Can cold exposure improve recovery after exercise? Original paper

In this meta-analysis of randomized controlled trials, cold water immersion enhanced recovery after exercise, as assessed by improved ratings of perceived exertion, delayed-onset muscle soreness, and certain blood biomarkers associated with recovery.

This Study Summary was published on March 1, 2023.

Background

Cold exposure (such as in the form of cold water immersion) is a popular method for reducing fatigue and improving recovery, but clinical studies have led to conflicting results regarding its usefulness. What does the totality of the evidence say?

The study

This meta-analysis of 20 randomized controlled trials (including 419 healthy adults, average ages of 19–31) examined the effects of cold water immersion on fatigue recovery at 0, 24, and 48 hours after high-intensity exercise (rugby, football, swimming, jumping, or running) compared to a passive control condition (e.g., resting in a room with a normal temperature).

The researchers measured ratings of perceived exertion, delayed-onset muscle soreness (DOMS), and countermovement jump test results, as well as blood markers associated with recovery, including lactate, lactate dehydrogenase, creatine kinase, C-reactive protein, and interleukin 6.

The researchers also assessed the quality of the evidence and performed subgroup analyses to determine whether the body parts immersed in cold water (up to the umbilicus/navel or up to the shoulders) or the water temperature (<10°C or ≥10°C) influenced the outcomes.

The results

Cold water immersion reduced DOMS at 0 hours and 24 hours after exercise, but not at 48 hours. Ratings of perceived exertion and countermovement jump were improved at 0 hours (but not 24 and 48 hours) after exercise.

Creatine kinase was improved (i.e., reduced) 24 hours after exercise, and lactate was improved (i.e., reduced) at 24 and 48 hours after exercise. Cold water immersion had no effects on other biomarkers associated with recovery.

Subgroup analyses showed that a water temperature of <10°C was more effective than ≥10°C in improving countermovement jump. However, there was no difference in the outcomes between immersing the body up to the umbilicus vs. up to the shoulders.

Note

Because the researchers judged the quality of the available evidence as concerning, the results of this meta-analysis should be interpreted with caution. Although cold water immersion showed short-term improvements in recovery, more studies are needed to confirm these findings.

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This Study Summary was published on March 1, 2023.