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Water Immersion Recovery for Athletes: Effect on Exercise Performance and Practical Recommendations

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Abstract

Water immersion is increasingly being used by elite athletes seeking to minimize fatigue and accelerate post-exercise recovery. Accelerated short-term (hours to days) recovery may improve competition performance, allow greater training loads or enhance the effect of a given training load. However, the optimal water immersion protocols to assist short-term recovery of performance still remain unclear. This article will review the water immersion recovery protocols investigated in the literature, their effects on performance recovery, briefly outline the potential mechanisms involved and provide practical recommendations for their use by athletes. For the purposes of this review, water immersion has been divided into four techniques according to water temperature: cold water immersion (CWI; ≤20 °C), hot water immersion (HWI; ≥36 °C), contrast water therapy (CWT; alternating CWI and HWI) and thermoneutral water immersion (TWI; >20 to <36 °C). Numerous articles have reported that CWI can enhance recovery of performance in a variety of sports, with immersion in 10–15 °C water for 5–15 min duration appearing to be most effective at accelerating performance recovery. However, the optimal CWI duration may depend on the water temperature, and the time between CWI and the subsequent exercise bout appears to influence the effect on performance. The few studies examining the effect of post-exercise HWI on subsequent performance have reported conflicting findings; therefore the effect of HWI on performance recovery is unclear. CWT is most likely to enhance performance recovery when equal time is spent in hot and cold water, individual immersion durations are short (~1 min) and the total immersion duration is up to approximately 15 min. A dose-response relationship between CWT duration and recovery of exercise performance is unlikely to exist. Some articles that have reported CWT to not enhance performance recovery have had methodological issues, such as failing to detect a decrease in performance in control trials, not performing full-body immersion, or using hot showers instead of pools. TWI has been investigated as both a control to determine the effect of water temperature on performance recovery, and as an intervention itself. However, due to conflicting findings it is uncertain whether TWI improves recovery of subsequent exercise performance. Both CWI and CWT appear likely to assist recovery of exercise performance more than HWI and TWI; however, it is unclear which technique is most effective. While the literature on the use of water immersion for recovery of exercise performance is increasing, further research is required to obtain a more complete understanding of the effects on performance.

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References

  1. Halson SL, Jeukendrup AE. Does overtraining exist? An analysis of overreaching and overtraining research. Sports Med. 2004;34(14):967–81.

    Article  PubMed  Google Scholar 

  2. Abbiss CR, Laursen PB. Models to explain fatigue during prolonged endurance cycling. Sports Med. 2005;35(10):865–98.

    Article  PubMed  Google Scholar 

  3. Montgomery P, Pyne D, Hopkins W, et al. The effect of recovery strategies on physical performance and cumulative fatigue in competitive basketball. J Sports Sci. 2008;26(11):1135–45.

    Article  PubMed  Google Scholar 

  4. Spencer M, Rechichi C, Lawrence S, et al. Time-motion analysis of elite field hockey during several games in succession: a tournament scenario. J Sci Med Sport. 2005;8(4):382–91.

    Article  PubMed  CAS  Google Scholar 

  5. Halson SL, Bridge MW, Meeusen R, et al. Time course of performance changes and fatigue markers during intensified training in trained cyclists. J Appl Physiol. 2002;93(3):947–56.

    PubMed  Google Scholar 

  6. Meeusen R, Watson P, Hasegawa H, et al. Central fatigue: the serotonin hypothesis and beyond. Sports Med. 2006;36(10):881–909.

    Article  PubMed  Google Scholar 

  7. Vaile J. Recovery: research and practice. Mod Ath Coach. 2007;45(3):37–42.

    Google Scholar 

  8. Bishop PA, Jones E, Woods AK. Recovery from training: a brief review. J Strength Cond Res. 2008;22(3):1015–24.

    Article  PubMed  Google Scholar 

  9. Barnett A. Using recovery modalities between training sessions in elite athletes: does it help? Sports Med. 2006;36(9):781–96.

