One session of partial-body cryotherapy (−110 °C) improves muscle damage recovery

Abstract

To evaluate the effects of a single session of partial-body cryotherapy (PBC) on muscle recovery, 26 young men performed a muscle-damaging protocol that consisted of five sets of 20 drop jumps with 2-min rest intervals between sets. After the exercise, the PBC group (n = 13) was exposed to 3 min of PBC at −110 °C, and the control group (n = 13) was exposed to 3 min at 21 °C. Anterior thigh muscle thickness, isometric peak torque, and muscle soreness of knee extensors were measured pre, post, 24, 48, 72, and 96 h following exercise. Peak torque did not return to baseline in control group (P < 0.05), whereas the PBC group recovered peak torques 96 h post exercise (P > 0.05). Peak torque was also higher after PBC at 72 and 96 h compared with control group (P < 0.05). Muscle thickness increased after 24 h in the control group (P < 0.05) and was significantly higher compared with the PBC group at 24 and 96 h (P < 0.05). Muscle soreness returned to baseline for the PBC group at 72 h compared with 96 h for controls. These results indicate that PBC after strenuous exercise may enhance recovery from muscle damage.

Full text

One session of partial-body cryotherapy (−110 °C) improves
muscle damage recovery
J. B. Ferreira-Junior1,6, M. Bottaro1, A. Vieira1, A. F. Siqueira1, C. A. Vieira1, J. L. Q. Durigan2, E. L. Cadore1,
L. G. M. Coelho3, H. G. Simões4, M. G. Bemben5
1College of Physical Education, University of Brasília, Brasilia, DF, Brazil, 2Physical Therapy Division, University of Brasília,
Brasilia, DF, Brazil, 3Federal Center for Technological Education of Minas Gerais, Divinopolis, MG, Brazil, 4Graduate Program on
Physical Education, Catholic University of Brasilia, Brasilia, DF, Brazil, 5Department of Health and Exercise Science, University of
Oklahoma, Norman, Oklahoma, USA, 6Federal Institute of Triangulo Mineiro, Paracatu, MG, Brazil
Corresponding author: João Batista Ferreira-Junior, PhD, Federal Institute of Triangulo Mineiro, Road MG 188, Km 167, 38600-00
Paracatu, MG, Brazil. Tel: 55 3836798200, Fax: 55 3836798200, E-mail: jbfjunior@gmail.com
Accepted for publication 3 October 2014
To evaluate the effects of a single session of partial-body
cryotherapy (PBC) on muscle recovery, 26 young men
performed a muscle-damaging protocol that consisted of
five sets of 20 drop jumps with 2-min rest intervals
between sets. After the exercise, the PBC group (n=13)
was exposed to 3 min of PBC at −110 °C, and the control
group (n=13) was exposed to 3 min at 21 °C. Anterior
thigh muscle thickness, isometric peak torque, and
muscle soreness of knee extensors were measured pre,
post, 24, 48, 72, and 96 h following exercise. Peak torque
did not return to baseline in control group (P<0.05),
whereas the PBC group recovered peak torques 96 h post
exercise (P>0.05). Peak torque was also higher afterPBC
at 72 and 96 h compared with control group (P<0.05).
Muscle thickness increased after 24 h in the control group
(P<0.05) and was significantly higher compared with the
PBC group at 24 and 96 h (P<0.05). Muscle soreness
returned to baseline for the PBC group at 72 h compared
with 96 h for controls. These results indicate that PBC
after strenuous exercise may enhance recovery from
muscle damage.
Muscular performance may be temporarily impaired by
high-intensity exercise performed during a training
session or competition. The reduction in muscle strength
may be transitory, lasting minutes, hours, or several days
following training or competition (Barnett, 2006).
Longer lasting impairment in muscle strength accompa-
nied by a decrease in range of motion, an increase in
muscle proteins in the blood, inflammatory response,
muscle thickness, and delayed onset muscle soreness is
referred to as exercise-induced muscle damage
(Clarkson & Hubal, 2002; Barnett, 2006; Paulsen et al.,
2012).
