What are the Physiological Mechanisms for Post-Exercise Cold Water Immersion in the Recovery from Prolonged Endurance and Intermittent Exercise?

Core Temperature Responses to Cold-Water Immersion Recovery: A Pooled-Data Analysis

PURPOSE

To examine the effect of postexercise cold-water immersion (CWI) protocols, compared with control (CON), on the magnitude and time course of core temperature (T_c) responses.

METHODS

Pooled-data analyses were used to examine the T_c responses of 157 subjects from previous postexercise CWI trials in the authors' laboratories. CWI protocols varied with different combinations of temperature, duration, immersion depth, and mode (continuous vs intermittent). T_c was examined as a double difference (ΔΔT_c), calculated as the change in T_c in CWI condition minus the corresponding change in CON. The effect of CWI on ΔΔT_c was assessed using separate linear mixed models across 2 time components (component 1, immersion; component 2, postintervention).

RESULTS

Intermittent CWI resulted in a mean decrease in ΔΔT_c that was 0.25°C (0.10°C) (estimate [SE]) greater than continuous CWI during the immersion component (P = .02). There was a significant effect of CWI temperature during the immersion component (P = .05), where reductions in water temperature of 1°C resulted in decreases in ΔΔT_c of 0.03°C (0.01°C). Similarly, the effect of CWI duration was significant during the immersion component (P = .01), where every 1 min of immersion resulted in a decrease in ΔΔT_c of 0.02°C (0.01°C). The peak difference in T_c between the CWI and CON interventions during the postimmersion component occurred at 60 min postintervention.

CONCLUSIONS

Variations in CWI mode, duration, and temperature may have a significant effect on the extent of change in T_c. Careful consideration should be given to determine the optimal amount of core cooling before deciding which combination of protocol factors to prescribe.

Effectiveness of Two Cold Water Immersion Protocols on Neuromuscular Function Recovery: A Tensiomyography Study

Cold water immersion (CWI) has become a highly used recovery method in sports sciences, which seeks to minimize fatigue and accelerate recovery processes; however, tensiomyography (TMG) is a new method to analyze the muscle mechanical response as a recovery indicator after CWI protocols, this relative new tool of muscle function assessment, can lead to new information of understand fatigue recovery trough CWI. The objective of the study was to compare the effect of two CWI protocols, on neuromuscular function recovery. Thirty-nine healthy males (21.8 ± 2.8 years, 73.2 ± 8.2 kg, 176.6 ± 5.3 cm and body fat 13.5 ± 3.4%) were included in the study. Participants were grouped into a continuous immersion (12 min at 12 ± 0.4°C) group, intermittent immersion (2 min immersion at 12 ± 0.4°C + 1 min out of water 23 ± 0.5°C) group, and a control group (CG) (12 min sitting in a room at 23 ± 0.5°C). Afterward, the participants performed eight sets of 30 s counter movement jumps (CMJs) repetitions, with a 90 s standing recovery between sets. Muscle contraction time (Tc), delay time (Td), muscle radial displacement (Dm), muscle contraction velocity at 10% of DM (V10), and muscle contraction velocity at 90% of DM (V90) in rectus, biceps femoris, and CMJ were measured. Neither CWI protocol was effective in showing improved recovery at 24 and 48 h after training compared with the CG (p > 0.05), in any TMG indicator of recovery in either muscle biceps or rectus femoris, nor was the CMJ performance (F_(6,111) = 0.43, p = 0.85, ωp2 = 0). Neither CWI protocol contributed to recovery of the neuromuscular function indicator.

An Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review With Meta-Analysis

Introduction: The aim of the present work was to perform a meta-analysis evaluating the impact of recovery techniques on delayed onset muscle soreness (DOMS), perceived fatigue, muscle damage, and inflammatory markers after physical exercise. Method: Three databases including PubMed, Embase, and Web-of-Science were searched using the following terms: ("recovery" or "active recovery" or "cooling" or "massage" or "compression garment" or "electrostimulation" or "stretching" or "immersion" or "cryotherapy") and ("DOMS" or "perceived fatigue" or "CK" or "CRP" or "IL-6") and ("after exercise" or "post-exercise") for randomized controlled trials, crossover trials, and repeated-measure studies. Overall, 99 studies were included. Results: Active recovery, massage, compression garments, immersion, contrast water therapy, and cryotherapy induced a small to large decrease (-2.26 < g < -0.40) in the magnitude of DOMS, while there was no change for the other methods. Massage was found to be the most powerful technique for recovering from DOMS and fatigue. In terms of muscle damage and inflammatory markers, we observed an overall moderate decrease in creatine kinase [SMD (95% CI) = -0.37 (-0.58 to -0.16), I2 = 40.15%] and overall small decreases in interleukin-6 [SMD (95% CI) = -0.36 (-0.60 to -0.12), I2 = 0%] and C-reactive protein [SMD (95% CI) = -0.38 (-0.59 to-0.14), I2 = 39%]. The most powerful techniques for reducing inflammation were massage and cold exposure. Conclusion: Massage seems to be the most effective method for reducing DOMS and perceived fatigue. Perceived fatigue can be effectively managed using compression techniques, such as compression garments, massage, or water immersion.

