(above) Rhonda Patrick’s 15 minute video on the advantages of sauna hyperthermic conditioning

This article is in some ways a continuation of the thought begun in my article: The Myth of Overtraining in Muay Thai, which calls for active rest and repair. The main reference article for the benefits of sauna use is: Are Suanas the Next Big Performance Enhancing “Drug?”

 Training in Heat, Sauna Benefits

Much has been made of the superpowers of  Thailand’s Isaan (and, in the west, just Thais generally) fighters whose training regimes are notoriously hard. They  are not only hard in their rigor, they are hard because much of the time the training is done in very high heat and humidity (100+ F, 40+ C is not rare). I’ve always taken this heat difficulty as just part of the mental toughness it builds – I mean, there’s really nothing you can do about it as most gyms are pretty much outdoors – but there may be something more to it. Note: training in extreme heat can lead to dangerous conditions, this article is for information purposes only.  Lawrence Kenshin alerted me to the work of Dr. Ronda Patrick, PhD , which has been making the rounds in MMA forums after Joe Rogan had her on a podcast. Dr. Patrick has been doing some work investigating the benefits of regular 30 minute sauna treatments (twice a week) and has some bold claims about just how good such “hypothermic conditioning” is for athletes, as well as the body and brain for anyone (all the below is in the video above)

Endurance Advantages:

• spares local glycogen stores in muscles, preserving reserve energy sources
• improves workload heart rate
• reduces core temperature during workload
• increases the release of growth hormone
• releases “heat shock proteins” – enhancing muscle growth, perhaps longevity
• improves insulin sensitivity

Brain Advantages:

• improves the store and release of norepinephrine, thus mental acuity
• increases prolactin which may improve brain function and nerve repair through myelination.
• increases BDNF which is associated with neurogenesis, learning, and recovery from some forms of depression

Now, this all sounds very science-y and wonderful, but it should be kept in mind that these are diverse and very limited studies being pulled together in a constellation of effects. This set of circumstances seems to produce more of x, x has been associated with improvements in y. If you add all the y together and you have something amazing. It does have the ring of the next health fad, like intermittent fasting or “altitude training.” But this being said, when you look at the training in Thailand, it is easy to extrapolate these same types of benefits as possible extensions of what is being claimed for bi-weekly sauna use. The benefit seems to come about through the heat stress itself, and what it stimulates the body to do; and while most of Thai training is not at sauna level heat (thank God), it is still in elevated heat; and Dr. Patrick says that exercise alone will stimulate some of these heat-stress related events as well. One has to raise the idea that the Thai standard of rather hot conditions for it’s rigorous workouts could have lasting and pronounced physiological and mental benefits across the board for the tens of thousands of athletes training in Muay Thai country-wide.

Note: tending to be smaller bodied Thais do have a biophysical advantage of being able to cool their bodies faster than larger, western bodies – fortunately, I am quite small (47 kg, 103 lb).  And no (!), this is not a suggestion that you should start doing burpees in the sauna. Heat can kill you, seriously. Though here is important evidence about heat illness misconceptions, including the supposed role of dehydration. There may be pre-existing pathological factors involved heatstroke illness, where the body just fails to respond as it should.

So with every precaution in mind, let’s consider that there may be across the board benefits to heat training, in the Thai sense, that are not regularly recognized – Thais do take the hottest part of the day off to rest (the middle of the day).  Even while avoiding the hottest part of the day, it’s pretty damn hot within an hour of sunrise and you will be training in high temperatures, so in coming to Thailand to train and improve yourself the role of heat may be something that could be more in the forefront of the mind, and becoming “heat acclimated” may further enhance your ability to handle the already very difficult training schedule that most gyms present. I’ve certainly become more accustomed to the heat than when I started and there are definitely days when it feels just too damn hot to do a run in that blazing sun.  This evidence is making me rethink and really appreciate the role heat may have played in my own conditioning, and perhaps my conditioning in the future. This role of heat, and the importance of getting acclimated also may inform some of the issues I brought up in my “Myth of Overtraining in Muay Thai” article. Discomfort is good, too much may be dangerous, but you should be looking to slowly but surely integrate yourself into the standard workout at the gym you are at.  (Again, heat can also be dangerous so use some common sense and self-understanding to determine whether or not you can be stressing your body in very high heat; there is a risk of heat stroke and all that – I’m just saying that acclimating yourself to the normal Thai heat training conditions can be very beneficial.) A rule of thumb may be: look at the Thais training with you, and gradually mirror them more and more, and this includes their patterns of rest, cooling and being at ease.  (Up in Chiang Mai at  Lanna, for example, on the really hot days the Thai boys and my trainer Den would wait until after evening training for the run, meaning they were heading out at 6:30 PM or so when the sun was going down to avoid the heat.)

