Cold water immersion enhances recovery of submaximal muscle function after resistance exercise

Effects of post-exercise cold-water immersion on performance and perceptive outcomes of competitive adolescent swimmers

PURPOSE

To evaluate the effects of repeated use of cold-water immersion (CWI) during a training week on performance and perceptive outcomes in competitive adolescent swimmers.

METHODS

This randomized-crossover study included 20 athletes, who received each intervention [CWI (14 ± 1 °C), thermoneutral water immersion (TWI) (27 ± 1 °C) as placebo, and passive recovery (PAS)] three times a week between the land-based resistance training and swim training. The interventions were performed in a randomized order with a 1-week wash-out period. We tested athletes before and after each intervention week regarding swim (100 m freestyle sprints) and functional performance (flexibility, upper and lower body power, and shoulder proprioception). We monitored athlete's perceptions (well-being, heaviness, tiredness, discomfort and pain) during testing sessions using a 5-item questionnaire. Athlete preferences regarding the interventions were assessed at the end of the study. We used generalized linear mixed models and generalized estimating equations for continuous and categorical variables, respectively (intervention x time).

RESULTS

We found a time effect for swim performance (p = .01) in which, regardless the intervention, all athletes improved sprint time at post-intervention compared to baseline. There was an intervention effect for pain (p = .04) and tiredness (p = .04), but with no significant post-hoc comparisons. We found no significant effects for other outcomes. All athletes reported a preference for CWI or TWI in relation to PAS.

CONCLUSION

The repeated use of CWI throughout a training week did not impact functional or swim performance outcomes of competitive adolescent swimmers. Perceptive outcomes were also similar across interventions; however, athletes indicated a preference for both CWI and TWI.

One size does not fit all: Methodological considerations and recommended solutions for intramuscular temperature assessment

Intramuscular temperature kinetics can provide insightful information for exercise and environmental physiology research. However, currently, there are no consistent method descriptions or guidelines for muscle temperature assessment in the literature. Studies have reported a great variation in muscle temperature assessment, from 1.5 cm under the skin to 4 cm under the muscle fascia. Moreover, a large variation in body composition components among participants exacerbates this issue, changing the depth and the muscle to be tested. For instance, in young adults (25 ± 5 yrs), the thigh subcutaneous fat thickness can vary from 0.11 to 1.69 cm, and vastus lateralis thickness from 1.62 to 3.38 cm; in older adults (68.5 ± 3 yrs), subcutaneous fat thickness plus gastrocnemius medialis thickness can vary from 1.03 to 3.22 cm. This variation results in inconsistent resting muscle temperature profiles and muscle temperature kinetics during and after an exercise or environmental thermal stress interventions (hot or cold). Hence, one fixed size does not fit all. Standardization and consistency in muscle temperature assessment procedures across studies are required to allow a better understanding and translation of the influence of a given stressor (exercise or thermal) on muscle temperature kinetics. This methodological manuscript i) summarizes the differences in muscle temperature assessment procedures and techniques used across different studies, ii) discusses current concerns related to variations in intramuscular needle depth, and subcutaneous fat and muscle thickness when assessing muscle temperature, and iii) suggests a systematic and more robust approach, based on individual body composition characteristics, to be considered when assessing intramuscular temperature.

The untapped potential of cold water therapy as part of a lifestyle intervention for promoting healthy aging

Healthy aging is a crucial goal in aging societies of the western world, with various lifestyle strategies being employed to achieve it. Among these strategies, hydrotherapy stands out for its potential to promote cardiovascular and mental health. Cold water therapy, a hydrotherapy technique, has emerged as a lifestyle strategy with the potential capacity to evoke a wide array of health benefits. This review aims to synthesize the extensive body of research surrounding cold water therapy and its beneficial effects on various health systems as well as the underlying biological mechanisms driving these benefits. We conducted a search for interventional and observational cohort studies from MEDLINE and EMBASE up to July 2024. Deliberate exposure of the body to cold water results in distinct physiological responses that may be linked to several health benefits. Evidence, primarily from small interventional studies, suggests that cold water therapy positively impacts cardiometabolic risk factors, stimulates brown adipose tissue and promotes energy expenditure-potentially reducing the risk of cardiometabolic diseases. It also triggers the release of stress hormones, catecholamines and endorphins, enhancing alertness and elevating mood, which may alleviate mental health conditions. Cold water therapy also reduces inflammation, boosts the immune system, promotes sleep and enhances recovery following exercise. The optimal duration and temperature needed to derive maximal benefits is uncertain but current evidence suggests that short-term exposure and lower temperatures may be more beneficial. Overall, cold water therapy presents a potential lifestyle strategy to enhancing physical and mental well-being, promoting healthy aging and extending the healthspan, but definitive interventional evidence is warranted.

The effects of cold water immersion and partial body cryotherapy on subsequent exercise performance and thermoregulatory responses in hot conditions

This study investigated the effects of cold water immersion (CWI) and partial body cryotherapy (PBC) applied within a 15-min post-exercise recovery period on thermoregulatory responses, subjective perceptions, and exercise performance under hot conditions (39 °C). Twelve male soccer players participated in team-sports-specific assessments, including Agility T-test (T-test), 20-m sprint test (20M-ST), and Yo-Yo Intermittent Endurance Test Level 1 (YY-T), during two exercise bouts (1st bout and 2nd bout) with a 15-min post-exercise recovery period. Within the recovery period, a 3-min of PBC at -110 °C or CWI at 15 °C or a seated rest (CON) was performed. Mean skin temperature (Tskin) decreased by 4.3 ± 1.08°C (p < 0.001) immediately after PBC, while CWI induced a reduction of 2.5 ± 0.21°C (p < 0.01). Furthermore, PBC and CWI consistently reduced Tskin for 15 and 33 min, respectively (p < 0.05). During the 2nd bout, core temperature (Tcore) was significantly lower in PBC compared to CON (p < 0.05). Heart rate (HR) was significantly lower in CWI compared to CON and PBC during the intervention period. Thermal sensation (TS) was significantly greater in PBC compared to CON and CWI (p < 0.05). Compared to the 1st bout, PBC alleviated the declines in T-test (p < 0.05) and 20M-ST (p < 0.05), while CWI alleviated the decreases in T-test (p < 0.05) and YY-T (p < 0.05), concurrently significantly enhancing 20M-ST (p < 0.05). 20M-ST and YY-T was greater from PBC (p < 0.05) and CWI (p < 0.05) compared with CON in 2nd bout. Additionally, the T-test in CWI was significantly greater than CON (p < 0.05). These results indicate that both PBC and CWI, performed between two exercise bouts, have the potential to improve thermoregulatory strain, reduce thermal perceptual load, and thereby attenuate the subsequent decline in exercise performance.

Effect of heat stress on heat shock protein expression and hypertrophy-related signaling in the skeletal muscle of trained individuals

Muscle mass is balanced between hypertrophy and atrophy by cellular processes, including activation of the protein kinase B-mechanistic target of rapamycin (Akt-mTOR) signaling cascade. Stressors apart from exercise and nutrition, such as heat stress, can stimulate the heat shock protein A (HSPA) and C (HSPC) families alongside hypertrophic signaling factors and muscle growth. The effects of heat stress on HSP expression and Akt-mTOR activation in human skeletal muscle and their magnitude of activation compared with known hypertrophic stimuli are unclear. Here, we show a single session of whole body heat stress following resistance exercise increases the expression of HSPA and activation of the Akt-mTOR cascade in skeletal muscle compared with resistance exercise in a healthy, resistance-trained population. Heat stress alone may also exert similar effects, though the responses are notably variable and require further investigation. In addition, acute heat stress in C2C12 muscle cells enhanced myotube growth and myogenic fusion, albeit to a lesser degree than growth factor-mediated hypertrophy. Though the mechanisms by which heat stress stimulates hypertrophy-related signaling and the potential mechanistic role of HSPs remain unclear, these findings provide additional evidence implicating heat stress as a novel growth stimulus when combined with resistance exercise in human skeletal muscle and alone in isolated murine muscle cells. We believe these findings will help drive further applied and mechanistic investigation into how heat stress influences muscular hypertrophy and atrophy.NEW & NOTEWORTHY We show that acute resistance exercise followed by whole body heat stress increases the expression of HSPA and increases activation of the Akt-mTOR cascade in a physically active and resistance-trained population.

