Musculoskeletal Medicine and PainORIGINAL ARTICLE

Retrospective analysis of whole-body cryotherapy adverse effects in Division I collegiate athletes

Emily A. Kelly, BS; Nazilla Seyed Forootan, MD; Jake X. Checketts, DO; Austin Frank, MS, ATC; and Christopher L. Tangen, DO
Notes and Affiliations
Notes and Affiliations

Received: July 30, 2022

Accepted: February 9, 2023

Published: March 17, 2023

  • Emily A. Kelly, BS, 

    Department of Medicine, Lake Erie College of Osteopathic Medicine, Erie, PA, USA

  • Nazilla Seyed Forootan, MD, 

    University Hospitals Sports Medicine Institute, Cleveland, OH, USA

  • Jake X. Checketts, DO, 

    Department of Orthopedic Surgery, Oklahoma State Medical Center, Tulsa, OK, USA

  • Austin Frank, MS, ATC, 

    Athletic Training Department, Kent State University, Kent, OH, USA

  • Christopher L. Tangen, DO, 

    University Hospitals Sports Medicine Institute, Cleveland, OH, USA

J Osteopath Med; 123(5): 249-257

Context: Although the physiological effects and the performance of athletes after utilizing whole-body cryotherapy (WBC) have been widely studied, there is a lack of data on its adverse effects. It is important to be aware of the adverse effects of any treatment for its use to be properly recommended.

Objectives: This study aims to provide insight to any adverse effects that collegiate athletes experienced after utilizing WBC to better utilize this therapeutic modality.

Methods: After the Institutional Review Board (IRB) deemed exemption, all 457 Division 1-A varsity athletes were recruited via email to participate in a retrospective survey. Participants consented to the study by continuing to the questions. The inclusion criteria were that they must be 18 years of age or older, had completed WBC at that university, and were a student-athlete. The survey was six questions long, and if any of the inclusion criteria was not met, they were redirected to end the survey. The data were analyzed utilizing odds ratios.

Results: Of the 457 student-athletes, 11.2% (n=51) responded and 6.3% (n=29) met the inclusion criteria. Responses were obtained from women’s lacrosse (27.6%; n=8), women’s gymnastics (24.1%, n=7), field hockey (17.2%, n=5), wrestling (6.9%, n=2), football (6.9%, n=2), women’s cross country (3.5%, n=1), men’s basketball (3.5%, n=1), women’s volleyball (3.5%, n=1), softball (3.5%, n=1), and baseball (3.5%, n=1). Among the responses, 79.3% (n=23) were females and 29.7% (n=6) were males. Within 1 h of WBC, the most frequently reported adverse effects were skin rash (27.6%, n=8), itching (13.8%, n=4), and fatigue (6.9%, n=2). More than 1 h after WBC, the most frequently reported adverse effects were skin rash (20.7%, n=6), itching (10.3%, n=3), and increased energy (6.9%, n=2). When stratified by female and male athletes, for both within 1 h and more than 1 h after WBC, there were increased odds for females reporting adverse effects; however, neither were statistically significant (OR 4.58, p=0.19, 95% CI 0.46 to 45.61) (OR 3.84, p=0.25, 95% CI 0.39 to 38.36). Within 1 h of WBC, 58.6% (n=17) of subjects reported no adverse effects, and more than 1 h after WBC, 65.5% (n=19) subjects reported no adverse effects. The mean satisfaction level rating was 6.34 (range 0–10, n=29). When asked if they would do WBC again, 65.5% (n=19) responded “yes” and 34.5% (n=10) responded “no.”

Conclusions: In this collegiate athlete population, negative adverse effects of WBC commonly included skin burns and itching while potentially proving a beneficial adverse effect of increased energy. Subjects commonly reported no adverse effects after WBC treatment as well.

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