Do Ice Baths Improve Recovery from Workouts?

evolution-primitive-manPrimitive man used to hike hundreds of miles up remote mountain paths risking life and limb to chip off a block of ice to bring back to his communal box, hoping to speed recovery from their WoDs so that one day, they might be crowned champion at the Primal Man's CrossFit Games, only to have their dreams dashed when the ice melted in their hands as they approached their place of training.

Was he foolish in his attempts?

With the popularity of hype shows that depict the training regimens of today’s top fighters and athletes, the ice bath is a tool that is much talked about for improving recovery from tough workouts.

Off the top of my head, I recall seeing Jon Jones, Wanderlei Silva, Big Nog and Junior Dos Santos all jumping into an ice bath after a workout.

nogueira-ice-bath

“If you say anything about what’s under the ice, I’ll break your arm. Plus, it’s freaking cold in here!”

Now I have never personally had the pleasure of jumping into an ice bath immediately after a workout…

I’ve taken cold showers and hung out in a cold room. I’ve also done the contrast method where I alternate hot/cold either in the shower or by alternating between the cold room/sauna at my gym.

I’ve also run out of a hot tub, rolled around in the snow, then jumped back into the hot tub and enjoyed that tingly feeling on my skin.

But I’ve never dug too deep into the science about it all because I’d heard these methods were useful from coaches I know and trust. So I’ve taken the recommendations personally and since they didn’t require any more time or money, I’ve recommended them to my athletes as well.

Last week, my man Josh posted an abstract  link on my Facebook page asking me for my opinion.

josh-fb-ice-bath

This got the wheels spinning and once the wheels are spinning, they won’t stop until I do something about it.

So I decided to do a full-on scientific literature review of the topic of ice baths.

If you’re the type that likes to know the science behind the methods, this article is for you.

Ready?

Then let’s begin.

 

Do Ice Baths Improve Recovery
from Workouts?

To answer this, I started by looking for articles called “systematic reviews”.

Basically, a systematic review is an article written that is a summary of past research on a certain topic.

For you and me, they are a convenient starting point for any type of research, because really poor quality studies are eliminated and only the best of the best remain.

[FYI – I have access to the scientific journals, so I read the full articles, not just the abstracts. That’s why these posts take so damn long and why I don’t do them too often. Hours of reading studies can be painful as anyone who has done so will tell you.]

In this case, I looked for reviews of the effects of ice baths/cold water immersion (CWI) and cold therapy on recovery from exercise and performance.

I found and read through 3 recent reviews of the literature and am going to quickly summarize the findings from each one, starting with the oldest.

But before we do that, let’s go through some of the theories behind the mechanisms of why ice baths may work:

  • Exercise causes body temp to increase, and increased body temp is stressful on the body so cooling it may help speed recovery by getting back to normal temp (and a normal, less-stressed body state) faster - this theory is more related to cooling either before or between workouts
  • It may have an anti-inflammatory effect, thereby reducing the potential for DOMS by speeding mechanical recovery, allowing you to perform better, sooner because you're not as stiff and sore
  • It may cause vasoconstriction (decreased blood vessel diameter), which stimulates blood flow and nutrient and waste transportation through the body after exercise, speeding metabolic recovery for greater performance on a cellular level

  • It may decrease nerve transmission speed and alter receptor threshold, resulting in decreased pain perception

These are just some of the theories as to why ice baths may work.

But do they actually?

Here’s what the literature has to say:

 

Systematic Review #1

Ranalli et al. 2010. Effect of body cooling on subsequent aerobic and anaerobic exercise performance: a systematic review. Journal of Strength and Conditioning Research, 24(12), 3488-3496.

This review is related to getting the body temperature down before or between workouts, so it’s relevant to you if you train multiple times per day or you’re an athlete that competes in tournaments where you might battle multiple times a day without much rest between, especially if your training takes place in a hot environment.

In this review, the authors boiled down 228 studies to 13 that met their criteria for a good study. All studies used running or cycling as measures for performance.

Both intervals (anaerobic – 6 studies) and steady state (aerobic – 9 studies) tests were used. [If you picked that up that 6+9 = 15 and I said 13 studies earlier, 2 studies looked at both steady state and intervals, you brainiac you]

The aerobic studies involved cooling the body before exercise (either before or during an active warmup, which seems contradictory) or between exercise bouts, mostly with an ice vest or cooling jacket, although a couple studies did use CWI.

They measured things like total distance run in a certain time period, time to finish a certain distance and total work output.

