Written by Kyle Hunt | BEXSci.
Fact checked by Kirsten Yovino, CPT Brookbush Institute
FACT CHECKED
In recent years, cold therapy has gained serious popularity among fitness influencers, athletes, and celebrities. At this point, it’s hard to scroll Instagram without seeing people climbing into a tub filled with ice.
But using cold temperatures as a means of recovery is nothing new. For decades, NFL players have jumped in tubs filled with ice after summer practices. It's just newer to the fitness world, and social media, of course.
So, does cold therapy work? Who does it work for? And if it does work, how do you use it correctly?
As with most things in fitness, cold therapy's effectiveness depends on many factors. Fortunately, we're going to cover all of it here, so you have all of the information you need to use cold therapy correctly.
Let's look at what the research says about cold therapy, in addition to what it is, how to use it, and who should use it.
Table of Contents:
- What is Cold Therapy?
- A Brief History of Cold Water Therapy
- How Cold Therapy Works
- What are the Different Types of Cold Therapy?
- Benefits and Downsides of Cold Therapy
- Who Will Benefit From Cold Therapy
- Who Should Avoid Cold Therapy
- How to Start Cold Water Therapy
- FAQs
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What is Cold Therapy?
As the name suggests, cold therapy exposes one's body to cold temperatures. There are many different forms of cold therapy, including ice baths, outdoor cold water swims, cold showers, ice packs, and cryotherapy.
The most popular form of cold therapy is using ice baths with water around 50-59 degrees Fahrenheit to stimulate the body to produce health benefits.
A Brief History of Cold Water Therapy
Although cold water therapy has recently gained a ton of popularity, it has been around for a long time. For example, Thomas Jefferson soaked his feet in cold water every morning for sixty years.
The draw to cold water therapy is understandable. Everyone is always looking for an edge or a hack to improve.
Wim Hoff essentially sparked the recent popularity of cold therapy. Wim Hof, also called The Iceman, is a Dutch motivational speaker, influencer, and extreme athlete famous for his ability to handle cold temperatures.
Part of his Wim Hoff Method for optimal health involves cold therapy. Through podcasts, social media, and books, Wim has generated a lot of attention. His disciples claim numerous health benefits from following the method.
How Cold Therapy Works
There are still questions regarding how cold exposure actually works, but some researchers suggest it involves decreased localized tissue temperature, changes in blood flow, and reduced acute and chronic pain1.
Vasoconstriction works by reducing blood flow by constricting the diameter of the transport vessels in the area, which reduces tissue temperature. The vasoconstriction directs blood to your organs.
When you get out of the tub, the blood vessels respond by expanding, called vasodilation. When this occurs, oxygen and nutrient-rich blood get pumped back into the tissues.
It is a common assumption that cold exposure reduces the inflammatory response from intense training, thus aiding in muscle recovery and delayed onset muscle soreness (DOMS).
But a 2017 study found ten minutes of cold water immersion post-exercise didn't change the inflammatory response compared to ten minutes of active recovery on an exercise bike2.
What are the Different Types of Cold Therapy?
Depending on your budget and needs, there are many different types of cold therapy.
Here are the most common.
1. Ice Bath:
An ice bath is the most basic and arguably most effective form of cold therapy. While you can use your regular bathtub or a large freezer (all you have to do is fill it with water and ice), with the increase in the popularity of cold treatment, a robust market for ice baths has sprung up.
There are inflatable options, tin tubs, and high-tech ice bath machines. Here at SET FOR SET, we featured a range of great options in our article on the 5 Best Ice Baths, suitable to any needs. You can get a cheaper option for a few hundred dollars or a fancy tub with tons of special features that will cost several thousand dollars.
One of our favorites is the Rubbermaid stock tank as it is both durable and budget-friendly. No matter what type of tub you're looking for, one exists that will align with your cold therapy goals!
The Rubbermaid Commercial Stock Tank, 150 gallon, has a sleek appearance and smooth black color. This 150 gallon stock tank features an easy-to-use drain and seamless structural foam construction that resists weathering and cracking for long use...
2. Cold Water Swim:
Nature’s cold water therapy is a short swim in a cold lake, pond, or river. Of course, with this method, you must take safety precautions because this can be dangerous.
Always do a cold water swim with another person around.