Cold water immersion in recovery following a single bout resistance exercise suppresses mechanisms of miRNA nuclear export and maturation

Cold water immersion (CWI) following intense exercise is a common athletic recovery practice. However, CWI impacts muscle adaptations to exercise training, with attenuated muscle hypertrophy and increased angiogenesis. Tissue temperature modulates the abundance of specific miRNA species and thus CWI may affect muscle adaptations via modulating miRNA expression following a bout of exercise. The current study focused on the regulatory mechanisms involved in cleavage and nuclear export of mature miRNA, including DROSHA, EXPORTIN-5, and DICER. Muscle biopsies were obtained from the vastus lateralis of young males (n = 9) at rest and at 2, 4, and 48 h of recovery from an acute bout of resistance exercise, followed by either 10 min of active recovery (ACT) at ambient temperature or CWI at 10°C. The abundance of key miRNA species in the regulation of intracellular anabolic signaling (miR-1 and miR-133a) and angiogenesis (miR-15a and miR-126) were measured, along with several gene targets implicated in satellite cell dynamics (NCAM and PAX7) and angiogenesis (VEGF and SPRED-1). When compared to ACT, CWI suppressed mRNA expression of DROSHA (24 h p = 0.025 and 48 h p = 0.017), EXPORTIN-5 (24 h p = 0.008), and DICER (24 h p = 0.0034). Of the analyzed miRNA species, miR-133a (24 h p < 0.001 and 48 h p = 0.007) and miR-126 (24 h p < 0.001 and 48 h p < 0.001) remained elevated at 24 h post-exercise in the CWI trial only. Potential gene targets of these miRNA, however, did not differ between trials. CWI may therefore impact miRNA abundance in skeletal muscle, although the precise physiological relevance needs further investigation.

Active recovery vs hot- or cold-water immersion for repeated sprint ability after a strenuous exercise training session in elite skaters

This study compared the acute effects of three recovery methods: active recovery (AR), hot- and cold-water immersion (HWI and CWI, respectively), used between two training sessions in elite athletes. Twelve national-team skaters (7 males, 5 females) completed three trials according to a randomized cross-over study. Fifteen minutes after an exhaustive ice-skating training session, participants underwent 20 min of HWI (41.1 ± 0.5°C), 15 min of CWI (12.1 ± 0.7°C) or 15 min of active recovery (AR). After 1 h 30 min of the first exercise, they performed a repeated-sprint cycling session. Average power output was slightly but significantly higher for AR (767 ± 179 W) and HWI (766 ± 170 W) compared to CWI (738 ± 156 W) (p = 0.026, d = 0.18). No statistical difference was observed between the conditions for both lactatemia and rating of perceived exertion. Furthermore, no significant effect of recovery was observed on the fatigue index calculated from the repeated sprint cycling exercises (p > 0.05). Finally, a positive correlation was found between the average muscle temperature measured during the recoveries and the maximal power output obtained during cycling exercises. In conclusion, the use of CWI in between high-intensity training sessions could slightly impair the performance outcomes compared to AR and HWI. However, studies with larger samples are needed to confirm these results, especially in less trained athletes.

Acute Performance, Daily Well-Being, and Hormone Responses to Water Immersion After Resistance Exercise in Junior International and Subelite Male Volleyball Athletes

ABSTRACT

Horgan, BG, Tee, N, West, NP, Drinkwater, EJ, Halson, SL, Colomer, CME, Fonda, CJ, Tatham, J, Chapman, DW, and Haff, GG. Acute performance, daily well-being and hormone responses to water immersion after resistance exercise in junior international and subelite male volleyball athletes. J Strength Cond Res XX(X): 000-000, 2023-Athletes use postexercise hydrotherapy strategies to improve recovery and competition performance and to enhance adaptative responses to training. Using a randomized cross-over design, the acute effects of 3 postresistance exercise water immersion strategies on perceived recovery, neuromuscular performance, and hormone concentrations in junior international and subelite male volleyball athletes (n = 18) were investigated. After resistance exercise, subjects randomly completed either 15-minute passive control (CON), contrast water therapy (CWT), cold (CWI), or hot water immersion (HWI) interventions. A treatment effect occurred after HWI; reducing perceptions of fatigue (HWI > CWT: p = 0.05, g = 0.43); improved sleep quality, compared with CON (p < 0.001, g = 1.15), CWI (p = 0.017, g = 0.70), and CWT (p = 0.018, g = 0.51); as well as increasing testosterone concentration (HWI > CWT: p = 0.038, g = 0.24). There were trivial to small (p < 0.001-0.039, g = 0.02-0.34) improvements (treatment effect) in jump performance (i.e., squat jump and countermovement jump) after all water immersion strategies, as compared with CON, with high variability in the individual responses. There were no significant differences (interaction effect, p > 0.05) observed between the water immersion intervention strategies and CON in performance (p = 0.153-0.99), hormone (p = 0.207-0.938), nor perceptual (p = 0.368-0.955) measures. To optimize recovery and performance responses, e.g., during an in-season competition phase, postresistance exercise HWI may assist with providing small-to-large improvements for up to 38 hours in perceived recovery (i.e., increased sleep quality and reduced fatigue) and increases in circulating testosterone concentration. Practitioners should consider individual athlete neuromuscular performance responses when prescribing postexercise hydrotherapy. These findings apply to athletes who aim to improve their recovery status, where postresistance exercise HWI optimizes sleep quality and next-day perceptions of fatigue.

The effect of cold water immersion on the recovery of physical performance revisited: A systematic review with meta-analysis

This review evaluated the effect of CWI on the temporal recovery profile of physical performance, accounting for environmental conditions and prior exercise modality. Sixty-eight studies met the inclusion criteria. Standardised mean differences were calculated for parameters assessed at <1, 1-6, 24, 48, 72 and ≥96 h post-immersion. CWI improved short-term recovery of endurance performance (p = 0.01, 1 h), but impaired sprint (p = 0.03, 1 h) and jump performance (p = 0.04, 6h). CWI improved longer-term recovery of jump performance (p < 0.01-0.02, 24 h and 96 h) and strength (p < 0.01, 24 h), which coincided with decreased creatine kinase (p < 0.01-0.04, 24-72 h), improved muscle soreness (p < 0.01-0.02, 1-72 h) and perceived recovery (p < 0.01, 72 h). CWI improved the recovery of endurance performance following exercise in warm (p < 0.01) and but not in temperate conditions (p = 0.06). CWI improved strength recovery following endurance exercise performed at cool-to-temperate conditions (p = 0.04) and enhanced recovery of sprint performance following resistance exercise (p = 0.04). CWI seems to benefit the acute recovery of endurance performance, and longer-term recovery of muscle strength and power, coinciding with changes in muscle damage markers. This, however, depends on the nature of the preceding exercise.

Effects of post-exercise cold-water immersion on resistance training-induced gains in muscular strength: a meta-analysis

The aim of this review was to perform a meta-analysis examining the effects of cold-water immersion (CWI) coupled with resistance training on gains in muscular strength. Four databases were searched to find relevant studies. Their methodological quality and risk of bias were evaluated using the PEDro checklist. The effects of CWI vs. control on muscular strength were examined in a random-effects meta-analysis. Ten studies (n = 170; 92% males), with 11 comparisons across 22 groups, were included in the analysis. Studies were classified as of good or fair methodological quality. The main meta-analysis found that CWI attenuated muscular strength gains (effect size [ES]: -0.23; 95% confidence interval [CI]: -0.45, -0.01; p = 0.041). In the analysis of data from studies applying CWI only to the trained limbs, CWI attenuated muscular strength gains (ES: -0.31; 95% CI: -0.61, -0.01; p = 0.041). In the analysis of data from studies using whole-body CWI, there was no significant difference in muscular strength gains between CWI and control (ES: -0.08; 95% CI: -0.53, 0.38; p = 0.743). In summary, this meta-analysis found that the use of CWI following resistance exercise sessions attenuates muscular strength gains in males. However, when CWI was applied to the whole body, there was no significant difference between CWI and control for muscular strength. Due to the attenuated gains in muscular strength found with single limb CWI, the use and/or timing of CWI in resistance training should be carefully considered and individualized.

Effects of cold water immersion after exercise on fatigue recovery and exercise performance--meta analysis

Cold water immersion (CWI) is very popular as a method reducing post-exercise muscle stiffness, eliminating fatigue, decreasing exercise-induced muscle damage (EIMD), and recovering sports performance. However, there are conflicting opinions as to whether CWI functions positively or negatively. The mechanisms of CWI are still not clear. In this systematic review, we used meta-analysis aims to examine the effect of CWI on fatigue recovery after high-intensity exercise and exercise performance. A total of 20 studies were retrieved and included from PubMed, PEDro and Elsevier databases in this review. Publication years of articles ranged from 2002 to 2022. In selected studies including randomized controlled trials (RCTs) and Crossover design (COD). Analyses of subjective indicators such as delayed-onset muscle soreness (DOMS) and ratings of perceived exertion (RPE), and objective indicators such as countermovement jump (CMJ) and blood plasma markers including creatine kinase(CK), lactate/lactate dehydrogenase(LDH), C-reactive protein(CRP), and IL-6 were performed. Pooled data showed as follows: CWI resulted in a significant decline in subjective characteristics (delayed-onset muscle soreness and perceived exertion at 0 h); CWI reduced countermovement jump(CMJ) significantly at 0 h, creatine kinase(CK) was lowered at 24 h, and lactate at 24 and 48 h. There was no evidence that CWI affects C-reactive protein(CRP) and IL-6 during a 48-h recovery period. Subgroup analysis revealed that different CWI sites and water temperatures have no effect on post-exercise fatigue recovery. Recommended athletes immersed in cold water immediately after exercise, which can effectively reduce muscle soreness and accelerate fatigue recovery.

