One of the stranger news stories of the year emerged last week when it was learned that NFL All-Pro wide receiver Antonio Brown developed frostbite on his feet from cryotherapy.

ESPN’s Adam Schefter initially reported the Oakland Raiders receiver missed three days of training camp to see a foot specialist. After Brown posted a picture of what appeared to be large blisters on the soles of both feet, Chris Simms of Pro Football Talk speculated he could have a fungal condition. Someone close to Brown then told Simms the receiver had developed frostbite from a session of cryotherapy in France.

Stranger still, the source claimed Brown’s frostbite resulted from not wearing “proper footwear” in the cryo chamber.

In the weeks since the story broke, three main questions have surfaced. Why would Brown not wear “proper footwear” in cryotherapy? How could he, or any athlete, suffer frostbite? And why is cryotherapy so popular with athletes in the first place?

In full disclosure, I’ve done cryotherapy several times a week for about a year.

When you do a session of whole-body cryotherapy, you spend up to three minutes in a chamber well below minus 100 degrees Celsius. Businesses that run these chambers require you to wear gloves, socks and slippers or boots they provide. Without knowing the specifics of Brown’s session, it seems odd someone would allow him to step in the chamber without those socks or slippers.

Where I can imagine issues with frostbite, though, comes from your socks. On a couple of occasions, I went straight from the gym to cryotherapy. Instead of wearing their socks, I left my workout socks on. Within seconds my feet were bitter cold.

Cryo is difficult but it’s not painful. However, with socks that are even slightly damp with sweat, it’s really uncomfortable. Fortunately, I didn’t suffer frostbite, but I can easily see how it could happen.

As to the larger question of why cryotherapy is so popular, look no further than pro athletes like Antonio Brown. Active people across the world try it to recover faster from their training because pro teams and athletes use it.

Some of the proposed benefits include reduced inflammation, increased energy, increased testosterone, improved metabolism and weight loss, decreased pain and muscle soreness. It is also believed to help with depression, anxiety and insomnia. With those possible results, it’s no wonder cryotherapy has become a $3 billion per year industry worldwide.

Unfortunately, scientific studies have failed to conclusively show a real benefit to whole-body cryotherapy for muscle recovery. While some small studies have shown decreased self-reported muscle soreness or improved subjective recovery, few well-designed studies have shown significant improvements in inflammatory, hormonal or muscle damage markers.

It’s worth noting that it’s hard to perform high-quality research studies on cryotherapy. The gold standard for a research study is a randomized, double-blinded study. It’s hard to randomize subjects because they want the real treatment. And it’s impossible to blind them so that they don’t know if they’re receiving the treatment or not. If you’re standing in a chamber with air as cold as minus 187 degrees Celsius blowing, you know it.

Another point to consider is the idea of belief and perceived benefits. I’ve seen this issue both in my research on whole-body cryotherapy and other recovery treatments (infrared sauna, compression boots, flotation tanks, etc.) for a book I’m writing and from trying them myself.

Cryo makes many athletes feel like they have recovered from tough workouts better and quicker. Those perceived benefits can be important. If you wake up the next day and you believe you can train harder, that’s a good thing.

After all, the goal of training is to push your body harder so that you get faster and stronger. If cryo helps you feel like you can train harder, then even without objective changes in your muscles or blood, it might help you.

For the last three months, I’ve been doing strength and sprinting workouts with a former Olympic gold medalist who trains a number of pro athletes, including Antonio Brown.

I stopped doing regular cryo about six weeks ago, not because I didn’t like it but because of my schedule. I realized I actually recover better and train harder the next day if I do not spend three minutes in the cryo chamber after my workouts. But that’s just my experience. You might have different results.

If you’re considering cryotherapy to recover from sports and exercise, it's worth a try. Just make sure to wear dry socks.

Editor’s note: Dr. David Geier is an orthopedic surgeon in Charleston and author of “That’s Gotta Hurt: The Injuries That Changed Sports Forever.”

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