7 of the 9 studies showed significant positive results, as depicted in this graph of performance change after cooling compared to the control group:

aerobic-results

Click to Enlarge (that’s what I say to the ladies)

What does this mean to you?

Cooling your core temp down before an aerobic event or between aerobic events can help improve your performance and is something to consider, especially if you’re training or competing multiple times per day and if your event takes place in the heat.

What about the 6 anaerobic studies?

Only 1 showed a significant improvement, while 1 also showed a significant decrease in performance.

BUT – these studies only tested cooling athletes before a performance test, not between multiple performance tests. Thumbs down!

IMO, it would’ve been more useful to see how it helped between anaerobic sessions, to make it more relevant for competitions or 2 or 3-a-day workouts.

I would suggest that based on this review, it is probably beneficial to get your core temperature down for an Aerobic event that takes place in the heat or between aerobic training sessions.

I believe the important point is HOW you cool yourself – in this review, the studies that showed the benefit used an ice vest or cooling jacket, not CWI.

The studies that did use CWI showed minimal to no improvements in performance.

The old ice pack on the neck in between rounds looks to have a bit of scientific clout, here, folks.  

speed-limitThe theory behind this is that much like a car that has a governor that limits your top speed, your brain has a governor that can limit your exercise output if your core temp gets too high.

For MMA, if you’re training in a hot gym, it’s probably beneficial to cool yourself down (via an ice pack on the neck) if you’ve got 2 or 3 workouts to do that day.

But CWI?

I’d stay away or at least use it very sparingly between workouts on the same day, for reasons I’ll explain later.

Either way, let’s continue our research and check out the 2nd review…

 

Systematic Review #2

Torres et al. 2012. Evidence of the physiotherapeutic interventions used currently after exercise-induced muscle damage: Systematic review and meta-analysis. Physical Therapy in Sport, 13, 101-114.

This review looked at cryotherapy as well as massage, stretching and low-intensity exercise (active recovery) and how they affect muscle soreness (DOMS) and various measures of strength, so it’s an interesting comparison at the most popular methods used for improving recovery post-workout.

However, it was a bit different than #1 because the authors performed something called a “meta-analysis”, which combines the results of several studies and draws conclusions based on those combined results.

After sifting through 5790 studies up to February 2011, they got 35 good ones. Here’s the breakdown of the # of studies reviewed and the conclusions from the meta-analysis:

  • 9 massage: significant effect for reducing DOMS at the 24 hour mark after the workout, no effect on strength
  • 10 cryotherapy: not effective for reducing DOMS or restoring strength
  • 9 stretching: no effect on reducing DOMS or restoring strength
  • 7 active recovery: no effect on DOMS or strength

So based on the meta-analysis, it seems that massage is the only effective modality for decreasing DOMS post-workout.

One thing to note throughout these studies is how strength was measured – using either maximal isometric or isokinetic contractions of the knee extensors or elbow flexors. Basically, the leg extension or a bicep curl.

So the strength measures are not very “functional” in nature and even if there were a positive effect, these tests might not translate to real sport (or training) performance.

I still have a takeaway from this study though – massage is probably a good idea post-workout, and your best bet is to FOAM ROLL the muscles you trained after your workout. It’s easy, free and feels (kinda) good.

Unless of course you can afford a $60-100 hit every time you workout. If that’s you, by all means, go for the massage.

I’m not sure what effect happy endings have, though. If you want to volunteer for that study, leave your name and contact info below. 😉

One more thing to keep in mind – stretching isn’t necessarily useless, it’s just not beneficial for decreasing DOMS. If you’ve got muscle/postural imbalances or just want to improve flexbility, it can be useful for those things, just don’t say you’re stretching to decrease soreness because it’s not true.

OK so the first 2 didn’t give us much to chomp on, but the last is more interesting…

 

Systematic Review #3

Leeder et al. 2012. Cold water immersion and recovery from strenuous exercise: a meta-analysis. British Journal of Sports Medicine, 46, 233-240.

So we’ve got another meta-analysis to look at here.

But it’s not the conclusions that are interesting to me.

It’s what they looked at…

This review looked at studies up to May 2010 and included those that met the following criteria:

  • Randomized control trials (as the previous ones had been)
  • Looked at 1 or more of 4 variables: muscle power (vertical jump, sprint), muscle strength (knee extension or elbow flexion), perceived DOMS and creatine kinase (CK), which is a marker of muscle damage – the more CK, the more muscle damage
  • Measured the variables at 24, 48, 72 and/or 96 hours post exercise
  • Used cold water immersion (CWI) within 1 hour post exercise

So this review basically included studies that are relevant to any MMA fighter or athlete looking to maximize recovery.

