Skip to main content

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

Abstract

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.

Graphic Abstract

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Abbreviations

1RM:

One-repetition maximum

CI95%:

Confidence interval of 95%

CWI:

Cold-water immersion

DOMS:

Delayed onset muscle soreness

MAP:

Maximal aerobic power

mRNA:

Messenger ribonucleic acid

PGC-1α:

Peroxisome proliferator-activated receptor-γ coactivator-1α

SMD:

Standardized mean difference

References

  1. 1.

    Wilcock IM, Cronin JB, Hing WA. Water immersion: does it enhance recovery from exercise? Int J Sports Physiol Perform. 2006;1:195–206.

    PubMed  Google Scholar 

  2. 2.

    Peiffer JJ, Abbiss CR, Watson G, Nosaka K, Laursen PB. Effect of cold-water immersion duration on body temperature and muscle function. J Sports Sci. 2009;27:987–93.

    PubMed  Google Scholar 

  3. 3.

    Brophy-Williams N, Landers G, Wallman K. Effect of immediate and delayed cold water immersion after a high intensity exercise session on subsequent run performance. J Sports Sci Med. 2011;10:665–70.

    PubMed  PubMed Central  Google Scholar 

  4. 4.

    Broatch JR, Petersen A, Bishop DJ. Cold-water immersion following sprint interval training does not alter endurance signaling pathways or training adaptations in human skeletal muscle. Am J Physiol Regul Integr Comp Physiol. 2017;313:R372–84.

    CAS  PubMed  Google Scholar 

  5. 5.

    Frohlich M, Faude O, Klein M, Pieter A, Emrich E, Meyer T. Strength training adaptations after cold-water immersion. J strength Cond Res. 2014;28:2628–33.

    PubMed  Google Scholar 

  6. 6.

    Ihsan M, Watson G, Lipski M, Abbiss CR. Influence of postexercise cooling on muscle oxygenation and blood volume changes. Med Sci Sports Exerc. 2013;45:876–82.

    CAS  PubMed  Google Scholar 

  7. 7.

    Earp JE, Hatfield DL, Sherman A, Lee EC, Kraemer WJ. Cold-water immersion blunts and delays increases in circulating testosterone and cytokines post-resistance exercise. Eur J Appl Physiol. 2019;119:1901–7.

    CAS  PubMed  Google Scholar 

  8. 8.

    Lee H, Natsui H, Akimoto T, Yanagi K, Ohshima N, Kono I. Effects of cryotherapy after contusion using real-time intravital microscopy. Med Sci Sports Exerc. 2005;37:1093–8.

    PubMed  Google Scholar 

  9. 9.

    Mawhinney C, Jones H, Low DA, Green DJ, Howatson G, Gregson W. Influence of cold-water immersion on limb blood flow after resistance exercise. Eur J Sport Sci. 2017;17:519–29.

    PubMed  Google Scholar 

  10. 10.

    Mawhinney C, Jones H, Joo CH, Low DA, Green DJ, Gregson W. Influence of cold-water immersion on limb and cutaneous blood flow after exercise. Med Sci Sport Exerc. 2013;45:2277–85.

    Google Scholar 

  11. 11.

    Gregson W, Black MA, Jones H, Milson J, Morton J, Dawson B, et al. Influence of cold water immersion on limb and cutaneous blood flow at rest. Am J Sports Med. 2011;39:1316–23.

    PubMed  Google Scholar 

  12. 12.

    Broatch JR, Petersen A, Bishop DJ. Postexercise cold water immersion benefits are not greater than the placebo effect. Med Sci Sports Exerc. 2014;46:2139–47.

    PubMed  Google Scholar 

  13. 13.

    de Malta ES, de Lira FS, Machado FA, Zago AS, do Amaral SL, Zagatto AM. Photobiomodulation by led does not alter muscle recovery indicators and presents similar outcomes to cold-water immersion and active recovery. Front Physiol Front. 2019;9:1948.

    Google Scholar 

  14. 14.

    Ascensão A, Leite M, Rebelo AN, Magalhäes S, Magalhäes J. Effects of cold water immersion on the recovery of physical performance and muscle damage following a one-off soccer match. J Sports Sci. 2011;29:217–25.

    PubMed  Google Scholar 

  15. 15.

    Eston R, Peters D. Effects of cold water immersion on the symptoms of exercise-induced muscle damage. J Sports Sci. 1999;17:231–8.

    CAS  PubMed  Google Scholar 

  16. 16.

    Pournot H, Bieuzen F, Duffield R, Lepretre P-M, Cozzolino C, Hausswirth C. Short term effects of various water immersions on recovery from exhaustive intermittent exercise. Eur J Appl Physiol. 2011;111:1287–95.

    CAS  PubMed  Google Scholar 

  17. 17.

