Injury to the body comes in many different forms at different times in our lives, and ultimately it is how each of us recovers from the event that makes the difference. In the fields of kinesiology and physical therapy great advancements are being made toward a more holistic rehabilitation approach. For many years deliberate heat and cold exposure were considered passive therapies, but more research has shown that a sauna may be an active part of a thorough rehabilitation program.
For many individuals recovery from an injury goes beyond simply healing the body, but also to include a psychological component. For many, after a traumatic wound has occurred the fear of moving the body again during physical therapy sensation can become a major issue, and when it does it is called kinesiophobia. Research has found that incorporating both saunas as well as whole body cold immersion can help to prime the patient for further physical movement later on during recovery. Moreover, the use of a sauna during rehabilitation can help to lessen kinesiophobia when it comes time to start moving again.
Find out what the research shows about incorporating sauna and cold immersion into an active part of a rehabilitation program after physical injuries have occurred. Furthermore, understand the multilateral impact that thermal therapy has on the biochemistry of the physical body as well as on the nervous system to impact not only physical recovery, but also psychological healing.
Saunas have found their place into clinical settings and are no longer just a luxury spa treatment, but also part of real medical practice. Determine if sauna therapy and cold plunge have a place in your recovery journey, and if using these modalities may be helpful for more minor injuries. Learn how to use a sauna and cold exposure from home safely for the smaller bumps and bruises along life’s path.
What is Kinesiophobia?
After an injury it is normal to move through a period of time when you may feel ambivalent about exercising or moving the body at all. If this anxiety and fear surrounding moving again after an accident continues then it is called kinesiophobia. One major role that physical therapy accomplishes after injury is to help patients overcome their fear of movement after an injury.
It makes sense that after a car accident, for example, that taking those initial steps on a previously broken leg would be scary. Going back to using the body after a major trauma can be scary, but also necessary. Researchers have found that in addition to many other health benefits, the use of a sauna as well as cold exposure can help prime both the body and mind of individuals returning to movement during rehabilitation.
In a paper published in late May of 2026 by the reputable journal Frontiers entitled ‘Thermal stress: an untapped potential in rehabilitation? An opinion paper on Finnish sauna and whole-body cryostimulation’ (1) the authors discuss the possibility that sauna use and cold exposure may be more than just passive therapies during rehabilitation, but may in fact, actually be major ‘boosters’ during the recovery phase.
(FS = Finnish Sauna & WBC = Whole Body Cryostimulation)
“Integrating systemic thermal therapies such as FS and WBC into rehabilitation represents a paradigm shift, moving away from purely active models and towards “priming” approaches that are consistent with interventions such as nature exposure and mind-body practices…These modalities act as physiological boosters, which are particularly beneficial during the early stages of recovery when kinesiophobia, pain and fatigue can hinder exercise.” (1)
Find out more about how the use of deliberate heat and cold exposure can help the process of rehabilitation after injury in detail, and what specific styles of therapies these researchers explored.
The Critical Role that Saunas and Cold Exposure May Play in Rehabilitation After Injury: Not Just Passive Tools, but ‘Boosters’ to Rehabilitation
- Reduction in Pain
- Decreased Anxiety Around Movement: Primer for Future Exercise
- Metabolic Health: Brown Fat to White Fat
- Optimization of Vagual Tone: Homeostasis of the Autonomic Nervous System
- Decreased Inflammation
The multilayer positive downstream effect of using both sauna and cold immersion during specific rehabilitation stages are considerable. Throughout history humans have turned to both directions of thermal therapies to treat different aspects of health. In more recent decades both modalities of deliberate heat and cold exposure have become more popular in allopathic care. Throughout the last several decades thermal therapies have been viewed mostly as passive therapies during rehabilitation, but now researchers are beginning to understand the important role they play as an active part of treatment.
In a paper published by Frontiers journal entitled ‘Thermal stress: an untapped potential in rehabilitation? An opinion paper on Finnish sauna and whole-body cryostimulation’ (1) the researchers used specific thermo therapies. For this research only traditional Finnish saunas (FS), and whole body cryotherapy (WBC) were used.
Both of these treatments rely on both very high heat, and very low temperatures. Cryotherapy cannot be used unsupervised and is a very precise form of cold exposure that cannot be done from home. It may be possible to replicate the benefits of cryotherapy by using a cold plunge, or an ice bath.
“WBC involves brief exposure to −110°C to −160°C air for 1–3 min, triggering neuroendocrine, immune, and circulatory adaptations.” (1)
Here are some of the detailed ways that thermotherapies can help the rehabilitation process.
