Cold-water immersion for recovery in elite athletes: Effects, practical application, and impact on training adaptations

Purpose: Cold-water immersion is increasingly used by athletes to support performance recovery. Recently, however, indications have emerged suggesting that the regular use of cold-water immersion might be detrimental to strength training adaptation. Methods: In a randomized crossover design, 11 participants performed two 8-week training periods including 3 leg training sessions per week, separated by an 8-week “wash out” period. After each session, participants performed 10 minutes of either whole-body cold-water immersion (cooling) or passive sitting (control). Leg press 1-repetition maximum and countermovement jump performance were determined before (pre), after (post) and 3 weeks after (follow-up) both training periods. Before and after training periods, leg circumference and muscle thickness (vastus medialis) were measured. Results: No significant effects were found for strength or jump performance. Comparing training adaptations (pre vs post), small and negligible negative effects of cooling were found for 1-repetition maximum (g = 0.42; 95% confidence interval [CI], −0.42 to 1.26) and countermovement jump (g = 0.02; 95% CI, −0.82 to 0.86). Comparing pre versus follow-up, moderate negative effects of cooling were found for 1-repetition maximum (g = 0.71; 95% CI, −0.30 to 1.72) and countermovement jump (g = 0.64; 95% CI, −0.36 to 1.64). A significant condition × time effect (P = .01, F = 10.00) and a large negative effect of cooling (g = 1.20; 95% CI, −0.65 to 1.20) were observed for muscle thickness. Conclusions: The present investigation suggests small negative effects of regular cooling on strength training adaptations.

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Cold water immersion enhances recovery of submaximal muscle function after resistance exercise

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.00180.2014 ◽

2014 ◽

Vol 307 (8) ◽

pp. R998-R1008 ◽

Cited By ~ 51

Author(s):

Llion A. Roberts ◽

Kazunori Nosaka ◽

Jeff S. Coombes ◽

Jonathan M. Peake

Keyword(s):

Resistance Exercise ◽

High Intensity ◽

Muscle Function ◽

Cold Water ◽

Water Immersion ◽

Venous Blood ◽

Cold Water Immersion ◽

Active Recovery ◽

Physically Active ◽

Training Adaptations

We investigated the effect of cold water immersion (CWI) on the recovery of muscle function and physiological responses after high-intensity resistance exercise. Using a randomized, cross-over design, 10 physically active men performed high-intensity resistance exercise followed by one of two recovery interventions: 1) 10 min of CWI at 10°C or 2) 10 min of active recovery (low-intensity cycling). After the recovery interventions, maximal muscle function was assessed after 2 and 4 h by measuring jump height and isometric squat strength. Submaximal muscle function was assessed after 6 h by measuring the average load lifted during 6 sets of 10 squats at 80% of 1 repetition maximum. Intramuscular temperature (1 cm) was also recorded, and venous blood samples were analyzed for markers of metabolism, vasoconstriction, and muscle damage. CWI did not enhance recovery of maximal muscle function. However, during the final three sets of the submaximal muscle function test, participants lifted a greater load ( P < 0.05, Cohen's effect size: 1.3, 38%) after CWI compared with active recovery. During CWI, muscle temperature decreased ∼7°C below postexercise values and remained below preexercise values for another 35 min. Venous blood O2 saturation decreased below preexercise values for 1.5 h after CWI. Serum endothelin-1 concentration did not change after CWI, whereas it decreased after active recovery. Plasma myoglobin concentration was lower, whereas plasma IL-6 concentration was higher after CWI compared with active recovery. These results suggest that CWI after resistance exercise allows athletes to complete more work during subsequent training sessions, which could enhance long-term training adaptations.

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Strength Training Adaptations After Cold-Water Immersion

The Journal of Strength and Conditioning Research ◽

10.1519/jsc.0000000000000434 ◽

2014 ◽

Vol 28 (9) ◽

pp. 2628-2633 ◽

Cited By ~ 34

Author(s):

Michael Fröhlich ◽

Oliver Faude ◽

Markus Klein ◽

Andrea Pieter ◽

Eike Emrich ◽

...

Keyword(s):

Strength Training ◽

Cold Water ◽

Water Immersion ◽

Cold Water Immersion ◽

Training Adaptations

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Post-exercise Cold Water Immersion Effects on Physiological Adaptations to Resistance Training and the Underlying Mechanisms in Skeletal Muscle: A Narrative Review

Frontiers in Sports and Active Living ◽

10.3389/fspor.2021.660291 ◽

2021 ◽

Vol 3 ◽

Author(s):

Aaron C. Petersen ◽

Jackson J. Fyfe

Keyword(s):