No effect of repeated post-resistance exercise cold or hot water immersion on in-season body composition and performance responses in academy rugby players: a randomised controlled cross-over design

PURPOSE

Following resistance exercise, uncertainty exists as to whether the regular application of cold water immersion attenuates lean muscle mass increases in athletes. The effects of repeated post-resistance exercise cold versus hot water immersion on body composition and neuromuscular jump performance responses in athletes were investigated.

METHODS

Male, academy Super Rugby players (n = 18, 19.9 ± 1.5 y, 1.85 ± 0.06 m, 98.3 ± 10.7 kg) participated in a 12-week (4-week × 3-intervention, i.e., control [CON], cold [CWI] or hot [HWI] water immersion) resistance exercise programme, utilising a randomised cross-over pre-post-design. Body composition measures were collected using dual-energy X-ray absorptiometry prior to commencement and every fourth week thereafter. Neuromuscular squat (SJ) and counter-movement jump (CMJ) performance were measured weekly. Linear mixed-effects models were used to analyse main (treatment, time) and interaction effects.

RESULTS

There were no changes in lean (p = 0.960) nor fat mass (p = 0.801) between interventions. CON (p = 0.004) and CWI (p = 0.003) increased (g = 0.08-0.19) SJ height, compared to HWI. There were no changes in CMJ height (p = 0.482) between interventions.

CONCLUSION

Repeated post-resistance exercise whole-body CWI or HWI does not attenuate (nor promote) increases in lean muscle mass in athletes. Post-resistance exercise CON or CWI results in trivial increases in SJ height, compared to HWI. During an in-season competition phase, our data support the continued use of post-resistance exercise whole-body CWI by athletes as a recovery strategy which does not attenuate body composition increases in lean muscle mass, while promoting trivial increases in neuromuscular concentric-only squat jump performance.

The Influence of Ambient Temperature Changes on the Indicators of Inflammation and Oxidative Damage in Blood after Submaximal Exercise

Physical activity has a positive effect on human health and well-being, but intense exercise can cause adverse changes in the organism, leading to the development of oxidative stress and inflammation. The aim of the study was to determine the effect of short-term cold water immersion (CWI) and a sauna bath as methods of postexercise regeneration on the indicators of inflammation and oxidative damage in the blood of healthy recreational athletes. Forty-five male volunteers divided into two groups: 'winter swimmers' who regularly use winter baths (n = 22, average age 43.2 ± 5.9 years) and 'novices' who had not used winter baths regularly before (n = 23, mean age 25 ± 4.8 years) participated in the study. The research was divided into two experiments, differing in the method of postexercise regeneration used, CWI (Experiment I) and a sauna bath (Experiment II). During Experiment I, the volunteers were subjected to a 30-min aerobic exercise, combined with a 20-min rest at room temperature (RT-REST) or a 20-min rest at room temperature with an initial 3-min 8 °C water bath (CWI-REST). During the Experiment II, the volunteers were subjected to the same aerobic exercise, followed by a RT-REST or a sauna bath (SAUNA-REST). The blood samples were taken before physical exercise (control), immediately after exercise and 20 min after completion of regeneration. The concentrations of selected indicators of inflammation, including interleukin 1β (IL-1β), interleukin 6 (IL-6), interleukin 8 (IL-8), interleukin 8 (IL-8), interleukin 10 (IL-10), transforming growth factor β1 (TGF-β1) and tumor necrosis factor α (TNF-α), as well as the activity of indicators of oxidative damage: α1-antitrypsin (AAT) and lysosomal enzymes, including arylsulfatase A (ASA), acid phosphatase (AcP) and cathepsin D (CTS D), were determined. CWI seems to be a more effective post-exercise regeneration method to reduce the inflammatory response compared to a sauna bath. A single sauna bath is associated with the risk of proteolytic tissue damage, but disturbances of cellular homeostasis are less pronounced in people who regularly use cold water baths than in those who are not adapted to thermal stress.

Functional Impact of Post-exercise Cooling and Heating on Recovery and Training Adaptations: Application to Resistance, Endurance, and Sprint Exercise

The application of post-exercise cooling (e.g., cold water immersion) and post-exercise heating has become a popular intervention which is assumed to increase functional recovery and may improve chronic training adaptations. However, the effectiveness of such post-exercise temperature manipulations remains uncertain. The aim of this comprehensive review was to analyze the effects of post-exercise cooling and post-exercise heating on neuromuscular function (maximal strength and power), fatigue resistance, exercise performance, and training adaptations. We focused on three exercise types (resistance, endurance and sprint exercises) and included studies investigating (1) the early recovery phase, (2) the late recovery phase, and (3) repeated application of the treatment. We identified that the primary benefit of cooling was in the early recovery phase (< 1 h post-exercise) in improving fatigue resistance in hot ambient conditions following endurance exercise and possibly enhancing the recovery of maximal strength following resistance exercise. The primary negative impact of cooling was with chronic exposure which impaired strength adaptations and decreased fatigue resistance following resistance training intervention (12 weeks and 4–12 weeks, respectively). In the early recovery phase, cooling could also impair sprint performance following sprint exercise and could possibly reduce neuromuscular function immediately after endurance exercise. Generally, no benefits of acute cooling were observed during the 24–72-h recovery period following resistance and endurance exercises, while it could have some benefits on the recovery of neuromuscular function during the 24–48-h recovery period following sprint exercise. Most studies indicated that chronic cooling does not affect endurance training adaptations following 4–6 week training intervention. We identified limited data employing heating as a recovery intervention, but some indications suggest promise in its application to endurance and sprint exercise.

Effect of 3 min whole-body and lower limb cold water immersion on subsequent performance of agility, sprint, and intermittent endurance exercise

The aim of this study was to investigate the effects of whole-body cold-water immersion (WCWI) and lower-limb cold-water immersion (LCWI) employed during a 15-min recovery period on the subsequent exercise performance as well as to determine the physiological and perceptual parameters in the heat (39°C). Eleven males performed team-sports-specific tests outdoors. The exercise program consisted of two identical exercise protocols (1 and 2) separated by a 15-min recovery period. The participants completed the same tests in each exercise protocol, in the following order: agility t test (t-test), 20-m sprint test (20M-ST), and Yo-Yo Intermittent Endurance Test Level 1 (Yo-Yo). During the recovery period, a 3-min recovery intervention of a passively seated rest (control, CON), WCWI, or LCWI was performed. The t-test and 20M-ST for the CON group were significantly longer during exercise protocol 2, but they were not significantly different between the two exercise protocols for the WCWI and LCWI groups. The completed Yo-Yo distance for the CON and LCWI groups was shorter during exercise protocol 2, but it was not significantly different between the two exercise protocols for the WCWI group. The chest temperature (Tchest), upper arm temperature (Tarm), thigh temperature (Tthigh), mean skin temperature (Tskin), and thermal sensation (TS) values were lower for the WCWI group than for the CON group; but only the Tthigh, Tskin, and TS values were lower for the LCWI group compared to the CON group. The Tchest, Tarm, Tskin, and TS values after the intervention were lower for the WCWI group than for the LCWI group. None of the three intervention conditions affected the core temperature (Tcore), heart rate (HR), or rating of perceived exertion (RPE). These results suggest that WCWI at 15°C for 3 min during the 15-min recovery period attenuates the impairment of agility, sprint, and intermittent-endurance performance during exercise protocol 2, but LCWI only ameliorates the reduction of agility and sprint performance. Furthermore, the ergogenic effects of WCWI and LCWI in the heat are due, at least in part, to a decrease of the Tskin and improvement of perceived strain.

Efficacy of Different Cold-Water Immersion Temperatures on Neuromotor Performance in Young Athletes

Cold-Water-Immersion (CWI) has been frequently used to accelerate muscle recovery and to improve performance after fatigue onset. In the present study, the aim was to investigate the effects of different CWI temperatures on neuromuscular activity on quadriceps after acute fatigue protocol. Thirty-six young athletes (16.9 ± 1.4 years-old; 72.1 ± 13.8 kg; 178.4 ± 7.2 cm) were divided into three groups: passive recovery group (PRG); CWI at 5 °C group (5G); and CWI at 10 °C group (10G). All participants performed a fatigue exercise protocol; afterwards, PRG performed a passive recovery (rest), while 5G and 10G were submitted to CWI by means of 5 °C and 10 °C temperatures during 10 min, respectively. Fatigue protocol was performed by knee extension at 40% of isometric peak force from maximal isometric voluntary contraction. Electromyography was used to evaluate neuromuscular performance. The passive recovery and CWI at 5 °C were associated with normalized isometric force and quadriceps activation amplitude from 15 until 120 min after exercise-induced fatigue (F = 7.169, p < 0.001). CWI at 5 °C and 10 °C showed higher muscle activation (F = 6.850, p < 0.001) and lower median frequency (MF) than passive recovery after 15 and 30 min of fatigue (F = 5.386, p < 0.001). For neuromuscular efficiency (NME) recovery, while PRG normalized NME values after 15 min, 5G and 10G exhibited these responses after 60 and 30 min (F = 4.330, p < 0.01), respectively. Passive recovery and CWI at 5 °C and 10 °C revealed similar effects in terms of recovery of muscle strength and NME, but ice interventions resulted in higher quadriceps activation recovery.