    Article  PubMed  Google Scholar 

  10. Vaile J, Halson S, Graham S. Recovery review: science vs. practice. J Aust Strength Cond. 2010;Suppl. 2:5–21.

    Google Scholar 

  11. Craig AB Jr, Dvorak M. Thermal regulation during water immersion. J Appl Physiol. 1966;21(5):1577–85.

    PubMed  Google Scholar 

  12. Becker BE. Biophysiologic aspects of hydrotherapy. In: Cole AJ, Becker BE, editors. Comprehensive aquatic therapy. 2nd ed. Philadelphia: Butterworth Heinemann; 2004. p. 19–56.

    Google Scholar 

  13. Bonde-Petersen F, Schultz-Pedersen L, Dragsted N. Peripheral and central blood flow in man during cold, thermoneutral, and hot water immersion. Aviat Space Environ Med. 1992;63(5):346–50.

    PubMed  CAS  Google Scholar 

  14. Park KS, Choi JK, Park YS. Cardiovascular regulation during water immersion. Appl Hum Sci. 1999;18(6):233–41.

    Article  CAS  Google Scholar 

  15. Wilcock IM, Cronin JB, Hing WA. Physiological response to water immersion: a method for sport recovery? Sports Med. 2006;36(9):747–65.

    Article  PubMed  Google Scholar 

  16. Wilcock IM, Cronin JB, Hing WA. Water immersion: does it enhance recovery from exercise? Int J Sports Physiol Perform. 2006;1(3):195–206.

    PubMed  Google Scholar 

  17. Nakamura K, Takahashi H, Shimai S, et al. Effects of immersion in tepid bath water on recovery from fatigue after submaximal exercise in man. Ergonomics. 1996;39(2):257–66.

    Article  PubMed  CAS  Google Scholar 

  18. Fiscus KA, Kaminski TW, Powers ME. Changes in lower-leg blood flow during warm-, cold-, and contrast-water therapy. Arch Phys Med Rehab. 2005;86(7):1404–10.

    Article  Google Scholar 

  19. Vaile J, O’Hagan C, Stefanovic B, et al. Effect of cold water immersion on repeated cycling performance and limb blood flow. Br J Sports Med. 2011;45(10):825–9.

    Article  PubMed  CAS  Google Scholar 

  20. Meeusen R, Lievens P. The use of cryotherapy in sports injuries. Sports Med. 1986;3(6):398–414.

    Article  PubMed  CAS  Google Scholar 

  21. Eston R, Peters D. Effects of cold water immersion on the symptoms of exercise-induced muscle damage. J Sports Sci. 1999;17(3):231–8.

    Article  PubMed  CAS  Google Scholar 

  22. Merrick M, Ranin J, Andres F, et al. A preliminary examination of cryotherapy and secondary injury in skeletal muscle. Med Sci Sports Exerc. 1999;31(11):1516–21.

    Article  PubMed  CAS  Google Scholar 

  23. Abramson DI, Chu LS, Tuck S Jr, et al. Effect of tissue temperatures and blood flow on motor nerve conduction velocity. JAMA. 1966;198(10):1082–8.

    Article  PubMed  CAS  Google Scholar 

  24. Washington LL, Gibson SJ, Helme RD. Age-related differences in the endogenous analgesic response to repeated cold water immersion in human volunteers. Pain. 2000;89(1):89–96.

    Article  PubMed  CAS  Google Scholar 

  25. Versey N, Halson S, Dawson B. Effect of contrast water therapy duration on recovery of cycling performance: a dose–response study. Eur J Appl Physiol. 2011;111(1):37–46.

    Article  PubMed  Google Scholar 

  26. Yeargin SW, Casa DJ, McClung JM, et al. Body cooling between two bouts of exercise in the heat enhances subsequent performance. J Strength Cond Res. 2006;20(2):383–9.

    PubMed  Google Scholar 

  27. Peiffer J, Abbiss C, Watson G, et al. Effect of a 5 min cold water immersion recovery on exercise performance in the heat. Br J Sports Med. 2010;44(6):461–5.