Several modalities of recovery have been used to
hasten the recovery period from muscle damage
(Barnett, 2006). Among the most common treatment
strategies used to restore muscle function are massage
(Barnett, 2006; Nelson, 2013), stretching (Barnett, 2006;
Herbert et al., 2011), nonsteroidal anti-inflammatory
drugs (Schoenfeld, 2012), active recovery (Cheung
et al., 2003; Barnett, 2006), compression garments (Hill
et al., 2014), contrast water therapy (Bieuzen et al.,
2013), and cryotherapy (Bleakley et al., 2012; Leeder
et al., 2012), among others (Cheung et al., 2003; Barnett,
2006). A relatively novel modality of cryotherapy is the
whole-body cryotherapy (WBC), which refers to a brief
exposure (2 to 3 min) to extremely cold air (−110 to
−195 °C) in a temperature-controlled chamber or
cryocabin (Banfi et al., 2010; Hausswirth et al., 2011;
Fonda & Sarabon, 2013). Sessions of partial-body cryo-
therapy (PBC), in which the head is not exposed to cold,
have also been used as a similar modality of WBC
(Hausswirth et al., 2013).
In sports medicine, WBC has been used recently as an
approach to accelerate recovery from muscle damage, to
improve between-training session recovery, and to
prevent overtraining syndrome (Banfi et al., 2010;
Bleakley et al., 2014). It has been reported that the
inflammatory process and muscular enzymes related to
muscle damage were reduced after five sessions of WBC
(Banfi et al., 2009). Hausswirth et al. (2011) observed
that three sessions of WBC hastened muscle damage
recovery after downhill running. On the other hand, two
sessions of WBC (2 h apart) performed 24 h after
muscle-damaging protocol did not improve muscle
recovery (Costello et al., 2012a). Additionally, according
to Fonda and Sarabon (2013), five WBC exposures accel-
erated recovery of peak torque, squat jump start power,
and decreased muscle soreness. However, biochemical
markers, squat, and counter movement jump perfor-
mance were not affected by WBC exposures (Fonda &
Scand J Med Sci Sports 2014: ••: ••–••
doi: 10.1111/sms.12353
© 2014 John Wiley & Sons A/S.
Published by John Wiley & Sons Ltd
1

Sarabon, 2013). Therefore, the effects of WBC on muscle
damage recovery are equivocal. These conflicting results
may be due to methodological differences, such as cross-
over vs between-subject design, number of WBC ses-
sions (1 vs 3 vs 5) and the time elapsed between
damaging exercise and WBC (immediately post or 24 h
following WBC muscle-damaging protocol). There is
also ambiguity regarding the optimal treatment protocol
in terms of duration, temperature and sex (Fonda et al.,
2014; Hammond et al., 2014; Selfe et al., 2014). To the
best of our knowledge, there is no study that evaluated the
effects of one session of PBC performed immediately
after damaging exercise on muscle recovery. Using only
one PBC exposure might reduce the cost and time asso-
ciated with multiple treatments, which has currently been
recommended by manufacturers. Thus, this topic
requires further investigation.
We hypothesized that the physiological responses to
cold exposure from PBC will improve muscle damage
recovery. A logic model regarding the physiological,
neuromuscular, and perceptual rationale for using PBC
has been proposed by Costello et al. (2013). According
to this model, PBC causes a vasoconstriction associated
with decreased core and muscle temperature (Costello
et al., 2012a, b). This vasoconstriction reduces blood
vessels permeability to immune cells and decreases the
inflammatory process (Hausswirth et al., 2011; Pournot
et al., 2011; Ferreira-Junior et al., 2014). This attenua-
tion in the acute inflammatory response could provide a
beneficial role by protecting muscle from secondary
muscle damage, which would result in a decrease in
edema, muscle soreness, and an improvement in muscle
strength (Hausswirth et al., 2011; Pournot et al., 2011;
Ferreira-Junior et al., 2014). Ferreira-Junior et al. (2014)
reported in a mechanistic version that the attenuation in
serum sICAM-1 caused by PBC exposure immediately
following EIMD may be responsible for the decreased
secondary muscle damage. Additionally, hastening mus-
cular recovery is especially important because athletes
are usually required to train or compete at maximal
intensity almost daily. Thus, the aim of this study was to
evaluate the effects of one session of PBC performed
immediately after muscle-damaging protocol on muscle
recovery in physically active young men.
