Cryotherapy, Hydrotherapy and other training recovery modalities: Effects on hormones’ balance and performance

Recovery modalities (RM) are an important aspect of training programmes, providing physiological benefits to athletes and enamelling them a homeostasis balance between training and competitions. Recovery allows the athlete to return to the state of performance readiness by restoring all the physiological parameters back to baseline levels (Barnett 2006, Reilly and Ekblom 2005, Gill et al. 2006). RMs have been largely investigated in regards to their ability to enhance blood lactate removal or to reduce exercise induced delayed onset of muscle soreness (DOMS) (Barnett 2006). The endogenous hormones influence the body’s adaptation to stress stimulus, therefore, investigating these hormones during and post stress might give a better insight on the metabolic side of the recovery (Urhausen et al. 1995). Salivary testosterone (T) / cortisol (C) ratio (T:C) is often used as an indicator of stress level imposed by exercise. These hormones are responsible for modulating responses that are elicited by exercise as they indicate the so-called anabolic-catabolic index. After strenuous exercise, C levels increase as a physiological effect of exercise, whereas T levels decrease. This indicates a disturbance in the anabolic-catabolic balance (Urhausen et al 1995). When T levels are higher compared to C levels then an athlete is in an anabolic state; when the T:C ratio is low then an athlete is in a catabolic state. The more stressful an exercise is the more cortisol C is produced and lower is the ratio. It is supposed that RM would help C levels to substantially decrease and T levels to increase. Many recovery studies have used various physiological markers like blood lactate and heart rates, however, hormone levels as an indicator of training-related physiological imbalance is not particularly investigated thoroughly. Hoogeveen and Zonderland (1996) noted that increased levels of cortisol and decreased levels of testosterone suggest a disturbance in anabolic-catabolic balance, which may result in a decreased performance. Therefore, applying RM to return the body’s physiological variables to their normal levels is a necessity. Cryotherapy (CR) (ice immersions) and hydrotherapy (HD) (cold showers) are two relatively new concepts compared to the active or passive recovery modalities and are being recently investigated to observe their effects on physical functions. Specifically CR, which is frequently used to prevent and to treat traumatic muscle injury, is fast becoming an often-used method for recovery during training sessions (Paddon-Jones and Quigley 1997, Hurme et al., 1993, Eston and Daniel 1999, Vaile et al. 2008). It is indeed, not uncommon to see athletes immersing in ice containers at the end of their session. Investigations on CR have shown mixed effects. Some have demonstrated an enhancement of the physiological markers which may improve subsequent performance. Others have demonstrated limited effects. Tricia et al (2004) noted that several CR studies had limited in-depth statistical analysis. Furthermore, the varying effects of CR on increasing performance after recovery and prevention of injury are mixed at best (Brian et al. 2000; Tricia et al 1997, 2004; Verducci 2000). Our review of the literature showed that most of the studies on CR were carried out on a field setting (during training or competitions). Delimiting and standardising the procedure for all participants in such setting is always problematic and lead to several “uncontrolled variables”. Delimitation and standardisation is always better managed in a lab setting studies. HD, in similar fashion, is used as preventive and therapeutic procedure for skeletal-muscle problems (Geytenbeek 2002, 2008). It is also being utilised in recent times for recovery from exercise and is starting to become more noticeable in the world of sports science as an effective means of enhancing recovery (Vaile et al 2008, Wilcock 2006). Its effects have been noted, ranging from fatigue reduction (Vaile 2008) to improving performance in people with chronic heart failure (Cider et al 2003). However, Cochrane (2004) and Wilcock et al (2006) noted that the literature available on HD as a means to improve athletic recovery is based on anecdotal information rather than actual “effect” assessment. Physiological rationale for enhancing recovery is less known when compared to its effect on reducing injuries. Solid conclusion from the small number of investigations carried out on HD cannot be drawn yet. Conversely, AR has been extensively investigated in the mid and late nineties. Its effects have not only been recognized as one of the most effective ways to recover post intense exercise bouts but also it has been applied in multiple cyclic and acyclic sports seeing its positive effects on performance (Ahmaïdi et al., 1996; Bogdanis et al., 1996; Bond et al., 1991; Jemni et 2003). The first purpose of this talk is to provide an overview on the latest studies carried out on cryotherapy, hydrotherapy and active recoveries whereby using hormones as indicators. The second purpose is to present the results of a recent study comparing the effects of these three recovery modalities on salivary testosterone/cortisol ratio and on the subsequent performance when they are applied in between two Wingate tests.