Are Cold (Ice) Water Immersions Effective?

Picture from Scienceforsport

I used to have lots of ice packs in the freezer when I was still competing. The commercial ones plus bags of peas and mixed vegetables (pictured below). Used to put it on my shin or anywhere that hurts. However, I did not do the ice/cold water immersions. It was way too cold for me (since I had less body fat then) and I did not feel it helped. 

Good for icing

However, the more we know about cold water immersion (from research), the more it seems we (athletes and non athletes) have it wrong. Regular immersion in cold water significantly inhibits recovery from strenuous exercise. 

When our muscles feel sore after strenuous exercise, it is a consequence of doing physical activity to which we are unaccustomed or not used to. That can be a hard run, gym session, a few hours of golf or a repetitive household chore that took longer than you expected.

Here's an example of how our muscles get overloaded. If you continuously stretch a rubber band, the rubber band becomes frayed. Likewise your muscles sustain micro tears when you exert too hard. The damage causes a few hours to days of inflammation, swelling and soreness. When it's severe, you get delayed onset of muscle soreness or DOMs.

This is normal and also an essential part of muscular adaptation to exercise, also known as the overload principle. If the stress (exercise) is applied regularly, and you get enough recovery, the muscles adapt, get stronger and bigger by laying down new fibers. Just like a construction crew assembling steel beams to support the infrastructure of a building.

Ice immersion inhibits this process. Researchers (Roberts et al, 2015) have found that cold water immersion after hard exercise suppressed signaling pathways associated with recovery. This suppression lasted several days. Another group of researchers (Fuchs et al, 2020) showed that ice bathing reduced the body's muscles uptake of dietary proteins, which is important for growth and cell maintenance.

The conclusions of 2 recent meta-analyses support the suppressed signaling pathways and reduced dietary protein intake mentioned above. Grgic (2022) showed that cold water immersion reduced exercise related strength gains while (Pinero et al, 2024) showed that ice bathing immediately after weight training inhibited muscle growth.

So, whether you are strength training to improve athletic performance or just about anyone who needs to repair and rebuild your muscles after exercise, you need to reconsider if you should use cold water immersion after your exercise/ training.

Why are athletes and non athletes still doing cold water immersions? Social media is probably the cause. Wim Hof (the Dutch iceman) says that cold "activates" your metabolism and strengthens the body's immune response. Others on Tik Tok swears that ice baths improves alertness and concentration. Purveyors of commercial health and wellness have likely jumped on the same bandwagon.

Perhaps sports scientists and researchers have to share some of the 'blame'. These articles are written and published in scientific language, using unrelatable sequence and you have to pay to access them.

Possibly, only the articles with the most sensational findings/ conclusions make it out of academia. Since it is not communicated well with the public, there is a gulf between the lab and the average lay person. This gulf is then filled gleefully by fitness influencers and wellness 'gurus' who share their knowledge on unregulated social media platforms.

I ice my sore body parts still, because it does reduce muscle pain. I fell and bruised my elbow last week and the icing provided pain relief as the ice numbs the skin and blocks pain signals to the brain. 

Pain is subjective. To you it may be a 3/10 pain, to me, it may be 7/10 or vice versa. Pain cannot be studied objectively. Pain perception is definitely different to cellular recovery and to actually speed up recovery, you need to sleep well.

References

Fuschs CJ, Kouw IWK, Churchward-Venne TA et al (2020). Postexercise Cooling Impairs Muscle Protein Synthesis Rates In Recreational Athletes. J Physio. 598: 755-772. DOI: 1113/JP278996.

Grgic J. (2023). Effects Of post-exercise Cold-water Immersion On Resistance Training-Induced Gains In Muscular Strength: A Meta-analysis. Eur J Sp Sci. 23(3): 372-308. DOI: 10.1080/17461391.2022.2033851.

Roberts LA, Raastad T, Markworth et al (2015). Post-exercise Cold Water Immersion Attenuates Acute Anabolic Signaling And Long-term Adaptations In Muscle To Strength Training. J Physiol 593(18) : 4285-4301. DOI: 10.1113/JP270570.

Pinero A, Burke R, Augustin F et al (2024). Throwing Cold Water On Muscle Growth: A Systematic Review With Meta-analysis Of The Effects Of Postexercise Cold Water Immersion On Resistance Training-induced Hypertrophy. Eur J Sp Sci. 24: 177-189. DOI: 10.1002/ejsc.12074