Ice bath explained

In sports therapy, an ice bath, or sometimes cold-water immersion, Cold plunge or cold therapy, is a training regimen usually following a period of intense exercise in which a substantial part of a human body is immersed in a bath of ice or ice-water for a limited duration.[1]

The method is controversial,[2] with a risk of hypothermia,[3] with the possibility of shock[4] leading to sudden death.[3] [5] [6] Many athletes have used cold water immersion after an intense exercise workout in the belief that it speeds up bodily recovery; however, the internal physical processes are not well understood and remain elusive.[7] Evidence supporting cold water immersion as part of an athletic training has been mixed,[8] with some studies suggesting a mild benefit such as reducing muscle damage and discomfort[9] and alleviating delayed onset muscle soreness,[10] [11] with other studies suggesting that cold water immersion may slow muscle growth and interfere with an overall training regimen.[12] [13] [14]

Techniques

Bath

It is done by standing or sitting in a bucket or bath of icy water. One writer advised: "don't overdo it." Wearing rubberized "dive booties" on the feet (to protect toes) as well as rubber briefs to warm the midsection have been recommended. Champion weightlifter Karyn Marshall, who won the world women's weightlifting championship in 1987,[15] described what it was like to take an ice bath after a day of competition at the CrossFit Games in 2011 in Los Angeles:

One report suggested that if ice water is circulating, it is even colder such that the water will be colder than measured by a thermometer, and that athletes should avoid overexposure.[16] Physical therapist Nikki Kimball explained a way to make the bath more endurable:

Ice bath only versus contrast bath therapy

Some athletes use a technique known as contrast water therapy or contrast bath therapy, in which cold water and warmer water are alternated. One method of doing this was to have two tubs––one cold (10–15 degrees Celsius) and another hot (37–40 degrees Celsius)––and to do one minute in the cold tub followed by two minutes in a hot tub, and to repeat this procedure three times.

Temperature and timing

The temperature can vary, but is usually in the range of 50–59 degrees Fahrenheit[17] or between 10 and 15 degrees Celsius.[18] Some athletes wear booties to keep their toes warm[17] or rubberized coverings around their midsection while immersed. Some drink a warm beverage such as tea.[17] One report suggested that "ten minutes immersed in 15 degree Celsius water" was sufficient.

Accounts vary about how long to be immersed and how often to do them. One adviser suggested that an athlete should take ten two-minute ice bath treatments over a two-week period.[19] One account suggested immersion times should be between ten and twenty minutes. Another suggested that immersion run from five to ten minutes, and sometimes to twenty minutes. There were no sources advocating being immersed for longer than twenty minutes.

Ice baths versus cold baths

Several sources suggest that cold baths (NaNF) were preferable to ice baths. Physiotherapist Tony Wilson of the University of Southampton said that extremely cold temperatures were unnecessary and a "cold bath" would be just as effective as an ice bath.[19] Another agreed that a mere cold bath is preferable to ice baths which are "unnecessary." A third report suggested that cool water (NaNF) was just as good as water at a lower temperature (NaNF) and that eight to ten minutes should be sufficient time, and warned against exceeding ten minutes.[16]

Effectiveness

After exercise, there is some evidence that taking an ice bath may reduce delayed onset muscle soreness and perceptions of fatigue, but no good evidence of any other benefit.[20] [21]

A 2024 meta-analysis of controlled trials concluded that cold water immersion immediately following resistance training may blunt the ensuing muscle hypertrophy, although the authors cautioned that their conclusion was uncertain due to the relatively fair to poor quality of the underlying studies.[22]

Safety

There is agreement in the medical and scientific communities that ice baths can pose serious risks to health. Risks include hypothermia,[3] shock[4] and the possibility of sudden cardiac death.[3] [5] [6] [23]

History

Marathon runner Paula Radcliffe won the 10,000m event at the 2002 European championships and attributed her victory to the use of ice baths.[24] She reportedly said "It's absolute agony, and I dread it, but it allows my body to recover so much more quickly."[25] She reported taking ice baths before racing and preferred her pre-race bath temperature to be "very cold."[19] After the Radcliffe comment, the technique has grown in popularity.[24] It is gaining in popularity among athletes,[17] [26] [24] such that some athletes "swear by it"[24] [27] [28] but other accounts suggest it may be a fad.[19] [24]

It has been used by athletes such as A. J. Soares and Olympic swimmer Michael Phelps[29] as well as other celebrity endorsers[30] and is getting to become "common practice" among athletes[31] [28] [32] from different sports, including American football,[33] association football (soccer),[34] [35] long distance running,[17] [2] [36] rugby,[37] [24] tennis,[38] volleyball,[39] and other sports. There was a report that sports equipment manufacturers are considering different designs for ice baths.[40] In the summer of 2014, as a fundraising method, the nonprofit ALS Association, which raises money for research and public awareness of amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, began the Ice Bucket Challenge which involved donors filming themselves and challenging other donors to participate and then being doused with a bucket of ice cold water; as a fundraising effort, it raised $16 million over a 22-day period.[41] [42]