Under Pressure: The Chronic Effects of Lower-Body Compression Garment Use during a 6-Week Military Training Course

Background: Previous studies have shown that compression garments may aid recovery in acute settings; however, less is known about the long-term use of compression garments (CG) for recovery. This study aimed to assess the influence of wearing CG on changes in physical performance, subjective soreness, and sleep quality over 6 weeks of military training. Methods: Fifty-five officer-trainees aged 24 ± 6 y from the New Zealand Defence Force participated in the current study. Twenty-seven participants wore CG every evening for 4−6 h, and twenty-eight wore standard military attire (CON) over a 6-week period. Subjective questionnaires (soreness and sleep quality) were completed weekly, and 2.4 km run time-trial, maximum press-ups, and curl-ups were tested before and after the 6 weeks of military training. Results: Repeated measures ANOVA indicated no significant group × time interactions for performance measures (p > 0.05). However, there were small effects in favour of CG over CON for improvements in 2.4 km run times (d = −0.24) and press-ups (d = 0.36), respectively. Subjective soreness also resulted in no significant group × time interaction but displayed small to moderate effects for reduced soreness in favour of CG. Conclusions: Though not statistically significant, CG provided small to moderate benefits to muscle-soreness and small benefits to aspects of physical-performance over a 6-week military training regime.

Short-term effects of two different recovery strategies on muscle contractile properties in healthy active men: A randomised cross-over study

The aim of this study was to compare the immediate effects of cold-water immersion (CWI) and hot-water immersion (HWI) versus passive resting after a fatigue-induced bout of exercise on the muscle contractile properties of the Vastus Medialis (VM). We conducted a randomised cross-over study involving 28 healthy active men where muscle contractile properties of the VM wer recorded using Tensiomyography (TMG) before and after CWI, HWI or passive resting and up to one-hour post-application. The main outcomes obtained were muscle displacement and velocity of deformation according to limb size (Dmr and Vdr). Our results showed a significant effect of time (F(3.9,405) =32.439; p <0.001; η²_p =0.29) and the interaction between time and temperature (F(7.9,405) =5.814; p <0.001; η²_p=0.13) on Dmr but no for temperature alone (F(2,81) =2.013; p =0.14; η²_p=0.04) while for Vdr, both time (F(5.2,486) =23.068; p <0.001 η²_p = 0.22) and temperature (F(2,81) =4.219; p = 0.018; η²_p= 0.09) as well as the interaction (F(10.4,486) =7.784; p <0.001; η²_p =0.16) were found significant. Compared to CWI, HWI increased Dmr post-application and Vdr both post-application as well as 15 and 45' thereafter. These findings suggest that applying HWI could be a valid alternative to CWI to promote muscle recovery.

Post-Match Recovery in Soccer with Far-Infrared Emitting Ceramic Material or Cold-Water Immersion

We investigated the effects of two common recovery methods; far-infrared emitting ceramic materials (Bioceramic) or cold-water immersion on muscular function and damage after a soccer match. Twenty-five university-level soccer players were randomized into Bioceramic (BIO; n = 8), Cold-water immersion (CWI; n = 9), or Control (CON; n = 8) groups. Heart rate [HR], rating of perceived exertion [RPE], and activity profile through Global Positioning Satellite Systems were measured during the match. Biochemical (thiobarbituric acid reactive species [TBARS], superoxide dismutase [SOD], creatine kinase [CK], lactate dehydrogenase [LDH]), neuromuscular (countermovement [CMJ] and squat jump [SJ], sprints [20-m]), and perceptual markers (delayed-onset muscle soreness [DOMS], and the perceived recovery scale [PRS]) were assessed at pre, post, 24 h, and 48 h post-match. One-way ANOVA was used to compare anthropometric and match performance data. A two-way ANOVA with post-hoc tests compared the timeline of recovery measures. No significant differences existed between groups for anthropometric or match load measures (P > 0.05). Significant post-match increases were observed in SOD, and decreases in TBARS in all groups (p < 0.05), without differences between conditions (p > 0.05). Significant increases in CK, LDH, quadriceps and hamstring DOMS (p < 0.05), as well as decreases in 20-m, SJ, CMJ, and PRS were observed post-match in all groups (p < 0.05), without significant differences between conditions (p > 0.05). Despite the expected post-match muscle damage and impaired performance, neither Bioceramic nor CWI interventions improved post-match recovery.

Mechanobiology-based physical therapy and rehabilitation after orthobiologic interventions: a narrative review

PURPOSE

This review aims to summarize the evidence for the role of mechanotherapies and rehabilitation in supporting the synergy between regeneration and repair after an orthobiologic intervention.

METHODS

A selective literature search was performed using Web of Science, OVID, and PubMed to review research articles that discuss the effects of combining mechanotherapy with various forms of regenerative medicine.

RESULTS

Various mechanotherapies can encourage the healing process for patients at different stages. Taping, bracing, cold water immersion, and extracorporeal shockwave therapy can be used throughout the duration of acute inflammatory response. The regulation of angiogenesis can be sustained with blood flow restriction and resistance training, whereas heat therapy and tissue loading during exercise are recommended in the remodeling phase.

CONCLUSION

Combining mechanotherapy with various forms of regenerative medicine has shown promise for improving treatment outcomes. However, further studies that reveal a greater volume of evidence are needed to support clinical decisions.

The Effect of Submaximal Exercise Followed by Short-Term Cold-Water Immersion on the Inflammatory State in Healthy Recreational Athletes: A Cross-Over Study

Cold-water immersion (CWI) after exercise is a method used by sportsmen to improve recovery. The aim of the study was to assess the effect of a 3 min CWI on the inflammatory state by measuring levels of interleukin 6 (IL-6), interleukin 10 (IL-10), tumor necrosis factor α (TNF-α), and transforming growth factor β1 (TGF-β1), and activities of α1-antitrypsin (AAT) and lysosomal enzymes, including arylsulfatase (ASA), acid phosphatase (AcP), and cathepsin D (CTS D), in the blood of healthy recreational athletes. Male volunteers (n = 22, age 25 ± 4.8 yr) performed a 30 min submaximal aerobic exercise, followed by a 20 min rest at room temperature (RT-REST) or a 20 min rest at room temperature with an initial 3 min 8 °C water bath (CWI-REST). Blood samples were taken at baseline, immediately after exercise, and after 20 min of recovery. The IL-6, IL-10, and TNF-α levels and the AAT activity increased significantly immediately after exercise. The IL-6 level was significantly higher after CWI-REST than after RT-REST. No changes in the activities of the lysosomal enzymes were observed. The effect of a 3 min CWI on the level of inflammatory markers during post-exercise recovery was limited. Thus, it might be considered as a widely available method of regeneration for recreational athletes.

Indirect Structural Muscle Injuries of Lower Limb: Rehabilitation and Therapeutic Exercise

Muscle injuries are the most common trauma in team and individual sports. The muscles most frequently affected are those of the lower limb, and in particular hamstrings, adductors, rectus femoris and calf muscles. Although several scientific studies have tried to propose different rehabilitation protocols, still too often the real rehabilitation process is not based on scientific knowledge, especially in non-elite athletes. Moreover, the growing use of physical and instrumental therapies has made it increasingly difficult to understand what can be truly effective. Therefore, the aim of the present paper is to review proposed therapeutic algorithms for muscle injuries, proposing a concise and practical summary. Following a three-phase rehabilitation protocol, this review aims to describe the conservative treatment of indirect structural muscle injuries, which are the more routinely found and more challenging type. For each phase, until return to training and return to sport are completed, the functional goal, the most appropriate practitioner, and the best possible treatment according to current evidence are expressed. Finally, the last section is focused on the specific exercise rehabilitation for the four main muscle groups with a structured explanatory timetable.

Adaptations to Post-exercise Cold Water Immersion: Friend, Foe, or Futile?

In the last decade, cold water immersion (CWI) has emerged as one of the most popular post-exercise recovery strategies utilized amongst athletes during training and competition. Following earlier research on the effects of CWI on the recovery of exercise performance and associated mechanisms, the recent focus has been on how CWI might influence adaptations to exercise. This line of enquiry stems from classical work demonstrating improved endurance and mitochondrial development in rodents exposed to repeated cold exposures. Moreover, there was strong rationale that CWI might enhance adaptations to exercise, given the discovery, and central role of peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α) in both cold- and exercise-induced oxidative adaptations. Research on adaptations to post-exercise CWI have generally indicated a mode-dependant effect, where resistance training adaptations were diminished, whilst aerobic exercise performance seems unaffected but demonstrates premise for enhancement. However, the general suitability of CWI as a recovery modality has been the focus of considerable debate, primarily given the dampening effect on hypertrophy gains. In this mini-review, we highlight the key mechanisms surrounding CWI and endurance exercise adaptations, reiterating the potential for CWI to enhance endurance performance, with support from classical and contemporary works. This review also discusses the implications and insights (with regards to endurance and strength adaptations) gathered from recent studies examining the longer-term effects of CWI on training performance and recovery. Lastly, a periodized approach to recovery is proposed, where the use of CWI may be incorporated during competition or intensified training, whilst strategically avoiding periods following training focused on improving muscle strength or hypertrophy.