What May Be Happening in Regular Thai Heat Training

Below is a more detailed description of how being heat acclimated enhances endurance (quoted from Dr. Patrick’s article). These are the kinds of things that the Thais could prospectively be benefiting from in their training schedules and conditions:

1. It increases plasma volume and blood flow to the heart (stroke volume).^2,5 This results in reduced cardiovascular strain and lowers the heart rate for the same given workload.² These cardiovascular improvements have been shown to enhance endurance in both highly trained and untrained athletes.^2,5,6
2. It increases blood flow to the skeletal muscles, keeping them fueled with glucose, esterified fatty acids, and oxygen while removing by-products of the metabolic process such as lactic acid. The increased delivery of nutrients to muscles reduces their dependence on glycogen stores. Endurance athletes often hit a “wall” (or “bonk”) when they have depleted their muscle glycogen stores. Hyperthermic conditioning has been shown to reduce muscle glycogen use by 40%-50% compared to before heat acclimation.^3,7 This is presumably due to the increased blood flow to the muscles.³ In addition, lactate accumulation in blood and muscle during exercise is reduced after heat acclimation.⁵
3. It improves thermoregulatory control, which operates by activating the sympathetic nervous system and increasing the blood flow to the skin and, thus the sweat rate. This dissipates some of the core body heat. After acclimation, sweating occurs at a lower core temperature and the sweat rate is maintained for a longer period.²

The Thais and Heat – Not Cold

One of the most interesting things I encountered here in Thailand is the role that heat conceptually plays in traditional modes of health. In the west we like to ice everything, in Thailand everything is treated with heat. I’ve already written about how this is so for healing shin damage where heat (and massage) is vital to quick recovery. But also, despite the heat everyday, the sauna figures heavily into the Thai concept of repair and preparation.

Nook is a 56-year-old trainer at Lanna Mauy Thai in Chiang Mai. I write about him often because he is just plain memorable.  He was known as the “Dragon of Chiang Mai” and then later “Iron Dynamite” as his fight names.  For 56 years old he’s in incredible shape – he’s in great shape for 40.  But he suffered a bad motorbike accident about 20+ years ago and since then he’s had permanent damage in his leg.  He’s always massaging the spot behind his knee, his thigh and knee cap are permanently swollen, and the stiffness, of his leg is quite evident when he’s trying to right himself for balance in sparring or while holding pads.  Nook doesn’t speak a lot of English, but he does provide therapeutic massage when you have injuries from Muay Thai and his advice is always this, “sao-nah, sao-nah, mass-age, mass-age.”  He takes his own advice and visits a sauna and massage clinic just outside of Chiang Mai at least once per week, more if he’s won some money at gambling on fights or the horse races.  Thai saunas are not the “dry” sauna of Scandinavia, but are simple and genius structures made out of a rice-cooker, herbs, and either a nice wooden room or just a tent to create a little steam room.  You can make one yourself out of a pop-tent and a rice-cooker; I made one to cut weight once by putting a plastic rain poncho over an umbrella and sitting under it with my rice-cooker in my shower.  When I finally convinced my trainer Den at Lanna that I was going to continue fighting 3-4 fights per month on a regular basis, he told me I should go take a sauna a few times per month to help me heal faster.  It’s absolutely part of being healthy and taking care of the body in the Thai concept of health.

