Benefits of an Ice Bath

“What do you think about ice baths?”

This is a question I have been getting quite frequently in the clinic over the last year or so. The popularity of ice baths seems to be on the rise, but what is the science behind this practice? Is this extreme intervention best practiced by professional athletes, or is there a reason for the casual exerciser to invest in an at-home tub?

Why ice?

Research on the topic of cryotherapy – the use of cold in medical treatment – has been ongoing for decades. We know that applying ice to an acute injury lessens the sensation of pain by decreasing local nerve conduction. It also acts by shrinking blood vessels which prevents excess inflammation and swelling from entering the area. The science behind ice baths, more frequently referred to as cold water immersion in medical literature, is similar to that of localized icing. However, because an ice bath involves the entire body, there are additional effects to consider.

It is thought that full-body ice baths may help to speed recovery and reduce fatigue. These effects have been studied in several ways including:

1. Markers of inflammation and muscle damage

This method utilizes blood draws or muscle tissue biopsies to look for indicators of fatigue on a cellular level. Findings are mostly inconsistent, with most information suggesting there is minimal change in these cellular markers following one bout of exercise and cold water immersion.

2. Heart rate data

This can be used to indicate the state of our nervous system, more specifically our parasympathetic nervous system. This is the part in charge of our bodies during restful times when the heart rate should be slower. Because of the correlation between heart rate measurements and nervous system activity, this type of information can be used to objectively report on recovery state following exercise. Data suggests that when participating in daily bouts of exercise, daily ice baths resulted in greater parasympathetic activity at rest suggesting a more recovered state when compared to those who did not participate in ice baths.

3. Perceived feelings of recovery

This category is the most compelling evidence in favor of ice baths. In general, participants perceive an improvement in their readiness for sports performance, sleep quality, or amount of muscle soreness (particularly delayed onset muscle soreness). This suggests that perhaps one of the best reasons to take an ice bath is to “feel better.”

So, are ice baths for everyone?

First things first, it is important to consult a physician before introducing any full-body cold therapy to your routine as certain health conditions could be exacerbated. Ice baths are not safe for everyone. Otherwise, it is key to realize that evidence in support of ice baths is mixed. It seems likely that ice baths are most beneficial after high-intensity exercise that is performed over several consecutive days. There is less support for benefits following just one bout of exercise, regardless of intensity level. It should also be said that inflammatory responses in the body are important for recovery and adaptation; the idea that we should eliminate inflammation is misguided. All things considered, it does appear that ice baths may make us feel better even in the absence of objective data to support recovery. If that is reason enough for you, then perhaps you could give it a try.

References:

1. Haddad HA, Parouty J, Buchheit M. Effect of daily cold water immersion on heart rate variability and subjective ratings of well-being in highly trained swimmers. International Journal of Sports Physiology and Performance. 2012; 7:33-38. https://pubmed.ncbi.nlm.nih.gov/21941017/
2. Coelho TM, Nunes RF, Nakamura FY, et al. Post-match recovery in soccer with far-infrared emitting ceramic material or cold water immersion. Journal of Sports Science and Medicine. 2021; 20: 732-742. https://pubmed.ncbi.nlm.nih.gov/35321145/
3. Allan R, Mawhinney C. Is the ice bath finally melting? Cold water immersion is no greater than active recovery upon local and systemic inflammatory cellular stress in humans. Journal of Physiology. 2017; 596(6): 1857-1858. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5350472/
4. Glasgow PD, Ferris R, Bleakley CM. Cold water immersion in management of delayed onset muscle soreness: Is dose important? A randomized controlled trial. Physical Therapy in Sport. 2014; 15 (4): 228-233. https://pubmed.ncbi.nlm.nih.gov/24768476/
5. Moore E, Fuller JT, Buckley JD, et al. Impact of Cold-Water immersion compared with passive recovery following a single bout of strenuous exercise on athletic performance in physically active participants: A systematic review with meta-analysis and meta-regression. Sports Medicine. 2022; 52(7):1667-1688. https://pubmed.ncbi.nlm.nih.gov/35157264/#:~:text=Conclusion%3A%20CWI%20was%20an%20effective,power%2024%20h%20after%20exercise.