The Effects of Regular Cold-Water Immersion Use on Training-Induced Changes in Strength and Endurance Performance: A Systematic Review with Meta-Analysis

BACKGROUND

Cold-water immersion (CWI) is one of the main recovery methods used in sports, and is commonly utilized as a means to expedite the recovery of performance during periods of exercise training. In recent decades, there have been indications that regular CWI use is potentially harmful to resistance training adaptations, and, conversely, potentially beneficial to endurance training adaptations. The current meta-analysis was conducted to assess the effects of the regular CWI use during exercise training on resistance (i.e., strength) and endurance (i.e., aerobic exercise) performance alterations.

METHODS

A computerized literature search was conducted, ending on November 25, 2019. The databases searched were MEDLINE, Cochrane Central Register of Controlled Trials, and SPORTDiscus. The selected studies investigated the effects of chronic CWI interventions associated with resistance and endurance training sessions on exercise performance improvements. The criteria for inclusion of studies were: (1) being a controlled investigation; (2) conducted with humans; (3) CWI performed at ≤ 15 °C; (4) being associated with a regular training program; and (5) having performed baseline and post-training assessments.

RESULTS

Eight articles were included before the review process. A harmful effect of CWI associated with resistance training was verified for one-repetition maximum, maximum isometric strength, and strength endurance performance (overall standardized mean difference [SMD] = - 0.60; Confidence interval of 95% [CI95%] = - 0.87, - 0.33; p < 0.0001), as well as for Ballistic efforts performance (overall SMD = - 0.61; CI95% = - 1.11, - 0.11; p = 0.02). On the other hand, selected studies verified no effect of CWI associated with endurance training on time-trial (mean power), maximal aerobic power in graded exercise test performance (overall SMD = - 0.07; CI95% = - 0.54, 0.53; p = 0.71), or time-trial performance (duration) (overall SMD = 0.00; CI95% = - 0.58, 0.58; p = 1.00).

CONCLUSIONS

The regular use of CWI associated with exercise programs has a deleterious effect on resistance training adaptations but does not appear to affect aerobic exercise performance.

TRIAL REGISTRATION

PROSPERO CRD42018098898.

Cold Water Immersion as a Strategy for Muscle Recovery in Professional Basketball Players During the Competitive Season

CONTEXT

Despite prior studies that have addressed the recovery effects of cold-water immersion (CWI) in different sports, there is a lack of knowledge about longitudinal studies across a full season of competition assessing these effects.

OBJECTIVE

To analyze the CWI effects, as a muscle recovery strategy, in professional basketball players throughout a competitive season.

DESIGN

A prospective cohort design.

SETTING

Elite basketball teams.

PARTICIPANTS

A total of 28 professional male basketball players divided into 2 groups: CWI (n = 12) and control (n = 16) groups.

MAIN OUTCOME MEASURES

Muscle metabolism serum markers were measured during the season in September-T1, November-T2, March-T3, and April-T4. Isokinetic peak torque strength and ratings of perceived exertion were measured at the beginning and at the end of the season. CWI was applied immediately after every match and after every training session before matches.

RESULTS

All serum muscular markers, except myoglobin, were higher in the CWI group than the control group (P < .05). The time course of changes in muscle markers over the season also differed between the groups (P < .05). In the CWI group, ratings of perceived exertion decreased significantly from the beginning (T1-T2) to the end (T3-T4). Isokinetic torque differed between groups at the end of the season (60°/s peak torque: P < .001 and ηp2=.884; and 180°/s peak torque: P < .001 and ηp2=.898) and had changed significantly over the season in the CWI group (P < .05).

CONCLUSIONS

CWI may improve recovery from muscle damage in professional basketball players during a regular season.

Intramuscular Temperature Changes in the Quadriceps Femoris Muscle After Post-Exercise Cold-Water Immersion (10°C for 10 min): A Systematic Review With Meta-Analysis

Post-exercise cold-water immersion (CWI) is a widely accepted recovery strategy for maintaining physical performance output. However, existing review articles about the effects of CWI commonly pool data from very heterogenous study designs and thus, do rarely differentiate between different muscles, different CWI-protocols (duration, temperature, etc.), different forms of activating the muscles before CWI, and different thickness of the subcutaneous adipose tissue. This systematic review therefore aimed to investigate the effects of one particular post-exercise CWI protocol (10°C for 10 min) on intramuscular temperature changes in the quadriceps femoris muscle while accounting for skinfold thickness. An electronic search was conducted on PubMed, LIVIVO, Cochrane Library, and PEDro databases. Pooled data on intramuscular temperature changes were plotted with respect to intramuscular depth to visualize the influence of skinfold thickness. Spearman's rho (r_s) was used to assess a possible linear association between skinfold thickness and intramuscular temperature changes. A meta-analysis was performed to investigate the effect of CWI on pre-post intramuscular temperature for each measurement depth. A total of six articles met the inclusion criteria. Maximum intramuscular temperature reduction was 6.40°C with skinfold thickness of 6.50 mm at a depth of 1 cm, 4.50°C with skinfold thickness of 11.00 mm at a depth of 2 cm, and only 1.61°C with skinfold thickness of 10.79 mm at a depth of 3 cm. However, no significant correlations between skinfold thickness and intramuscular temperature reductions were observed at a depth of 1 cm (r _s = 0.0), at 2 cm (r _s = -0.8) and at 3 cm (r _s = -0.5; all p > 0.05). The CWI protocol resulted in significant temperature reductions in the muscle tissue layers at 1 cm (d = -1.92 [95% CI: -3.01 to -0.83] and 2 cm (d = -1.63 [95% CI: -2.20 to -1.06]) but not at 3 cm (p < 0.05). Skinfold thickness and thus, subcutaneous adipose tissue, seems to influence temperature reductions in the muscle tissue only to a small degree. These findings might be useful for practitioners as they demonstrate different intramuscular temperature reductions after a specific post-exercise CWI protocol (10°C for 10 min) in the quadriceps femoris muscle.

The cold truth: the role of cryotherapy in the treatment of injury and recovery from exercise

Cryotherapy is utilized as a physical intervention in the treatment of injury and exercise recovery. Traditionally, ice is used in the treatment of musculoskeletal injury while cold water immersion or whole-body cryotherapy is used for recovery from exercise. In humans, the primary benefit of traditional cryotherapy is reduced pain following injury or soreness following exercise. Cryotherapy-induced reductions in metabolism, inflammation, and tissue damage have been demonstrated in animal models of muscle injury; however, comparable evidence in humans is lacking. This absence is likely due to the inadequate duration of application of traditional cryotherapy modalities. Traditional cryotherapy application must be repeated to overcome this limitation. Recently, the novel application of cooling with 15 °C phase change material (PCM), has been administered for 3-6 h with success following exercise. Although evidence suggests that chronic use of cryotherapy during resistance training blunts the anabolic training effect, recovery using PCM does not compromise acute adaptation. Therefore, following exercise, cryotherapy is indicated when rapid recovery is required between exercise bouts, as opposed to after routine training. Ultimately, the effectiveness of cryotherapy as a recovery modality is dependent upon its ability to maintain a reduction in muscle temperature and on the timing of treatment with respect to when the injury occurred, or the exercise ceased. Therefore, to limit the proliferation of secondary tissue damage that occurs in the hours after an injury or a strenuous exercise bout, it is imperative that cryotherapy be applied in abundance within the first few hours of structural damage.

Post-exercise Cold Water Immersion Effects on Physiological Adaptations to Resistance Training and the Underlying Mechanisms in Skeletal Muscle: A Narrative Review

Post-exercise cold-water immersion (CWI) is a popular recovery modality aimed at minimizing fatigue and hastening recovery following exercise. In this regard, CWI has been shown to be beneficial for accelerating post-exercise recovery of various parameters including muscle strength, muscle soreness, inflammation, muscle damage, and perceptions of fatigue. Improved recovery following an exercise session facilitated by CWI is thought to enhance the quality and training load of subsequent training sessions, thereby providing a greater training stimulus for long-term physiological adaptations. However, studies investigating the long-term effects of repeated post-exercise CWI instead suggest CWI may attenuate physiological adaptations to exercise training in a mode-specific manner. Specifically, there is evidence post-exercise CWI can attenuate improvements in physiological adaptations to resistance training, including aspects of maximal strength, power, and skeletal muscle hypertrophy, without negatively influencing endurance training adaptations. Several studies have investigated the effects of CWI on the molecular responses to resistance exercise in an attempt to identify the mechanisms by which CWI attenuates physiological adaptations to resistance training. Although evidence is limited, it appears that CWI attenuates the activation of anabolic signaling pathways and the increase in muscle protein synthesis following acute and chronic resistance exercise, which may mediate the negative effects of CWI on long-term resistance training adaptations. There are, however, a number of methodological factors that must be considered when interpreting evidence for the effects of post-exercise CWI on physiological adaptations to resistance training and the potential underlying mechanisms. This review outlines and critiques the available evidence on the effects of CWI on long-term resistance training adaptations and the underlying molecular mechanisms in skeletal muscle, and suggests potential directions for future research to further elucidate the effects of CWI on resistance training adaptations.

