Here is why you should be spending more time outdoors in the winter, and finishing your showers with cold water.
| A Brief History of Cold Therapy
Cold therapy has long been used in medicine, with the earliest recorded history mentioned in the oldest known medical text, The Edwin Smith Papyrus, dating back to 2500 B.C. It had been used for the treatment of malignancies, brain injury, pain reduction, infectious diseases and anaesthesia for amputation(1). There is also record of the use of cold as a treatment in the writing of both Hippocrates and Galen(2).
In the 19th century, after a long period of disregard for cold therapy by the medical establishment, a man by the name of Vincent Priessnitz wrote heavily on the medicinal value of cold water. He learned of the benefits of cold water by watching as a roebuck use a cold stream of water to submerge and cure a wound. He later tested this observation on himself after an injury to his finger caused by felling timber and another more serious injury, a broken rib(2,3). Priessnitz developed many hydrotherapy spas where he was using cold water to heal a number of injuries and diseases(3).
The practice of cold therapy experienced a dormancy around WWII, but began to re-emerge in the 80's with research showing benefits for the use of hypothermia as a neuroprotective therapy in patients suffering from traumatic brain injuries(1).
The practice of cold exposure remains unrecognized, or rather not utilized in mainstream Allopathic medicine, but has gained an increase in alternative medical fields with the emergence of cryotherapy machines, hydrotherapy spas and strong advocates for the healing power of the cold such as Wim Hof, "the ice man".
| Health Benefits of Cold Therapy
Aids in Fat Loss & Prevents Obesity
Cold exposure increases the activity and quantity of brown fat in the body compared to white fat. Brown fat is more metabolically active than white fat(4,7). This means that brown fat transforms fat into heat, thus utilizing it for fuel and burning calories. White fat stores energy and is abundant in those who are experiencing weight gain and fat deposition(5,6).
In addition to increased levels of Brown adipose tissue, frequent cold exposure also increases levels of the protein adiponectin, which is involved in the breakdown of fat for fuel aka "fat burning"(8,9).
Improved Muscle Recovery Post-Workout
Cold water immersion(CWI) done at the right time and temperature post work-out was shown to decrease muscle recovery time, meaning the participant's muscles were sore less long in the group receiving CWI. They showed that the optimal timeframe and temperature range for muscles to recover faster after a workout is between 11-15 minutes in temperatures of 11 to 15 degrees celsius(10).
Strengthens the Nervous System
Our sympathetic nervous system(SNS) becomes activated during cold exposure. By physiologically activating the sympathetic nervous system with cold stress, it appears to re-sensitize the autonomic nervous system, helping the body return to a parasympathetic state. Human's undergoing a lot of unproductive stress (YOU) are in a constant sympathetic state. In this state they can actually develop high amounts of a stress hormone called cortisol and experience weight gain around the abdomen known as central obesity(11). Excessive sympathetic activation has also been linked to a number of nervous and mood related disorders such as anxiety, ADHD and depression, as well as certain pain disorders such as fibromyalgia(12). They also often experience a decrease in digestion and proper sleep, as these are mitigated by the opposing nervous system, the Parasympathetic Nervous System (PNS).
Both the PNS and the SNS are two branches of our Autonomic Nervous System(ANS). The control of the ANS was thought to be an automatic response from our body that we were unable to consciously control. Wim Hof, also known as 'The Ice Man', was able to show that humans are capable of controlling their ANS by using a combination of breath-work techniques and cold exposure.
Improves Blood Sugar Regulation
As with aiding in fat loss, cold stress has been shown to increase adiponectin levels. Decreased levels of adiponectin has been correlated with a decrease in insulin sensitivity (9). Insulin is a hormone responsible for regulating blood glucose by regulating the absorption of glucose into tissues from the blood. Insulin loses sensitivity and becomes resistant in Type II diabetes. In addition to important dietary changes, cold stress can help prevent resistance and lower the risk of developing Type II diabetes.
Helps heal injuries
Cooling after a burn has been shown to increase wound healing and reduce tissue damage (13). This can be done by running cool tap water oven a burn. Unfortunately with a burn, using ice water could lead to further tissue damage upon immediate exposure, so maintaining a cool temperature between 16-18 degrees celsius was shown to be most effective(13). Some sources suggest that the cooling benefits the tissue helping with repair by maintaining microcirculation to the area(14). Maintaining blood flow to the site of injury would in theory prevent tissue necrosis.