    Rowsell GJ, Coutts AJ, Reaburn P, Hill-Haas S. Effect of post-match cold-water immersion on subsequent match running performance in junior soccer players during tournament play. J Sports Sci. 2011;29:1–6.

    PubMed  Google Scholar 

  18. 18.

    Machado AF, Ferreira PH, Micheletti JK, de Almeida AC, Lemes ÍR, Vanderlei FM, et al. Can water temperature and immersion time influence the effect of cold water immersion on muscle soreness? A systematic review and meta-analysis. Sports Med. 2016;46:503–14.

    PubMed  Google Scholar 

  19. 19.

    Vaile J, Halson S, Gill N, Dawson B. Effect of hydrotherapy on the signs and symptoms of delayed onset muscle soreness. Eur J Appl Physiol. 2008;102:447–55.

    PubMed  Google Scholar 

  20. 20.

    Roberts LA, Nosaka K, Coombes JS, Peake JM. Cold water immersion enhances recovery of submaximal muscle function after resistance exercise. Am J Physiol Regul Integr Comp Physiol. 2014;307:R998-1008.

    CAS  PubMed  Google Scholar 

  21. 21.

    Aguiar PF, Magalhães SM, Fonseca IAT, Santos VB da C, Matos MA de, Peixoto MFD, et al. Post-exercise cold water immersion does not alter high intensity interval training-induced exercise performance and Hsp72 responses, but enhances mitochondrial markers. Cell Stress Chaperones 2016;21:793.

  22. 22.

    Ihsan M, Markworth JF, Watson G, Choo HC, Govus A, Pham T, et al. Regular postexercise cooling enhances mitochondrial biogenesis through AMPK and p38 MAPK in human skeletal muscle. Am J Physiol Integr Comp Physiol. 2015;309:R286–94.

    CAS  Google Scholar 

  23. 23.

    Roberts LA, Raastad T, Markworth JF, Figueiredo VC, Egner IM, Shield A, et al. Post-exercise cold water immersion attenuates acute anabolic signalling and long-term adaptations in muscle to strength training. J Physiol. 2015;593:4285–301.

    CAS  PubMed  PubMed Central  Google Scholar 

  24. 24.

    Fyfe JJ, Broatch JR, Trewin AJ, Hanson ED, Argus CK, Garnham AP, et al. Cold water immersion attenuates anabolic signalling and skeletal muscle fiber hypertrophy, but not strength gain, following whole-body resistance training. J Appl Physiol. 2019;127:1403–18.

    CAS  PubMed  Google Scholar 

  25. 25.

    Fuchs CJ, Kouw IWK, Churchward-Venne TA, Smeets JSJ, Senden JM, van Lichtenbelt WDM, et al. Postexercise cooling impairs muscle protein synthesis rates in recreational athletes. J Physiol. 2019;598:755–72.

    PubMed  PubMed Central  Google Scholar 

  26. 26.

    de Matos MA, Vieira DV, Pinhal KC, Lopes JF, Dias-Peixoto MF, Pauli JR, et al. High-intensity interval training improves markers of oxidative metabolism in skeletal muscle of individuals with obesity and insulin resistance. Front Physiol. 2018;9:1451.

    PubMed  PubMed Central  Google Scholar 

  27. 27.

    Halson SL, Bartram J, West N, Stephens J, Argus CK, Driller MW, et al. Does hydrotherapy help or hinder adaptation to training in competitive cyclists? Med Sci Sports Exerc. 2014;46:1631–9.

    PubMed  Google Scholar 

  28. 28.

    Yamane M, Teruya H, Nakano M, Ogai R, Ohnishi N, Kosaka M. Post-exercise leg and forearm flexor muscle cooling in humans attenuates endurance and resistance training effects on muscle performance and on circulatory adaptation. Eur J Appl Physiol. 2006;96:572–80.

    PubMed  Google Scholar 

  29. 29.

    Gamble P. Periodization of training for team sports athletes. Strength Cond J. 2006;28:56–66.

    Google Scholar 

  30. 30.

    Issurin VB. New horizons for the methodology and physiology of training periodization. Sport Med. 2010;40:189–206.

    Google Scholar 

  31. 31.

    Suchomel TJ, Nimphius S, Bellon CR, Stone MH. The importance of muscular strength: training considerations. Sport Med. 2018;48:765–85.

    Google Scholar 

  32. 32.

    Versey NG, Halson SL, Dawson BT. Water immersion recovery for athletes: effect on exercise performance and practical recommendations. Sports Med. 2013;43:1101–30.

    PubMed  Google Scholar 

  33. 33.

    Broatch JR, Petersen A, Bishop DJ. The influence of post-exercise cold-water immersion on adaptive responses to exercise: a review of the literature. Sport Med. 2018;48:1369–87.

    Google Scholar 

  34. 34.