Pain Reduction
Addressing pain after injury is a critical factor that will determine whether the patient can safely begin to move the body again. Ensuring that pain management is executed safely is a necessary aspect to rehabilitation.
“It (thermotherapy) has recently emerged as a promising non-pharmacological intervention in the rehabilitation field to modulate chronic pain, reduce neuroinflammation, and serve as a “priming” tool to facilitate the transition to active therapeutic exercise.” (1)
Saunas may help to reduce pain in many ways including increasing certain hormones such as norepinephrine as well endorphins which can help to shift the perception of pain for some patients. Additionally, saunas may help during rehabilitation to lessen pain in these areas, according to the researchers.
“In rehabilitation, FS alleviates musculoskeletal pain, osteoarthritis, and chronic headaches.” (1)
Full body cold immersion is also known to help reduce pain as indicated in what the researchers report here.
“In neurological and pain syndromes, it reduces fatigue, improves sleep quality, and alleviates symptoms of Multiple Sclerosis (MS), fibromyalgia, and central sensitization.” (1)
Furthermore, cold exposure causes nociceptive signaling which helps to elevate pain thresholds.
“Nociceptive Signaling: Activation of TRPM8 ion channels and release of β-endorphins, which suppress pain signaling and elevate pain thresholds.” (1)
In addition to serving as a pain reduction mechanism, thermal therapies can also help prime the body for movement by reducing fear and anxiety. This means that the use of deliberate heat and cold therapies work with the central nervous system and the vagus nerve to reduce anxiety in general, and specifically around exercise and movement itself.
Decreased Anxiety Around Movement: Primer for Future Exercise
Kinesiophobia can arise after traumatic injury and prevent patients from rehabilitating fully through supervised movement, such as during physical therapy sessions. Overcoming fear of movement is a key aspect to recovery and it appears that both sauna and cold exposure may help to ameliorate kinesiophobia by reducing anxiety in general and balancing the autonomic nervous system.
“It (saunas) modulates autonomic balance, reducing sympathetic tone while increasing parasympathetic activity during recovery. Notably, the levels of norepinephrine reached during sauna exposure are comparable to those observed after maximal exercise, indicating a potent autonomic stimulus.” (1)
By promoting the health of the autonomic nervous system it makes it easier for individuals to move out of anxiety and stress (sympathetic dominance) and back into states of relaxation and trust (parasympathetic dominance). While thermal therapy is not the only way to reduce anxiety around movement post injury, it does help tremendously by working with the physiology of anxiety rather than with the psychology of it. Here is what the authors of the research write about balancing the autonomic nervous system to over kinesiophobia.
“By modulating the autonomic nervous system, specifically via the vagus nerve, thermal stress can improve systemic homeostasis and psychological readiness . This convergence towards optimized autonomic flexibility and HRV creates a “priming zone”. This homeostatic window optimizes the physiological response, reducing kinesiophobia and allowing the transition to active exercise protocols to be facilitated.” (1)
The use of cold and heat therapies can help reduce anxiety about future exercise and prime the body for movement by regulating the nervous system. The combination of both therapies can help facilitate the transition to exercise for patients in recovery from injury.
“These pathways converge in the central zone, optimizing vagal tone and HRV and promoting systemic autonomic homeostasis. This provides symptomatic relief and facilitates the clinical transition to active exercise protocols.” (1)
Furthermore, by promoting metabolic health, those patients who are obese may also find that exercise becomes accessible after a period of sauna and cold therapies. Additionally, it is possible to improve mitochondrial function and presence with the use of thermal therapies.
Improve Metabolic Health: Brown Fat to White Fat
The use of thermal therapies can help to prime patients for movement by changing metabolic health. Both heat and cold exposure can increase the presence of mitochondria. Cold exposure may be slightly more effective in inducing mitochondrial biogenesis compared to sauna.
Increased mitochondria can be measured by the presence of brown or beige fat compared to white fat in the body. Brown fat takes on this color specifically because of the increased presence of mitochondria. An increased number of mitochondria can help with energy conversion in the body, as well as by regulating the life death cycle of cells. (2)
Adipose tissue is the scientific word for body fat, and the authors of the Frontiers paper examined here, write this about whole body cold exposure and brown fat here.
“WBC serves as a multi-target adjunctive therapy in rehabilitation. It supports metabolic health by activating brown adipose tissue (BAT) and enhancing thermogenic lipolysis, aiding in weight management and insulin sensitivity” (1)
Additionally, sauna use can help make movement and exercise more accessible for obese patients. Saunas can help regulate and manage weight through cardiovascular engagement without placing additional weight on the extremities. This can be an excellent tool for physical therapists helping obese patients regain movement after injury. Here is what the authors of the Frontiers paper write.
