richard told me that he not only does Level 3 but that he also jacks the temp even lower by having the attendant pre-cool the chamber. I did that once, and it got my attention. The last 30 seconds, I went to my Lamaze breathing.

Does cryotherapy work? Is it a miracle cure? Other than the sciatica relief, I seemed to feel a little less creaky in the joints, and a bit energized after the sessions. If not miraculously healed, I felt way cooler.

Story by Scott Ostler – Originally posted at sfchronicle.com

 

Book your cryotherapy session today:  https://gocryosd.com/booknow/

Whole-Body Cryotherapy in Athletes: From Therapy to Stimulation. An Updated Review of the Literature

Abstract
Nowadays, whole-body cryotherapy is a medical physical treatment widely used in sports medicine. Recovery from injuries (e.g., trauma, overuse) and after-season recovery are the main purposes for application. However, the most recent studies confirmed the anti-inflammatory, anti-analgesic, and anti-oxidant effects of this therapy by highlighting the underlying physiological responses. In addition to its therapeutic effects, whole-body cryotherapy has been demonstrated to be a preventive strategy against the deleterious effects of exercise-induced inflammation and soreness. Novel findings have stressed the importance of fat mass on cooling effectiveness and of the starting fitness level on the final result. Exposure to the cryotherapy somehow mimics exercise, since it affects myokines expression in an exercise-like fashion, thus opening another possible window on the therapeutic strategies for metabolic diseases such as obesity and type 2 diabetes. From a biochemical point of view, whole-body cryotherapy not always induces appreciable modifications, but the final clinical output (in terms of pain, soreness, stress, and post-exercise recovery) is very often improved compared to either the starting condition or the untreated matched group. Also, the number and the frequency of sessions that should be applied in order to obtain the best therapeutic results have been deeply investigated in the last years. In this article, we reviewed the most recent literature, from 2010 until present, in order to give the most updated insight into this therapeutic strategy, whose rapidly increasing use is not always based on scientific assumptions and safety standards.

Introduction
Local and systemic cold therapies (cryotherapies) are widely used to relieve symptoms of various diseases including inflammation, pain, muscle spasms, and swelling, especially chronic inflammatory ones, injuries, and overuse symptoms (Bettoni et al., 2013; Jastrzabek et al., 2013). The beneficial effects of cold as a therapeutic agent have been known for a long time, with ancient population aware about the reinvigorating effects of cold water either taken orally or used for baths. The use of cold, mainly locally, still remains in our daily common activities. A still up-to-date survey of a sample of Irish emergency physicians highlighted the fact that 73% of consultants frequently “prescribe” cold, 7% never suggest to use cryotherapy, and 30% is unsure about the benefits of using cold. Experience (47%) and common sense (27%) were the most frequently declared reasons for using ice, while only 17% referred to scientific reasoning (Collins, 2008).

Forty years ago, following personal observations of Prof. Toshiro Yamauchi (who recognized that the combination of cold and physical exercise was beneficial for clinical outcomes of treatments received by his patients’, affected by rheumatoid arthritis, coming back from mountain localities after winter holidays), whole-body cryotherapy was introduced into clinical practice (Yamauchi et al., 1981a,b).

At present, the use of very cold air in special, controlled chambers may be proposed for treating symptoms of various diseases (Bouzigon et al., 2016). Beside its clinical applications, a brief full body exposure to dry air at cryogenic temperatures lower than −110°C has become widely popular in sports medicine, often used to enhance recovery after injuries and to counteract inflammatory symptoms resulting from overuse or pathology (Furmanek et al., 2014). The number of studies about the use of whole-body cryotherapy (WBC) in sports medicine is growing, however, it is still lower than the topic’s potential if the wide range of application of this methodology is considered. Studies published on athletes had mainly focused on post-training or competitive season recovery. Only a limited number of papers had investigated the effects of WBC used in preparation phase for competitive season to enhance form and performance, or during periods of high intensity of training to limit overuse and overreaching. Studies should be acknowledged to define safety, effectiveness, and efficacy of the treatment in athletes and to discover underlying molecular mechanisms supporting the claimed beneficial effects.

