Br J Sports Med doi:10.1136/bjsports-2013-092433
  • PEDro systematic review update

Cold water immersion (cryotherapy) for preventing muscle soreness after exercise

  1. Steven J Kamper2,3
  1. 1Discipline of Biomedical Science, Sydney Medical School, The University of Sydney, Lidcombe, New South Wales, Australia
  2. 2Musculoskeletal Division, The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
  3. 3Department of Epidemiology and Biostatistics, EMGO+ Institute, VU University Medical Centre, Amsterdam, Netherlands
  1. Correspondence to Dr Joanna Diong, Discipline of Biomedical Science, Sydney Medical School, The University of Sydney, Lidcombe, NSW 1825, Australia; joanna.diong{at}
  • Received 14 March 2013
  • Accepted 29 March 2013
  • Published Online First 25 April 2013

▸ Bleakley C, McDonough S, et al. Cold-water immersion (cryotherapy) for preventing and treating muscle soreness after exercise. Cochrane Database Syst Rev 2012;2:CD008262.


Intense exercise involving eccentric muscle contractions often leads to delayed onset muscle soreness. Eccentric muscle contractions cause damage to muscle fibres which lead to pain, stiffness and loss in joint range of motion.1 The anti-inflammatory effects of cold water immersion, a form of cryotherapy where the limb(s) or body is submerged in a cold water bath, are thought to reduce pain and swelling following acute soft tissue injury.2 Cold water immersion immediately after exercise may have anti-inflammatory effects and prevent delayed onset muscle soreness, however these effects remain unclear.


This study aimed to determine the effects of cold water immersion on the prevention of muscle soreness after exercise.

Searches and inclusion criteria

The following databases were searched up to 2010 or 2011: the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, CENTRAL, Medline, EMBASE, CINAHL, PEDro and British Nursing Index and archive. The authors also searched databases for ongoing trials and hand-searched journals and conference proceedings. Experts in the field were contacted for relevant data from published, unpublished or ongoing studies.

Randomised and quasi-randomised trials examining cold water immersion for preventing muscle soreness after exercise were included. Participants had to receive cold …

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