The Effect of Water Temperature during Cold-Water Immersion on Recovery from Exercise-Induced Muscle Damage
Vieira A, Siqueira AF, Ferreira-Junior JB, do Carmo J, Durigan JLQ, Blazebich A, & Bottaro M. Int J Sports Med. 2016; 37: 937-943. doi: 10.1055/s-0042-111438
Take Home Message: After exercise, cold water immersion at 15°C may offer some improvements in recovery based on performance of a jump task and possibly markers of muscle damage. A colder temperature may not be as effective as cool water, so controlling the treatment parameters based on evidence is important.
Muscle damage after activity is associated with soreness and decreased function. There is mixed evidence that cold-water immersion helps reduce soreness, but its effects on muscle function are unknown. Some of this variability may be attributed to inconsistent methodology regarding temperature and time. The authors of this study tested the effects of 3 treatments (i.e., 2 different cold-water immersion treatments and 1 control treatment) on recovery from exercise as measured by isometric quadriceps strength, performance, soreness, and creatine kinase (a marker of muscle damage). Performance was measured with a jump counter movement, soreness was assessed using a visual analogue scale during a sit to stand task, and creatine kinase was assessed through a blood sample. The authors randomized 42 collegiate males to one of 3 treatment groups for 20 minutes immediately post exercise: 5°C cold-water immersion (14 males), 15°C cold-water treatment (14 males), or rest group (14 males). The authors assessed participants pre-exercise, immediately post-exercise, and at 24, 48, 72, 96, and 168 hours post exercise. Muscle soreness was induced through a standardized bout of drop jumps (5 sets of 20 drop jumps). The exercise effectively reduced strength and performance with increased soreness and creatine kinase. The 15°C cold-water treatment group recovered better than the other 2 groups based on muscle performance. Interestingly, there was a secondary decrease in performance 48 hours post exercise in the control and 5°C groups, but not in the 15°C group. Overall, treatment groups did not differ nor did it seem to help accelerate return to baseline strength, soreness, or creatine kinase levels.
These findings are interesting because it demonstrates that cold-water immersion may help with functional recovery, but not in isometric strength, soreness, or serum measures of muscle damage. The authors noted that the functional jump task may be a better measure of recovery than isometric strength. Additionally, a colder whirlpool (5°C) failed to help expedite the improvements. Participants who were in the 15°C cold-water immersion had a better jump task recovery than those in the 5°C treatment group. This may be interesting to further investigate, as there has been the introduction of whole-body cryogenic-chamber treatments use among elite-level athletes. While it appears that the 15°C whirlpool had some favorable outcomes, the comparison control group was doing nothing. It would be interesting to compare the 15°C treatment to an effective active recovery of mobility/foam rolling or a novel treatment such as compression boots. Clinically, a 20-minute 15°C treatment immediately post exercise may help improve functional recovery after exercise but clinicians should be mindful that colder water doesn’t offer better results.
Questions for Discussion: What protocols do you utilize when using cold-water immersion for recovery? Are there any other treatments that you have found to be successful for expediting recovery?
Written by: Nicole Cattano
Reviewed by: Jeffrey Driban
Cold-water immersion (Cryotherapy) for Preventing and Treating Muscle Soreness After Exercise (Review)