This review article collects the most recent literature (since 2010, Banfi et al., 2010b) on whole-body cryotherapy with the purpose of delivering a complete and updated overview of the newest findings and the directions taken in research in this field. In particular, given the high number of new scientific findings mostly associated with great technological developments of this therapeutic method, this review discusses both technical aspects (i.e., therapeutic protocols, contraindications, thermoregulatory responses) and effects on a wide range of physiological (i.e., hematological, metabolic, energetic, endocrinological, skeletal, muscular, inflammatory) and functional parameters (post-exercise and post-traumatic recovery, pain, performance). We are aware of the limitations of this literature review. Almost all published research included in this review discuss results of using whole-body cryotherapy without providing any insight into molecular mechanisms involved in observed responses to the treatment. Also, although the review takes a non-systematic approach, an alternative meta-analysis would only offer a limited article coverage due to the type and, sometimes, the quality of available papers. Furthermore, we only reviewed reports on the WBC procedures performed in cryochambers (regardless of the cooling system, but considering the operating temperature); we do not consider treatments performed in cryosauna (also named cryocabins). Exposure to cold in a cryosauna cannot be deemed whole-body since during the treatment the head remains outside of the cabin. The two settings were concluded to, activate different molecular pathways and, possibly, exert different outcomes. Indeed, in a cryosauna, cooling is delivered through direct insufflation of liquid nitrogen vapors into the box. Free vapors are heavy and tend to remain within the cabin, below the chin; contrarily, in a nitrogen-cooled cryochamber liquid nitrogen fluxes through pipes inside the chamber’s wall, and thus, there is no free nitrogen within the chamber. These differences also account for different safety standards of these treatments: free nitrogen vapor in a cryosauna could be potentially hazardous due to the risk of asphyxia.

In the present paper we refer to “whole-body cryotherapy,” which is the most commonly used term to define the methodology, but also to “whole-body cryostimulation,” which better describes effects of WBC in improving the metabolic and inflammatory responses as well as in enhancing recovery from exercise and injuries. In contrast, the term “cryotherapy” refers to a real therapy aimed at treating painful symptoms of inflammatory or traumatic conditions.

Technical aspects
Standardized protocol for WBC

WBC is performed in special chambers, with the temperature and humidity strictly controlled. A subject, minimally dressed (for e.g., bathing suit, socks, clogs, headband, and surgical mask to avoid direct exhalation of humid air), enters a vestibule chamber at −60°C, where he stays for about 30 s of body adaptation and then passes to a cryochamber at −110° to −140°C, depending on the cooling system (electrical or nitrogen), where he remains for no more than 3 min. It is mandatory to remove any sweat before entry to avoid the risk of skin burning and necrosis. Access to the chamber is allowed only in the presence of a skilled personnel, controlling the procedures. A patients is free to leave the chamber at any time.

Contraindications

Being a medical therapy, WBC should follow strict guidelines and indications. Currently accepted contraindications for WBC include: cryoglobulinaemia, cold intolerance, Raynaud disease, hypothyroidism, acute respiratory system disorders, cardio-vascular system diseases (unstable angina pectoris, cardiac failure in III and IV stage according to NYHA), purulent-gangrenous cutaneous lesions, sympathetic nervous system neuropathies, local blood flow disorders, cachexia, and hypothermia, as well as claustrophobia and mental disorders hindering cooperation with patients during the treatment. When performed in the appropriate and controlled conditions, WBC is a safe procedure, which was demonstrated to be deleterious neither for lung (Smolander et al., 2006) nor heart function (Banfi et al., 2009a); however, recorded observation of a very slight, clinically irrelevant increase in the systolic blood pressure (Lubkowska and Szygula, 2010) justifies precautions indicated for patients affected by cardiovascular conditions.