14 studies met their criteria, and here’s what they found:

DOMS: CWI had a moderate effect in reducing muscle soreness at all time points up to 96 h post exercise, especially following what they called “high intensity exercise” at the 24 and 48 hour marks. High intensity exercise included various sports, shuttle runs and intervals – exercises more similar to MMA training than a few sets of eccentric isokinetic bicep curls. 

Muscle Power: CWI improved the rate of recovery of muscle power, at 24, 48 and 72 hours post exercise compared to controls. Power tests included various jumps and sprints.

Muscle Strength: CWI was not effective in improving rate of recovery of strength (remember, strength was tested with either isolated knee flexion or elbow extension exercises).

Creatine Kinase: small but beneficial effect in reducing CK, which again, is a marker of muscle damage. So less CK means less muscle damage.

Based on this review, CWI is an effective tool used post-workout.

The specs for CWI range from 5-15 minutes in water anywhere from 5 to 15° C.

The review resulted in contrary findings regarding DOMS compared to #2, but what I find most revealing is the fact that CWI improved  high intensity exercise and muscle power, but did not improve muscle strength.

This goes to show the benefit to anyone participating in the combat arts or functional resistance training workouts.

First of all, the power tests are more related to what we do in the MMA world whether it be sparring or an MMA S&C workout instead of an isolated, isometric elbow flexion or knee extension.

Second, muscle power and high intensity exercise is as much related to your NERVOUS SYSTEM as it is to your muscles and local metabolism. This might explain why the tests using the isolated movements show no changes – it’s a very local and relatively easy exercise on the nervous system.

I would LOVE to see some research done on CWI where the exercise protocol is used to drain the nervous system and measurements are taken using tests that really tap into the nervous system.

These tests could be as simple as a handgrip dynamometer test, or use more functional exercises such as a 1RM Deadlift, Olympic Lifts, the shotput, etc.

Direct or indirect measures of nervous system function using things such as heart rate variability would be great to see as well.

Most of the research has focused on the muscles and energetic pathways, but I think the nervous system could play an even stronger role in discovering the true effects of CWI.

I may be totally off-base but hopefully we’ll see some more research come out in the future looking at these variables. If you’re student or researcher, see what you can do. 🙂

 

One More Interesting Study…

Tucker et al. 2012. Effect of local cold application on glycogen recovery.Journal of Sports Medicine and Physical Fitness, Apr, 52(2), 158-64.

Before we close out, I’d like to go through one  more study.

There have been a shit load of studies since February 2011 (the date of the latest study included in the reviews above) to sift through and most corroborate what we’ve already talked about.

So, for the sake of my sanity, I’ve selectively chosen this last one because it’s interesting and can give us one more takeaway…

The researchers looked at the effect of LOCAL cold application on muscle glycogen re-synthesis in subjects after the subjects performed a 90 minute glycogen depleting ride. 

During recovery, ice was applied intermittently to one leg and the other relaxed and acted as a control.

A carb drink (1.8 g/kg bodyweight) was given at 0 and 2 hours to restore glycogen.

Muscle biopsies were taken from both the cold and relaxed leg, which means the researchers extracted a sample of muscle and analyzed it.

What they found was that muscle glycogen was significantly LOWER in the cold leg compared to the relaxed leg, which means that the muscle didn’t refuel with glycogen as quickly when it was cold.

What does this mean?

When we look at it in the context of review #1, we see that for multiple workouts in one day, we don’t want to stay too cool for too long, otherwise glycogen restoration might be hampered and you’ll have less energy to burn for subsequent workouts.

If you’re going to use a bath, get in, chill for 5-10 minutes max, then get out.

Or, use an ice vest or neck collar to cool your core temperature down.

But if it’s your last workout of the day or you’re only doing 1 workout, spend 5-15 minutes in an ice bath and you can expect lower DOMS and increased power in upcoming workouts.

Eric's Ice Baths Research Summary

1. Ice baths are cool and probably work to decrease muscle soreness and hasten recovery of expressing power. Jump in for 10 minutes in water that's 5-15 °C after hard workouts.

2. If you're working out multiple times in one day, your safest bet is to wear an ice collar or vest to cool your core temperature down as quickly as possible, which will help you maintain a higher level of performance. Feel free to jump into an ice bath or apply topical cooling to soothe joints or numb pain if necessary, but make sure you don't do it for more than 5 minutes or you'll hamper glycogen recovery.