Methods
Subjects
Sample size for both PBC and control groups were determined by
GPower (version 3.1.2; Franz Faul, Universitat Kiel, Germany)
according to Beck (2013). The following design specifications
were taken into account: α=0.05; (1-β)=0.8; effect size f=0.25;
test family =Ftest, and statistical test =analysis of variance
(ANOVA) repeated measures, within-between interaction. The
sample size estimated according to these specifications was 20
subjects. Twenty-six young male university students (20.2 ±2.5
years, weight 71.4 ±9.1 kg and height 174.8 ±7.3 cm) volun-
teered to participate. Inclusion criteria included physically active
subjects involved in moderate physical activity (jogging, agility, or
endurance) for an average of 3 days a week, not performing
resistance training or plyometric exercise at least 3 months prior to
the study. Subjects were informed of the purpose, procedures,
possible discomforts, risks, and benefits of the study prior to
signing the written informed consent form. They were considered
healthy and fit for physical exercise by answering no to all
Physical-Activity Readiness Questionnaire questions (Thomas
et al., 1992). Also, based on Pobdielska et al. (2006), this study
adopted the following exclusion criteria: untreated arterial hyper-
tension, cardiovascular and respiratory diseases, angina, periph-
eral artery occlusive disease, venous thrombosis, urinary tract
diseases, severe anemia, allergy to cold, tumor diseases, viral and
bacterial infections, Raynaud’s syndrome, claustrophobia, or con-
vulsions. The present study was approved by the Institutional
Ethics Committee of the Catholic University of Brasília (Protocol:
71484/2012).
Experimental design
Subjects were randomly placed, using a random number table, in
two groups: PBC and control group (Table 1). Age, weight, height,
skin folds (chest, thigh, and abdomen), peak torque, and muscle
soreness were not significantly different between groups at base-
line (P>0.05); however, anterior thigh muscle thickness was
higher in the PBC group when compared with the control group
(P=0.02; Table 1). Volunteers visited the laboratory on six occa-
sions. The first visit consisted of a familiarization of experimental
procedures and for anthropometric assessment. One week after
familiarization, on visit two, volunteers performed a muscle-
damaging protocol. In order to test the effects of a single session of
PBC performed after damaging exercise on muscle recovery, the
PBC group was exposed to 3 min of PBC at −110 °C 10 min after
Table 1. Physical characteristics and baseline peak torque and muscle soreness of the participants of each experimental group
Physical characteristics Control group (n= 13) PBC group (n= 13) P-value
Age (years) 20.3 ±2.2 20.2 ±2.7 0.88
Weight (kg) 72.1 ±9.9 70.6 ±7.8 0.67
Height (cm) 176.0 ±8.0 173.5 ±5.9 0.38
Thighskin fold (mm) 15 ±913±7 0.56
Chestskin fold (mm) 9 ±58±2 0.63
Abdomenskin fold (mm) 19 ±11 16 ±6 0.45
Anterior thigh muscle thickness (mm) 37.2 ±4.6 41.2 ±3.3* 0.02
Peak torque (N.m) 246.2 ±61.4 261.8 ±36.8 0.46
Muscle soreness (mm) 19 ±14 15 ±14 0.31
*P<0.05, higher than control group.
PBC, partial-body cryotherapy.
Ferreira-Junior et al.
2

completing the muscle-damaging protocol. The control group was
not exposed to PBC 10 min after the damaging exercise. Indirect
markers of muscle damage were evaluated before (pre), immedi-
ately post, 24, 48, 72, and 96 h following the damaging exercise by
measuring always in the same order: anterior thigh muscle thick-
ness, knee extensors isometric peak torque, and knee extensors
muscle soreness. To avoid circadian influences, subjects were
asked to visit the laboratory always at the same time of day.
