The positive effects of ice baths for athletes

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Original study

Barber, Sean; Pattison, John; Brown, Freddy; Hill, Jessica Efficacy of Repeated Cold Water Immersion on Recovery After a Simulated Rugby Union Protocol, Journal of Strength and Conditioning Research: December 2020 – Volume 34 – Issue 12 – p 3523-3529 doi: 10.1519/JSC.0000000000002239
Click here for abstract

Background & Objective

The physical nature of rugby elicits repeated and forceful collisions as well as potential trauma to the body during competition, with the muscle damage sustained from this activity likely to negatively impact recovery (see HERE and HERE). As such, measures to improve the recovery status of rugby players, such as cold-water immersion (CWI) are often used. This study investigated the efficacy of repeated CWI on recovery after a simulated rugby union match.

What They Did

Sixteen club-level male rugby players (age = 20 ± 1.2 yr) completed a simulated rugby match and were assigned to either a CWI or control group (CON). After the simulation, the CWI group completed 2 x 5-min immersions at 10°C separated by 2.5-min seated at room temperature, whilst the CON group were required to remain seated for 15-min at room temperature. The following markers of recovery were collected pre-, immediately post-, 24-, and 48h post-exercise:
⇒ Creatine kinase (CK)
⇒ Delayed onset of muscle soreness (DOMS) with a 200-mm visual analogue scale
⇒ Countermovement jump (CMJ) height
⇒Knee extensor maximum voluntary isometric contraction (MVIC)

What They Found

⇒ DOMS
⇒  Both protocols resulted in an increase immediately post-exercise.

⇒  Soreness peaked immediately post-exercise in the CWIgroup and 24h post-exercise within the CON group.

⇒  CWI led to a reduction of muscle soreness when compared to the CON.

MVIC
⇒  Both protocols led to a decrease immediately post-exercise.

⇒  Peak reduction in MVIC occurred immediately post-exercise for the CWI group and at 24h post-exercise for the CON group.

⇒  CWI limited reductions any in strength at 24- and 48h post-exercise compared to the CON.

CMJ
⇒  Peak declines in jump height occurred immediately post-exercise for the CWI group and at 24h post-exercise for the CON group.

⇒ CWI limited reductions in CMJ performance immediately-, 24-, and 48h post-exercise compared to the CON.

CK
⇒  CWI blunted the increase in CK immediately post-exercise and more substantially at 24- and 48h post-exercise when compared to the CON.

Practical Takeaways

⇒ During instances where athletes may be required to perform either an intense training session or a competitive match within 48h of a previous match, restoration of muscle function (maximum force, power and perceived soreness) is key. As such, the prioritisation of recovery strategies to return the body to a resting/baseline state is essential and should be prioritised during these instances.

⇒ Further to this, the weekly habitual training regimes generally found in professional rugby, where we see the recommencement of training at 48h post-competition, need to be challenged. If subsequent training sessions are performed at a period too soon in the recovery period, the accumulation of fatigue may increase as will the risk of injury, or the preparedness for the next match may be suboptimal.

⇒ During instances where practitioners are seeking to maximise adaptation from an exercise stimulus, CWI may not be actually suitable due to its blunting of the adaptation process. Alternatively, allowing the natural time-course for recovery and adaptation to occur may provide a greater adaptive response. Further to this, an additional application of passive stimuli such as heating may provide additional adaptation (see HERE).

⇒ Previous research investigating the effects of single bout CWI at higher water temperatures (15°C) on muscle soreness is conflicting. Therefore, it seems to be important that practitioners utilising CWI strategies should employ precise monitoring of water at colder temperatures of around (10°C) and repeated bouts as opposed to single bouts.

Reviewer’s Comments

“In the present study a repeated-bout method was utilised, whereby 2 x 5-min exposures to CWI were given, which is different from previous literature which often implements a single bout of longer duration. It would’ve been really interesting to see a third condition of single but sustained immersion in the study, to allow a comparison for single- vs. repeated-bout (1 x 10-min vs. 2 x 5-min) to determine the possible differences. From an applied perspective, both 1 x 10-min and 2 x 5-min have pros and cons so understanding whether one is superior to the other would be of interest.

One limitation of the present study worth highlighting is the ‘simulated’ nature of the exercise. Although the authors attempted to closely match the requirements of a competitive match, it is impossible to completely replicate the reactive, indecisive, emotional, and cognitive aspects of a competitive rugby match. As such, it cannot be confirmed that the physiological impact perceived by the participants is fully representative of a competitive match.”

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