“Rehabilitation, especially for patients with obesity, WBC facilitates engagement in exercise by reducing musculoskeletal discomfort and systemic inflammation.” (1)
Thermal therapy may aid in rehabilitation by improving metabolic health both by converting more white fat to brown fat and increasing the population of mitochondria, as well as by helping to reduce overall weight for obese patients.
Inflammation can be a major source of pain for individuals recovering from injury. A reduction in inflammation can help reduce pain, and help recover at a faster rate.
Reduce Inflammation
Both saunas and cold immersion can help to reduce inflammation quickly and effectively. Not only do these therapies induce circulation to help minimize inflammation, but also they may help minimize inflammation at the biochemical level.
According to the paper published by Frontiers journal, both saunas and cold immersion help to down regulate pro-inflammatory cytokines.
“Downregulation of pro-inflammatory cytokines (such as TNF-α, IL-6, and IL-1β) and upregulation of the anti-inflammatory cytokine IL-10.” (1)
Specifically, this same research paper discusses in detail how cold immersion can help to reduce inflammation.
“WBC has also been shown to exert anti-inflammatory effects, primarily through a shift in cytokine profiles such as TNF-α, IL-6, and IL-1β, while promoting an increase in IL-10, a key anti-inflammatory cytokine.” (1)
The cocktail of biochemical changes that occur when deliberate heat and cold immersion occur creates an ideal platform to re-introduce movement after injury, including for those living with kinesiophobia.
The authors of the Frontiers research paper conclude with very positive remarks regarding the use of both saunas and cold immersion during the initial stages of rehabilitation.
“Although these interventions are traditionally viewed as “passive”, they can act as a rehabilitation booster, particularly during the early stages of recovery when pain and deconditioning often impede progress.” (1)
They further continue to conclude with this statement:
“Systemic heat- and cold-based therapies, such as FS and WBC, are emerging as promising additional strategies in the field of rehabilitation medicine. Their ability to trigger diverse systemic responses, including cardiovascular, neuromuscular, metabolic, autonomic and immunological responses, makes them valuable tools for addressing chronic pain, fatigue and neuroinflammation.” (1)
If you or someone you love has recently been injured it may be worthwhile consulting with your physical therapist about incorporating sauna and cold immersion into your treatment protocol. Additionally, for minor injuries it may also be possible to translate the same results from the above examined study into your home use.
Using a Sauna and Cold Therapy After Injury: Overall Patient Satisfaction
It does not take a rocket scientist to know that it is a good idea to turn to cold or heat to heal minor injuries. It is run of the mill to apply ice after a bump to the head, or heat on a torn ligament. For robust rehabilitation purposes it appears to be significantly helpful to move beyond single body part thermal exposure into full body immersion. The paper published by Frontiers journal examined in this article discusses how sauna and full body cold immersion can help prime patients for movement during rehabilitation by relying on the biochemical changes that occur in the body as result of these therapies.
In addition to the scientific evidence to support the use of sauna and cold immersion during periods of physical rehabilitation, the researchers also found that there was a high level of patient satisfaction.
“Furthermore, high levels of patient satisfaction and immediate symptomatic relief can help to overcome common barriers such as low motivation and poor treatment adherence.” (1)
If you are in a hospital, or clinic recovering from an injury, and especially if you are experiencing anxiety about moving your body again safely, then please ask your doctor or physical therapist about using a sauna or cold therapy to help prepare your body for movement.
If you are at home and have experienced a minor injury, you can apply the same principles that you learned here to help rehabilitate your minor injury. Use a sauna and cold exposure in combination for best results. If you only have a sauna, then you can even use a cold shower or an ice bath to induce many of the same physiological responses as seen in the research above.
It is not necessary to use only a traditional Finnish sauna, so if you have an infrared sauna, steam room, or sweat lodge available you will be able to benefit from many of the same physiological changes discussed above.
For both personal, and clinical uses, sauna and full body cold therapy appears to be more than just a passive treatment, but may help in a very robust way during rehabilitation to prime the body for movement once again.
If you choose to sauna or use a form of cold therapy please consult with your medical provider ahead of time. While using a sauna it is very important to maintain excellent hydration at all times including drinking plenty of fluids rich in electrolytes.
Citations:
- https://www.frontiersin.org/journals/rehabilitation-sciences/articles/10.3389/fresc.2026.1720021/full
- https://pmc.ncbi.nlm.nih.gov/articles/PMC6567990/
- https://pubmed.ncbi.nlm.nih.gov/20524715/