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Ice Bath Controversy. Does freezing your legs really improve recovery?

In my pro racing days, ice baths were THE non-invasive, nonpharmaceutical option to speed recovery after a hard training session or race. My running coach told me to do them and I really felt they helped me recover faster and decrease muscle soreness. Over the past several years, studies are starting to show that ice baths may impede muscle function. But, the issue is far from black and white.

Cool the burn

Athletes at all levels have been standing or sitting in ice baths for decades. I remember sitting in a big vat of ice water in the training room when I had shin splints during my college running career. There were football players, hockey players, volleyball players along with us runners. Most of us had a specific injury that required ice to help control inflammation. It is still the first go-to healing modality with acute injury because ice and cold do decrease that inflammatory “burn”.

Placing ice on injuries or surgeries does also decrease swelling and pain. Cold application can be a go-to painkiller for some.

Recent popularity of the “cold plunge” and reducing the stress response

Dutch motivational speaker and “ice man”, Wim Hof, has helped popularize the daily cold plunge in recent years. This method uses cold therapy (baths, frozen bodies of water, and showers) as part of a program of breathing and meditation to decrease stress in daily life. Participants in this method claim to have higher energy levels and pain relief from various conditions.

Coach’s note: One concept I find very valuable in his teachings (and others), is the idea that when you knowingly put yourself into a stressful situation (such as a super cold body of water), you have some control over your stress response both mentally and physically. This is where breathing exercises come in. When I have athletes preparing for a cold triathlon swim, I have them prep with cold showers and practice controlling their stress response to the cold through breathing and positive mantras. This transfers very well to improved race day performance. By decreasing your anxiety to the cold water, you are then able to put your mental and physical energy into your race.

Theory behind the ice bath

The theory behind ice baths is that hard training causes tiny tears in muscle fibers. This muscle damage stimulates muscle cell activity that helps repair the damage and strengthen the muscles, but is also linked with delayed onset muscle soreness (DOMS). In theory, the ice bath,

  1. constricts blood vessels and flushes waste products out of the muscles,
  2. decreases metabolic activity and slows down physiological processes, and
  3. reduces swelling and tissue breakdown.

Then as the body re-warms, fresh blood flows through the system, thus improving the healing process.

Claims for what ice baths can do include: reduce muscle soreness, keep muscles limber, repair muscles, reduce muscle and soft tissue inflammation, induce better sleep, reduce muscle pain, reduce muscle stiffness, prevent injury, speed recovery between sessions and feel good after training. Science has not proven all of these claims; in fact, some studies have shown just the opposite.

Anti-cold therapy research

One Australian study on weight lifters threw doubt on the effectiveness of an ice bath. After heavy strength training, subjects who performed three one-minute cold water plunges showed no improvement in pain, or performance nor a decrease in creatine kinase (an enzyme marker of inflammation and muscle damage.) Some subjects in this study even felt an increase in leg pain the next day.

In another study of cyclists, subjects were followed for a 4-6 week period. After each training session, they put one leg in an ice bath and kept one leg out. Researchers found that the non-iced leg gained more strength, circulation, and endurance than the ice bath leg. Another study of swimmers found similar results. Ice baths following hard training did not produce improved next-day performance or blood tests. They did, however, feel better the next day.

Pro-cold therapy research

On the other side of the argument, there are several studies that point to the effectiveness of cold water therapy. In one study, researchers had cyclists ride 7 days in a row of very hard interval training. After each workout, subjects either took a cold bath, hot bath, contrast bath (alternating cool and hot water), or complete rest. Cyclists performed better in sprint and TT events after cold water and contrast therapy, but performance declined with both hot baths and complete rest. Another study of rugby players was followed during successive games. As with the cyclists, the rugby players’ performance improved with consistent use of either ice baths or contrast therapy.

A study of runners found similar results in runners completing back-to-back hard runs. Yet another study of runners who ran at steady state followed by intervals, then immersed one leg in an ice bath and the other stayed at room temperature, concluded that the iced leg did show a significant decrease in swelling in the muscles.

How to choose what is right for you

Clear evidence supports both sides of the freeze-your-buns argument. Here are a few things to consider when making a choice about whether or not to take the cold plunge.

  • Slight swelling after a hard workout is a normal part of the healing and adaptation process in the muscles. By habitually taking steps to limit this process, you may be limiting your body’s ability to fully benefit from the workout.
  • Several studies rated the athletes’ sensations after taking the baths. In studies where athletes reported feeling better; they also performed better. Simply taking action to enhance your perception or belief of a recovery therapy may in and of itself be most beneficial, especially if you have a strong belief that the therapy is helpful.
  • Light recovery movements are an effective alternative to speed the recovery process: easy walking, cycling, foam roller, massage, stretching (static and ballistic), compression gear and devices.
  • Cold immersion is a great option when training and racing in very hot conditions. Keeping core temperature normalized in the heat lowers the amount of blood pumped to the skin surface to dissipate heat.

But, how does it make you feel?

So, why do these studies and claims vary so widely? The answer lies in the fact that it may all be in your head, i.e the placebo effect in action. If you believe that the ice bath helps you feel and perform better, then you are more likely to have that experience. While someone else has a different idea and may experience a negative result. This is the power of the mind and our belief systems.

Finally…

There is no one clear answer to this question, at least not one that will fit all athletes in all situations. Most studies were very small and short-term. They also studied different athletes, different sports, and used different protocols. The bottom line is that if it feels good to you and there is no damage being caused, it is most likely helping you. Stay away from the “more is better” mentality. The water does not need to have ice floating in it to be effective (about 50-60 degrees for 10-15 minutes works fine). And, instead of daily cold baths, do them only after your hardest training days such as: track workouts, long hilly runs, races in the heat, or back-to-back races for maximum results.

 

 

References & Resources

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