There are indications that ice baths may be gaining popularity with groups outside sports, such as dance. The Pittsburgh Post-Gazette reported that some Radio City Rockettes, a precision dance company performing in New York City, use ice baths after a long day of performing as a way to "unwind" and cope with "aches and pains."[43] One report suggested that entertainer Madonna used ice baths after her performances.[44] And there are indications that use of ice baths is spreading to amateur sports, such as high school football.[45]

Explorer and athlete Fiann Paul is known for using ice baths as part of his training routine.

Ice baths are a part of a broader phenomenon known as cryotherapy—the Greek word cryo (κρυο) means cold—which describes a variety of treatments when cold temperatures are used therapeutically. Cryotherapy includes procedures where a person is placed in a room with "cold, dry air at temperatures as low as −135 °C" for short periods of time, and which has been used in hospitals in Poland as well as a center in London to treat not only muscular ailments, but psychological problems such as depression.[19] Basketball player Manny Harris reportedly used a Cryon-X machine featuring extreme low temperatures around minus 166 degrees Fahrenheit, but used it with wet socks resulting in a serious freezer burn.[46]

Occasionally ice baths have been an ill-advised treatment of fever in young children, but that doctors were counseled not to use this technique because of the risk of hypothermia.[47] Ice baths have been suggested as a way to prevent muscle soreness after shoveling snow.[26]

In addition, there have been instances of ice bathing as an extreme bodily test by persons vying for an endurance record, such as Dutch Iceman Wim Hof,[48] and Chinese record-holders Chen Kecai[49] and Jin Songhao.[50] According to reports, doctors and scientists are studying how these people can spend an hour and a half submerged in an ice bath, and survive.

Ice baths began to become extremely popular after being discussed extensively by Joe Rogan and his universe of scientist and comedians such as Dr. Andrew Huberman (Stanford) and Aubury Marcus (Onnit).[51]

Ice bath vs. cryotherapy

Ice baths, an activity within the practice of cryotherapy, has been predominately utilised for multiple decades for therapeutic purposes, typically for exercise recovery for athletes, and more recently for perceived mental health benefits, such as the alleviation of symptoms of mental health problems such as depression. Cryotherapy can be tracked "as far back as the Egyptians in 3000 BCE" as a wound treatment [52]

Cryotherapy can be dated back to ancient Greece, its first mention in an ancient Egyptian medical text Edwin Smith Papyrus that is believed to date to around 3500 BCE,[53] and furthermore through Hippocrates's theory of the four humours.[54] Although, when applying a historical perspective,cold-water immersion was used first as a form of socialisation and relaxation, before its physiological and psychological benefits were noted.[55]

The main medical treatments that Ancient Greeks employed the use of cold-water immersion for were fever, as the cold was thought to counteract the body's heat,[53] and for pain relief. The use of cold-water immersion for medical treatments for physiological symptoms continued until the late 1950s. In fact, it was not utilised for post-exercise recovery until the 1960s, by D H Clarke.[53] However, the use of cold-water immersion for post-exercise recovery and treatment is by far the most popular and well-known use of the technique, despite being the most recent.