    Article  PubMed  CAS  Google Scholar 

  28. Vaile J, Halson S, Gill N, et al. Effect of hydrotherapy on recovery from fatigue. Int J Sports Med. 2008;29(7):539–44.

    Article  PubMed  CAS  Google Scholar 

  29. Peiffer JJ, Abbiss CR, Watson G, et al. Effect of cold-water immersion duration on body temperature and muscle function. J Sports Sci. 2009;27(10):987–93.

    Article  PubMed  Google Scholar 

  30. Peiffer JJ, Abbiss CR, Nosaka K, et al. Effect of cold water immersion after exercise in the heat on muscle function, body temperatures, and vessel diameter. J Sci Med Sport. 2009;12(1):91–6.

    Article  PubMed  Google Scholar 

  31. Halson S, Quod M, Martin D, et al. Physiological responses to cold water immersion following cycling in the heat. Int J Sports Physiol Perform. 2008;3(3):331–46.

    PubMed  Google Scholar 

  32. Duffield R. Cooling interventions for the protection and recovery of exercise performance from exercise-induced heat stress. Med Sport Sci. 2008;53:89–103.

    Article  PubMed  Google Scholar 

  33. Gregson W, Black M, Jones H, et al. Influence of cold water immersion on limb and cutaneous blood flow at rest. Am J Sports Med. 2011;39(6):1316–23.

    Article  PubMed  Google Scholar 

  34. Peiffer J, Abbiss C, Watson G, et al. Effect of cold water immersion on repeated 1-km cycling performance in the heat. J Sci Med Sport. 2010;13(1):112–6.

    Article  PubMed  Google Scholar 

  35. Myrer JW. Contrast therapy and intramuscular temperature in the human leg. J Athl Train. 1994;29(4):318–22.

    PubMed  CAS  Google Scholar 

  36. Higgins D, Kaminski TW. Contrast therapy does not cause fluctuations in human gastrocnemius intramuscular temperature. J Athl Train. 1998;33(4):336–40.

    PubMed  CAS  Google Scholar 

  37. Fradkin AJ, Zazryn TR, Smoliga JM. Effects of warming-up on physical performance: a systematic review with meta-analysis. J Strength Cond Res. 2010;24(1):140–8.

    Article  PubMed  Google Scholar 

  38. Quod MJ, Martin DT, Laursen PB. Cooling athletes before competition in the heat: comparison of techniques and practical considerations. Sports Med. 2006;36(8):671–82.

    Article  PubMed  Google Scholar 

  39. Ranalli GF, DeMartini JK, Casa DJ, et al. Effect of body cooling on subsequent aerobic and anaerobic exercise performance: a systematic review. J Strength Cond Res. 2010;24(12):3488–96.

    Article  PubMed  Google Scholar 

  40. Cochrane DJ. Alternating hot and cold water immersion for athlete recovery: a review. Phys Ther Sport. 2004;5(1):26–32.

    Article  Google Scholar 

  41. Hing WA, White SG, Bouaaphone A, et al. Contrast therapy: a systematic review. Phys Ther Sport. 2008;9(3):148–61.

    Article  PubMed  Google Scholar 

  42. Bleakley CM, Davison GW. What is the biochemical and physiological rationale for using cold water immersion in sports recovery? A systematic review. Br J Sports Med. 2010;44(3):179–87.

    Article  PubMed  Google Scholar 

  43. Howatson G, Goodall S, van Someren KA. The influence of cold water immersions on adaptation following a single bout of damaging exercise. Eur J Appl Physiol. 2009;105:615–21.

    Article  PubMed  Google Scholar 

  44. Ingram J, Dawson B, Goodman C, et al. Effect of water immersion methods on post-exercise recovery from simulated team sport exercise. J Sci Med Sport. 2009;12(3):417–21.