3. Massage after workouts is also a good idea to decrease DOMS. Foam rolling is a poor man's massage so do that if you can't afford a massage after every workout. If you're going to do an ice bath and a massage, do the massage/foam rolling first, then the ice bath. I hope that was obvious.

4. The duck quacks at midnight. Quack, quack.

5. Want to know even more powerful methods for recovery? Whole, natural food and a good amount of restful sleep. Remember - we're holistic around here, biach.

And I’m Out!

Shit, that was long. My eyes are blurry, my ass is sore, my wife is pissed off at me and I’ve got to take a leak.

I hope this has helped you out a little bit.

Do you use ice baths or any other form of recovery means after workouts?

Or will reading this article change the way you do things?

Let me know below. Or maybe at least hit me with a ‘Like’ – it’ll let me know you dig this kinda content.

PEACE

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Cassidy
Cassidy

Hey Eric, where do you find all these research reports and how can I get my hands on them?

Eric
Eric

I’m hooked up through the University of Toronto here, my professor friend helped me out…

Find a friend at a local university (prof, student) and they can help you access the journals.

Woody
Woody

Great article on cold emersion, apart from the info above is there any evidence that cooling the body <10 degrees will assist with cooling Fat Cells and when they warm they are destroyed similar to CoolSculping. If so I'll give it a go, the trick is not to freeze too low, staying between 5 and 10 degrees and then warming that area. If you have any thoughts on this please let me know, much appreciated.

To Paul regarding Hypoxi Vacunaut, I tried this for 12 sessions and apart from my normal weight loss due to weight and cardio training e.g. losing 1 kg per week there was no significant advantage, e.g. didn't see any greater loss from what I am currently doing, hope this helps, but I an looking at CoolSculping for that stubborn Visceral Fat in the lower abs.

Paul
Paul

Hi Eric, really liked this article found it informative. Recently a few mates have started to do hypoxi training and was just wondering your opinion of this.

Cheers

Paul

Eric
Eric

I think it’s good for stimulating blood flow via constriction/relaxation, but I’m not 100% sure. I’ll have to ask my friend Daniel and see what the mechanisms are as he uses a similar unit for rehab.

But for fat loss? I’m not a fat loss researcher so I don’t know.

Josh
Josh

Thanks for this great research, Eric! Has anyone done similar studies using contrast therapy??

Leinz
Leinz

Great article, thanks Eric !
Personally, I dont have much experience about ice bathing.
But a (pretty cold / alp) river is running 200 meters from the place I workout.
From time to time I jump in head first after a hard training.
DOMs or power increase are also influenced may be,
but I definitely recommend it for a good feeling

Anthony Gilormini
Anthony Gilormini

Great article, definitely makes me feel a little more assured that I’m not wasting my time with CWI after and between my workouts. That last study you referenced was the best one I think, because it was definitely done in a manner that proves certain effects of cold therapy. I’ll definitely be watching how long I stay in the water! Like you said, hopefully soon they’ll come out with more in depth and relevant studies on MMA training recoveries.

Andy "Bunso" Paves
Andy "Bunso" Paves

Great read. Love your scientific approach. Certainly helps a ton.

King David

Eric

Great article..

Here’s a couple links on cooling type recovery methods on workout performance and on testosterone..

http://news.stanford.edu/news/2012/august/cooling-glove-research-082912.html

http://www.4hourlife.com/2011/03/11/testosterone-four-hour-body-sex-machine-cheat-sheet/

Check em out!
KDH

Alan b

Great!!!! Eric , your the man!

walter J
walter J

Hi, After switching from Krav Maga to Long Slow Distance running, I can assure you that there is a great difference between which limbs, organs and muscle tissues that is being used.
Naturally in running its the legs and feet that cop most of the trauma, the cold baths, or ice buckets have sure helped me stave off injuries and helped recovery time in a great way.
The old RICE includes ice and cannot be underestimated of its healing powers.
Alas, like everything, you have to be careful of the adaptation of those subjected muscles to your recovery process. Stay injury free, wj

Barrett
Barrett

Great post Eric cool & to the point with a fact back up to shut up the near Sayers. Thank you keep on kicking the Martial science.your follower in Michigan Barrett.

YuFeng
YuFeng

It feels good to be able to read english after reading a bunch of psychological research papers. On another note, I read somewhere about cwi/ cold showers increasing testosterone levels, you ever heard anything about this?