[The dynamics of hemodynamic, psychophysiological parameters and adaptive potential of men of working age engaged in water-cold hardening]

The article shows the influence of repeated repetition of contrasting temperature effects on hemodynamic, psychophysiological parameters and the adaptive potential of men of working age.

OBJECTIVE

To assess changes of hemodynamic and psychophysiological parameters, as well as the adaptive potential in healthy men of working age under the influence of repeated contrasting temperature exposures, the difference of which is about 70 °C.

MATERIAL AND METHODS

Blood pressure, heart rate and Luscher test were measured 20 minutes before and 20 minutes after repeated exposure of contrasting temperature changes (alternation of temperature cycles). The following parameters were calculated: dynamics of pulse pressure and mean arterial pressure, Stroke volume (SV), Cardiac output (CO), the Kerdo vegetative index (KVI). Assessment of adaptive potential (AP) was carried out according to the Baevsky's Stress Index and Robinson index. Also, integral parameters of psychophysiological status were evaluated by the Luscher test.

RESULTS

In the course of the study, it was proved that 20 minutes before repeated contrast temperature exposure, the level of SBP and heart rate was increased (p<0.01), and 20 minutes after the completion of procedures the decrease of SBP level was observed (p<0.05). The CO level before the start of temperature exposure was decreased (p<0.01), and 20 minutes after the finish of the contrasting effects this dynamics was preserved (p<0.01). The AP level before the start of contrasting exposure was 2.79±0.10, and after contrasting exposure it was decreased (p<0.05). The Robinson index (RI) was higher than the established normal values before temperature effects (112.53±6.82), then its decrease was noted (p<0.01). According to Luscher's test, the integral parameters «Heteronomy-autonomy», «Balance of personal properties», «Vegetative coefficient» significantly changed psychophysiological characteristics. The parameter «Total deviation» indicated an average level of unproductive neuropsychic tension (before - 14.71±2.19, after - 14.36±2.26) both before and after repeated temperature exposures. The VIC parameter of the study participants testified to the predominance of parasympathicotonia (before - -2.07±5; after - -7.23±5.62). At the same time, correlations were established only before repeated contrast exposure.

CONCLUSIONS

Repeatedly repeated contrasting temperature effects cause ambiguous reactions of the body. Changes in hemodynamic, psychophysiological parameters and adaptive potential are observed some time before the alternation of cycles of contrasting exposures. Most likely, this reaction of the body is a reaction to the upcoming temperature stress. If the model of stress exposure, when the temperature variation is about 70 °C, occurs regularly and systematically (once a week throughout the entire winter season), in this case, the main recommendation is to control the blood pressure level before the start of contrast exposure as a precautionary measure to prevent the development of adverse cardiovascular reactions.

Vitamins C and E Associated With Cryotherapy in the Recovery of the Inflammatory Response After Resistance Exercise: A Randomized Clinical Trial

de Brito, E, Teixeira, AdO, Righi, NC, Paulitcth, FdS, da Silva, AMV, and Signori, LU. Vitamins C and E associated with cryotherapy in the recovery of the inflammatory response after resistance exercise: A randomized clinical trial. J Strength Cond Res XX(X): 000-000, 2019-The objective of this research was to compare the effects of cryotherapy associated with vitamins (C and E) on the recovery of the inflammatory response from the resistance exercise (RE) session of untrained volunteers. Fourteen subjects (26.2 ± 5 years old, 25.8 ± 3 kg·m) underwent 4 sessions of RE with different forms of recovery. The RE consisted of 4 sets of 10 maximal repetitions for each exercise (extensor bench, squat, and leg press). The recoveries were randomized and comprised the passive (control), with vitamins C (1 g) and E (800 UI) supplementation 40 minutes before exercise, with cryotherapy (immersion in water 15° C for 10 minutes), and the association (vitamins and cryotherapy). Hemogram, inflammatory markers (C-reactive protein and creatine kinase [CK]), and parameters of oxidative stress (lipid peroxidation [LPO] and antioxidant capacity against radical peroxyl) were evaluated before (baseline) and after (0, 30, and 120 minutes) the RE sessions. Muscle pain (primary outcome) was evaluated 24 hours after exercise. C-reactive protein (p = 0.010) and LPO (p < 0.001) increased (120 minutes) only in passive recovery. Recovery with cryotherapy (30 minutes), with vitamins and the association (0 and 30 minutes) delayed increases in CK (p < 0.001). Antioxidant capacity against radical peroxyl increased (30 minutes) only in recovery with the association (p < 0.011). The pain decreased in the recoveries with cryotherapy and association (p < 0.001). The association of vitamins (C and E) with cryotherapy attenuated the inflammatory response and pain, favoring recovery after an acute RE session.

Water immersion methods do not alter muscle damage and inflammation biomarkers after high-intensity sprinting and jumping exercise

Purpose

The aim of this study was to compare the efficacy of three water immersion interventions performed after active recovery compared to active recovery only on the resolution of inflammation and markers of muscle damage post-exercise.

Methods

Nine physically active men (n = 9; age 20‒35 years) performed an intensive loading protocol, including maximal jumps and sprinting on four occasions. After each trial, one of three recovery interventions (10 min duration) was used in a random order: cold-water immersion (CWI, 10 °C), thermoneutral water immersion (TWI, 24 °C), contrast water therapy (CWT, alternately 10 °C and 38 °C). All of these methods were performed after an active recovery (10 min bicycle ergometer), and were compared to active recovery only (ACT). 5 min, 1, 24, 48, and 96 h after exercise bouts, immune response and recovery were assessed through leukocyte subsets, monocyte chemoattractant protein-1, myoglobin and high-sensitivity C-reactive protein concentrations.

Results

Significant changes in all blood markers occurred at post-loading (p < 0.05), but there were no significant differences observed in the recovery between methods. However, retrospective analysis revealed significant trial-order effects for myoglobin and neutrophils (p < 0.01). Only lymphocytes displayed satisfactory reliability in the exercise response, with intraclass correlation coefficient > 0.5.

Conclusions

The recovery methods did not affect the resolution of inflammatory and immune responses after high-intensity sprinting and jumping exercise. It is notable that the biomarker responses were variable within individuals. Thus, the lack of differences between recovery methods may have been influenced by the reliability of exercise-induced biomarker responses.

Electronic supplementary material

The online version of this article (10.1007/s00421-020-04481-8) contains supplementary material, which is available to authorized users.

Effects of acute cooling on cycling anaerobic exercise performance and neuromuscular activity: a randomized crossover study

BACKGROUND

While cryotherapy is known for its favorable long-term recovery effects on muscle-damaging eccentric and plyometric exercises, studies showed that cryotherapy when used as an acute recovery mode (same day) had a negligible or negative effect on high-intensity and explosive exercises. However, there is lack of evidence regarding the mechanisms underlying the detrimental effect of acute cooling on the anaerobic performance. We hypothesized that acute cooling for the lower body would reduce anaerobic power output during a subsequent Wingate anaerobic tests (WAnT), which is at least in part due to decreased neuromuscular firing rate as indexed by mean frequency.

METHODS

We performed a randomized crossover design experiment. Eleven young healthy males completed two consecutive 30-sec Wingate anaerobic tests (WAnT 1 and 2). Subjects rested for 10 min between the WAnT 1 and the WAnT 2. Neuromuscular activity on the rectus femoris of both legs was recorded using wireless electromyography (EMG) during WAnT.

RESULTS

Anaerobic power during the first 5 sec of WAnT 2 was decreased in the cooling suit recovery group relative to WAnT 1. Mean frequency (MNF) in WAnT 2 was also lower in a cooled leg during WAnT 2 during the first 10 sec when compared with WAnT 1.

CONCLUSIONS

Acute cooling application blunts the initial phase of anaerobic power output during a subsequent WAnT, which could be explained by a concomitant reduction in neuromuscular firing rate. Given that cryotherapy is widely utilized in a variety of sports, athletes and trainers should pay close attention to the appropriate application of cryotherapy.

