Frequently Asked Questions

Cryotherapy is the application of cold to produce a cold induced therapeutic effect.

Any temperature below the temperature of the skin, typically around 30°C / 86°F, can be considered to be cryotherapy though temperatures above 15° or 20°C / 60°F or 70°F will only have a mild effect.

Low temperature hydrotherapy is typically between 5°C / 40°F and 12°C / 55°F

Air temperatures can go as low -150°C / -200°F as air has a very low thermal conductivity (air is an insulator) but at these extreme temperatures cooling is solely by conduction to avoid severe frostbite.

Cold water immersion, or ice baths, help reduce tissue swelling due to muscle breakdown and micro tears that occur during intense, or lengthy, physical activity and, also, help to control inflammation.

Some inflammation is a good thing but too much can lead to secondary damage or hypoxic injury.

The mechanisms include aiding normalization of body temperature, flushing out muscles due to constriction of blood vessels & compression through hydrostatic pressure, a decrease in metabolic activity, balancing of the sympathetic & parasympathetic systems and a reduction in muscle damage.

The therapeutic effect is a factor of temperature and time. The colder it is, and the more penetrating that cold, then less time is required to cool the tissue to a therapeutic level.

Traditional ice baths consisted of adding ice to water and depending on the amount of ice versus the amount of water these ice baths could be as high as 10 or 12C [50 – 55F]. In these circumstances, the recommended dosage varied from 10 to 15 or even 20 minutes.

With modern digitally controlled ice baths, or CryoSpas, which chill by conduction and convection [i.e. the jets are creating a ‘wind chill’ effect], the average treatment time is typically 3 to 6 minutes.

Ice bath therapy is a factor of time and temperature. The higher the temperature the longer is the required duration.

In the past most researchers used a time of 10, 15 or even 20 minutes at typically 10C to 15C [50F to 59F]. The problem with the longer sessions is that the temperature is not maintained unless you constantly add more ice. And the colder water floats at the top unless you constantly stir the water. In practice, most people sit still as the body warms the water around the skin making it more tolerable.

However, this strategy can be counter-productive as the generally recognised therapeutic tissue temperature of 12C to 15C cannot be readily achieved in traditional ice baths.

Modern ice baths do not use ice but have a digitally controlled chiller maintaining the temperature at a pre-set level throughout the therapy session. This enables both lower temperatures and shorter sessions to achieve an improved therapeutic effect.

Also, when the ice bath has jets, like the CryoSpa, there is chilling by both conduction and convection (wind chill) leading to a much more penetrating cold and ensuring the tissue is chilled to the therapeutic level.

Many elite football clubs, rugby clubs and Olympic training facilities are now using temperatures in the 6C to 10C (42F to 50F) range with some even as low as 4C (39F). When combined with the windchill effect the therapy sessions are most often in the 3 to 6 minute range.

Cold water immersion or ice baths, help reduce tissue swelling due to muscle breakdown and micro tears that occur during intense or lengthy physical activity and, also, help to control inflammation.

Some inflammation is a good thing but too much can result in secondary damage or hypoxic injury.

The mechanisms include aiding normalisation of body temperature, flushing out muscles through the combination of hydrostatic pressure and cold induced blood vessel constriction, a decrease in metabolic activity, balancing of the sympathetic & parasympathethic systems and a reduction in muscle damage.

Sports recovery i.e. post-exercise recovery is a non-medical application for CryoSpa therapy.

However, treatment of soft tissue injuries such as tendon & ligament sprains is considered to be medical use.

In the USA, the FDA, which approves devices & medicines for medical use, have exempted hydrotherapy, such as CryoSpa therapy, from Medical Device Approval requirements due to the low risk to patients and the non-invasive nature of the therapy. Consequently, CryoSpa therapy is available for medical use throughout the USA.

In other countries that adopt FDA guidelines this rule will also apply.

In the EU hydrotherapy is not exempt from medical device approval so a manufacturer cannot make medical claims for such devices.

Air is an excellent insulator but a poor conductor of heat. Water, for example, conducts heat 26 times faster than air. When you combine the conductivity with the density of water compared to air it is easy to understand why water delivers a superior cooling environment. For every molecule of air touching the skin there are more than 800 molecules of water.

Another important element is the effect of cooling by convection as well as conduction. In a typical Cryo Chamber using liquid nitrogen to cool the air you are only cooling by conduction to minimise the risk of frostbite. In a CryoSpa ice bath you are delivering the superior cooling properties of water via conduction and convection with the result that tissue temperature is reduced much more and much faster as well as penetrating into the tissue not just lowering the temperature of the skin.

According to research conducted by Joseph Costello at the University of Sydney, a traditional ice bath at 46°F / 8°C will reduce skin temperatures to around 20°C / 70°F after 3 minutes compared to 18°C / 64°F in a Cryo Chamber at -130°C / -202°F after 3 minutes.

In contrast cooling with water at 8°C / 46°F in a CET CryoSpa will reduce the skin temperature to 9°C / 48°F in less than 3 minutes – much more than cooling with nitrogen gas at -130°C/-202°F and in less time!

The theory behind contrast bathing is that the hot water stimulates vasodilation of the blood vessels near the surface of the skin and when followed by immersion in the cold water ,which causes vasoconstriction, a ‘pumping action’ ensues, which increases blood circulation.  

Typically, contrast bathing would consist of several cycles e.g. 1 or 2 minutes hot followed by 1 minute cold and repeated 3 times.

In a sporting context contrast bathing is used by some elite sports clubs as an alternative to cold water immersion alone.

There is also some research which supports the theory that the cold is the more critical element and where an athlete has a sustained soft tissue injury with symptoms including a combination of pain, heat & inflammation the application of additional heat would be contra-indicated during the acute phase of the injury (typically the first 48 to 72 hours).

Some research studies have also supported the theory that thermal stress positively influences the auto-immune system.

A type of tendonitis, tennis elbow can cause intense pain and while it is more common in people over 40 it can occur at any age.

It is the most common reason that people visit a doctor with elbow pain.

Healing of tendons and ligaments is much slower than muscle injuries due partially at least to the low blood flow in this type of tissue.

Typical interventions include strapping to minimise movement in the elbow and the taking of pain killers and anti-inflammatories alongside the application of cold. The bag of frozen peas being a common diy treatment.

The CryoSpa Mini offers much faster resolution of tennis elbow and similar elbow issues such as golfer’s elbow and pitcher’s elbow due to the intense penetrating cold.

Three or four sessions of typically 3 minute duration has been seen to have a dramatic impact on elbow pain.

The CryoSpa Mini may also be useful as a preventative modality for those at risk of over-use injury in particular competitive tennis & golf players and baseball pitcher’s.