Effect of Body Composition on Physiological Responses to Cold-Water Immersion and the Recovery of Exercise Performance

Purpose: To explore the influence of body composition on thermal responses to cold-water immersion (CWI) and the recovery of exercise performance. Methods: Male subjects were stratified into 2 groups: low fat (LF; n = 10) or high fat (HF; n = 10). Subjects completed a high-intensity interval test (HIIT) on a cycle ergometer followed by a 15-min recovery intervention (control [CON] or CWI). Core temperature (Tc), skin temperature, and heart rate were recorded continuously. Performance was assessed at baseline, immediately post-HIIT, and 40 min postrecovery using a 4-min cycling time trial (TT), countermovement jump (CMJ), and isometric midthigh pull (IMTP). Perceptual measures (thermal sensation [TS], total quality of recovery [TQR], soreness, and fatigue) were also assessed. Results: Tc and TS were significantly lower in LF than in HF from 10 min (Tc, LF 36.5°C ± 0.5°C, HF 37.2°C ± 0.6°C; TS, LF 2.3 ± 0.5 arbitrary units [a.u.], HF 3.0 ± 0.7 a.u.) to 40 min (Tc, LF 36.1°C ± 0.6°C, HF 36.8°C ±0.7°C; TS, LF 2.3 ± 0.6 a.u., HF 3.2 ± 0.7 a.u.) after CWI (P < .05). Recovery of TT performance was significantly enhanced after CWI in HF (10.3 ± 6.1%) compared with LF (3.1 ± 5.6%, P = .01); however, no differences were observed between HF (6.9% ±5.7%) and LF (5.4% ± 5.2%) with CON. No significant differences were observed between groups for CMJ, IMTP, TQR, soreness, or fatigue in either condition. Conclusion: Body composition influences the magnitude of Tc change during and after CWI. In addition, CWI enhanced performance recovery in the HF group only. Therefore, body composition should be considered when planning CWI protocols to avoid overcooling and maximize performance recovery.

Recovery following a marathon: a comparison of cold water immersion, whole body cryotherapy and a placebo control

PURPOSE

Cryotherapy is an increasingly popular recovery strategy used in an attempt to attenuate the negative impact of strenuous physical activity on subsequent exercise. Therefore, this study aimed to assess the effects of whole body cryotherapy (WBC) and cold water immersion (CWI) on markers of recovery following a marathon.

METHODS

Thirty-one endurance trained males completed a marathon. Participants were randomly assigned to a CWI, WBC or placebo group. Perceptions of muscle soreness, training stress and markers of muscle function were recorded before the marathon and at 24 and 48 h post exercise. Blood samples were taken at baseline, post intervention and 24 and 48 h post intervention to assess inflammation and muscle damage.

RESULTS

WBC had a harmful effect on muscle function compared to CWI post marathon. WBC positively influenced perceptions of training stress compared to CWI. With the exception of C-reactive protein (CRP) at 24 and 48 h, neither cryotherapy intervention positively influenced blood borne markers of inflammation or structural damage compared to placebo.

CONCLUSION

The findings show WBC has a negative impact on muscle function, perceptions of soreness and a number of blood parameters compared to CWI, contradicting the suggestion that WBC may be a superior recovery strategy. Further, cryotherapy is no more effective than a placebo intervention at improving functional recovery or perceptions of training stress following a marathon. These findings lend further evidence to suggest that treatment belief and the placebo effect may be largely responsible for the beneficial effects of cryotherapy on recovery following a marathon.

