As we enter into 2023, what better way to restart the AmaZulu High Performance Column, than focusing on recovery and the different types of modalities out there. This month we will focus on cold water immersion (ice baths).
Inadequate recovery can result in overtraining, burnout and poor performance. It is with this in mind that sports teams across the world have sought to hasten the recovery process through the implementation of various recovery interventions (Table 1). One such intervention that is commonly used to aid recovery from exhaustive exercise is cold water immersion (CWI; Rupp et al., 2012; Sanchez-Ureña et al., 2015).
Table 1: Various recovery strategies (Adapted from: Cook, Kilduff and Jones, 2014).
Cold water immersion: evidence associated with recovery and performance
The rationale behind CWI is the effects of hydrostatic pressure and cooling of body tissue. The external pressure that is applied to the body improves the removal of inflammatory cells, enhances metabolic waste removal and improves contractile function, whilst reducing secondary muscle damage. The reduction in skin temperature is thought to reduce the extent of inflammation, reduce the perception of pain and aid in the recovery of muscular contractile function (Ascensão et al., 2011; Cook, Kilduff and Jones, 2014).
Ingram et al. (2009) found that the use of CWI directly after exercise and then 24 hours after the exercise stress returned athletes to baseline performance measures faster, and reduced muscle soreness and exercise induced inflammation. The authors associated these benefits with the 10 °C temperature that was implemented in their protocol.
The benefit of 10°C temperature was further reinforced by Rowsell et al. (2011), who found that 10°C promoted a better maintenance of high intensity running performance and minimized the decrement in total distance covered in a tournament setting. Athletes that performed CWI felt the therapy was beneficial in reducing leg soreness and fatigue as well as helped maintain their ability to perform in subsequent matches, this is supported further by a number of studies that verify the role of CWI in enhancing feelings of recovery and reduced perceptions of fatigue (Stacey et al., 2010; Stanley, Buchheit and Peake, 2012; Broatch, Petersen and Bishop, 2014).
Vaile et al. (2008) found that CWI (15°C) better maintained performance, and in some cases, increased average power and sprint time. Similarly, in a study performed by Lane and Wenger (2004), it was found that whilst CWI, massage and active recovery all facilitated the recovery process, the only modality that improved performance was CWI. Tenney and Schmid (2016) found that six to eight minutes of CWI resulted in both increased parasympathetic nervous system activation and self-reported sleep recovery scores in football players. Ascensão et al. (2011) found that CWI immediately after a soccer match reduced muscle damage and discomfort, contributing to a faster recovery of neuromuscular function.
Contradictory findings to the physiological and perceptual benefits of CWI were reported by Rupp et al. (2012), who noted that CWI performed immediately and 24 hours after volitional fatigue did not affect physical performance or perception of fatigue (12°C for 15 minutes), whilst Parouty et al. (2010) found that despite a subjective perception of improved recovery, CWI resulted in slower swimming times in well-trained athletes swimming in simulated competition conditions (14°C for 5 minutes).
It was stated by White and Wells (2013) that studies are needed to establish whether cryotherapy has an effect greater than simply a placebo or subjective improvement. This was investigated by Broatch, Petersen and Bishop (2014), who found that there were similar levels of improvement in performance when comparing the use of CWI and a CWI placebo. The authors state that these findings suggest that “the commonly hypothesized physiological benefits surrounding CWI are at least partly placebo related.” This is one of the only papers that has implemented a placebo condition in the assessment of the benefits of CWI.
There is conflicting evidence surrounding CWI and its role in recovery from exhaustive exercise, this due largely to methodological variations among the studies – type of exercise investigated and employed, water temperature, immersion time, immersion level, and the time interval between the end of the immersion and subsequent exercise bout.
Despite this, it is well established that CWI has several psychological benefits. These benefits cannot be underemphasized, as a link has been established between perception and performance, where athletes instinctively regulate their individual performance based on their sensation of fatigue (Noakes, Gibson and Lambert, 2005). Noting this link and the assertion that “a strong belief in CWI, combined with any potential physiological benefits will maximize its worth in recovery from exercise.” (Broatch, Petersen and Bishop, 2014) underpin the role that periodized CWI has to play in recovery from exhaustive exercise.
I hope this has shed more light on the value of cold water immersion and how they can 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 https://learn.isspf.com/partner/amazulu/a/110/.
