Does cold water immersion improve recovery of strength, power, and endurance following
exhaustive exercise?
Adam Scofield, Kelsey Picha, and Patrick Sexton, EdD, ATC
Department of Human Performance: Athletic Training Education
Minnesota State University, Mankato
[email protected] [email protected]
Introduction/Background
Methodology/Design
Results
Cryotherapy is defined as “the application of cold
modalities that have a temperature range between thirty-two
degrees Fahrenheit and sixty-five degrees Fahrenheit,”
(Starkey pg. 103). It is known that the physiological effects of
cold modalities on the body include the following:
vasoconstriction, decrease nerve conduction, decrease cell
metabolism, decrease muscle spasms, and a decrease tissue
temperature.
In immediate care of injuries, cryotherapy is used to
prevent swelling, stimulate delta-A nerve fibers to reduce pain,
and to slow cell metabolism which in turn will decrease
secondary tissue death due to hypoxia. In competitive
athletics some athletes and coaches have come to believe that
the use of cold water immersion will accelerate recovery from
fatiguing exercise and therefore enhance subsequent
performance. Anecdotal reports of professional football
players and other competitive athletes using use cold water
immersion on a daily basis for recovery are becoming more
numerous. According to Reggie Torbor of the Buffalo Bills
“Scientifically, I don’t know how it works, but I know it works,”
(Skurski, 2010). Torbor’s anecdotal comment seems to reflect
a trend toward the use of cold immersion by athletes in order
to enhance recovery.
This may not be the case, since there is currently little
research on cryotherapy’s effect on recovery following
exercise. The few studies that have been conducted on the on
cryotherapy show either no effect on performance or found
inconclusive results (Barnett, 2006; Burgess & Lambert, 2010;
Easton & Peters, 1999). Therefore, since the known
physiologic effects of cryotherapy do not seem to support its
use as an adjunct to recovery.
This was an experimental design that was conducted
over several days. Day one of our study each subject was
familiarized with the Biodex Isokinetic Testing dynanometer
(Biodex System 3, Biodex Medical Systems, Inc.) and
underwent a two speed bilateral knee flexion/extension
(concentric-concentric) isokinetic test at 90 and 180 degrees
per second. Following warm-up each subject performed five
maximal repetitions at 90 degrees per second and 15 maximal
repetitions at 180 degrees per second in order to familiarize
the subject with the Biodex testing protocol and to reduce the
learning effect between pre- and post test during actual data
collection. Within 48 hours of the familiarization test each
subject underwent the same Biodex test for data collection
prior to any fatiguing.
During the interval between the familiarization and the
pre-test the subjects were asked to refrain from any physical
activity. Following the pre-test each subject underwent a knee
fatigue protocol on the Biodex. The knee fatigue protocol
uses a subjects baseline (obtained from their pre-test) peak
torque at 180 degrees per second. The subjects then
maximally exercised their dominant knee (defined as the leg
they use to kick a ball) on the Biodex until their peak torque
fell below 50% baseline (Wikstrom, 2003) . The fatigue
protocol ensured adequate fatigue relative to each subject’s
physiologic capacity and ensured that all subjects were
fatigued to the same degree.
Following the fatigue protocol the subjects were
randomly placed into a cold immersion whirlpool at 50° F for
10 minutes (treatment group) (Patterson, Udermann,
Doberstein, & Reineke, 2008) or into a tepid pool (control) at
78° F (Sellwood, Brukner, Wiliams, Nicol, & Hinman, 2007).
All subjects had their entire lower extremities immersed to the
level of their anterior superior iliac spines (ASIS). The control
group was immersed in neutral temperature water in order to
eliminate the impact hydrostatic pressure exerted by the water
may have had on recovery.
Twenty four hours following fatiguing exercise and
immersion each subject returned for post-test data collection
consisting of the same isokinetic test.
Using a Student T-test to analyze data, we found no
significant within group difference for either the control or
experimental group on any of the objective measures for
muscle strength, muscle power, or muscle endurance (total
work) (see Table 1 & Table 2). Due to the variability of the
data obtained and a relatively small sample size a repeated
measures ANOVA was not performed. Subjectively the
majority (5 of 6) of the subjects in the experimental group did
report feeling improvement in their post-test performance
compared to their pre-test while the majority (4 of 6) of the
subjects in the control group felt their performance was worse.