Cold-Water Immersion Does Not Accelerate Performance Recovery After 10-km Street Run: Randomized Controlled Clinical Trial

The use of strategies to assure better post-effort recovery is frequent in sports settings. There are several interventions available for exercise induced muscle damage recovery, but cold-water immersion (CWI) stands out among them. The effects of CWI are unclear in the literature and, although the number of street runners has been growing, there is a gap in the scientific evidence regarding the use of CWI to recover runners' performance after a 10-km street run. Purpose: The goal of our study was to analyze the effects of CWI on the recovery of muscle damage markers after a 10-km street run. Method: We randomly assigned thirty male recreational street runners, immediately after a 10-km street run, into three recovery groups: control (rest for 10 minutes), immersion (10 min immersed in water without ice at room temperature) and CWI (10 min immersed in water with ice at 10ºC). We assessed pain, triple hop distance, extensor peak torque and blood creatine kinase levels pre- and post-run, post-intervention and 24 hours after the run. Results: The 10-km run was enough to decrease triple hop distance and extensor peak torque, and increase levels of creatine kinase (p < 0.05); however, we found no time/group interactions in any of the assessed variables after we applied the appropriate interventions (p > 0.05). Conclusion: 10-min CWI at 10°C was no more effective than water immersion and rest in recovering muscle damage markers after 10-km runs.

Partial sleep deprivation after an acute exercise session does not augment hepcidin levels the following day

The purpose of the present study was to determine the effects of partial sleep deprivation (PSD) after an exercise session in the evening on the endurance exercise-induced hepcidin response the following morning. Ten recreationally trained males participated under two different conditions. Each condition consisted of 2 consecutive days of training (days 1 and 2). On day 1, participants ran for 60 min at 75% of maximal oxygen uptake ( V ˙ O2max ) followed by 100 drop jumps. Sleep duration at night was manipulated, with a normal length of sleep (CON condition, 23:00-07:00 hr) or a shortened length of sleep (PSD condition). On the morning of day 2, the participants ran for 60 min at 65% of V ˙ O2max . Sleep duration was significantly shorter under the PSD condition (141.2 ± 13.3 min) than under the CON condition (469.0 ± 2.3 min, p < .0001). Serum hepcidin, plasma interleukin (IL)-6, serum haptoglobin, iron, and myoglobin levels did not differ significantly between the conditions (p > .05) on the morning (before exercise) of day 2. Additionally, the 3-hr postexercise levels for the hematological variables were not significantly different between the two conditions (p > .05). In conclusion, the present study demonstrated that a single night of PSD after an exercise session in the evening did not affect baseline serum hepcidin level the following morning. Moreover, a 60 min run the following morning increased serum hepcidin and plasma IL-6 levels significantly, but the exercise-induced elevations were not affected by PSD.

Males benefit more from cold water immersion during repeated handgrip contractions than females despite similar oxygen kinetics

The purpose of the present study was to assess the effect of different water immersion temperatures on handgrip performance and haemodynamic changes in the forearm flexors of males and females. Twenty-nine rock-climbers performed three repeated intermittent handgrip contractions to failure with 20 min recovery on three separate laboratory visits. For each visit, a randomly assigned recovery strategy was applied: cold water immersion (CWI) at 8 °C (CW8), 15 °C (CW15) or passive recovery (PAS). While handgrip performance significantly decreased in the subsequent trials for the PAS (p < 0.05), there was a significant increase in time to failure for the second and third trial for CW15 and in the second trial for CW8; males having greater performance improvement (44%) after CW15 than females (26%). The results indicate that CW15 was a more tolerable and effective recovery strategy than CW8 and the same CWI protocol may lead to different recovery in males and females.

Recovery after volleyball: a narrative review

Volleyball is a popular sport, but there has been little research to date investigating the recovery process. Volleyball involves short bouts of high intensity exertion, often with limited time to rest between matches. This literature review highlights the specific methods used to recover after playing volleyball and evaluates their effectiveness. Recovery strategies have been shown to increase performance and prevent injury. Specific techniques identified include nutritional strategies, proper sleep, mental and psychological techniques, cold water immersion, and laser therapy. Some, such as nutrition and sleep, have been definitively shown to benefit volleyball players, while others, such as cold water immersion and laser therapy, have shown promise but require further research to determine their overall effect. Other areas of future research include evaluating the effectiveness of combined recovery techniques as well as determining which are best for rapid recovery.

Postexercise cooling impairs muscle protein synthesis rates in recreational athletes

Key points

Protein ingestion and cooling are strategies employed by athletes to improve postexercise recovery and, as such, to facilitate muscle conditioning. However, whether cooling affects postprandial protein handling and subsequent muscle protein synthesis rates during recovery from exercise has not been assessed.

We investigated the effect of postexercise cooling on the incorporation of dietary protein‐derived amino acids into muscle protein and acute postprandial (hourly) as well as prolonged (daily) myofibrillar protein synthesis rates during recovery from resistance‐type exercise over 2 weeks.

Cold‐water immersion during recovery from resistance‐type exercise lowers the capacity of the muscle to take up and/or direct dietary protein‐derived amino acids towards de novo myofibrillar protein accretion. In addition, cold‐water immersion during recovery from resistance‐type exercise lowers myofibrillar protein synthesis rates during prolonged resistance‐type exercise training.

Individuals aiming to improve skeletal muscle conditioning should reconsider applying cooling as a part of their postexercise recovery strategy.

Abstract

We measured the impact of postexercise cooling on acute postprandial (hourly) as well as prolonged (daily) myofibrillar protein synthesis rates during adaptation to resistance‐type exercise over 2 weeks. Twelve healthy males (aged 21 ± 2 years) performed a single resistance‐type exercise session followed by water immersion of both legs for 20 min. One leg was immersed in cold water (8°C: CWI), whereas the other leg was immersed in thermoneutral water (30°C: CON). After water immersion, a beverage was ingested containing 20 g of intrinsically (l‐[1‐¹³C]‐phenylalanine and l‐[1‐¹³C]‐leucine) labelled milk protein with 45 g of carbohydrates. In addition, primed continuous l‐[ring‐²H₅]‐phenylalanine and l‐[1‐¹³C]‐leucine infusions were applied, with frequent collection of blood and muscle samples to assess myofibrillar protein synthesis rates in vivo over a 5 h recovery period. In addition, deuterated water (²H₂O) was applied with the collection of saliva, blood and muscle biopsies over 2 weeks to assess the effects of postexercise cooling with protein intake on myofibrillar protein synthesis rates during more prolonged resistance‐type exercise training (thereby reflecting short‐term training adaptation). Incorporation of dietary protein‐derived l‐[1‐¹³C]‐phenylalanine into myofibrillar protein was significantly lower in CWI compared to CON (0.016 ± 0.006 vs. 0.021 ± 0.007 MPE; P = 0.016). Postexercise myofibrillar protein synthesis rates were lower in CWI compared to CON based upon l‐[1‐¹³C]‐leucine (0.058 ± 0.011 vs. 0.072 ± 0.017% h⁻¹, respectively; P = 0.024) and l‐[ring‐²H₅]‐phenylalanine (0.042 ± 0.009 vs. 0.053 ± 0.013% h⁻¹, respectively; P = 0.025). Daily myofibrillar protein synthesis rates assessed over 2 weeks were significantly lower in CWI compared to CON (1.48 ± 0.17 vs. 1.67 ± 0.36% day⁻¹, respectively; P = 0.042). Cold‐water immersion during recovery from resistance‐type exercise reduces myofibrillar protein synthesis rates and, as such, probably impairs muscle conditioning.

Protein ingestion and cooling are strategies employed by athletes to improve postexercise recovery and, as such, to facilitate muscle conditioning. However, whether cooling affects postprandial protein handling and subsequent muscle protein synthesis rates during recovery from exercise has not been assessed.

We investigated the effect of postexercise cooling on the incorporation of dietary protein‐derived amino acids into muscle protein and acute postprandial (hourly) as well as prolonged (daily) myofibrillar protein synthesis rates during recovery from resistance‐type exercise over 2 weeks.

Cold‐water immersion during recovery from resistance‐type exercise lowers the capacity of the muscle to take up and/or direct dietary protein‐derived amino acids towards de novo myofibrillar protein accretion. In addition, cold‐water immersion during recovery from resistance‐type exercise lowers myofibrillar protein synthesis rates during prolonged resistance‐type exercise training.

Individuals aiming to improve skeletal muscle conditioning should reconsider applying cooling as a part of their postexercise recovery strategy.

Exploring the Efficacy of a Safe Cryotherapy Alternative: Physiological Temperature Changes From Cold-Water Immersion Versus Prolonged Cooling of Phase-Change Material

PURPOSE

To evaluate the effectiveness between cold-water immersion (CWI) and phase-change-material (PCM) cooling on intramuscular, core, and skin-temperature and cardiovascular responses.

METHODS

In a randomized, crossover design, 11 men completed 15 min of 15°C CWI to the umbilicus and 2-h recovery or 3 h of 15°C PCM covering the quadriceps and 1 h of recovery, separated by 24 h. Vastus lateralis intramuscular temperature at 1 and 3 cm, core and skin temperature, heart-rate variability, and thermal comfort were recorded at baseline and 15-min intervals throughout treatment and recovery.

