Effect of Water Temperature during Cold-Water Immersion on Recovery from
Exercise-Induced Muscle Damage

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.

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?

Nicole Cattano
by: Jeffrey Driban


Vieira, A., Siqueira, A., Ferreira-Junior, J., do Carmo, J., Durigan, J., Blazevich, A., & Bottaro, M. (2016). The Effect of Water Temperature during Cold-Water Immersion on Recovery from Exercise-Induced Muscle Damage International Journal of Sports Medicine, 37 (12), 937-943 DOI: 10.1055/s-0042-111438