Volunteers were not allowed to perform any vigorous physical
activities or unaccustomed exercise during the experiment period.
They were also instructed not to take medications or supplements
during the study.
Exercise-induced muscle damage protocol
The muscle-damaging protocol consisted of five sets of 20 drop
jumps from a 0.6 m box with 2-min rest intervals between sets.
After dropping down from the box and landing on the floor, sub-
jects were instructed to perform a maximally explosive vertical
jump upward and then land on the floor. Volunteers were also
instructed to flex their knees to at least at 90° (0° full extension)
during all landings, and to maintain their hands on their hips
during the exercise. Additionally, they received verbal encourage-
ment throughout the exercise. Asimilar muscle-damaging protocol
has been used by other studies (Miyama & Nosaka, 2004;
Howatson et al., 2009; Fonda & Sarabon, 2013).
Recovery modalities
During the PBC exposure (Fig. 1), subjects stood in a head out
cryochamber based on gaseous nitrogen (Kryos Tecnologia, Bra-
sília, Brazil) at −110 °C for 3 min. The temperature and duration
of PBC exposure were based on a study by Costello et al. (2012a,
b). Subjects wore bathing suits, gloves, socks, and shoes with
thermic protection to protect their extremities. The control group
performed a sham treatment control, during which subjects stood
in the cryochamber for 3 min at 21 °C. Thigh temperatures (ante-
rior central area) were measured by an infrared thermometer
(Fluke, 566, China) before and immediately after PBC exposure
and passive recovery. The measurement area was marked with a
pen (Pilot 2 mm, Brazil) before each condition.
Muscle thickness assessment
Muscle thickness of the anterior thigh was measured by ultraso-
nography using B-Mode ultrasound (Philips-VMI, Ultra Vision
Flip, New York, NY, USA, model BF), and a single technician
evaluated subjects. A water-soluble transmission gel was applied
to the measurement site, and a 7.5-MHz ultrasound probe was
placed on the skin, perpendicular to the tissue interface without
depressing the skin. Subjects were evaluated in supine position,
after resting for 10 min. Muscle thickness of the anterior thigh was
measured at 60% of the distance from the greater trochanter to the
lateral epicondyle and 3 cm lateral to the midline of the anterior
thigh (Chilibeck et al., 2004). Once the technician was satisfied
with the quality of the image, it was frozen on the monitor
(Bemben, 2002). The images were then digitalized and later ana-
lyzed in Image-J software (National Institute of Health, Bethesda,
MD, USA, version 1.37). Muscle thickness was defined as the
distance from the subcutaneous adipose tissue–muscle interface to
the muscle–bone interface (Abe et al., 2000). Additionally, base-
line test/retest reliability coefficient (intraclass correlation coeffi-
cient; ICC) value for anterior thigh muscle thickness was 0.9.
Peak torque assessment
Maximal isometric peak torque of the right knee extensors was
measured by the Biodex System 3 Isokinetic Dynamometer
(Biodex Medical, Inc., Shirley, New York, USA). Subjects were
positioned comfortably on the dynamometer seat with belts fas-
tened across the trunk, pelvis, and thigh to minimize extraneous
body movements, which could affect peak torque and power
values. The lateral epicondyle of the femur was used to align the
knee with the dynamometer’s lever arm. With the participants
positioned on the seat, the following measures were recorded: seat
height, backrest inclination, dynamometer height, and lever arm
length in order to standardize the test position for each participant.
Gravity correction was obtained at full extension by measuring
the torque exerted by the lever arm and the participant’s relaxed
leg. All isokinetic variables were automatically adjusted for
gravity within the Biodex Advantage software. Calibration of
the dynamometer was carried out according to manufacturer’s
specifications.