RESULTS

Intramuscular temperature decreased (P < .001) during and after both treatments. A faster initial effect was observed from 15 min of CWI (Δ: 4.3°C [1.7°C] 1 cm; 5.5°C [2.1°C] 3 cm; P = .01). However, over time (2 h 15 min), greater effects were observed from prolonged PCM treatment (Δ: 4.2°C [1.9°C] 1 cm; 2.2°C [2.2°C] 3 cm; treatment × time, P = .0001). During the first hour of recovery from both treatments, intramuscular temperature was higher from CWI at 1 cm (P = .013) but not 3 cm. Core temperature deceased 0.25° (0.32°) from CWI (P = .001) and 0.28°C (0.27°C) from PCM (P = .0001), whereas heart-rate variability increased during both treatments (P = .001), with no differences between treatments.

CONCLUSIONS

The magnitude of temperature reduction from CWI was comparable with PCM, but intramuscular temperature was decreased for longer during PCM. PCM cooling packs offer an alternative for delivering prolonged cooling whenever application of CWI is impractical while also exerting a central effect on core temperature and heart rate.

Cold water immersion settings for reducing muscle tissue temperature: a linear dose-response relationship

BACKGROUND

Although cold water immersion (CWI) is widely accepted and integrated as a recovery modality in sports practice, questions regarding its proposed working mechanisms remain. This study systematically reviews the existing literature on one the proposed mechanisms of CWI, its effect on muscle tissue temperature, and subsequently tries to identify a dose-response relationship in order to describe an optimal dose.

EVIDENCE ACQUISITION

A systematic literature search (PubMed and Sport Discus) was conducted in October 2017. Dose-response relationships were analyzed using linear regression while controlling for possible confounders (muscle measurement depth and immersion position).

EVIDENCE SYNTHESIS

A total of 10 studies, with a total of 104 participants, were included utilizing 26 different CWI protocols. Muscle tissue temperatures were reduced significantly by 24 CWI protocols. A significant, relationship with a medium effect size (r=0.51) was identified between muscle tissue temperature and CWI. The most optimal dose-response relationship, with a large effect size, (r=0.87) was described for CWI protocols using full-body immersion at a measurement depth of 30 mm (y = 4.051 x + 0.535).

CONCLUSIONS

CWI can decrease muscle tissue temperature significantly if a minimum CWI dose of 1.1 is applied, corresponding with an immersion of 11 minutes with a water temperature of 10 °C.

High-intensity interval training followed by postexercise cold-water immersion does not alter angiogenic circulating cells, but increases circulating endothelial cells

High-intensity interval training (HIIT) induces vascular adaptations that might be attenuated by postexercise cold-water immersion (CWI). Circulating angiogenic cells (CAC) participate in the vascular adaptations and circulating endothelial cells (CEC) indicate endothelial damage. CAC and CEC are involved in vascular adaptation. Therefore, the aim of the study was to investigate postexercise CWI during HIIT on CAC and CEC and on muscle angiogenesis-related molecules. Seventeen male subjects performed 13 HIIT sessions followed by 15 min of passive recovery (n = 9) or CWI at 10 °C (n = 8). HIIT comprised cycling (8-12 bouts, 90%-110% peak power). The first and the thirteenth sessions were similar (8 bouts at 90% of peak power). Venous blood was drawn before exercise (baseline) and after the recovery strategy (postrecovery) in the first (pretraining) and in the thirteenth (post-training) sessions. For CAC and CEC identification lymphocyte surface markers (CD133, CD34, and VEGFR2) were used. Vastus lateralis muscle biopsies were performed pre- and post-training for protein (p-eNOS^ser1177) and gene (VEGF and HIF-1) expression analysis related to angiogenesis. CAC was not affected by HIIT or postexercise CWI. Postexercise CWI increased acute and baseline CEC number. Angiogenic protein and genes were not differently modulated by post-CWI. HIIT followed by either recovery strategy did not alter CAC number. Postexercise CWI increased a marker of endothelial damage both acutely and chronically, suggesting that this postexercise recovery strategy might cause endothelial damage. Novelty HIIT followed by CWI did not alter CAC. HIIT followed by CWI increased CEC. Postexercise CWI might cause endothelial damage.

Recovery following Rugby Union matches: effects of cold water immersion on markers of fatigue and damage

We investigated the effect of postmatch cold-water immersion (CWI) on markers of muscle damage, neuromuscular fatigue, and perceptual responses within 72 h after a rugby match. Twenty-two professional male rugby players were randomized into CWI (10 °C/10 min; n = 11) or control (CON: 30 min seated; n = 11) groups. Activity profile from Global Positioning Satellite systems and postmatch rating of perceived exertion were measured to determined match load. Biochemical (tumor necrosis factor alpha (TNF-α), interleukin-6), neuromuscular performance (squat (SJ) and countermovement jumps (CMJ), peak power output (PPO), rate of force development (RFD), stiffness, 10- and 30-m sprint time, and perceptual markers (soreness, perceived recovery) were obtained before and immediately after the match, and then at 30 min, 24 h, 48 h, and 72 h after the match. Magnitude-based inference and Cohen’s effect size (ES) were used to analyze change over time and between groups. Thus, the higher/beneficial, similar/trivial, or lower/harmful differences were evaluated as follows: <1%, almost certainly not; 1% to 5%, very unlikely; 5% to 25%, unlikely; 25% to 75%, possible; 75% to 95%, likely; 95% to 99%, very likely; >99%, almost certainly. Changes were unclear for the match loads, sprint times, and perceptual markers between groups. Higher %ΔSJ at 24 h (very likely (ES = 0.75)) and in %ΔPPO_SJ at 48 h (likely (ES = 0.51)) were observed in CWI than in CON. Values in %ΔRDF_CMJ were higher immediately after (likely (ES = 0.83)), 30 min after (very likely (ES = 0.97)), and 24 h after the match (likely (ES = 0.93)) in CWI than in CON. Furthermore, %Δlog TNF-α were lower in the CWI group than in the CON group immediately after (almost certainly (ES = −0.76)), 24 h after (very likely (ES = −1.09)), and 72 h after the match (likely (ES = −0.51)), and in Δstiffness_SJ at 30 min after (likely (ES = −0.67)) and 48 h after the match (very likely (ES = −0.97)). Also, different within-groups effects throughout postmatch were reported. Implementing postmatch CWI-based strategies improved the recovery of markers of inflammation and fatigue in rugby players, despite no change in markers of speed or perceptual recovery.

Effects of cold water immersion and compression garment use after eccentric exercise on recovery

[Purpose]

The combined effect of different types of post-exercise treatment has not been fully explored. We investigated the effect of combined cold water immersion (CWI) and compression garment (CG) use after maximal eccentric exercise on maximal muscle strength, indirect muscle damage markers in the blood, muscle thickness, and muscle soreness score 24 h after exercise.

[Methods]

Ten men performed two trials (CWI + CG and CON) in random order. In the CWI + CG trial, the subjects performed 15 min of CWI (15°C), followed by wearing of a lower-body CG for 24 h after exercise. In the CON trial, there was no post-exercise treatment. The exercise consisted of 6 × 10 maximal isokinetic (60°·s^-1) eccentric knee extensions using one lower limb. The maximal voluntary contraction (MVC) and maximal isokinetic (60°·s^-1) strength during knee extension, as well as the indirect muscle damage markers, were evaluated before exercise and 24 h after exercise.

[Results]

The maximal muscle strength decreased in both trials (p < 0.001), with no difference between them. The exercise-induced elevation in the myoglobin concentration tended to be lower in the CWI + CG trial than in the CON trial (p = 0.060). The difference in the MVC, maximal isokinetic strength, muscle thickness, and muscle soreness score between the trials was not significant.

[Conclusion]

CWI followed by wearing of a CG after maximal eccentric exercise tended to attenuate the exercise-induced elevation of indirect muscle damage markers in the blood.

Effects of Chronic Cold-Water Immersion in Elite Rugby Players

PURPOSE

Although the acute effects of cold-water immersion (CWI) have been widely investigated, research analyzing the effects of CWI over a chronic period in highly trained athletes is scarce. The aim of this study was to investigate the effects of CWI during an intense 3-wk preseason phase in elite rugby athletes.

METHODS

A total of 23 elite male rugby union athletes were randomized to either CWI (10 min at 10°C, n = 10) or a passive recovery control (CON, n = 13) during 3 wk of high-volume training. Athletes were exposed to either CWI or CON after each training day (12 d in total). Running loads, conditioning, and gym sessions were kept the same between groups. Measures of countermovement jump, perceived muscle soreness, and wellness were obtained twice a week, and saliva samples for determining cortisol and interleukin-6 were collected once per week.

RESULTS

Although no significant differences were observed between CWI and CON for any measure, CWI resulted in lower fatigue markers throughout the study as demonstrated by the moderate effects on muscle soreness (d = 0.58-0.91) and interleukin-6 (d = -0.83) and the small effects (d = 0.23-0.38) on countermovement jump in comparison with CON.

CONCLUSIONS

CWI may provide some beneficial effect by reducing fatigue and soreness during an intense 3-wk training phase in elite rugby athletes.