Temperature changes

Studying body temperature modifications following WBC, in comparison to changes observed in response to other cooling techniques, represents a hot topic. This is thought to be important since cooling effectiveness is the function of temperature decrease within a certain range.

Shifts in skin temperature (Tsk) of chosen body regions monitored by thermography and contact thermometry, before and immediately after a single WBC session (30 s at −60°C, 3 min at −120°C) showed, for the first time, the influence of body mass index (BMI) on the range of alternations. The highest magnitude of temperature changes was observed within lower extremities (tibias: −8.7°C; feet: −5.2°C), the mean total body temperature decreased by 5.8°C, while the internal body temperature dropped only by 0.8°C. The mean changes of temperatures at different sites correlated with BMI (r = −0.46); for example, explicative images show that temperature decreased down to 8.1° and 7.9°C in a thin volunteer (BMI <25 kg/m2) and down to 4.8° and 5.5°C in an obese participant (BMI > 30 kg/m2), in the chest and back regions, respectively (Cholewka et al., 2012). Even more precisely than BMI, the fat-free mass index (FFMI: fat-free mass/height2) and body fat percentage in males were both found to correlate with changes in skin temperature following WBC, (Hammond et al., 2014). Body composition was, thus, observed to be one of the main determinants of potential temperature changes and, possibly, of therapy’s effectiveness. Cooling efficacy, indeed, differs between males and females as demonstrated by Hammond et al.; however, despite females having higher levels of adiposity than males, they experience greater mean temperature changes compared to males (12.07 ± 1.55°C vs. 10.12 ± 1.86°C). Compared to males, females have 20% smaller body mass, 14% more fat, 33% smaller lean body mass, and 18% smaller surface area, a higher subcutaneous to visceral fat ratio and a smaller ratio of fat mass index (FMI) to FFMI. Furthermore, females’ BSA-to-mass ratio is higher than males, and the heat loss increases proportionally to this ratio. Under cold stress, females have a more extensively vasoconstricted periphery, with greater surface heat losses and show a significantly reduced sensitivity of the shivering response. Taken together these evidences could explain the discrepancy in cooling efficiency between sexes (Hammond et al., 2014).

Costello analyzed reduction in skin, muscle (vastus lateralis, at 1, 2, and 3 cm) and rectal temperatures following a single exposure to either WBC (−110°C) or cold-water immersion (CWI, at 8°C). Immediately after these procedures, the maximum drop in Tsk was observed with WBC (−12.1 ± 1.0°C), marking a bigger drop compared to CWI (−8.8 ± 2.0°C). On the contrary, core (−0.3° to −0.4°C) and muscle (−1.2° to −2.0°C) temperatures shifted slightly with no differences between the two treatments and the maximum decrease occurring after 60 min (Costello et al., 2012b). Similar results were obtained on changes in Tsk at the patellar region; a greater drop was observed with WBC immediately after the procedure, while 10–60 min after the treatment a lower temperature was reached with CWI (Costello et al., 2014). Interestingly, the authors had set the question whether or not either WBC or CWI were capable of achieving the Tsk (<13°C) believed to be required for analgesic purposes (Bleakley and Hopkins, 2010), yet they concluded that this temperature was reached by neither of the two procedures (Costello et al., 2014). Zalewski et al. confirmed that the maximum drop in core temperature occurred 50–60 min post-WBC (Zalewski et al., 2014).

In a systematic review, comparing 10 controlled trials, considering either a 10 min-long ice pack application, 5 min CWI, or 2.5–3 min WBC (−110° to −195°C), the authors illustrated that the largest reduction in Tsk was obtained by the ice pack application due to the higher heat transfer constant (k = 2.18) compared to water (k = 0.58) and air (k = 0.024). The obtained results confirmed negligible intramuscular temperature variation regardless of the cooling modality as well as importance of adiposity in determining cooling efficiency (k = 0.23 vs. k = 0.46 of muscles; Bleakley et al., 2014).

