SCIENCE  |  RECOVERY

Cold-Water Immersion

Cold-water immersion (CWI) is a recovery technique where the body is submerged in cold water, typically at temperatures between 10-15°C, for a duration ranging from a few minutes to around 20 minutes. This method is used to reduce muscle soreness and inflammation after exercise, and is popular among athletes for its potential to speed up recovery and enhance performance.

The systematic review and meta-analysis studies indicate that cold-water immersion (CWI) and cryostimulation enhance parasympathetic activity and aid recovery by improving heart rate variability indices and reducing muscle soreness, perceived exertion, and creatine kinase levels post-exercise. CWI is more effective than other recovery methods for muscle soreness and comparable for muscle power recovery. However, CWI’s effects on resistance training are detrimental, reducing strength gains, while it has no significant impact on endurance performance. Shorter durations and lower temperatures of CWI are more beneficial, especially after high-intensity exercise.

PUBLICATIONS

  1. The effects of cold exposure (cold water immersion, whole- and partial-body cryostimulation) on cardiovascular and cardiac autonomic control responses in healthy individuals: A systematic review, meta-analysis and meta-regression.
          • J Therm Biol. 2024 Apr;121:103857.
          • Design: Systematic review and meta-analysis on the impact of cold exposures on cardiovascular and cardiac autonomic activity.
          • Summary: Cryostimulation and CWI significantly enhance parasympathetic activity, increasing HRV indices (RMSSD, RR, HF) and reducing LF and LF/HF ratio. Heart rate decreased slightly while blood pressure showed a minor increase. Effects depend on individual characteristics and cooling techniques.
  2. Effects of Cold-Water Immersion Compared with Other Recovery Modalities on Athletic Performance Following Acute Strenuous Exercise in Physically Active Participants: A Systematic Review, Meta-Analysis, and Meta-Regression.
          • Sports Med. 2023 Mar;53(3):687-705.
          • Design: Systematic review, meta-analysis, and meta-regression comparing CWI with other recovery methods post-exercise.
          • Summary: CWI is more effective than other methods for reducing muscle soreness and comparable for recovering muscle power and flexibility. It outperforms active recovery, contrast water therapy, and warm-water immersion. Air cryotherapy is superior for immediate muscular strength and power recovery.
  3. Effects of post-exercise cold-water immersion on resistance training-induced gains in muscular strength: a meta-analysis.
          • Eur J Sport Sci. 2023 Mar;23(3):372-380.
          • Design: Meta-analysis on the impact of CWI on resistance training-induced strength gains.
          • Summary: CWI following resistance exercise attenuates strength gains, especially when applied to trained limbs. Whole-body CWI showed no significant difference from control. These findings suggest careful consideration of CWI timing and application in resistance training programs.
  4. Effects of cold water immersion after exercise on fatigue recovery and exercise performance–meta analysis.
          • Front Physiol. 2023 Jan 20;14:1006512.
          • Design: Meta-analysis on CWI’s effect on fatigue recovery and exercise performance post-exercise.
          • Summary: CWI significantly reduces muscle soreness and perceived exertion immediately post-exercise and improves CMJ performance and CK levels. No significant impact on CRP and IL-6 was observed. Immediate immersion post-exercise is recommended for effective fatigue recovery.
  5. What Parameters Influence the Effect of Cold-Water Immersion on Muscle Soreness? An Updated Systematic Review and Meta-Analysis.
          • Clin J Sport Med. 2023 Jan 1;33(1):13-25.
          • Design: Systematic review and meta-analysis on the efficacy of CWI for managing muscle soreness.
          • Summary: CWI is superior to control for reducing muscle soreness, with effectiveness varying by immersion time and type of exercise. Short and medium immersion times are most effective, particularly after endurance exercises. Immediate application yields the best results.
  6. Impact of Cold-Water Immersion Compared with Passive Recovery Following a Single Bout of Strenuous Exercise on Athletic Performance in Physically Active Participants: A Systematic Review with Meta-analysis and Meta-regression.
          • Sports Med. 2022 Jul;52(7):1667-1688.
          • Design: Systematic review, meta-analysis, and meta-regression on CWI versus passive recovery post-exercise.
          • Summary: CWI effectively improves recovery of muscular power, reduces muscle soreness, and CK levels 24 hours post-exercise. Shorter durations and lower temperatures enhance recovery efficacy, particularly after high-intensity exercise. Endurance performance benefits from CWI were dose-dependent on duration.
  7. The Effects of Regular Cold-Water Immersion Use on Training-Induced Changes in Strength and Endurance Performance: A Systematic Review with Meta-Analysis.
          • Sports Med. 2021 Jan;51(1):161-174.
          • Design: Systematic review and meta-analysis on the regular use of CWI during exercise training.
          • Summary: Regular CWI use is detrimental to resistance training adaptations, reducing strength gains and performance. Conversely, it does not significantly impact endurance training performance. These findings suggest careful consideration of CWI in resistance training programs.
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