After having their right leg positioned by the dynamometer at
an angle of 60° (0° represented the full extension), subjects were
asked to cross their arms across the chest and to maximally con-
tract their right knee extensors for 4 s. They had two attempts to
achieve their maximal isometric peak torque. One minute of rest
was given between each attempt. Subjects also received verbal
encouragement throughout the test and all testing procedures were
performed by the same examiner. All procedures were in accor-
dance with Cadore et al. (2012). Moreover, warm-up was not
conducted prior to isometric peak torque assessment because in a
recent study, it was verified that there was no difference between
five types of warm-up protocols and no warm-up protocol on
isokinetic performance (Ferreira-Júnior et al., 2013). Baseline test/
retest reliability coefficient (ICC) value for knee extensors isomet-
ric peak torque was 0.91.
Muscle soreness
Knee extensor muscle soreness was assessed using a 100-mm
visual analog scale with “no soreness” (0 mm) and “severe sore-
ness” (100 mm), respectively (Flores et al., 2011). Subjects rated
their quadriceps soreness during maximal isometric contractions
of the right knee extensors.
Fig. 1. Subject during head out/partial-body cryotherapy
(PBC): 3 min at −110 °C.
Cryotherapy (−110 °C) improves muscle recovery
3

Statistical analyses
Data are presented as mean ±standard deviation. The Shapiro–
Wilk test was used to check data for normal distribution. Peak
torque and muscle thickness were analyzed using percent change
from baseline. Considering that the peak torque and muscle thick-
ness data were normally distributed, a two-way [group (PBC and
control) ×time (before, immediately, 24, 48, 72, and 96 h after
damaging exercise)] repeated measures ANOVA was used to
analyze peak torque and muscle thickness. In the case of signifi-
cant differences, a Holm-Sidak post-hoc test was used. The physi-
cal characteristics and baseline peak torque values were evaluated
by using an independent t-test. Given that muscle soreness data did
not present a normal distribution, the nonparametric Mann-
Whitney (between groups) and Friedman (within group) tests were
used to analyze this variable. Significance level was set a priori at
P<0.05. Additionally, the effect size calculation was used to
examine the magnitude of each condition effect. Cohen’s ranges of
0.1, 0.25, and 0.4 were used to define small, medium, and large ƒ
values, respectively, obtained from the following formula (Cohen,
1988; Beck, 2013):
fk
j
k
=
−
()
=
∑μμ
j
error
2
1
2
σ
[1]
where μjis the population mean for an individual group, μis the
overall mean, kis the number of groups, and σerror is the within-
group standard deviation.
Results
Knee extensors peak torques are presented in Fig. 2.
There was a significant group-by-time interaction for
peak torque (F=2.3, P=0.049, power =0.44, ƒ=0.26).
Peak torque dropped immediately after damaging exer-
cise with no difference between groups (32.0 ±13.3%
for control group and 28.6 ±11.9% for PBC group,
P=0.46). The PBC group recovered peak torque 96 h
after damaging exercise (P>0.05) while the control
group did not recover peak torque throughout the 96 h
post-testing period (P<0.05). Peak torque was also
higher for the PBC group at 72 (PBC: 238.5 ±50.4 N.m
vs control group: 189.8 ±52.6 N.m) and 96 h
(255.8 ±41.6 N.m vs 207.3 ±56.9 N.m) when com-
pared with the control group (P<0.05).
There was a significant group-by-time interaction for
anterior thigh muscle thickness (F=3.57, P=0.005,
power =0.78, ƒ=0.37). Muscle thickness increased at
24 h in the control group (P<0.001), while it was not
altered in the PBC group throughout the entire 96 h
(P>0.05). Moreover, muscle thickness was higher in
control group at 24 and 96 h after damaging exercise
when compared with the PBC group (P<0.05; Fig. 3).
The PBC group recovered from knee extensor muscle
soreness at 72 h after damaging exercise (χ2=24.53,
P<0.001), while the control group recovered only at
96 h after damaging exercise (χ2=29.36, P<0.001;
Fig. 4). There was no difference in muscle soreness
between groups (P>0.05).
