Spring 2022 - Take The Plunge

Let me start by confessing: I hate the cold.  I was that kid in ski school who made the whole group go indoors every 2nd run to warm up.  I used to make my last running partner giggle when I’d show up fully bundled in contrast to her shorts and T.  Since moving from Vancouver to Toronto, I have found the cold to be even more intrusive.  I can easily be found wearing a parka and mitts in May.  But despite all this, and much to my surprise, I am creating a new and interesting relationship with deliberate cold exposure.

You are likely thinking ‘She’s nuts!’ (most of my family and friends would agree).  But stick with me.  This type of cold feels somehow different then being underdressed in crummy weather.  My story goes like this:  It was one of the many groundhog days of the pandemic, and while scrolling through social media, I stumbled upon a ‘cold club’.  It was an informal group of women, led by one more experienced facilitator, who were dipping together once a week at sunrise. This group practiced a brief round of breath work and meditation, and then dipped in Lake Ontario staying in for a few minutes at a time.  I was both terrified and intrigued.  In the past, I had jumped in the lake in Spring on a dare, and used the cold plunge at the spa, but never had I done anything quite like this.  On a cold windy day in April last year, I decided to try it out.  What did I have to lose?

It turns out, I have gained a whole lot, and have stuck with it ever since.  This morning I even celebrated my 1 year anniversary of regular cold dips.  As I was getting ready to go in the water today, a first timer approached me and asked: ‘why do you do it?’ I tried to explain, but realized, I wasn’t totally sure.  From a naturopathic medical standpoint, I knew the benefits to mental health, physical health, and performance (read on for details).  But for me,it felt like more.  Over the past year, after every dip, I’ve thought ‘well that was good, and now I’ll take my winter break, and maybe come back in spring’.  I enjoyed it, but had no intention of dipping outdoors year round in Toronto.  But somehow, like clockwork, every couple weeks I was inexplicably pulled back.  But why?  For me, the flood of neurotransmitters is surely creating a positive feedback loop.  Fortunately, I don’t struggle badly with musculoskeletal pain, so that isn’t my hook.  I have always been someone who loves to swim, especially outdoors (in summer), is that it?  Full disclosure:  The whole thing has taken me a bit off guard.  What the heck is going on? 

With some thought, I’ve decided that the specific combination of extra neuro-chemicals, time in nature, practicing awe at the lake and sunrise, getting uncomfortable, being in water, challenging myself, and connecting with a community, is creating a powerful combination bringing me back time and time again.  

I’m writing to you now because I have gotten several questions about cold exposure, and have also thought of it often when building your treatment plans.  I want to suggest, from one ‘non-cold lover’ to another, that you all consider giving it a shot.  Who knows what it will uncover for you.  Worst comes to worst, you will have a hard time warming up (read on for my insider hacks on that), but best case scenario, you will reap many more rewards.  Most of you reading this live near a body of cold water, and all of you have at least a shower, and likely a bath too.  This means that cold exposure is available to each and every one of you (at no cost!).  Have I piqued your interest?

THE SCIENCE
1. Mental Health
Deliberate cold exposure causes the release of a cascade of neurotransmitters, notably noradrenaline (aka norepinephrine) and dopamine.  Dopamine is in charge of motivation, pleasure, reward, and pursuit. It improves mood and attention. Imbalances are often involved in the cycle of addiction.  Noradrenaline (sister to adrenaline) increases alertness, arousal, and attention.  It is instrumental to our sleep-wake cycle, mood, and memory.  These two neurotransmitters are commonly released in tandem, and as a culture, we are continuously trying to optimize our levels of both.  Increased amounts of both dopamine and noradrenaline improves our overall grit, ability to cope with stress and challenge, and our overall resilience.  Cold exposure teaches us how to stay calm during elevated stress.  What an amazing tool for day to day life!

2.  Inflammation

Anyone recall seeing Roy Kent (of Ted Lasso fame) soaking in an ice bath post game?  Many athletes throughout history have used ice baths to reduce inflammation.  There is also evidence that it enhances overall athletic performance.  Nuance exists though according to the research.  For strength training specifically, it may be ideal to delay cold exposure to 4 or more hours after a session.  While other types of training (like endurance), do not require the same delay.  When used accurately, cold exposure is found to be a helpful tool to improve overall recovery and reduce soreness post exercise. 

3. Metabolism

Cold exposure therapy has also been found to increase metabolism.  It does so by converting ‘white fat’ cells into ‘brown fat’ cells.  Brown fat is more biologically active, and increases core body temperature, in comparison to white fat.  It speeds up metabolism, and helps the body burn the less useful white fat.  This benefit occurs during the cold exposure, and immediately after.  It’s possible that longer exposure times may be necessary to enjoy a significant change in metabolism. Cold exposure is being studied for its fat burning effect in the management of type 2 diabetes and obesity.  

HEALTH WARNING

Cold exposure therapy is a very potent stimulus, and is not universally healthy. There is such a thing as too cold (leading to cold shock / hypothermia). That temperature threshold is individual to each person, level of experience, duration, and circumstance.  To safely cold dip, always have a warm up plan (which I will speak more about below).  I do not recommend cold dipping alone, especially if you are a beginner (although cold showering alone is likely fine).  

PROTOCOLS

There are many different options for cold exposure.  The most common are cold showers, cold immersion in nature, or ice baths. NB Going for a walk outside in winter in a T-shirt can also be a type of deliberate cold exposure.  In my learning, I have not found one universal  protocol, or set point.  It depends on you as an individual, the circumstance, and also what benefits you are hoping to achieve.  Experts often use temperatures ranging anywhere from 10-18℃.  A good rule of thumb is using a temperature that is uncomfortably cold, where you want to get out, but can safely stay in.  Session duration can be somewhere between 2-5 minutes, and there is evidence to show that 11 min total per week in 2-4 divided doses may be ideal.  If you are doing contrast (in the shower, or at the spa), always end on cold.  Some practitioners do specific breathing exercises before, or during, especially those trained in the Wim Hof Method (the person who has done the most work to raise awareness around cold exposure therapy to where it is today, the ‘Ice Man’)

DR. P’S INSIDER TIPS

Remember:  the beginning is always the hardest.  I have found that as a particular session goes on, and the more dips I have done, the easier it has become.  As I mentioned, you always need a warm up plan.  This can include some or all of:  moving your body, hot showers, saunas, hot tubs, hot beverages, hand/foot warmers, hot water bottles, and more. I personally rarely dip my head under (partly because I am dipping in Lake Ontario!), nor submerge my hands.  A lot of heat is lost through the head, so some dippers dunk their head at the end of their session.  Also, depending on the temperature, I always wear water shoes when outside on uneven terrain to stay safe.  Personally, what has worked for me well, is that once I am in dry clothes, I always go for a big dog walk right after.  Moving my body brings back my circulation and equilibrium, and I don’t find it hard to warm up after (and remember, my circulation is not fantastic).  

In conclusion, I am not ready to say I love the cold (my brain literally interrupts that thought!).  But, I definitely keep going back to it.  It is a helpful tool that brings me incredibly present in this very moment.  While in cold water, I am forced to breathe, slow down, and access my calm.  It is obviously helping my overall health, and mental state.  I think, at times like these, we can all use a few more quick and cheap tools in our toolkit.  Let cold exposure be just one more that you consider.  And if you are at all curious, give it a shot, even just end your next shower with 15 seconds of cold.  The cold just might surprise you, I know it has for me!

XO Dr. P