3. Cold Shower:
A cold shower is the most affordable option for cold therapy because you don't need to buy anything. Although it is not as effective as the other methods, a cold shower can be a great introduction to cold therapy for most people. Almost everyone has access to a cold shower, and the ease of entry is slightly lower.
A cold shower is like dipping your toe in cold therapy before moving onto ice baths or cold swims, both of which require complete immersion in ice-cold water.
Start by ending your regular shower with a few minutes of cold water. Turn off the hot water and crank the cold on full blast. It will not be comfortable, but you will get used to it. Over time, try to spend more time with cold water and less with hot.
Keep in mind a few minutes of a cold shower is a far cry from ten to fifteen minutes in a 50-degree ice bath. The benefits are likely to be much less for cold showers.
You could also try contrast water therapy, alternating between hot and cold water.
Interested in learning more about cold showers and some of their more specific benefits? Check out our article: Do Cold Showers Boost Testosterone?
4. Cryotherapy:
Cryotherapy, which is when you stand in a tank up to your neck that blasts freezing temperatures over your body for 2-4 minutes, is the latest buzzword in recovery protocols.
But, how does it compare to cold water immersion? A 2016 study compared CWI head-to-head with cryotherapy and found CWI was superior. Subjects using CWI had lower levels of muscle soreness and higher perceived recovery 24-48 hours post-exercise3.
Additionally, cryotherapy is expensive and not as easily accessible, as they are typically only found at wellness facilities.
5. Ice Pack:
We have all used an ice pack at some point in our childhood.
Whether we fell off a bike or got injured on the playground, chances are, your mom put an ice pack on the injury. You may not consider this cold therapy, but it is.
Cold therapy machines also fall under this category, as they combine the idea of ice packs with compression to help heal injuries and promote muscle recovery. This could also include things like coolant sprays and ice massage, which is when you massage an area of your body using ice.
Benefits of Cold Therapy
Supporters of cold therapy claim it has many health benefits. In fact, we touch on a lot of these in our article on ice bath benefits.
For cold therapy as a whole, anecdotal benefits include everything from improving recovery and sleep, reducing inflammation and treating pain, increasing energy, and boosting mental toughness.
But what does the science say?
1) Reduces Muscle Soreness:
There is substantial research support for cold therapy, more specifically cold water immersion therapy, as superior to active rest for improving muscle soreness post-training.
A meta-analysis from 2011 found that post-exercise CWI reduced muscle soreness for up to four days4.
2) Reduces body temperature:
Elevated core temperature is highly associated with fatigue and decreased performance5. If you overheat following intense exercise in a hot environment, cold water immersion can be beneficial, especially if you have another event in a short time.
Cold water therapy can lower body temperature faster than resting in a room-temperature environment.
3) Improves Muscular Power:
A recent meta-analysis found that cold-water immersion is more likely to influence muscular power performance but not muscular strength performance positively.
Cold water immersion improved the recovery of muscular power 24 hours after exercise6. Muscular power is high force production over a short period. Examples include explosive jumping, sprinting, Olympic lifts, punching, kicking, tackling, etc.
Sports that require high rates of power development would benefit from cold therapy.
4) Perceived feelings of recovery:
Perceived recovery is an athlete's impression of readiness for the next training session. Research shows cold water immersion effectively increases feelings of perceived recovery within 24 hours after high-intensity exercise6.
However, since this is a subjective measure, it's important to note that it could be influenced by the athlete's belief in cold water therapy, reflecting a placebo effect.
You can learn more about this in our article that examines the question: Why Do Athletes Take Ice Baths?
5) Improves Mood:
Cold stress, like what occurs during cold water immersion, can improve your mood due to endorphin release7. Endorphins are known to trigger a beneficial feeling in the body.
The euphoric feeling you get following exercise, eating chocolate, or having sex, is due to endorphins.
6) Builds discipline:
You will find little, if any, scientific research on cold therapy building discipline, but anecdotal evidence is strong. Being able to do uncomfortable things is a beneficial skill. It is what separates successful people from unsuccessful.
There are other ways to build disciple besides sitting in cold water. However, anyone who has consistently done cold exposure will tell you it changes your mindset.
A cold water dip first thing in the morning makes everything you do the rest of the day seem like a piece of cake.