Discussion
The aim of this study was to evaluate the effects of one
session of PBC (3 min at −110 °C) 10 min after damag-
ing exercise on muscle recovery in physically active
young men. The initial hypothesis was confirmed, as the
PBC session resulted in a quicker recovery of muscle
strength and relieved pain 72 h after damaging exercise
with no alteration in muscle thickness. In contrast, the
control group did not recover muscle strength to baseline
values, and recovered muscle thickness to baseline
values and from pain 48 and 96 h after damaging exer-
cise, respectively. Apossible reason for these results may
Time
(
h
)
Normalized isometric peak torque (%)
0
20
40
60
80
100
120
Control
PBC
PrePost24487296
*
*
#
#
*
*
*
***
*
Fig. 2. Mean ±SD percent change from baseline in knee exten-
sors isometric peak torque before (pre), immediately post, and
24–96 h following exercise-induced muscle damage. PBC,
partial-body cryotherapy (−110 °C). *P<0.05, lower than pre.
#P<0.05, higher than control group.
Muscle thickness (%)
0
20
40
60
80
100
120
Control
PBC
Time (h)
Pre Post 24 48 72 96
*##
Fig. 3. Mean ±SD percent change from baseline in anterior
thigh muscle thickness before (pre), immediately post, and
24–96 h following exercise-induced muscle damage. PBC,
partial-body cryotherapy (−110 °C). *P<0.05, higher than pre.
#P<0.05, higher than PBC group.
Ferreira-Junior et al.
4

be related to a decrease in core, muscle, and skin tem-
peratures after WBC exposure (Costello et al., 2012a, b).
This thermal response may lead to increased vasocon-
striction, which can cause a reduction in blood vessel
permeability to immune cells and thus decrease the
inflammatory process (Hausswirth et al., 2011; Pournot
et al., 2011; Ferreira-Junior et al., 2014).
Regarding the effects of WBC on inflammatory
process, it has been reported that five sessions of WBC
(30 s at 60 °C and 2 min at −110 °C) in athletes
decreased blood concentrations of muscular enzymes
(creatine kinase and lactate dehydrogenase) and pro-
inflammatory response (prostaglandin E2, adhesion mol-
ecule sICAM-I, interleukin IL-2 and IL-8; Banfi et al.,
2009). Additionally, anti-inflammatory cytokine IL-10
was increased (Banfi et al., 2009). Moreover, Pournot
et al. (2011) evaluated the effect of three sessions of
WBC (3 min at −110 °C) after damaging exercise on the
acute inflammatory response of well-trained runners.
They observed an increase in IL-1ra and a decrease in
IL-1βand C-reactive protein. Thus, according to the
authors, WBC exposure decreased the inflammatory
response via vasoconstriction at the muscular level
caused by drop in muscle temperature. This hypothesis is
supported by Costello et al. (2012a, b), who found a
decrease of 1.6 ±0.6 °C in the vastus lateralis tempera-
ture after WBC session. It was also reported that rectal
temperature decreased 0.3 ±0.2 °C 60 min after WBC
session (Costello et al., 2012a, b). Although muscle tem-
perature was not measured, skin thigh temperature in
the present study dropped from 33.0 ±0.9 °C to
15.7 ±3.9 °C immediately after WBC exposure.
The results reported in the present study are similar to
others that evaluated the effect of WBC on exercise-
induced muscle damage recovery (Hausswirth et al.,
2011; Fonda & Sarabon, 2013).A previous study verified
that three sessions of WBC (3 min at −110 °C) after
muscle-damaging protocol in well-trained runners
improved muscle strength and perceived sensation, and
also decreased muscle pain (Hausswirth et al., 2011).
Additionally, five WBC exposures (3 min at −140 to
−190 °C) accelerated recovery of peak torque, squat
jump start power, and decreased muscle soreness in a
different investigation (Fonda & Sarabon, 2013).
Besides the number of WBC exposures, the current
study differs from those cited above (Hausswirth et al.,
2011; Fonda & Sarabon, 2013) in the experimental
design used. The present study used a between-subject
design, whereas the others (Hausswirth et al., 2011;
Fonda & Sarabon, 2013) used a crossover design.