In summary, the following reports have been made about the WBC treatment:

– WBC is a medical practice that must be performed in specialized facilities under supervision of a well-trained personnel.
– WBC has contraindications that must be considered before prescription.
– Cooling efficiency and, possibly, treatment effectiveness can be influenced by body composition.
– Due to differences in body composition, cooling efficiency is potentially greater in females than in males.
– WBC effectiveness in lowering Tsk exceeds that of CWI; muscle and core temperatures seem to decrease in a similar way in response to both treatments.
– The maximum decrease in core temperature has been noted 50–60 min post-WBC.
Go to:
Hematology
The study of hematological response to WBC allows to define a wide range of effects covering modification of oxygen supply potential, inflammatory response, and coagulation function.

Erythrocytes and hemoglobin

We studied hematological parameters, including iron metabolism ones, in 27 athletes belonging to National Italian Rugby Team, during a summer camp (Lombardi et al., 2013a). Two daily sessions of WBC (3 min, −140°C) were performed for seven consecutive days, one in the morning before the first training session, the second in the evening after the second training session. Athletes were strictly controlled for diet, especially the correct iron uptake. A typical plasma volume shift due to a prolonged training session of aerobic exercises was taken into account when interpreting the results. Among hematological parameters, erythrocytes (RBC), hematocrit (Ht), and hemoglobin (Hb) decreased noticeably; particularly, Hb decreased from 15.06 ± 0.84 to 14.70 ± 0.62 g/dL. Red cell distribution width (RDW) increased, indicating a rise of anisocytosis of RBC, although reticulocytes were stable, but the immature fraction of reticulocytes (IRF) was significantly decreased (Lombardi et al., 2013a). A decrease of hemoglobinization could be a specific feature of the WBC treatment. Indeed, a similar decrease of Hb (about 0.3 g/dL) and IRF had been previously reported in rugby players, however, in that case, RBC and Ht had not been affected (Banfi et al., 2008). This difference could be attributable to a milder WBC protocol, with only five WBC (one per day, at −110°C). The decrease in the levels of Hb as well as RBC and Ht, is transitory and it recovered during continuative treatments as demonstrated by Szygula and colleagues in a study performed on students of the Polish National Military Academy, who can be considered physically active subjects, continuously performing exercises and controlled for variables as diet and lifestyle (Szygula et al., 2014). Recruited cadets were divided into two groups of 15 subjects; one group was treated with WBC, the other did not receive the treatment. Hematological parameters were measured after 10, 20, and 30 sessions, which were performed daily in a cryochamber at −130°C, for 3 min. After 10 sessions, Hb decreased from a mean of 15.1 ± 0.74–14.4 ± 0.94 g/dL and remained at this concentration after 20 sessions (14.5 ± 0.71 g/dL). It then rose to 15.1 ± 1.1 g/dL after 30 sessions. Similar changes were observed for Ht and RBC. The decrease of Hb, RBC and Ht lasted through 20 sessions of the WBC treatment; then the bone marrow reacted by releasing new RBCs (Szygula et al., 2014). A decrease in Hb and RBC was already described in elite Polish field hockey players after 18 sessions of WBC (Straburzyńska-Lupa et al., 2007). Hb also showed a decreasing though not statistically significant trend, dropping from 15.0 ± 1.0 to 14.4 ± 0.8 g/dL, in nine collegiate physically active subjects, who had completed 30 min step up/down exercise, aimed at inducing delayed-onset muscle soreness (DOMS), and had been treated with two daily WBC sessions for 5 consecutive days. In opposite, the control group, which had undergone the same DOMS-inducing training without the WBC or any other recovery treatment, experienced stable levels of Hb (Ziemann et al., 2014). Nevertheless, some data revealed that Hb and RBC were stable in 12 professional tennis players, following 10 sessions of WBC applied twice a day, at –120°C for 3 min, over 5 days, during a controlled training camp (Ziemann et al., 2012) as well as in 16 kayakers treated twice a day for the first 10 days of a 19 day physical training cycle (Sutkowy et al., 2014). It is thus, possible that shifts in Hb and RBC induced by WBC are dependent on the discipline and baseline hematological profile. This issue, however, still has not been investigated. Mean curpuscular volume (MCV) grew following the WBC treatment applied in rugby players and in field hockey players (Straburzyńska-Lupa et al., 2007; Lombardi et al., 2013a); in the latter group values of MCV, mean curpuscular hemoglobin (MCH), and of mean curpuscular hemoglobin concentration (MCHC) remained elevated up to a week after the end of the treatment (Straburzyńska-Lupa et al., 2007).