Cold Therapy Downsides
There are no shortcuts in physiology. Everything is a tradeoff, and cold therapy is no different.
1) Decreases training adaptations:
Cold therapy allows for the enhancement of recovery at the cost of some amount of adaptation from training.
Because of this, there is a tradeoff you need to take into account. In certain circumstances, when the athlete's immediate performance needs to be maintained, it makes sense to favor recovery using cold therapy at the expense of adaptation.
Other times, as in the offseason or phases focusing on building muscle, losing adaptation only to alleviate minor soreness is not worth it.
2) Can impede muscle and strength gains:
Research comparing the effects of cold water immersion and active recovery on muscle mass and strength changes after 12 weeks of strength training found strength and muscle mass increased more with active recovery.
The researchers also found CWI blunted the activation of critical proteins and satellite cells in the muscle up to two days after strength exercise8.
Another study that looked at long-term adaptation in muscle growth found cold water immersion blunted resistance training-induced protein anabolism and increased catabolism9.
3) Uncomfortable (less likely to consistently do it):
Yes, the fact that cold exposure is uncomfortable is both a benefit and a downside. It's mentally challenging, so it will likely help you build discipline if you do it. However, as a recovery modality, there are things you can do that are easier.
There is a time for performing hard tasks, but when it comes to recovery, it's about effectiveness. Cold water immersion is only effective if you do it consistently.
Who Will Benefit From Cold Therapy?
Not everyone will benefit from cold therapy, at least not all the time. In-season athletes who have to compete or practice multiple times within hours or days will reap cold therapy benefits the most.
When events occur close together, performance is the priority over adaptation. Using cold therapy to reduce muscle soreness would help restore performance, as it is hard to perform well with debilitating soreness. Additionally, athletes who rely on muscular power will likely benefit the most.
Another group of athletes who will benefit from cold therapy is athletes peaking for an event. At the end of the season, most sports culminate with the most important games or matches of the year.
It is essential athletes are at their best during this time. Using cold therapy to minimize muscle soreness as much as possible would be advantageous to peak for a particular day or weekend.
In addition, those looking for an added weight-loss boost may benefit from cold therapy. You can learn more about this in our article: Do Cold Showers Burn Fat?
Who Should Avoid Cold Therapy?
Cold therapy is not for everyone. Before starting anything new, it is a good idea to run it by your physician first. There are pre-existing conditions such as high blood pressure, cardiovascular or heart disease, and diabetes where cold therapy is not a good idea.
Additionally, athletes interested in maximizing adaptations from training, especially muscle building and strength, should avoid cold therapy.
So, for competitive bodybuilders and powerlifters, like those featured in this list of best bodybuilders, for example, cold exposure is only advisable under some circumstances, like peaking for an event or recovering from an injury.
How to Start Cold Water Therapy
Every method of cold water therapy requires a unique protocol. Since ice baths are highly effective and practical, we will review how to do them below.
The research varies in terms of frequency, duration, and water temperature for ice baths. However, the consensus from experts in the field is 10-15 minutes in water, which is around 50-59 degrees Fahrenheit or 10-15 degrees Celsius10. You can learn more about ice bath timing in our article: How Long Should You Stay In An Ice Bath?
When starting, aim to do three to five minutes and go from there. You only need to do part of the ten to fifteen minutes the first few times.
Aim for water to ice ratio of around three to one. However, use a thermometer to help achieve the ideal temperature when balancing ice with the water mixture. If it is too cold, add more water. If it is too warm, add more ice.
Ease in as the cold will be a shock to the system. To get the most benefit, try to submerge your entire body underwater with only your head above water.
Once you develop the habit of doing regular ice baths, aim to do two to three weekly. Many people like to do them first thing in the morning, but you can jump in the tub whenever it is convenient.
FAQs
Lingering cold therapy questions? Let's answer them here.
What is cold therapy good for?
Cold therapy is best for mitigating muscle soreness following high-intensity exercise. Cold therapy can also reduce body temperature, increase perceived recovery, increase muscle power, enhance mood, and build discipline.
Can I do cold therapy at home?
Yes, you can do cold therapy at home. You can start with cold showers and eventually move to ice baths.
Does cold therapy help anxiety?
Although no direct research shows that cold therapy helps anxiety, it can increase endorphins, which are feel-good hormones. It can also temporarily take your mind off things that might be causing stress.
