Monday 8 April 2013

Ice baths to reduce muscle soreness and improve recovery - Do they work?

850 Words, Read time ~4.5 mins.

Ice baths - also know as Cold Water Immersion (CWI) - have long been used following exercise as a means to aid recovery and reduce muscle soreness. This method has gained increased popularity over the years, however most reported benefits are anecdotal and lack real scientific evidence. Having said that, I have used this method myself on a number of occasions and I must say I do personally 'feel better' after these sessions - placebo? Possibly.

A good example of when I took several ice bath applications was when I took part in the 3 Peaks Challenge in June 2011 - I used ice bath applications before and after this challenge and several times since this event too.

Reported benefits of CWI include:

  1. Reduced inflammation
  2. Reduced DOMS (Delayed onset muscle soreness)
  3. Improved range of motion
  4. Faster recovery and improved performance

The questions is - does Cold Water Immersion (CWI) actually work?

Recently I have spent some time looking over the research evidence into CWI with the aim of giving a balanced view on this recovery method. There have been a number of scientific studies that have been published in this area. The Cochrane Review - Cold-water immersion for preventing and treating muscle soreness after exercise - found 17 studies that met the inclusion criteria for their review.

For the purpose of this blog post I will review the evidence from a free access paper published in the Journal of Sports Science and Medicine. I will also contribute my own ideas from experimenting with CWI personally.

The Study

The above study recruited 18 males and caused exercise-induced muscle damage (EIMD) by getting the participants to perform 100 drop jumps. I know 100 drop jumps doesn't sound like much, but if you are unaccustomed to this type of exercise I can assure you that this WILL cause severe DOMS for several days after the activity.

The 18 participants were then randomly split up into two groups, with 9 in each and assigned to either a treatment group (CWI) or a control group (no CWI).

Tap water reading at 8 degree C
The treatment group were given CWI immediately following the 100 drop jumps by sitting in an 'ice bath' up to their waist. They were then given 3 more applications of CWI every 24hrs for the following 3 days. Water temperature was set at 15 degrees C and each CWI session lasted 12 minutes. The control group had no CWI sessions.
My own CWI sessions - When taking my own 'ice baths' in the past I have normally remained immersed for around 10-15 minutes per session at between 10-12 degrees C. This is the temperature that comes out of my cold bath tap at home during the summer months. I didn't have to add any ice to the water to achieve these temperatures. Notice that the temperature is colder than that of the study. In addition, a quick check this morning showed a reading of around 8 degrees C from my tap - though it is still very cold at the moment (See the image on the left).
What was measured in the study?

The purpose of the study was to establish whether the treatment group recovered more efficiently than the control group. The study measured 5 areas to see if there was a difference between the two groups - the following was measured:

  1. Leg strength (Knee extensor, maximal voluntarily contraction) 
  2. Perceived muscle soreness - DOMS 
  3. Creatine kinase activity
  4. Range of motion at the knee (flexion)
  5. Thigh girth / circumference (swelling)
The study results 

In all 5 of the areas above, the study showed no significant difference between the two groups. The researchers concluded that 'these results suggest that repeated CWI does not enhance recovery'.

Other studies have also found similar results showing no differences between the treatment group and control group.

However, in contrast to the above findings, the Cochrane review in the same area concluded the following; 'While the evidence shows that cold-water immersion reduces delayed onset muscle soreness after exercise, the optimum method of cold-water immersion and its safety are not clear.'

My thoughts 

If you are an avid 'ice bather' then these results may be a bit disappointing to hear.  To be honest, I was also a little disappointed. This should not be the case, scientific literature is often inconclusive and requires a large body of evidence over several decades to gain consensus around an area.

The good news is that the evidence so far does also indicate CWI or 'ice baths' are unlikely to cause any detrimental effects.

My advice is that if you 'feel better' having ice baths after strenuous activity then carry on doing it for the time being. Many professional football and rugby teams still use ice baths on a regular basis with their players.

Finally other interventions, such as compression to reduce inflammation, may be more useful than CWI in reducing DOMS and improving recovery. Again though the evidence is still inconclusive. Hopefully research in this area will catch up and give us all better understanding of how we should apply these therapies, if at all!

3 comments:

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