    Article  PubMed  Google Scholar 

  45. Kuligowski LA, Lephart SM, Giannantonio FP, et al. Effect of whirlpool therapy on the signs and symptoms of delayed-onset muscle soreness. J Athl Train. 1998;33(3):222–8.

    PubMed  CAS  Google Scholar 

  46. Robey E, Dawson B, Goodman C, et al. Effect of postexercise recovery procedures following strenuous stair climb running. Res Sports Med. 2009;17(4):245–59.

    Article  PubMed  Google Scholar 

  47. Takahashi J, Ishihara K, Aoki J. Effect of aqua exercise on recovery of lower limb muscles after downhill running. J Sports Sci. 2006;24(8):835–42.

    Article  PubMed  Google Scholar 

  48. Vaile J, Halson S, Gill N, et al. Effect of hydrotherapy on signs and symptoms of delayed onset muscle soreness. Eur J Appl Physiol. 2008;102(4):447–55.

    Article  PubMed  Google Scholar 

  49. Sellwood K, Brukner P, Williams D, et al. Ice-water immersion and delayed-onset muscles soreness: a randomised controlled trial. Br J Sports Med. 2007;41(6):392–7.

    Article  PubMed  Google Scholar 

  50. Paddon-Jones D, Quigley B. Effect of cryotherapy on muscle soreness and strength following eccentric exercise. Int J Sports Med. 1997;18(8):588–93.

    Article  PubMed  CAS  Google Scholar 

  51. Yamane M, Teruya H, Nakano M, et al. 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(5):572–80.

    Article  PubMed  Google Scholar 

  52. Heyman E, De Geus B, Mertens I, et al. Effects of four recovery methods on repeated maximal rock climbing performance. Med Sci Sports Exerc. 2009;41(6):1303–10.

    Article  PubMed  Google Scholar 

  53. Lane KN, Wenger HA. Effect of selected recovery conditions on performance of repeated bouts of intermittent cycling separated by 24 hours. J Strength Cond Res. 2004;18(4):855–60.

    PubMed  Google Scholar 

  54. Rowsell G, Coutts A, Raeburn P, et al. 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):1–6.

    Article  PubMed  Google Scholar 

  55. Vaile J, Halson S, Gill N, et al. Effect of cold water immersion on repeat cycling performance and thermoregulation in the heat. J Sports Sci. 2008;26(5):431–40.

    Article  PubMed  Google Scholar 

  56. Bailey D, Erith S, Griffin P, et al. Influence of cold-water immersion on indices of muscle damage following prolonged intermittent shuttle running. J Sports Sci. 2007;25(11):1163–70.

    Article  PubMed  CAS  Google Scholar 

  57. Kinugasa T, Kilding AE. A comparison of post-match recovery strategies in youth soccer players. J Strength Cond Res. 2009;23(5):1402–7.

    Article  PubMed  Google Scholar 

  58. Buchheit M, Peiffer J, Abbiss C, et al. Effect of cold water immersion on postexercise parasympathetic reactivation. Am J Physiol Heart Circ Physiol. 2009;296(2):H421–7.

    Article  PubMed  CAS  Google Scholar 

  59. Jakeman J, Macrae R, Eston R. A single 10-min bout of cold water immersion therapy after strenuous plyometric exercise has no beneficial effect on recovery from the symptoms of exercise-induced muscle damage. Ergonomics. 2009;52(4):456–60.

    Article  PubMed  CAS  Google Scholar 

  60. Stacey D, Gibala M, Martin Ginis K, et al. Effects of recovery method after exercise on performance, immune changes, and psychological outcomes. J Orthop Sport Phys. 2010;40(10):656–65.

    Article  Google Scholar 

  61. Crowe MJ, O’Connor D, Rudd D. Cold water immersion reduces anaerobic performance. Int J Sports Med. 2007;28:994–8.

    Article  PubMed  CAS  Google Scholar 

  62. Parouty J, Al Haddad H, Quod M, et al. Effect of cold water immersion on 100-m sprint performance in well-trained swimmers. Eur J Appl Physiol. 2010;109(3):483–90.

