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

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

Bleakley C, McDonough S, Gardner E, Baxter GD, Hopkins JT, Davison GW. Cochrane Database of Systematic Reviews 2012


To determine the effects of cold-water immersion in the management of muscle soreness after exercise.

Main results

17 small trials were included, involving a total of N366 participants. Study quality was low. The temperature, duration and frequency of cold-water immersion varied between the different trials as did the exercises and settings.

14 studies compared cold-water immersion with passive intervention. Pooled results for muscle soreness showed statistically significant effects in favour of cold-water immersion after exercise. These results were heterogeneous. Exploratory subgroup analyses showed that studies using cross-over designs or running based exercises showed significantly larger effects in favour of cold- water immersion. Pooled results from two studies found cold-water immersion groups had significantly lower ratings of fatigue and potentially improved ratings of physical recovery immediately after the end of cold-water immersion.

5 studies compared cold-water with contrast immersion. Pooled data for pain showed no evidence of differences between the groups (immediately, 24, 48 and 72 hours after treatment).

Authors’ conclusions

There was some evidence that cold-water immersion reduces muscle soreness at 24, 48, 72 and even at 96 hours after exercise compared with ’passive’ treatment. Limited evidence from four trials indicated that participants considered that cold-water immersion improved recovery/reduced fatigue immediately afterwards. Most of the trials did not consider complications relating to cold-water immersion and so we cannot say whether these are a problem. There were only limited data available for other comparisons of cold-water immersion versus warm or contrasting (alternative warm/cold) water immersion, light jogging, and compression stockings. None of these showed important differences between the interventions being compared.

While the evidence shows that cold-water immersion reduces delayed onset muscle soreness after exercise, the optimum method of cold-water immersion and its safety are not clear.


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