Joshua Smith; MSc., PGDip, BSc (HONS)
High Performance Manager – AmaZulu FC
Ascensão, A., Leite, M., Rebelo, A. N., Magalhäes, S. and Magalhäes, J. (2011) ‘Effects of cold water immersion on the recovery of physical performance and muscle damage following a one-off soccer match’, Journal of Sports Sciences, 29(3), pp. 217–225. doi: 10.1080/02640414.2010.526132.
Broatch, J. R., Petersen, A. and Bishop, D. J. (2014) ‘Postexercise cold water immersion benefits are not greater than the placebo effect’, Medicine and Science in Sports and Exercise, 46(11), pp. 2139–2147. doi: 10.1249/MSS.0000000000000348.
Cook, C. J., Kilduff, L. P. and Jones, M. R. (2014) ‘Recovering effectively in high-performance sports’, in Joyce, D. and Lewindon, D. (eds) High-performance training for sports. Champaign, IL: Human Kinetics, pp. 321–330.
Ingram, J., Dawson, B., Goodman, C., Wallman, K. and Beilby, J. (2009) ‘Effect of water immersion methods on post-exercise recovery from simulated team sport exercise’, Journal of Science and Medicine in Sport, 12(3), pp. 417–421. doi: 10.1016/j.jsams.2007.12.011.
Lane, K. N. and Wenger, H. A. (2004) ‘Effects of selected recovery conditions on performance of repeated bouts of intermittent cycling seperated by 24 hours’, Journal of strength and conditioning research, 18(4), pp. 855–860. doi: 10.1519/14183.1.
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. doi: 10.1136/bjsm.2003.010330.
Parouty, J., Haddad, H. Al, Quod, M., Leprêtre, P. M., Ahmaidi, S. and Buchheit, M. (2010) ‘Effect of cold water immersion on 100-m sprint performance in well-trained swimmers’, European Journal of Applied Physiology, 109(3), pp. 483–490.
Rowsell, G. J., Coutts, A. J., Reaburn, P. and Hill-Haas, S. (2011) ‘Effect of post-match cold-water immersion on subsequent match running performance in junior soccer players during tournament play.’, Journal of sports sciences, 29(1), pp. 1–6. doi: 10.1080/02640414.2010.512640.
Rupp, K. A., Selkow, N. M., Parente, W. R., Ingersoll, C. D., Weltman, A. L. and Saliba, S. A. (2012) ‘The effect of cold water immersion on 48-hour performance testing in collegiate soccer players’, Journal of Strength and Conditioning Research, 26(8), pp. 2043–2050.
Sanchez-Ureña, B. A., Barrantes-Brais, K., Ureña-Bonilla, P., Calleja-González, J., Ostojic, S., Sánchez-Ureña, B., Barrantes-Brais, K., Ureña-Bonilla, P., Calleja-González, J. and Ostojic, S. (2015) ‘Effect of Water Immersion on Recovery from Fatigue: A Meta-analysis’, European Journal of Human Movement, 34, pp. 1–14. Available at: http://www.eurjhm.com/index.php/eurjhm/article/view/338.
Stacey, D. L., Gibala, M. J., Ginis, K. A. M. and Timmons, B. W. (2010) ‘Effects of recovery method after exercise on performance, immune changes, and psychological outcomes’, Journal of Orthopaedic & Sports Physical Therapy, 40(10), pp. 656–665. doi: 10.2519/jospt.2010.3224.
Stanley, J., Buchheit, M. and Peake, J. M. (2012) ‘The effect of post-exercise hydrotherapy on subsequent exercise performance and heart rate variability’, European Journal of Applied Physiology, 112(3), pp. 951–961.
Tenney, D. and Schmid, S. (2016) ‘Fatigue management and heart rate variability’, in Strudwick, T. (ed.) Soccer Science. Champaign, IL: Human Kinetics, pp. 497–498.
Vaile, J., Halson, S., Gill, N. and Dawson, B. (2008) ‘Effect of hydrotherapy on recovery from fatigue’, International Journal of Sports Medicine, 29(7), pp. 539–544. doi: 10.1055/s-2007-989267.
White, G. E. and Wells, G. D. (2013) ‘Cold-water immersion and other forms of cryotherapy: physiological changes potentially affecting recovery from high-intensity exercise’, Extreme Physiology & Medicine, 2(1), p. 26. doi: 10.1186/2046-7648-2-26.