Skeletal Muscle ◽

Resistance Training ◽

Cold Water ◽

Water Immersion ◽

Cold Water Immersion ◽

Post Exercise ◽

Training Adaptations ◽

Physiological Adaptations ◽

Underlying Mechanisms

Post-exercise cold-water immersion (CWI) is a popular recovery modality aimed at minimizing fatigue and hastening recovery following exercise. In this regard, CWI has been shown to be beneficial for accelerating post-exercise recovery of various parameters including muscle strength, muscle soreness, inflammation, muscle damage, and perceptions of fatigue. Improved recovery following an exercise session facilitated by CWI is thought to enhance the quality and training load of subsequent training sessions, thereby providing a greater training stimulus for long-term physiological adaptations. However, studies investigating the long-term effects of repeated post-exercise CWI instead suggest CWI may attenuate physiological adaptations to exercise training in a mode-specific manner. Specifically, there is evidence post-exercise CWI can attenuate improvements in physiological adaptations to resistance training, including aspects of maximal strength, power, and skeletal muscle hypertrophy, without negatively influencing endurance training adaptations. Several studies have investigated the effects of CWI on the molecular responses to resistance exercise in an attempt to identify the mechanisms by which CWI attenuates physiological adaptations to resistance training. Although evidence is limited, it appears that CWI attenuates the activation of anabolic signaling pathways and the increase in muscle protein synthesis following acute and chronic resistance exercise, which may mediate the negative effects of CWI on long-term resistance training adaptations. There are, however, a number of methodological factors that must be considered when interpreting evidence for the effects of post-exercise CWI on physiological adaptations to resistance training and the potential underlying mechanisms. This review outlines and critiques the available evidence on the effects of CWI on long-term resistance training adaptations and the underlying molecular mechanisms in skeletal muscle, and suggests potential directions for future research to further elucidate the effects of CWI on resistance training adaptations.

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Patient Involvement in Treatment Decision Making Can Help or Hinder Placebo Analgesia

Zeitschrift für Psychologie ◽

10.1027/2151-2604/a000179 ◽

2014 ◽

Vol 222 (3) ◽

pp. 165-170 ◽

Cited By ~ 2

Author(s):

Andrew L. Geers ◽

Jason P. Rose ◽

Stephanie L. Fowler ◽

Jill A. Brown

Keyword(s):

Patient Involvement ◽

Cold Water ◽

Prior Experience ◽

Water Immersion ◽

Treatment Decision ◽

Cold Water Immersion ◽

Not Given ◽

Placebo Analgesia ◽

Treatment Decision Making ◽

Immersion Experience

Experiments have found that choosing between placebo analgesics can reduce pain more than being assigned a placebo analgesic. Because earlier research has shown prior experience moderates choice effects in other contexts, we tested whether prior experience with a pain stimulus moderates this placebo-choice association. Before a cold water pain task, participants were either told that an inert cream would reduce their pain or they were not told this information. Additionally, participants chose between one of two inert creams for the task or they were not given choice. Importantly, we also measured prior experience with cold water immersion. Individuals with prior cold water immersion experience tended to display greater placebo analgesia when given choice, whereas participants without this experience tended to display greater placebo analgesia without choice. Prior stimulus experience appears to moderate the effect of choice on placebo analgesia.

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Thermoregulatory responses to cold water at different times of day

Journal of Applied Physiology ◽

10.1152/jappl.1999.87.1.243 ◽

1999 ◽

Vol 87 (1) ◽

pp. 243-246 ◽

Cited By ~ 7

Author(s):

John W. Castellani ◽

Andrew J. Young ◽

James E. Kain ◽

Michael N. Sawka

Keyword(s):

Cold Water ◽

Water Immersion ◽

Early Morning ◽

Cold Water Immersion ◽

Time Of Day ◽

Mean Skin Temperature ◽

Mean Body Temperature ◽

Metabolic Heat ◽

Body Temperature Change ◽

The Mean

This study examined how time of day affects thermoregulation during cold-water immersion (CWI). It was hypothesized that the shivering and vasoconstrictor responses to CWI would differ at 0700 vs. 1500 because of lower initial core temperatures (Tcore) at 0700. Nine men were immersed (20°C, 2 h) at 0700 and 1500 on 2 days. No differences ( P > 0.05) between times were observed for metabolic heat production (M˙, 150 W ⋅ m−2), heat flow (250 W ⋅ m−2), mean skin temperature (T sk, 21°C), and the mean body temperature-change in M˙(ΔM˙) relationship. Rectal temperature (Tre) was higher ( P < 0.05) before (Δ = 0.4°C) and throughout CWI during 1500. The change in Tre was greater ( P < 0.05) at 1500 (−1.4°C) vs. 0700 (−1.2°C), likely because of the higher Tre-T skgradient (0.3°C) at 1500. These data indicate that shivering and vasoconstriction are not affected by time of day. These observations raise the possibility that CWI may increase the risk of hypothermia in the early morning because of a lower initial Tcore.