A slight dehemoglobinazion has two direct consequences. Firstly, since the OFF-score, a parameter used to calculate the probability of blood doping in athletes, depends on Hb concentration and Ret count (Sottas et al., 2010; Robinson et al., 2011; which remained stable), WBC may reduce the result of this score and, thus, cannot be considered a performance enhancing practice. On the other hand, the use of WBC to mask illicit practices is unjustified because the potential decrease in Hb is too small and the change itself is short-lasting and/or temporary (Lombardi et al., 2013a). Secondly, the decrease in Hb and RBC should be considered when the timeline of recovery strategies, within a competitive season, is drawn.

Iron metabolism

Martial status was not modified after the treatment in 27 rugby players submitted to two daily WBC sessions for 7 consecutive days (Lombardi et al., 2013a). Only soluble transferring receptor (sTfR) increased significantly, but not pathologically, possibly demonstrating initial high functional iron demand (Lombardi et al., 2013b). Similar results were obtained in a more recent paper by Dulian and colleagues. Regardless of the fitness level, in a cohort of obese subjects (BMI > 30 kg/m2), serum iron and ferritin remained unchanged after the 1st and 10th WBC session. Only hepcidin, a hepatocyte-derive peptide hormone mediating iron depletion in inflammation (Lombardi et al., 2013b), decreased moderately (Dulian et al., 2015).

Hemolysis

WBC enhances hemolysis, which could explain the Hb decrease during initial phase of the treatment. A decrease of haptoglobin, scavenger protein for free Hb released from broken RBC was described in the above-mentioned paper by Szygula and co-workers, after 10 and 20 WBC sessions, but a recovery appeared after 30 sessions, following the changes in Hb and RBC. Contemporarily, bilirubin increased, reflecting Hb catabolism. Hemolysis stimulated release of erythropoietin (EPO), which increased by 4.5% compared to baseline after 10 sessions, and further by 10.8 and 10.1% after 20 and 30 sessions, respectively, possibly supporting the recovery of RBC number after the initial decrease. Even in the case of EPO, the shifts in concentrations remained within physiological ranges (Szygula et al., 2014).

Leukocytes

Levels of leukocytes did not show any changes after 14 sessions of WBC (twice a day, over 7 days) in the group of 27 rugby players, belonging to National Italian Rugby Team, studied during a summer camp (Lombardi et al., 2013a). The same was found for the group of 16 kayakers treated twice a day for the first 10 days of a 19 day physical training cycle (Sutkowy et al., 2014).

At the same time, leukocytes increased in the students of the Polish Military Academy after 10 and 20 sessions, but returned to baseline values after 30 sessions. The increase trend covered both granulocytes and lymphocytes (Szygula et al., 2014). Similar increase was also reported in tennis players, but not for subcategories of granulocytes and lymphocytes (Ziemann et al., 2012). Despite the increase, leukocytes always remained within the physiological range. Mobilization of leukocytes from the bone marrow and organs of residence has been hypothesized as a possible cause of these increases although an explanation of this phenomenon is still lacking.

In endurance trained runners, a simulated 45 min trail run, designed specifically to trigger exercise-induced muscle damage (EIMD), followed by four sessions of WBC applied once a day, resulted in an increase in neutrophil count of 114% compared to baseline, with the maximum peak recorded 1 h after the exercise. The correspondent increase in neutrophils, following passive recovery, accounted for 101% shift against baseline. The authors hypothesized that the increase of circulating neutrophils stimulated angiogenesis (via vascular endothelial growth factor—VEGF expression) and the consequent improved perfusion was associated with a reduced delayed onset of muscle soreness (DOMS) and, hence, an improved recovery (Pournot et al., 2011).