    Article  PubMed  Google Scholar 

  63. Schniepp J, Campbell TS, Powell KI, et al. The effects of cold water immersion on power output and heart rate in elite cyclists. J Strength Cond Res. 2002;16(4):561–6.

    PubMed  Google Scholar 

  64. 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(4):665–70.

    Google Scholar 

  65. Higgins TR, Heazlewood IT, Climstein M. A random control trial of contrast baths and ice baths for recovery during competition in U/20 rugby union. J Strength Cond Res. 2011;25(4):1046–51.

    Article  PubMed  Google Scholar 

  66. Pournot H, Bieuzen F, Duffield R, et al. Short term effects of various water immersions on recovery from exhaustive intermittent exercise. Eur J Appl Physiol. 2011;111(7):1287–95.

    Article  PubMed  CAS  Google Scholar 

  67. Hamlin MJ. The effect of recovery modality on blood lactate removal and subsequent repetitive sprint performance in netball players. N Z J Sports Med. 2007;34(2):12–7.

    Google Scholar 

  68. King M, Duffield R. The effects of recovery interventions on consecutive days of intermittent sprint exercise. J Strength Cond Res. 2009;23(6):1795–802.

    Article  PubMed  Google Scholar 

  69. Ascensão A, Leite M, Rebelo AN, et al. 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(3):217–25.

    Article  PubMed  Google Scholar 

  70. Rowsell G, Coutts A, Reaburn P, et al. Effects of cold-water immersion on physical performance between successive matches in high-performance junior male soccer players. J Sports Sci. 2009;27(6):565–73.

    Article  PubMed  Google Scholar 

  71. Stanley J, Buchheit M, Peake J. The effect of post-exercise hydrotherapy on subsequent exercise performance and heart rate variability. Eur J Appl Physiol. 2012;112(3):951–61.

    Article  PubMed  Google Scholar 

  72. Leeder J, Gissone C, van Someren K, et al. Cold water immersion and recovery from strenuous exercise: a meta-analysis. Br J Sports Med. 2012;46(4):233–40.

    Article  PubMed  Google Scholar 

  73. Bosak A, Bishop P, Green J, et al. Impact of cold water immersion on 5 km racing performance. Sport J. 2009;12(2).

  74. Baker PT, Farrington Daniels JR. Relationship between skinfold thickness and body cooling for two hours at 15°C. J Appl Physiol. 1956;8:409–16.

    PubMed  CAS  Google Scholar 

  75. Keatinge WR. The effects of subcutaneous fat and of previous exposure to cold on the body temperature, peripheral blood flow and metabolic rate of men in cold water. J Physiol. 1960;153:166–78.

    PubMed  CAS  Google Scholar 

  76. Anderson GS. Human morphology and temperature regulation. Int J Biometeorol. 1999;43:99–109.

    Article  PubMed  CAS  Google Scholar 

  77. Lemire B, Gagnon D, Jay O, et al. Influence of adiposity on cooling efficiency in hyperthermic individuals. Eur J Appl Physiol. 2008;104(1):67–74.

    Article  PubMed  Google Scholar 

  78. Hopkins WG, Hawley JA, Burke LM. Design and analysis of research on sport performance enhancement. Med Sci Sports Exerc. 1999;31(3):472–85.

    Article  PubMed  CAS  Google Scholar 

  79. Baker DG, Newton RU. Adaptations in upper-body maximal strength and power output resulting from long-term resistance training in experienced strength-power athletes. J Strength Cond Res. 2006;30(3):541–6.

    Google Scholar 

  80. Hakkinen K. Neuromuscular and hormonal adaptations during strength and power training: a review. J Sports Med Phys Fitness. 1989;29(1):9–26.

    PubMed  CAS  Google Scholar 

  81. Ahtiainen JP, Pakarinen A, Alen M, et al. Muscle hypertrophy, hormonal adaptations and strength development during strength training in strength-trained and untrained men. Eur J Appl Physiol. 2003;89(6):555–63.