Purpose of Research
The purpose of this study was to determine whether
or not cold water immersion had an effect on muscle
strength, muscle power, or muscle endurance (total work)
of college-age male lacrosse athletes 24 hours after an
exhaustive exercise bout.
Conclusion/Discussion
Table1. Knee Extension at 180 Degrees
t-Test of Equality of Means
t
df
Sig.
(2-tailed)
Mean
Difference
Std. Error
Difference
PrPkT180
0.258 10
0.801
3.6667
14.2012
PoPk180
-0.073 10
0.943
-1.05
14.3962
PrAvgPw180
-0.081 10
0.937
-2.65
32.674
PoAvgPw180
-0.411 10
0.689
-13.1667
31.9992
PrTotWk180
0.322 10
0.754
83.15
257.9636
PoTotWk180
-0.289 10
0.778
-87.1167
301.4293
Table 2. Knee Extension at 90 Degrees
There was no difference between the control and
variable groups on objective measures from pre- to post test
even though anecdotally the experimental (i.e. cold
immersion) subjects believe they performed better following
cold immersion. This may account for the popular perception
among athletes and coaches that cold immersion assists
recovery following exercise when, in fact, the known
physiologic effects of cryotherapy would suggest just the
opposite.
Following completion of this study, future research
considerations are as follows: require a larger number of
subjects, require a larger variety of subjects (ie. gender and
sport), use a larger variety of water temperatures in order to
further blind the study, and lastly use a functional fatigue test
(ie. VO2 Max test) rather than using the Biodex Fatigue
Protocol.
References
1)
2)
3)
t-Test of Equality of Means
t
PrPkT90
PoPkT90
df
Sig.
Mean
Std. Error
(2-tailed) Difference
Difference
0.52 10
0.661
8.1167
17.9522
-0.237 10
0.818
-4.033
17.046
PrAvgPw90
0.475 10
0.645
12.1833
25.6308
PoAvgPw90
-0.212 10
0.836
-5.45
25.6939
PrTotWk90
0.733 10
0.481
85.4167
116.5703
PoTotWk90
-0.093 10
0.928
-13.8833
149.078
4)
5)
6)
7)
Limitations
This study was primarily limited by the low subject
numbers. We were also unable to control the subjects’
nutrition, sleep, and outside activity during the study, which in
turn could have affected their recovery. It was also not
possible to blind the subjects to the treatment since
temperature of the water immersion cannot be disguised.
Finally, the subjects had a preconceived bias believing that
cold immersion would improve their recovery.
8)
Barnett, Anthony. (2006). Using recovery modalities
between training sessions in elite atheltes: does it help?.
Sports Medicine, 36(9).
Burgess, T, & Lambert, M. (2010). The efficacy of
cryotherapy on recovery following exercise-induced
muscle damage. International SportMed Journal, 11(2),
p. 258 20p.
Eston, R, & Peters, D. (1999). Effect of cold water
immersion on the symptoms of exercise-induced
muscle damage. Journal of Sports Sciences, 17(3), pp.
231-38.
Patterson, S, Udermann, B, Doberstein, S, & Reineke,
D. (2008). The effects of cold whirlpool on power,
speed, agility, and range of motion. The Journal of
Sports Science and Medicine, 7.
Sellwood, K, Brukner, P, Wiliams, D, Nicol, A, & Hinman,
R. (2007). Ice-water immersion and delayed-onset
muscle soreness: a. Br J Sports Med, 41.
Skurski, J. (2010, October 17). Bills believe in cold
therapy.
Starkey, C. (2004). Theraputic modalities: 3rd edition.
Philadelphia, PA: F. A. Davis Company.
Urticaria and Angioedema. (2000-2010). World allergy
organization. Retrieved November 20, 2010, from
Wikstrom, E. (2003). Functional vs isokinetic fatigue
protocol: effects on time to. Unpublished manuscript,
Human Performance Department, University of Florida,
Gainsville, Florida.
Acknowledgments
We would like to thank Patrick Sexton, MSU Men’s Club
Lacrosse Team, Amy Arndt, and Elizabeth Drake for their
help and support throughout our research.