    Harries SK, Lubans DR, Callister R. Systematic review and meta-analysis of linear and undulating periodized resistance training programs on muscular strength. J strength Cond Res. 2015;29:1113–25.

    PubMed  Google Scholar 

  35. 35.

    Higgins JP, Altman DG. Assessing risk of bias in included studies. Cochrane Handb Syst Rev Interv. Chichester: Wiley; 2018.

    Google Scholar 

  36. 36.

    Yamane M, Ohnishi N, Matsumoto T. Does regular post-exercise cold application attenuate trained muscle adaptation? Int J Sports Med. 2015;36:647–53.

    CAS  PubMed  Google Scholar 

  37. 37.

    Grosshans E, Campbell H, Eddama O, Azzopardi D, Edwards AD, Strohm B, et al. Who should we cool after perinatal asphyxia? J Drugs Dermatol. 2014;26:59–67.

    Google Scholar 

  38. 38.

    Jones EJ, Bishop PA, Woods AK, Green JM. Cross-sectional area and muscular strength: A brief review. Sport Med. 2008;38:987–94.

    Google Scholar 

  39. 39.

    Kraemer WJ, Ratamess NA. Fundamentals of resistance training: progression and exercise prescription. Med Sci Sports Exerc. 2004;36:674–88.

    Google Scholar 

  40. 40.

    Shima A, Matsuda R. The expression of myogenin, but not of MyoD, is temperature-sensitive in mouse skeletal muscle cells. Zoolog Sci. 2008;25:1066–74.

    CAS  PubMed  Google Scholar 

  41. 41.

    Fukunaga T, Miyatani M, Tachi M, Kouzaki M, Kawakami Y, Kanehisa H. Muscle volume is a major determinant of joint torque in humans. Acta Physiol Scand. 2001;172:249–55.

    CAS  PubMed  Google Scholar 

  42. 42.

    Buckner SL, Dankel SJ, Mattocks KT, Jessee MB, Mouser JG, Counts BR, et al. The problem of muscle hypertrophy: revisited. Muscle Nerve. 2016;54:1012–4.

    PubMed  Google Scholar 

  43. 43.

    Fujita S, Rasmussen BB, Cadenas JG, Grady JJ, Volpi E. Effect of insulin on human skeletal muscle protein synthesis is modulated by insulin-induced changes in muscle blood flow and amino acid availability. Am J Physiol Metab. 2006;291:E745–54.

    CAS  Google Scholar 

  44. 44.

    Tipton KD, Wolfe RR. Exercise, protein metabolism, and muscle growth. Int J Sport Nutr. 2001;11:109–32.

    CAS  Google Scholar 

  45. 45.

    Slattery KM, Wallace LK, Murphy AJ, Coutts AJ. Physiological determinants of three-kilometer running performance in experienced triathletes. J Strength Cond Res. 2006;20:47.

    PubMed  Google Scholar 

  46. 46.

    Jacobs RA, Rasmussen P, Siebenmann C, Díaz V, Gassmann M, Pesta D, et al. Determinants of time trial performance and maximal incremental exercise in highly trained endurance athletes. J Appl Physiol. 2011;111:1422–30.

    CAS  PubMed  Google Scholar 

  47. 47.

    Bassett DR, Howley ET. Limiting factors for maximum oxygen uptake and determinants of endurance performance. Med Sci Sports Exerc. 2000;32:70–84.

    PubMed  Google Scholar 

  48. 48.

    Lundby C, Jacobs RA. Adaptations of skeletal muscle mitochondria to exercise training. Exp Physiol. 2016;101:17–22.

    CAS  PubMed  Google Scholar 

  49. 49.

    Meinild-Lundby AK, Jacobs RA, Gehrig S, de Leur J, Hauser M, Bonne TC, et al. Exercise training increases skeletal muscle mitochondrial volume density by enlargement of existing mitochondria and not de novo biogenesis. Acta Physiol. 2018;2018:222.

    Google Scholar 

  50. 50.

    Hawley JA, Lundby C, Cotter JD, Burke LM. Maximizing cellular adaptation to endurance exercise in skeletal muscle. Cell Metab. 2018;27:962–76.

    CAS  PubMed  Google Scholar 

  51. 51.

    MacInnis MJ, Gibala MJ. Physiological adaptations to interval training and the role of exercise intensity. J Physiol. 2017;595:2915–30.

    CAS  PubMed  Google Scholar 

  52. 52.

    Ihsan M, Watson G, Choo HC, Lewandowsk P, Papazzo A, Cameron-Smith D, et al. Postexercise muscle cooling enhances gene expression of PGC-1α. Med Sci Sport Exerc. 2014;46:1900–7.

    CAS  Google Scholar 

  53. 53.