Big at Lanna making weight

The Thai Making Weight Process

This study has had me also rethink how I feel about the Thai weight-cutting process. I have to say that knowing that in the west (armed with our wrestling extremes and our science-y Science) that we can drop several kilos for a fight without too much struggle – this has been my occasional process – by essentially forcing the water from our bodies in a short-lived but extreme state of dehydration, it was painful for me to watch my favorite fighters at Lanna, like Big, go through agonizing sweat runs in thermal jackets in afternoon heat, sometimes more than a week in advance of having to step on the scale, and then repeatedly eat and drink to put on nearly everything he had lost that day. It seemed like a crazy and very ineffective way to cut weight for a fight – putting on, taking off, putting on, taking off.

I remember watching Big, who is a quiet but generally very happy and playful in his disposition, turn into a zombie over the period of a week or so before a fight where he had to make weight.  I assume he was making adjustments to his diet somewhere, but with an already very lean body there wasn’t a lot that his body could lose without struggle and mainly he was putting on a sauna suit (jacket and long pants) to run in the hot sun, then come back and skip rope, have someone massage his muscles (which cramp badly from the dehydration) and then towel off before stepping on the gym scale.  If he was above his number he’d put the suit back on and skip rope again; if he hit the number he could shower and because he was at an age where someone’s not monitoring him and he can make decisions himself, he’d generally then have a drink and a snack of pure salt and sugar.  Nice.  But that just means he gets to start over again tomorrow, in the sauna suit in the morning and again in the afternoon, always dropping back down to that number.  He would do this for days and he always seemed miserable.

For those who have to lose more kilos than Big ever did, or those who are better monitored, the Thai process was pretty much the same but with more strict diet restrictions, but still hitting the weight and then eating and drinking for sustenance and then gunning for the number again the next session .  By pulling down to get the number on the scale closer and closer to what the fighter must weigh in as, and finally hitting that number at least a day in advance, the fighter experiences being at weigh-in weight for a period before ever stepping on the official scale.  In the western way most fighters hit the correct weight only hours (if that) prior to checking weight.  It seemed utterly like torture to watch this process, but it works and it’s how it’s been done for a long time.  I reasoned, just for myself, that there must be something to this process that is meaningful to fighters and their trainers – that the struggle of it or training at the weight that one will weigh in must be strengthening for the mind and the body in some way.  You don’t see fighters gassing out in round 2 the way you see MMA fighters who have these weight cutting “experts” on their payroll.  (They also don’t cut the crazy amount of weight that westerners do.)

But if these studies, like the investigations that Dr. Patrick is undertaking, are suggestive of deep benefits of heat conditioning training, benefits that have simply become coded into the customs and traditions of weight loss, the Thai may be doing more than just losing water weight (or fat) in preparation for a fight. They may in some way be supercharging their bodies through heat conditioning, as well.  I don’t know and it’s not being studied in this context, but the possibilities need to be raised.

What This Means to Me – Sauna – Increasing the Role of Heat

I’ve definitely taken up the use of heat as a primary tool for health here in Thailand.  Even though it’s hot almost all the time I still love a hot shower and I do, in fact, get quite cold when the sun goes down even while I’m still training.  After my fights – directly after when I’m just coming in the door from the venue – I sit in an ice-bath for about 15 minutes to take the edge off of any swelling I have on my shins or anywhere else I might have impact trauma.  After that, however, I don’t use ice for much of anything.  I’ll use the same big bucket (it’s a plastic storage bucket – I’m small) that I use for ice-baths and fill it with boiling water and hot water from the tap to soak in a hot bath after long workout weeks or to help heal my shins a couple days after fights.  And I use the saunas that some massage places offer only periodically – it’s not expensive but it is an expense that I can’t afford with the regularity that is suggested for sauna as a health therapy.