A customised cold-water immersion protocol favours one-size-fits-all protocols in improving acute performance recovery

The purpose of the present study was to investigate whether a customised cold-water immersion (CWIc) protocol was more effective in enhancing acute performance recovery than a one-size-fits-all CWI (CWIs) or active recovery (AR) protocol. On three separate testing days, 10 healthy, physically active, non-smoking males completed the same fatiguing protocol (60 squat jumps and a 2'30″ all-out cycling time-trial) followed by CWIc (12°C, 10-17 min), CWIs (15°C, 10 min) or AR (60 W, 10 min). Outcome measures to assess acute recovery were heart rate variability (HRV) as HRVrecovery, muscle power (MP) as absolute and relative decline, and muscle soreness (MS) at 0 and 24 h. HRVrecovery for CWIc was significantly higher compared to CWIs (p = .026, r = 0.74) and AR (p = .000, r = 0.95). The relative decline in MP after CWIc was significantly lower than after CWIs (p = .017, r = 0.73). MS 0 h and MS 24 h post-intervention were not different after CWIc compared to CWIs and AR (p > .05). The findings of the present study demonstrated that CWIc outperforms CWIs and AR in the acute recovery of cardiovascular (HRV) and CWIs in neuromuscular (MP) performance with no differences in MS. To optimise the effects of CWI, contributions of the protocol duration and water temperature should be considered to guarantee an optimal customised dose.

Post-exercise recovery of contractile function and endurance in humans and mice is accelerated by heating and slowed by cooling skeletal muscle

KEY POINTS

We investigated whether intramuscular temperature affects the acute recovery of exercise performance following fatigue-induced by endurance exercise. Mean power output was better preserved during an all-out arm-cycling exercise following a 2 h recovery period in which the upper arms were warmed to an intramuscular temperature of ̴ 38°C than when they were cooled to as low as 15°C, which suggested that recovery of exercise performance in humans is dependent on muscle temperature. Mechanisms underlying the temperature-dependent effect on recovery were studied in intact single mouse muscle fibres where we found that recovery of submaximal force and restoration of fatigue resistance was worsened by cooling (16-26°C) and improved by heating (36°C). Isolated whole mouse muscle experiments confirmed that cooling impaired muscle glycogen resynthesis. We conclude that skeletal muscle recovery from fatigue-induced by endurance exercise is impaired by cooling and improved by heating, due to changes in glycogen resynthesis rate.

ABSTRACT

Manipulation of muscle temperature is believed to improve post-exercise recovery, with cooling being especially popular among athletes. However, it is unclear whether such temperature manipulations actually have positive effects. Accordingly, we studied the effect of muscle temperature on the acute recovery of force and fatigue resistance after endurance exercise. One hour of moderate-intensity arm cycling exercise in humans was followed by 2 h recovery in which the upper arms were either heated to 38°C, not treated (33°C), or cooled to ∼15°C. Fatigue resistance after the recovery period was assessed by performing 3 × 5 min sessions of all-out arm cycling at physiological temperature for all conditions (i.e. not heated or cooled). Power output during the all-out exercise was better maintained when muscles were heated during recovery, whereas cooling had the opposite effect. Mechanisms underlying the temperature-dependent effect on recovery were tested in mouse intact single muscle fibres, which were exposed to ∼12 min of glycogen-depleting fatiguing stimulation (350 ms tetani given at 10 s interval until force decreased to 30% of the starting force). Fibres were subsequently exposed to the same fatiguing stimulation protocol after 1-2 h of recovery at 16-36°C. Recovery of submaximal force (30 Hz), the tetanic myoplasmic free [Ca²⁺ ] (measured with the fluorescent indicator indo-1), and fatigue resistance were all impaired by cooling (16-26°C) and improved by heating (36°C). In addition, glycogen resynthesis was faster at 36°C than 26°C in whole flexor digitorum brevis muscles. We conclude that recovery from exhaustive endurance exercise is accelerated by raising and slowed by lowering muscle temperature.

Influence of body composition on physiological responses to post-exercise hydrotherapy

This study examined the influence of body composition on temperature and blood flow responses to post-exercise cold water immersion (CWI), hot water immersion (HWI) and control (CON). Twenty-seven male participants were stratified into three groups: 1) low mass and low fat (LM-LF); 2) high mass and low fat (HM-LF); or 3) high mass and high fat (HM-HF). Experimental trials involved a standardised bout of cycling, maintained until core temperature reached 38.5°C. Participants subsequently completed one of three 15-min recovery interventions (CWI, HWI, or CON). Core, skin and muscle temperatures, and limb blood flow were recorded at baseline, post-exercise, and every 30 min following recovery for 240 min. During CON and HWI there were no differences in core or muscle temperature between body composition groups. The rate of fall in core temperature following CWI was greater in the LM-LF (0.03 ± 0.01°C/min) group compared to the HM-HF (0.01 ± 0.001°C/min) group (P = 0.002). Muscle temperature decreased to a greater extent during CWI in the LM-LF and HM-LF groups (8.6 ± 3.0°C) compared with HM-HF (5.1 ± 2.0°C, P < 0.05). Blood flow responses did not differ between groups. Differences in body composition alter the thermal response to post-exercise CWI, which may explain some of the variance in the responses to CWI recovery.