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Changes in myocardial myosin heavy chain isoform composition with exercise and post-exercise cold-water immersion

Journal of Muscle Research and Cell Motility ◽

10.1007/s10974-021-09603-z ◽

2021 ◽

Author(s):

Ramzi A. Al-horani ◽

Mukhallad A. Mohammad ◽

Saja Haifawi ◽

Mohammed Ihsan

Keyword(s):

Myosin Heavy Chain ◽

Heavy Chain ◽

Cold Water ◽

Water Immersion ◽

Cold Water Immersion ◽

Post Exercise ◽

Myosin Heavy Chain Isoform

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Recovery strategies implemented by sport support staff of elite rugby players in South Africa

South African Journal of Physiotherapy ◽

10.4102/sajp.v65i1.78 ◽

2009 ◽

Vol 65 (1) ◽

Cited By ~ 6

Author(s):

D.V. Van Wyk ◽

M.I. Lambert

Keyword(s):

Cold Water ◽

Water Immersion ◽

Total Duration ◽

Cold Water Immersion ◽

Support Staff ◽

Medical Support ◽

Cross Sectional ◽

Study Results ◽

Recovery Strategies ◽

Rugby Players

Objective: The main aim of this study was to determine strategies used toaccelerate recovery of elite rugby players after training and matches, asused by medical support staff of rugby teams in South A frica. A secondaryaim was to focus on specifics of implementing ice/cold water immersion asrecovery strategy. Design: A Questionnaire-based cross sectional descriptive survey was used.Setting and Participants: Most (n=58) of the medical support staff ofrugby teams (doctors, physiotherapists, biokineticists and fitness trainers)who attended the inaugural Rugby Medical A ssociation conference linked to the South A frican Sports MedicineA ssociation Conference in Pretoria (14-16th November, 2007) participated in the study. Results: Recovery strategies were utilized mostly after matches. Stretching and ice/cold water immersion were utilized the most (83%). More biokineticists and fitness trainers advocated the usage of stretching than their counter-parts (medical doctors and physiotherapists). Ice/Cold water immersion and A ctive Recovery were the top two ratedstrategies. A summary of the details around implementation of ice/cold water therapy is shown (mean) as utilized bythe subjects: (i) The time to immersion after matches was 12±9 min; (ii) The total duration of one immersion sessionwas 6±6 min; (iii) 3 immersion sessions per average training week was utilized by subjects; (iv) The average water temperature was 10±3 ºC.; (v) Ice cubes were used most frequently to cool water for immersion sessions, and(vi) plastic drums were mostly used as the container for water. Conclusion: In this survey the representative group of support staff provided insight to which strategies are utilizedin South A frican elite rugby teams to accelerate recovery of players after training and/or matches.

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Cold-water immersion following sprint interval training does not alter endurance signaling pathways or training adaptations in human skeletal muscle

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.00434.2016 ◽

2017 ◽

Vol 313 (4) ◽

pp. R372-R384 ◽

Cited By ~ 13

Author(s):

James R. Broatch ◽

Aaron Petersen ◽

David J. Bishop

Keyword(s):

Mitochondrial Biogenesis ◽

Molecular Mechanisms ◽

Cold Water ◽

P53 Protein ◽

Water Immersion ◽

Interval Training ◽

Cold Water Immersion ◽

Peroxisome Proliferator ◽

Sprint Interval Training ◽

Single Session

We investigated the underlying molecular mechanisms by which postexercise cold-water immersion (CWI) may alter key markers of mitochondrial biogenesis following both a single session and 6 wk of sprint interval training (SIT). Nineteen men performed a single SIT session, followed by one of two 15-min recovery conditions: cold-water immersion (10°C) or a passive room temperature control (23°C). Sixteen of these participants also completed 6 wk of SIT, each session followed immediately by their designated recovery condition. Four muscle biopsies were obtained in total, three during the single SIT session (preexercise, postrecovery, and 3 h postrecovery) and one 48 h after the last SIT session. After a single SIT session, phosphorylated (p-)AMPK, p-p38 MAPK, p-p53, and peroxisome proliferator-activated receptor-γ coactivator-1α ( PGC-1α) mRNA were all increased ( P < 0.05). Postexercise CWI had no effect on these responses. Consistent with the lack of a response after a single session, regular postexercise CWI had no effect on PGC-1α or p53 protein content. Six weeks of SIT increased peak aerobic power, maximal oxygen consumption, maximal uncoupled respiration (complexes I and II), and 2-km time trial performance ( P < 0.05). However, regular CWI had no effect on changes in these markers, consistent with the lack of response in the markers of mitochondrial biogenesis. Although these observations suggest that CWI is not detrimental to endurance adaptations following 6 wk of SIT, they question whether postexercise CWI is an effective strategy to promote mitochondrial biogenesis and improvements in endurance performance.

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