According to Fonda and Sarabon (2013) and
Ferreira-Junior et al. (2014), the major limitation of a
crossover design to evaluate the effects of exercise-
induced muscle damage is that it can be influenced by
the repeated bout effect (Clarkson & Hubal, 2002;
McHugh, 2003). Additionally, a between-subject design
has been considered the gold standard when evaluating
healthcare interventions (Schulz et al., 2010).
On the other hand, using a between-subject design,
Costello et al. (2012a, b) reported that two sessions of
WBC (20 s at −60 °C and 3 min at −110 °C) in healthy
subjects did not hasten muscle strength nor decrease
muscle soreness. The main difference between our study
and Costello et al.’s (2012a, b) study was the timing of
the WBC session. In the current study, the subjects were
exposed 10 min after damaging exercise, while the ses-
sions of WBC was applied 24 h after damaging exercise
in the other study (Costello et al., 2012a, b). Immedi-
ately after damaging exercise, neutrophils and
lymphocytes are mobilized to the injured tissue, and
pro-inflammatory cytokines are produced in muscle by
lymphocytes and monocytes (Clarkson & Hubal, 2002;
Peake et al., 2005; Paulsen et al., 2012). Together, these
substances cause an intramuscular degradation, which
amplify the initial muscle damage (Clarkson & Hubal,
2002; Peake et al., 2005; Paulsen et al., 2012). Thus, it
would make sense to suggest that WBC applied 24 h
after damaging exercise did not avoid or decrease the
secondary muscle damage caused by the acute inflam-
matory process.
As expected, the muscle-damaging protocol used in
the present study caused significant muscle damage,
observed through a reduction of 32.0 ±13.3% in peak
torque, an increase in muscle thickness of 8.5 ±5.1%,
and moderate muscle soreness in the control group. This
muscle damage corroborates the findings from other
studies that used drop jump exercise as a muscle-
damaging protocol (Miyama & Nosaka, 2004; Howatson
et al., 2009).
Methodological considerations
A major limitation of the present study was that core and
quadriceps muscle temperature, muscular enzymes, and
Muscle soreness VAS (mm)
0
20
40
60
80
100 Control
PBC
*
Time
(
h
)
Pre Post 24 48 72 96
**
*
*
**
Fig. 4. Mean ±SD of knee extensors muscle soreness visual
analog scale (VAS) before (pre), immediately post, and 24–96 h
following exercise-induced muscle damage. PBC, partial-body
cryotherapy (−110 °C). *P<0.05, higher than pre- within group.
Cryotherapy (−110 °C) improves muscle recovery
5

biochemical inflammatory markers were not measured.
Future studies are necessary in order to understand the
WBC effects on muscle inflammatory process caused by
damaging exercise. The current study evaluated only
physically active young men. WBC might be more
accessible to athletes’ population and muscle damage
can also be less profound in this population (Barnett,
2006). In addition, anthropometric characteristics and
sex seem to affect magnitude of skin cooling following
WBC exposure (Hammond et al., 2014). Thus, further
studies on these topics are necessary in order to verify if
WBC can improve muscle recovery after high intense
training or competition in other populations, such as
athletes and women. Moreover, taking into account that
there is ambiguity regarding the optimal treatment pro-
tocol in terms of number of sessions, duration, and tem-
perature (Fonda et al., 2014; Selfe et al., 2014), future
studies should evaluate the effects of these issues on
exercise-induced muscle damage recovery.
Perspectives
The results of the present study showed that a single
session of PBC (3 min at −110 °C) 10 min after
muscle-damaging protocol enhanced muscle recovery
in physically active young men. From a practical stand-
point, PBC might be applied after an intense training
session in order to improve muscle recovery. However,
a question that should be investigated in future studies
is if the same effect would be observed in athletes who
used to experience less profound muscle damaging but
more regularly use WBC. Further studies also need to
evaluate biochemical inflammatory markers, tissue
blood flow, and tissue temperature in order to under-
stand the mechanistic effects of PBC. In addition, find-
ings reported in this study can only be applied when
PBC is administered 10 min after exercise-induced
muscle damage.
Key words: Recovery modality, peak torque, muscle
thickness, muscle soreness.
Acknowledgement
The study was partially funded by CAPES-Brazil.
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