What are the risks of cold therapy?
Under most circumstances, the risks of cold therapy are minor. If done for too long, it can cause skin, tissue, or nerve damage. Even frostbite is a possibility. The risks increase if the mode of cold therapy is an outdoor swim. Swimming in cold water could result in cold water shock and hypothermia, which can impact your ability to swim and could cause you to drown.
How long should you use cold therapy?
An excellent cold therapy protocol is two to three ice baths per week for ten to fifteen minutes per session. You will need to work up to this amount. Start with a few minutes per session and add time as you get more comfortable. Learn more about timing in our article: When's The Best Time To Take A Cold Plunge?
Ready to begin your weekly ice bath protocol? Step one, decide which of these 5 Ice Bath Tubs is best for you! Step two, once you've got your tub, make taking a cold plunge part of your weekly recovery routine!
References:
- Ihsan M, Watson G, Abbiss CR. What are the Physiological Mechanisms for Post-Exercise Cold Water Immersion in the Recovery from Prolonged Endurance and Intermittent Exercise? Sports Med. 2016 Aug. doi: 10.1007/s40279-016-0483-3. PMID: 26888646.
- Peake JM, Roberts LA, Figueiredo VC, Egner I, Krog S, Aas SN, Suzuki K, Markworth JF, Coombes JS, Cameron-Smith D, Raastad T. The effects of cold water immersion and active recovery on inflammation and cell stress responses in human skeletal muscle after resistance exercise. J Physiol. 2017 Feb 1. doi: 10.1113/JP272881. Epub 2016 Nov 13. PMID: 27704555; PMCID: PMC5285720.
- Abaïdia AE, Lamblin J, Delecroix B, Leduc C, McCall A, Nédélec M, Dawson B, Baquet G, Dupont G. Recovery From Exercise-Induced Muscle Damage: Cold-Water Immersion Versus Whole-Body Cryotherapy. Int J Sports Physiol Perform. 2017 Mar. doi: 10.1123/ijspp.2016-0186. Epub 2016 Aug 24. PMID: 27396361.
- Leeder J, Gissane C, van Someren K, Gregson W, Howatson G. Cold water immersion and recovery from strenuous exercise: a meta-analysis. Br J Sports Med. 2012 Mar. doi: 10.1136/bjsports-2011-090061. Epub 2011 Sep 22. PMID: 21947816.
- González-Alonso J, Teller C, Andersen SL, Jensen FB, Hyldig T, Nielsen B. Influence of body temperature on the development of fatigue during prolonged exercise in the heat. J Appl Physiol (1985). 1999 Mar. doi: 10.1152/jappl.1999.86.3.1032. PMID: 10066720.
- Moore, E., Fuller, J.T., Buckley, J.D. 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 Med 52, 1667–1688 (2022). https://doi.org/10.1007/s40279-022-01644-9
- Tipton MJ, Collier N, Massey H, Corbett J, Harper M. Cold water immersion: kill or cure? Exp Physiol. 2017 Nov 1. doi: 10.1113/EP086283. Epub 2017 Sep 21. PMID: 28833689.
- Roberts LA, Raastad T, Markworth JF, Figueiredo VC, Egner IM, Shield A, Cameron-Smith D, Coombes JS, Peake JM. Post-exercise cold water immersion attenuates acute anabolic signalling and long-term adaptations in muscle to strength training. J Physiol. 2015 Sep 15. doi: 10.1113/JP270570. Epub 2015 Aug 13. PMID: 26174323; PMCID: PMC4594298.
- Fyfe JJ, Broatch JR, Trewin AJ, Hanson ED, Argus CK, Garnham AP, Halson SL, Polman RC, Bishop DJ, Petersen AC. Cold water immersion attenuates anabolic signaling and skeletal muscle fiber hypertrophy, but not strength gain, following whole-body resistance training. J Appl Physiol (1985). 2019 Nov 1. doi: 10.1152/japplphysiol.00127.2019. Epub 2019 Sep 12. PMID: 31513450.
- Versey NG, Halson SL, Dawson BT. Water immersion recovery for athletes: effect on exercise performance and practical recommendations. Sports Med. 2013 Nov. doi: 10.1007/s40279-013-0063-8. PMID: 23743793
Kyle Hunt
Author