Icing or cold applications during the acute phase of soft-tissue injury (ie. ankle sprain) is an effective way to help improve tissue recovery. The proposed mechanism being that cold application in the acute phase of an injury (day 1-2) can help reduce excess inflammation and prevent ischemia (tissue death) (14,15). Cold application can slow the rate of chemical reactions at the site of injury, lessoning the requirement for energy. This may seem counter intuitive, however it prevents excess cell death caused by the high amount of anaerobic activity and hypoxia that occur at the site of tissue damage (15).
| Suggestions for Cold Exposure
1. Boost your energy and Fat burning by ending your showers with 1 minute of cold water exposure. This is always difficult the first few showers, but becomes much easier to do with time. It also helps you feel warmer upon exiting the shower!
2. Submerge acute swollen limbs/injuries in cold water or apply an ice pack for 10 minutes. You may want to consider alternating between hot and cold if the injury is more than 3 days old. This will help flush out debris by bringing blood in and out of the area. *With chronic joint or muscle pain, warm applications may be best!
3. Cryotherapy.
4. Cold water Treading in a bathtub or in a cold creek (spring to fall)
5. Do the polar dip, or snow angels post sauna/hot tub for those who live in the North.
References
1. Wang, H., Olivero, W., Wang, D., & Lanzino, G. (2006). Cold as a therapeutic agent. Acta neurochirurgica, 148(5), 565-570.
2. Weiss, H. B., & Kemble, H. R. (1967). The great American water-cure craze: a history of hydropathy in the United States. The Past Times Press.
3. Legan, M. S. (1971). Hydropathy in America: A nineteenth century panacea. Bulletin of the History of Medicine, 45(3), 267-280.
4. Saito, M., Okamatsu-Ogura, Y., Matsushita, M., Watanabe, K., Yoneshiro, T., Nio-Kobayashi, J., ... & Kawai, Y. (2009). High incidence of metabolically active brown adipose tissue in healthy adult humans: effects of cold exposure and adiposity. Diabetes.
5. Seale, P., & Lazar, M. A. (2009). Brown fat in humans: turning up the heat on obesity. Diabetes, 58(7), 1482-1484.
6. Cypess, A. M., Haft, C. R., Laughlin, M. R., & Hu, H. H. (2014). Brown fat in humans: consensus points and experimental guidelines. Cell metabolism, 20(3), 408-415.
7. van der Lans, A. A., Hoeks, J., Brans, B., Vijgen, G. H., Visser, M. G., Vosselman, M. J., ... & Schrauwen, P. (2013). Cold acclimation recruits human brown fat and increases nonshivering thermogenesis. The Journal of clinical investigation, 123(8), 3395-3403.
8. Imbeault, P., Dépault, I., & Haman, F. (2009). Cold exposure increases adiponectin levels in men. Metabolism, 58(4), 552-559.
9. Ukkola, O., & Santaniemi, M. (2002). Adiponectin: a link between excess adiposity and associated comorbidities?. Journal of molecular medicine, 80(11), 696-702.
10. Machado, A. F., Ferreira, P. H., Micheletti, J. K., de Almeida, A. C., Lemes, Í. R., Vanderlei, F. M., ... & Pastre, C. M. (2016). Can water temperature and immersion time influence the effect of cold water immersion on muscle soreness? A systematic review and meta-analysis. Sports Medicine, 46(4), 503-514.
11. Björntorp, P., & Rosmond, R. (2000). Obesity and cortisol. Nutrition, 16(10), 924-936.
12. Tsigos, C., & Chrousos, G. P. (2002). Hypothalamic–pituitary–adrenal axis, neuroendocrine factors and stress. Journal of psychosomatic research, 53(4), 865-871.
13. Jandera, V., Hudson, D. A., De Wet, P. M., Innes, P. M., & Rode, H. (2000). Cooling the burn wound: evaluation of different modalites. Burns, 26(3), 265-270.
14. Raine, T. J., Heggers, J. P., Robson, M. C., London, M. D., & Johns, L. (1981). Cooling the burn wound to maintain microcirculation. The Journal of trauma, 21(5), 394-397.
15. Weber, K. (2009). The technical benefits of icing.
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