REF-323 · Wolska B, Domagala L, Kisilewicz A, Hassanlouei H, Makar P, Kawczynski A & Klich S, 2023 · Frontiers in Physiology, · Paper · PubMed
Multiple cryosauna sessions for post-exercise recovery of delayed onset muscle soreness (DOMS): a randomized control trial
Four −110 °C sessions after 10 × 10 jumps lowered leukocytes (24-72 h) and creatine kinase (24-96 h) versus control; within the cryo group stiffness still rose at 48 h (and at 72 h in two muscles), which the authors read as the stiffness response being confined to the first 48 h
Participants
n=31 volunteers: CRYO n=16, CONT n=15.
Protocol
Exercise-induced muscle damage in both groups: repeated countermovement jumps, 10 sets × 10 repetitions.
CRYO group: cryosauna at −110 °C for 1.5 min per session, four sessions — immediately after exercise and at 24, 48 and 72 h.
CONT group: same exercise, no intervention.
Outcomes: blood (leukocyte count, myoglobin, creatine kinase activity) at baseline and 24-48-72-96 h; lower-limb muscle stiffness at baseline, immediately after and 24-48-72-96 h.
Key Results — exactly as the abstract states them
Leukocyte count was significantly greater in CONT than CRYO at 24, 48 and 72 h after exercise (p ≤ 0.05 for all).
Creatine kinase activity was greater in CONT than CRYO at 24, 48 and 96 h (p ≤ 0.05 for all).
In the CRYO group, muscle stiffness increased significantly in rectus femoris, tibialis anterior and fibula muscle at 48 h post-exercise, and in tibialis anterior and fibula at 72 h (p ≤ 0.05 for all).
The abstract reports no between-group comparison of stiffness and no result for myoglobin.
Authors' conclusion: multiple cryosauna sessions were an effective recovery strategy that "reduced blood biomarkers and muscle stiffness" after exercise-induced muscle damage, and the development of DOMS, expressed as greater post-exercise stiffness, "was attenuated to the first 48 h".
How to read the stiffness result
The two statements sit side by side in the abstract: within the cryo group stiffness rose at 48 h (three muscles) and at 72 h (two muscles); the authors interpret this as the stiffness response being limited to the first 48 h rather than building further. Whether stiffness was lower than in the control group is not stated in the abstract.
Inference, not tested here: the firm result is the lower inflammatory/damage markers in the cryo group; the stiffness benefit rests on the authors' interpretation and would need the full text's group comparison to be quoted as a number.
Practical Application
In 31 volunteers after 10 × 10 countermovement jumps, four cryosauna sessions (−110 °C, 1.5 min; immediately and at 24, 48 and 72 h) left leukocytes lower than control at 24-72 h and creatine kinase lower at 24-96 h; within the cryo group muscle stiffness still rose at 48 h (rectus femoris, tibialis anterior, fibula) and at 72 h (tibialis anterior, fibula), which the authors read as the stiffness response being confined to the first 48 h. So repeated cold-air sessions demonstrably blunt the blood markers of damage after eccentric work; the claim that they reduce stiffness is the authors' reading, and the abstract gives no cryo-vs-control stiffness number.
Inference, not tested: the protocol was four sessions on consecutive days, not one — a single session after a hard day is not what was tested.
Limitations
Cryosauna (−110 °C air) is not cold-water immersion; do not transfer numbers between the two.
Jump-based damage protocol — not endurance-specific.
Training status of the "volunteers" is not given in the abstract; sex not given.
Short session (1.5 min); other durations not tested.
The abstract gives no between-group stiffness statistic, so the size of any stiffness benefit is unknown from it.
How this entry was checked and changed
Why this level
regraded 2026-09-27 from A-: parallel RCT with n=31
Content correction 2026-09-27
Key Results said stiffness "increased in CRYO at 48 h and 72 h" while the conclusion said cryo "attenuated overall stiffness" -> both statements are in the abstract and are now presented together with the explanation: the rise is a within-CRYO-group result, the "attenuated to the first 48 h" wording is the authors' interpretation, and no cryo-vs-control stiffness comparison is given in the abstract.
"Cryotherapy reduces both inflammation markers AND tissue stiffness — validated recovery modality", "48-72 h is peak stiffness — target cryotherapy then", "cold works on the root cause, others on symptoms" -> overstated relative to the abstract; reduced to what is shown (lower leukocytes and CK) and labelled inference elsewhere.
Tier "Tier 2 (trained/active)" -> Tier 1-2 (volunteers; training status not in the abstract). Level A- -> B+ (parallel RCT, n=31).