    Allan R, Sharples AP, Close GL, Drust B, Shepherd SO, Dutton J, et al. Postexercise cold water immersion modulates skeletal muscle PGC-1α mRNA expression in immersed and nonimmersed limbs: evidence of systemic regulation. J Appl Physiol. 2017;123:451–9.

    CAS  PubMed  Google Scholar 

  54. 54.

    Joo CH, Allan R, Drust B, Close GL, Jeong TS, Bartlett JD, et al. Passive and post-exercise cold-water immersion augments PGC-1α and VEGF expression in human skeletal muscle. Eur J Appl Physiol. 2016;116:2315–26.

    CAS  PubMed  PubMed Central  Google Scholar 

  55. 55.

    Granata C, Jamnick NA, Bishop DJ. Training-induced changes in mitochondrial content and respiratory function in human skeletal muscle. Sport Med. 2018;48:1809–28.

    Google Scholar 

  56. 56.

    Vogel C, Marcotte EM. Insights into the regulation of protein abundance from proteomic and transcriptomic analyses. Nat Rev Genet. 2012;13:227–32.

    CAS  PubMed  PubMed Central  Google Scholar 

  57. 57.

    Foster C, Costill DL, Daniels JT, Fink WJ. Skeletal muscle enzyme activity, fiber composition and VO2 max in relation to distance running performance. Eur J Appl Physiol Occup Physiol. 1978;39:73–80.

    CAS  PubMed  Google Scholar 

  58. 58.

    Sutton JR. Limitations to maximal oxygen uptake. Sport Med An Int J Appl Med Sci Sport Exerc. 1992;13:127–33.

    CAS  Google Scholar 

  59. 59.

    Siqueira AF, Vieira A, Bottaro M, Ferreira-Júnior JB, de Nóbrega OT, de Souza VC, et al. Multiple cold-water immersions attenuate muscle damage but not alter systemic inflammation and muscle function recovery: a parallel randomized controlled trial. Sci Rep. 2018;8:10961.

    PubMed  PubMed Central  Google Scholar 

  60. 60.

    Abaïdia AE, Lamblin J, Delecroix B, Leduc C, McCall A, Nédélec M, et al. Recovery from exercise-induced muscle damage: cold-water immersion versus whole-body cryotherapy. Int J Sports Physiol Perform. 2017;12:402–9.

    PubMed  Google Scholar 

  61. 61.

    De Paula F, Escobar K, Ottone V, Aguiar P, de Matos MA, Duarte T, et al. Post-exercise cold-water immersion improves the performance in a subsequent 5-km running trial. Temperature. 2018;5:359–70.

    Google Scholar 

  62. 62.

    Peake JM, Neubauer O, Della Gatta PA, Nosaka K. Muscle damage and inflammation during recovery from exercise. J Appl Physiol. 2017;122:559–70.

    CAS  PubMed  Google Scholar 

  63. 63.

    Pedersen BK, Hoffman-Goetz L. Exercise and the immune system: regulation, integration, and adaptation. Physiol Rev. 2000;80:1055–81.

    CAS  PubMed  Google Scholar 

  64. 64.

    Ritchie D, Hopkins WG, Buchheit M, Cordy J, Bartlett JD. Quantification of training and competition load across a season in an Elite Australian football club. Int J Sports Physiol Perform. 2016;11:474–9.

    PubMed  Google Scholar 

  65. 65.

    Tnønessen E, Sylta Ø, Haugen TA, Hem E, Svendsen IS, Seiler S. The road to gold: training and peaking characteristics in the year prior to a gold medal endurance performance. PLoS ONE. 2014;9:e101796.

    Google Scholar 

  66. 66.

    Ihsan M, Abbiss CR, Gregson W, Allan R. Warming to the ice bath: Don’t go cool on cold water immersion just yet! Temperature. 2020;2020:1–3.

    Google Scholar 

Download references

Author information

Affiliations

Authors

Contributions

ESM, YMD and AMZ contributed to the study conception, design, material preparation, data collection and analysis. ESM, YMD, JRB, DJB, and AMZ contributed to data interpretation and manuscript writing. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Alessandro M. Zagatto.

Ethics declarations

Conflict of interest

Elvis Malta, Yago Dutra, James Broatch and David Bishop declare no conflicts of interest.

Funding

Elvis de Souza Malta was supported by São Paulo Research Foundation (FAPESP) fellowship (no. 2017/21724-8). This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001.

Ethics approval

Not applicable.

Consent to participate

Not applicable.

Consent for publication

Not applicable.

Code availability

Not applicable.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Malta, E.S., Dutra, Y.M., Broatch, J.R. et al. The Effects of Regular Cold-Water Immersion Use on Training-Induced Changes in Strength and Endurance Performance: A Systematic Review with Meta-Analysis. Sports Med 51, 161–174 (2021). https://doi.org/10.1007/s40279-020-01362-0

Download citation