Palmar Cooling as a Thermoregulatory Intervention: Mechanistic Basis and Implications for Exercise and Clinical Applications.
- 1College of Osteopathic Medicine Kansas City University 1750 Independence Avenue Kansas Missouri 64106 USA kcumb.edu.
- 2Heritage College of Osteopathic Medicine Ohio University 191 W Union St Athens Ohio 45701 USA ohio.edu.
Abstract
During exercise, rising metabolic heat production creates competition for blood flow between skeletal muscle and the cutaneous vasculature. The resulting redistribution elevates cardiovascular (CV) strain and accelerates fatigue, particularly during environmental heat stress or in individuals with impaired thermoregulatory capacity. Strategies that enhance heat dissipation without further burdening CV function may therefore improve exercise tolerance. Palmar cooling (PC) is an intervention that targets the glabrous skin of the hands, where dense arteriovenous anastomoses facilitate high-flow, low-resistance blood flow and efficient convective heat exchange, thereby augmenting systemic heat dissipation through the peripheral circulation. Evidence in healthy and athletic populations suggests that PC can decrease thermal strain while improving endurance capacity, resistance training volume, and perceptual responses when applied under meaningful heat stress, although current findings remain heterogeneous. Given age- and disease-related reductions in thermoregulatory and CV reserve, PC may have translational relevance for enhancing exercise tolerance during rehabilitation, reducing heat-related illness risk, and supporting individuals with cardiopulmonary disease. Improved within-session tolerability may, in turn, facilitate greater cumulative training stimulus and adherence, with potential downstream benefits for overall exercise capacity. This narrative review discusses the thermoregulatory, CV, and exercise physiology underlying PC, evaluates the current evidence, and outlines future directions to support clinical translation.
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BibTeX
@article{heins2026palmar,
title = {{Palmar Cooling as a Thermoregulatory Intervention: Mechanistic Basis and Implications for Exercise and Clinical Applications.}},
author = {Robert J Heins and William E Reisinger and Brett Norris and Robert Rogers},
journal = {Translational sports medicine},
year = {2026},
month = oct,
doi = {10.1155/tsm2/4204958},
url = {https://europepmc.org/article/MED/42898568},
note = {CC BY},
}
RIS
TY - JOUR
TI - Palmar Cooling as a Thermoregulatory Intervention: Mechanistic Basis and Implications for Exercise and Clinical Applications.
AU - Robert J Heins
AU - William E Reisinger
AU - Brett Norris
AU - Robert Rogers
PY - 2026
DA - 2026/10/18
JO - Translational sports medicine
DO - 10.1155/tsm2/4204958
UR - https://europepmc.org/article/MED/42898568
AB - During exercise, rising metabolic heat production creates competition for blood flow between skeletal muscle and the cutaneous vasculature. The resulting redistribution elevates cardiovascular (CV) strain and accelerates fatigue, particularly during environmental heat stress or in individuals with impaired thermoregulatory capacity. Strategies that enhance heat dissipation without further burdening CV function may therefore improve exercise tolerance. Palmar cooling (PC) is an intervention that targets the glabrous skin of the hands, where dense arteriovenous anastomoses facilitate high-flow, low-resistance blood flow and efficient convective heat exchange, thereby augmenting systemic heat dissipation through the peripheral circulation. Evidence in healthy and athletic populations suggests that PC can decrease thermal strain while improving endurance capacity, resistance training volume, and perceptual responses when applied under meaningful heat stress, although current findings remain heterogeneous. Given age- and disease-related reductions in thermoregulatory and CV reserve, PC may have translational relevance for enhancing exercise tolerance during rehabilitation, reducing heat-related illness risk, and supporting individuals with cardiopulmonary disease. Improved within-session tolerability may, in turn, facilitate greater cumulative training stimulus and adherence, with potential downstream benefits for overall exercise capacity. This narrative review discusses the thermoregulatory, CV, and exercise physiology underlying PC, evaluates the current evidence, and outlines future directions to support clinical translation.
SN - 2573-8488
ER -