Cold-water Immersion (Cryotherapy) for Preventing and Treating Muscle Soreness After Exercise (Review).

Bleakley C, McDonough S, Gardner E, Baxter GD, Hopkins JT and Davison GW. Cochrane Databases Syst Rev. 2012; 2.

Various strategies to attenuate muscle soreness following exercise exist. One popular intervention, cold water immersion (CWI), consists of immersion in water with a temperature less than 59°F (15°C). However, the clinical benefit of CWI to reduce exercise-induced muscle soreness remains unclear. Therefore, Bleakley et al. performed a systematic review to determine the effects of CWI on delayed onset muscle soreness. Following an electronic database search, two authors used a standardized form to select eligible trials by first screening titles and abstracts. After obtaining the full text, the same authors extracted data using a customized form. Whenever disagreements occurred between these two authors the issue was resolved by consensus or a third party. A total of 58 articles were initially identified and then narrowed down to 17 studies which were included in the review (366 participants, CWI: 5°C to 15°C, treatment time: 5 to 24 minutes). All of these studies were randomized controlled studies published between 1998 and 2009 Overall study quality was “low” (small sample size, high risk of bias [e.g., insufficient blinding, selection bias], etc.). Fourteen studies compared CWI with rest or “no treatment”, while three studies compared CWI to an alternative treatment (contrast baths and warm water immersion). Pooled analysis of these studies showed a statistically significant effect favoring CWI following activity at 24, 48, 72 and 96 hour follow-ups compared to no treatment or alternative treatments.

Overall, CWI attenuated muscle soreness after exercise better than doing nothing but the variability between trials (e.g., different exercise protocols used to induce muscle soreness, temperature and duration of CWI) made determining the best protocol difficult. This demonstrates a need for future research to begin to focus, not only on the effectiveness of the treatment, but on optimizing protocol guidelines. The authors also raised a question regarding the safety of this treatment because there was insufficient evidence to determine the risk of adverse events associated with CWI. Do you find this treatment of be effective and if so, how long after activity do you use it?

Written by: Kyle Harris
Reviewed by: Jeffrey Driban

Related Post:

Bleakley C, McDonough S, Gardner E, Baxter GD, Hopkins JT, & Davison GW (2012). Cold-water immersion (cryotherapy) for preventing and treating muscle soreness after exercise. Cochrane database of systematic reviews (Online), 2 PMID: 22336838