Platelets

Platelets did not shift in response to WBC sessions applied in groups of rugby and tennis players (Lombardi et al., 2013a; Ziemann et al., 2014) nor students of the Polish Military Academy (Szygula et al., 2014).

In summary, the following reports have been made about the WBC treatment:

– WBC causes a decrease in Hb, Ht, and RBC after 5, 10, and 20 sessions. A recovery of hemoglobinization is reached after 30 sessions. Ret counts remains unaffected by WBC.
– The effect of WBC on RBC and Hb can be influenced by the type and intensity of physical training since in some groups of athletes these changes did not occur.
– Hemolysis may be the cause behind the drop in RBC, Hb, and Ht following the WBC treatment of 10–20 sessions.
– EPO is induced in the course of WBC with the aim to recover to baseline levels of RBC and Hb.
– WBC should not have a boosting effect on bone marrow and is not influencing athletes’ hematological parameters usually controlled to test for illicit bone marrow stimulation.
– The level of leukocytes either does not change or only slightly increases in response to WBC. Cryotherapy possibly mobilizes leukocytes, especially neutrophils, with a positive effect on DOMS.
– Platelets are not affected by WBC.

Performance recovery
Performance recovery using different cooling methods, especially CWI and contrast water immersion, has been extensively studied so far. Their average effect on recovery of trained athletes is rather limited, as reported in a recent review, but under appropriate conditions (whole-body cooling, recovery from sprint exercise) post-exercise cooling has positive effects even for elite athletes (Poppendieck et al., 2013).

Positive effects induced by WBC after 96 h were reported in 18 physically active subjects, who performed a single maximal eccentric contractions of the left knee extensors, through two WBC sessions (−110°C) 24 and 48 h after exercise. The effects were negative at 24 and 48 h post-exercise (Costello et al., 2012a). Positive effects were also reported 24 and 48 h after the treatment in nine runners completing a simulated 48-min trail run, submitted to three WBC sessions, immediately after the exercise as well as 1 and 2 days after (Hausswirth et al., 2011).

Eleven endurance athletes were tested twice in a randomized crossover design with 5 × 5 min of high intensity running followed by 1 h of passive recovery, including either WBC (−110°C, 3 min) or a 3 min walk. Time-to-exhaustion difference between a ramp-test protocol before running and 1 h post-recovery was lower in WBC-treated subjects. WBC improves acute recovery during high-intensity intermittent exercise in thermoneutral conditions. This could be induced by enhanced oxygenation of the working muscles as well as by reduction of cardiovascular strain and increased work economy at submaximal intensities (Krüger et al., 2015). In addition to beneficial effects on inflammation and muscle damage, WBC induces peripheral vasoconstriction, which improves muscle oxygenation (Hornery et al., 2005), lowers submaximal heart rate and increases stroke volume (Zalewski et al., 2014), stimulates autonomic nervous parasympathetic activity and increases norepinephrine (Hausswirth et al., 2013). These effects favor post-exercise recovery and induce analgesia (Krüger et al., 2015).

Although these evidences, a recent meta-analysis by Bleakley et al., based on a small number of randomized studies, highlighted that WBC sustains improvements in subjective recovery and muscle soreness following metabolic or mechanical overload, but little benefit toward functional recovery (Bleakley et al., 2014). The authors concluded that, until further researches will be available, less expensive cooling modality (local ice-pack, cold water immersion) would be used in order to gain the same physiological and clinical effects to WBC.