    Article  PubMed  CAS  Google Scholar 

  82. Bloom SR, Johnson RH, Park DM, et al. Differences in the metabolic and hormonal responses to exercise between racing cyclists and trained individuals. J Physiol. 1976;258(1):1–18.

    PubMed  CAS  Google Scholar 

  83. Viitasalo J, Niemela K, Kaappola R, et al. Warm underwater water-jet massage improves recovery from intense physical exercise. Eur J Appl Physiol. 1995;71(5):431–8.

    Article  CAS  Google Scholar 

  84. Coffey V, Leveritt M, Gill N. Effect of recovery modality on 4-hour repeated treadmill running performance and changes in physiological variables. J Sci Med Sport. 2004;7(1):1–10.

    Article  PubMed  CAS  Google Scholar 

  85. French DN, Thompson KG, Garland SW, et al. The effect of contrast bathing and compression therapy on muscular performance. Med Sci Sports Exerc. 2008;40(7):1297–306.

    Article  PubMed  Google Scholar 

  86. Vaile JM, Gill ND, Blazevich AJ. The effect of contrast water therapy on symptoms of delayed onset muscle soreness. J Strength Cond Res. 2007;21(3):697–702.

    PubMed  Google Scholar 

  87. Dawson B, Gow S, Modra S, et al. Effects of immediate post-game recovery procedures on muscle soreness, power and flexibility levels over the next 48 hours. J Sci Med Sport. 2005;8(2):210–21.

    Article  PubMed  CAS  Google Scholar 

  88. Hamlin MJ. The effect of contrast temperature water therapy on repeated sprint performance. J Sci Med Sport. 2007;10(6):398–402.

    Article  PubMed  Google Scholar 

  89. Buchheit M, Horobeanu C, Mendez-Villanueva A, et al. Effects of age and spa treatment on match running performance over two consecutive games in highly trained young soccer players. J Sports Sci. 2011;29(6):591–8.

    Article  PubMed  Google Scholar 

  90. Versey NG, Halson SL, Dawson BT. Effect of contrast water therapy duration on recovery of running performance. Int J Sports Physiol Perform. 2012;7(2):130–40.

    PubMed  Google Scholar 

  91. Sayers M, Calder A, Sanders J. Effect of whole-body contrast-water therapy on recovery from intense exercise of short duration. Eur J Sport Sci. 2011;11(4):293–302.

    Article  Google Scholar 

  92. Cortis C, Tessitore A, D’Artibale E, et al. Effects of post-exercise recovery interventions on physiological, psychological, and performance parameters. Int J Sports Med. 2010;31(5):327–35.

    Article  PubMed  CAS  Google Scholar 

  93. Lum D, Landers G, Peeling P. Effects of a recovery swim on subsequent running performance. Int J Sports Med. 2010;31(1):26–30.

    Article  PubMed  CAS  Google Scholar 

  94. Tessitore A, Meeusen R, Cortis C, et al. Effects of different recovery interventions on anaerobic performances following preseason soccer training. J Strength Cond Res. 2007;21(3):745–50.

    PubMed  Google Scholar 

  95. Tessitore A, Meeusen R, Pagano R, et al. Effectiveness of active versus passive recovery strategies after futsal games. J Strength Cond Res. 2008;22(5):1402–12.

    Article  PubMed  Google Scholar 

  96. Kellmann M. Preventing overtraining in athletes in high-intensity sports and stress/recovery monitoring. Scand J Med Sci Sports. 2010;20(Suppl. 2):95–102.

    Article  PubMed  Google Scholar 

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The authors declare that they have no conflicts of interest relevant to this review and no funding was used to assist in the preparation of this review.

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Versey, N.G., Halson, S.L. & Dawson, B.T. Water Immersion Recovery for Athletes: Effect on Exercise Performance and Practical Recommendations. Sports Med 43, 1101–1130 (2013). https://doi.org/10.1007/s40279-013-0063-8

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