Background <p>Physiological tremor is known to increase following intense exercise due to neuromuscular fatigue and altered sensorimotor control. While cryotherapy is widely used in sports medicine to modulate peripheral excitability and afferent feedback, its potential role in attenuating exercise-induced tremor has not been directly examined. This study investigated whether targeted cryostimulation of myofascial trigger points (MTrPs) can modulate lower-limb physiological tremor in adolescent swimmers.</p> Methods <p>Thirty-four competitive adolescent swimmers completed a randomized counterbalanced crossover trial involving two conditions: 60-s localized cryostimulation of identified MTrPs and a control condition without intervention. Tremor of both lower limbs was recorded using accelerometry at baseline and after a standardized 7-min recovery period following a 30-s maximal tethered swimming test. Log-transformed tremor spectral power [L(2–5 Hz), L(9–14 Hz)] and tremor frequency parameters [F(2–5 Hz), F(9–14 Hz)] were analyzed using repeated-measures ANOVA. </p> Results <p>Exercise increased tremor spectral power, whereas MTrP cryostimulation attenuated the post-exercise response in the 9–14 Hz frequency band (Condition × Time interaction, p = 0.010). The modulatory effect was observed predominantly in tremor spectral power, whereas frequency outcomes were more heterogeneous: F(2–5 Hz) did not show a consistent overall post-exercise shift, whereas F(9–14 Hz) increased following exercise and remained lower in the cryostimulation condition. </p> Conclusions <p>Targeted pre-exercise localized cooling of MTrPs may partially modulate selected post-exercise neuromuscular responses in adolescent swimmers, particularly within the 9–14 Hz tremor frequency band, although the functional relevance of these effects for sport-specific performance remains to be established.</p> Trial registration <p>ClinicalTrials.gov NCT07480200, registered 13 March 2026 (retrospectively registered)</p>