Exposure Time

Three-minute WBC exposure significantly differ from a 1–2-min exposure. Blood volume decreased within vastus lateralis and gastrocnemius occurred 0–5 min after WBC in 14 professional rugby players. Oxyhemoglobin and deoxyhemoglobin increased in 15 min post-WBC, reaching baseline values indicative of venous pooling. Extreme cold induces vasodilation after constriction in very short time. Gastrocnemius is more susceptible to pooling at all exposure times than vastus lateralis. Two-minute WBC exposure causes changes in core and Tsk, tissue oxygenation in vastus lateralis, and gastrocnemius and thermal sensation. The optimum exposure time is 30 s at −60°C followed by 2 min WBC at −135°C (Selfe et al., 2014).

It is also crucial to keep a constant temperature between two consecutive treatments. Door opening and subject permanence within a chamber increase temperature and reduce therapeutic effectiveness, particularly for electrical cryochambers, but also for liquid nitrogen-cooled chambers. A 2 min wait between two consecutive treatments would allow temperature recovery to therapeutic levels.

Sessions

The number of sessions is crucial for WBC effectiveness, as previously discussed. A recent Cochrane review, reporting on the absence of beneficial effects of WBC on prevention and treatment of muscle soreness in athletes, involves on only four papers. One out of these four papers talked about six treatments in cryocabin, the other two investigated the effects of a single treatment in a cryochamber and the final one reported the effects of only three treatments in a cryochamber (Costello et al., 2015). A single session is probably not sufficient to exert any significant effect. Twenty consecutive sessions should be a minimum for effectiveness evaluation; 30 sessions should be the optimum, because a complete hematological and immunological recovery after the initial response is possible (Szygula et al., 2014). Studies evaluating long-term WBC treatment are not easily performable in professional athletes during competitive seasons, but they could be proposed during training and summer camps. Although offseason injuries are rarer than contusions incurred during competitions, it is important to note that standardization of exercise and training offseason is more easily achievable.

Furthermore, randomization is very difficult, if not impossible, to be proposed to elite athletes, and professional teams: the treatment is proposed to improve recovery or to prevent injuries, thus, it should not be limited to a subgroup of athletes. On the other hand, when WBC is used for accelerating recovery from trauma/injury, only injured athletes are treated. Crossover studies could be more easily performed during training camps (but not during competitive season), but they would be only devoted to physiological modifications and not to recovery.

Different, and sometime discrepant results presented in current literature could be attributable to different levels of subjects ranging from “physically active” to “elite” to “national/international selection.” A stratification of WBC effects should be evoked for different subjects, because of different adaptation to effort, recovery capacity/velocity, and energy metabolism.

Conclusions
Based on the findings here collected, the majority of evidence supports effectiveness of WBC in relieving symptomatology of the whole set of inflammatory conditions that could affect an athlete. A small number of studies that did not report any positive effects should, however, not be neglected. The same applies to improvement of post-exercise recovery, and noteworthy, to limiting or even preventing EIMD. The perception of WBC is changing from a conventionally intended symptomatic therapy to a stimulating treatment able to enhance the anti-inflammatory and -oxidant barriers and to counteract harmful stimuli. Importantly, cooling effectiveness depends on the percentage of fat mass of a subject and the starting fitness level. These results, combined with evidence that WBC somehow mimics exercise, at least in its ability to induce a pulsatile expression of myokines (IL-6, irisin), open another window of possible therapeutic strategies for obesity and type 2 diabetes.

As above highlighted, some of the applied WBC protocols have been ineffective in inducing appreciable modifications of certain biochemical parameters. However, in these cases, the final clinical output (in a subjective assessment: in terms of pain, soreness, stress, and recovery) was significantly improved even when compared to other recovery strategies.

WBC, used either as a therapy or stimulation, is a medical treatment and as such it has contraindications and standard safety procedures. The undeniable risks for the users can be rendered negligible if all the procedures are conducted following precise rules under supervision of highly-skilled personnel. If these procedures are carefully followed, WBC is absolutely safe.

Originally published in Frontiers in Physiology by Giovanni Lombardi, Ewa Ziemann and Giuseppe Banfi1

 

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