I’d been thinking about turning up my sauna use lately, despite the expense, as part of my rest and recovery. Some of this flowed out of finally writing my Myth of Overtraining post and taking stock of my rest investments. One has to get very serious about that if one is going to train extremely hard, and continually look for improvements.

me and the closet sauna at Big C – gameshow-girling it

After seeing this study by Dr. Patrick  I was intrigued by the possibilities.  So I bit the bullet and bought a portable sauna for my house.  It’s basically a canvas tent with a hole for your head to stick out, a built in bench inside to sit on, and a small cooker that goes under the bench to provide the steam.  We bought it at Big C, which is kind of the Wall-Mart of Thailand. (I can only hope it’s less evil than Wall-Mart, but I don’t know, unfortunately.)  It cost about 3,000 Baht ($100), which isn’t a lot but it’s a big expense for me, so it was an investment – it should be balanced out after 15 sauna home sessions.  Last night I came back from my double evening sessions at Petchrungruang and O. Meekhun, went for my run, plugged in the cooker to heat up the sauna while I cooked myself dinner and then zipped myself into the sauna-pod for a 30 minute session.

me in the sauna – first time

First of all, it is a remarkably different experience having your head sticking out of a steam room than it is with your head in it.  The first 10 minutes were an absolute delight, my body all warm and immediately sweaty and my head nice and cool with the fan blowing nearby.  There are two little flaps covering holes where you can stick your hands out, to hold a magazine, book, or in my case a remote for the TV.  I think for next time I’ll skip watching TV and try to meditate or do something that busies my mind a bit more.  I say that because after the first 10 minutes it gets a bit harder to bear the heat and my head and face began sweating, despite being outside the pod.  After the 15 minute mark it becomes difficult to handle the heat.  I could feel droplets of water running down my body and spattering into a substantial pool of water at the bottom of the pod and my thirst was amazing.  I had a cold can of tea that I drank way too fast.  If I were trying to cut weight instead of just use this for recovery… it would be awful not being able to drink anything.  And the final 5 minutes of my 30 minute session were really, really hard.  When the alarm sounded I wasted no time unzipping the pod and getting out into the cool air.  I was dripping everywhere and felt not fully “dizzy” but a bit cloudy as I unplugged the cooker and put myself into a cool shower.

After bringing my skin temperature down a bit in the shower I went and sat on the balcony. I’m sure it was a warm night but it felt very cool to me.  My skin was very flushed and I still sweated and felt hot, but as my core temperature slowly began to fall I felt very invigorated.  Much less “heavy” than I usually feel at this point in the night, when I’m usually crawling into bed to finish a blog post or watch something on the computer with Kevin before falling asleep.  My muscles felt more relaxed, which I reckon is why I felt less heavy.  I was also incredibly thirsty and downed a few glasses of cool water over the next hour before going to sleep.  I woke up throughout the night a few times (I always do) and used the bathroom a few times, but definitely was not expelling much of the water I drank, meaning it was replacing what I’d lost and not so much excess, but I didn’t feel “restless” and always fell back to sleep again quickly.  When I woke up in the morning I felt very rested.  I wasn’t popping out of bed by any means – I never do, I’m just not a morning person – but I didn’t feel protest from my muscles as I rose to get the puppy out the door for his morning walk.  That is highly unusual. Kevin makes fun of how I walk when I get out of bed, he calls it my “baby walk,” because the stiffness of my legs and back make me kind of wobbly for the first 10 steps or so.

I certainly still feel a bit tired as I get going and morning training is still a push, but I’m definitely feeling a difference in the way my muscles feel more rested and relaxed.  It’s a small increase in recovery that feels like a big difference.  That’s only after one go of it, so I’ll have to keep experimenting.  I reckon I’ll start out with a steam sauna session ever third day and increase to every other day if I continue to see improvements.  And I’ll keep getting my weekly massages to see how the two work together – that is Nook’s prescription: “sauna, sauna, massage, massage.”

what it looks like all folded up

More Sources on Hyperthermic Conditioning

The Blog of Tim Ferriss published Ronda Patrick’s paper under the post title: Are Saunas the Next Big Performance-Enhancing “Drug”? – this has the sources of most of the data being discussed.

Ben Greenfield’s 1 hour pretty informed podcast interview with Ronda Patrick: Everything You Need To Know About How To Use Heat Exposure To Enhance Performance, Burn Fat, Gain Muscle And Think Better. He’s kind of a Body Hacker, and so asked some good questions that she didn’t always have the answers to.

Joe Rogan’s 2+ hour podcase interview with Ronda Patrick: JRE #459. Have not listened to this yet (as of the writing).

A Mike Matthews interview podcast on YouTube.

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