Cold therapy for sport injuries has been around for a long time, but ice baths take it a step further. The theory is that cold-water immersion causes the blood vessels to constrict, decreasing swelling, inflammation, pain and muscle spasms.

Conflicting studies

Some coaches, trainers and clinicians swear by ice baths, but recent research has called the practice into question. A study in the European Journal of Applied Physiology sought to determine the effects of ice on the inflammatory response to exercise. Researchers did this by measuring leg strength, thigh circumference and reported soreness following bouts of what they called “muscle damaging exercise.” Twenty active males were asked to complete a 40-minute run to induce muscle damage. Ten subjects were put in an ice bath for 20 minutes following activity, while the other 10 remained dry.

The results of the tests showed no significant difference in muscle soreness or leg strength between the subjects who had the ice bath and those who didn’t. The researchers concluded that use of ice baths for muscle recovery was ineffective.

But another recent study had entirely different results. Nine endurance-trained athletes were asked to complete two exhaustive runs on three different occasions, separated by 15 minutes of rest without cold-water immerson (CWI) and 15 minutes with CWI at 8 degrees Celsius. Intestinal temperature, blood lactate levels and V02 max were recorded. The results showed decreases in heart rate and intestinal temperature with blood lactate levels and V02 max left unaffected. The researchers concluded that 15 minutes of CWI can enhance running performance.

Could the results just be mental?

The British Journal of Sports Medicine analyzed the individual perception of recovery along with the body temperature responses to water immersion. Twelve high-level rugby players took part in a three-week trial featuring one-hour conditioning sessions followed by either a 15-minute CWI at 14 degrees Celsius; warm water immersion (WWI) at 30 degrees Celsius; or nothing. The researchers recorded post-exercise body temperature and subjective ratings, and the results were incredible. CWI produced a large reduction in core body temperature as well as improved sprint performance when compared to WWI. Even more interesting was the strong correlation between reduced body temperature and the subjective ratings of recovery when related to sprint performance.

Conclusion? A combination of physiological effects and perception of those effects enhances muscle recovery—meaning that if an athlete believes cold water immersion is helpful in recovery, he or she will likely benefit from it.

What should athletes do?

Use common sense and exercise caution. Research remains unclear on whether ice baths are effective, and there are too many differences in applied and recommended treatment protocols. Many endurance athletes stay in an ice bath for 15 to 20 minutes, whereas football players and other high-intensity athletes likely stay for 10 minutes or less. This may be because many runners and triathletes generally look to ice baths not only to decrease soreness and pain, but also to improve their endurance and running performance. Football players, on the other hand, use ice baths more for muscle recovery and to reduce pain.

Here are a few guidelines to take into account when you choose to get into the cold tub.

1. Start with a dip, not a plunge.

It is wise to take your first ice bath on the day before a competition. Before structuring a routine around game time, experiment with ice baths several days before important athletic events so you can get an idea of how your body responds.

2. Be conservative

Most ice baths are in the range of 54 to 60 degrees Fahrenheit. If you have never done one before, do not go any lower. You can easily risk hypothermia.

3. Shower before ice baths.

This is more of a preventative measure if you are on a team. If several players on a team choose to go into a cold tub after practice, you and your teammates should shower first. Doing so reduces the risk of MRSA and other bacterial infections.

4. Keep it short.

Combining ice and water at 54 degrees can be an uncomfortable experience. Staying in the cold tub too long beyond your personal threshold can be incredibly dangerous. Most athletes stay in from five to 10 minutes. But don’t feel you have to mimic that. If you cannot handle that temperature, either increase it or get out of the tub. Also, you can get booties for your toes or a hot pack for your neck to help you cope with the cold.

5. Save it until the very end.

Avoid ice baths right before practice or competition. You will be stiff, and it will be much harder to warm up. Save it until the end of the day. After your practice or game, go through your other recovery methods first.

If you decide to try ice baths, remember they are only a supplement to muscle recovery and not an overall solution. Full muscle recovery from games and workouts, as well as the prevention of sports injuries, demands a combination of proper training, good nutrition, adequate rest and sound recovery.

References:

1. Ciolek, Jeffrey. “Cryotherapy, review of physiological effects and clinical application.” Cleveland Clinic Journal of Medicine. June 1985, vol 52 pg 193-201.
2. Crystal et al. “Effect of cryotherapy on muscle recovery and inflammation following a bout of damaging exercise.” European Journal of Applied Physiology. 2013 Oct;113(10):2577-86.
3. Dunne et al. “Effect of post-exercise hydrotherapy water temperature on subsequent exhaustive running performance in normothermic conditions.” Journal of Science And Medicine In Sport/Sports Medicine Australia. 2013 Sep;16(5):466-71.

4. Cook et al. “Individual perception of recovery is related to subsequent sprint performance.” British Journal of Sports Medicine. January 4, 2013.
5. 5. Schmitz, Andy. “8 Ice Baths Dos and Donts.” Active.com.

Read More:

• Beat Muscle Soreness with Ice and Heat
• Should You Ice or Heat That Injury?
• Injury Recovery with RICE: Rest, Ice, Compression and Elevation

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