AmaZulu High Performance Column – February 2023

Welcome back to our monthly performance column, we started the year with the idea of a series on recovery in professional football, and the first recovery modality we reviewed was cold water immersion. This month we will shift focus to contrast water therapy (CWT), what it is and its potential benefits.


Elite athletes are required to perform at a consistently high level, with the optimisation of recovery from training and matches being incredibly important in facilitating this (Versey, Halson and Dawson, 2011).

Table 1: Various recovery strategies (Cook, Kilduff and Jones, 2014).

Contrast Water Therapy: what is it and how does it help?

Contrast Water Therapy, involves immersing your body in one of two temperature controlled water baths, alternating between 1 – 2 minutes in cold water (8-15 degrees Celsius) and 1 -2 minutes in hot water (38 – 42 degrees Celsius); if you want to focus on muscle recovery then you should finish in the cold water, whilst you should finish in the hot water if you want to focus on relaxation (Gill, Beaven and Cook, 2006; Cook, Kilduff and Jones, 2014).

The rationale behind CWT is the creation of a “pump-like-action” through the alternating between hot and cold water, which in turn results in vasoconstriction and vasodilation of the athlete’s blood vessels (Image 1), which is suggested to influence blood flow changes, reduce muscle spasm and have a positive influence on the inflammatory response (Rivenburgh, 1992).

Image 1: Vasoconstriction and vasodilation of blood vessels (Sourced from:, 2023).

Gill, Beavan and Cook (2006) investigated the effectiveness of post-match recovery strategies and found that CWT produced 85.0% recovery after 84-hours, which was significantly greater than the passive recovery intervention (39.0%), and similar to an active recovery protocol and compression garment intervention of 88.2% and 84.4% respectively.

Further comparison of CWT to passive recovery was conducted by Vaile and colleagues (2007), and it was found that CWT was, “associated with a smaller reduction and faster restoration, of strength and power”, whilst Kinugasa and Kilding (2009) observed no substantial differences in vertical jump height (a physical performance measure) results pre- and post-recovery protocol (when comparing CWT and passive recovery). However, a more recent systematic review and meta-analysis of CWT and exercise induced muscle damaged was conducted, with it being found that CWT is superior to passive recovery (Bieuzen, Bleakley and Costello, 2013).

De Nardi et al. (2011) reported that the principal benefit of CWT was the reduction of fatigue perception after the training session, and that this reduction in fatigue perception would improve training compliance and ultimately, performance in competition. This can concept on perception of fatigue can be linked back to the previous article on cold water immersion, where athletes instinctively regulate their individual performance based on their sensation of fatigue (Noakes, Gibson and Lambert, 2005). This is reinforced by Juliff et al. (2014), who found that contrast water therapy did not accelerate physical recovery, however, the psychological benefit needs to be considered.


Of the studies reviewed, most point to a level of benefit over passive recovery, whilst other report similar findings to other methods of recovery. What can be noted down is that there is certainly a level of benefit for those that believe in the modality, and this brings us to the important take home point I wanted to raise, there is no one size fits all for your players or athletes. Recovery, just like a training program needs to be individualised and consider the individuals age, gender, body composition, health, physical fitness, anatomy and skill level.

I hope this has shed more light on contrast water therapy and how it could be used to enhance player recovery. As the year progresses, we will continue to discuss different methods of recovery and the benefits associated.

If you would like to know more about soccer specific physical training, take a look at the courses offered by our Official Education Partner, the International Soccer Science and Performance Federation on

Joshua Smith; MSc., PGDip, BSc (HONS)
High Performance Manager
AmaZulu FC


Bieuzen, F., Bleakley, C.M. and Costello, J.T. (2013) ‘Contrast Water Therapy and Exercise Induced Muscle Damage: A Systematic Review and Meta-Analysis’, PLoS ONE, 8(4). Available at:
Cook, C.J., Kilduff, L.P. and Jones, M.R. (2014) ‘Recovering effectively in high-performance sports’, in D. Joyce and D. Lewindon (eds) High-performance training for sports. Champaign, IL: Human Kinetics, pp. 321–330.

Gill, N.D., Beaven, C.M. and Cook, C. (2006) ‘Effectiveness of post-match recovery strategies in rugby players’, British Journal of Sports Medicine, 40(3), pp. 260–264. Available at:
Juliff, L.E. et al. (2014) ‘Influence of contrast shower and water immersion on recovery in elite netballers’, Journal of Strength and Conditioning Research, 28(8), pp. 2353–2358. Available at:

Noakes, T.D., Gibson, A.S.C. and Lambert, E. V (2005) ‘From catastrophe to complexity: a novel model of integrative central neural regulation of effort and fatigue during exercise in humans: summary and conclusions’, British Journal of Sports Medicine, 39, pp. 120–124. Available at:
Rivenburgh, D.W. (1992) ‘Physical modalities in the treatment of tendon injuries.’, Clinical Sports Medicine, (11), pp. 645–659.

Versey, N., Halson, S. and Dawson, B. (2011) ‘Effects of contrast water therapy duration on recovery of cycling performance: a dose-response study’, European Journal of Applied Physiology, (111), pp. 37–46.