See also

Notes and References

  1. Note: This article only refers to the use of ice baths in sports therapy and not to their use in cold exposure programs like the Wim Hof Method where ice baths are of different temperatures and are used differently.
  2. News: Julie Deardorff . Rules for runners: Skip the ice bath . Chicago Tribune . ... many of my RW colleagues swear by ice baths after a long run or race. Not me. I still maintain that ice baths are an elaborate practical joke being played on runners ... . October 12, 2009 . 2011-08-13.
  3. Tipton MJ . The initial responses to cold-water immersion in man . Clinical Science . 77 . 6 . 581–8 . 1989 . 2691172 . 10.1042/cs0770581.
  4. Datta A, Tipton M . Respiratory responses to cold water immersion: neural pathways, interactions, and clinical consequences awake and asleep . Journal of Applied Physiology . 100 . 6 . 2057–64 . 2006 . 16714416 . 10.1152/japplphysiol.01201.2005 .
  5. Shattock MJ, Tipton MJ . 'Autonomic conflict': a different way to die during cold water immersion? . The Journal of Physiology . 590 . 14 . 3219–30 . 2012 . 22547634 . 3459038 . 10.1113/jphysiol.2012.229864 .
  6. Heller K, Salata S . Cardiopulmonary arrest after cold water immersion and hypothermia . Journal of Emergency Nursing . 14 . 1 . 5–8 . 1988 . 3279252 .
  7. White GE, Wells GD . Cold-water immersion and other forms of cryotherapy: physiological changes potentially affecting recovery from high-intensity exercise . Extreme Physiology & Medicine . 2 . 1 . 26 . 2013 . 24004719 . 3766664 . 10.1186/2046-7648-2-26 . free .
  8. Rowsell GJ, Reaburn P, Toone R, Smith M, Coutts AJ . Effect of run training and cold-water immersion on subsequent cycle training quality in high-performance triathletes . Journal of Strength and Conditioning Research . 28 . 6 . 1664–72 . 2014 . 24626137 . 10.1519/JSC.0000000000000455 . 10453/41986 . 12032750 . free .
  9. Ascensão A, Leite M, Rebelo AN, Magalhäes S, Magalhäes J . Effects of cold water immersion on the recovery of physical performance and muscle damage following a one-off soccer match . Journal of Sports Sciences . 29 . 3 . 217–25 . 2011 . 21170794 . 10.1080/02640414.2010.526132 . 20424150 . free .
  10. Christine Kearney, 20 February 2012, Medical News Today, Muscle Soreness – Is Cold Water Immersion Effective For Treatment?, Retrieved October 5, 2016, "...a cold bath may be an effective way to prevent and help sore muscles. ...difficult for researchers to determine exactly how much cold water immersion helps sore muscles, ...The researchers say it is necessary for more studies to be done in order to be sure of the effectiveness of cold water baths in treating muscle soreness. ..."
  11. Machado AF, Ferreira PH, Micheletti JK, de Almeida AC, Lemes ÍR, Vanderlei FM, Netto Junior J, Pastre CM . Can Water Temperature and Immersion Time Influence the Effect of Cold Water Immersion on Muscle Soreness? A Systematic Review and Meta-Analysis . Sports Medicine . 46 . 4 . 503–14 . 2016 . 26581833 . 4802003 . 10.1007/s40279-015-0431-7 .
  12. 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 . The Journal of Physiology . 593 . 18 . 4285–301 . 2015 . 26174323 . 4594298 . 10.1113/JP270570 .
  13. Yamane M, Ohnishi N, Matsumoto T . Does Regular Post-exercise Cold Application Attenuate Trained Muscle Adaptation? . Int J Sports Med . July 2015 . 36 . 8 . 647–53 . 10.1055/s-0034-1398652 . 25760154. 19934538 .
  14. 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 . November 1, 2019 . 127 . 5 . 1403–1418 . 10.1152/japplphysiol.00127.2019 . 31513450 . 2 April 2023. 10536/DRO/DU:30129996 . 202569354 . free .
  15. News: Julie Carft. Image is Heavy Burden – Weightlifter Karyn Marshall Feels Pressure to Project 'Femininity, Intelligence'. Los Angeles Times. July 29, 1989. 2009-10-02.
  16. News: Andy Schmitz . USA Triathlon . 8 Ice Bath Dos and Don'ts . Active.com . DO: Be aware that moving water is colder water. . 2011-08-14.
  17. News: Lenny Bernstein . Recovering from high-intensity athletics . Washington Post . ...you want to keep those tired muscles limber. . November 9, 2010 . 2011-08-13.
  18. News: Stephen Mirarchi . Owner's Manual: Chill Out: Better recovery with ice baths . Running Times Magazine . ... First, immersion allows controlled, even constriction around all muscles, effectively closing microscopic damage that cannot be felt and numbing the pain that can. ... . September 2006 . 2011-08-14 . https://web.archive.org/web/20120522191620/http://www.runningtimes.com/Article.aspx?ArticleID=8731 . 2012-05-22 . dead .
  19. News: Ellie Levenson . It's hot to be cold . The Guardian . Not only has recent research from the Scripps Research Institute in California shown that reducing the core body temperature of mice makes them live for longer... . 21 November 2006 . 2011-08-13 . London.
  20. Bleakley C, McDonough S, Gardner E, Baxter GD, Hopkins JT, Davison GW . Cold-water immersion (cryotherapy) for preventing and treating muscle soreness after exercise . Cochrane Database Syst Rev . 2 . CD008262 . 2012 . 2012 . 22336838 . 10.1002/14651858.CD008262.pub2 . Systematic review. 6492480 .
  21. Higgins TR, Greene DA, Baker MK . Effects of Cold Water Immersion and Contrast Water Therapy for Recovery From Team Sport: A Systematic Review and Meta-analysis . J Strength Cond Res . 31 . 5 . 1443–1460 . May 2017 . 27398915 . 10.1519/JSC.0000000000001559 . 36435842 .
  22. Alec . Piñero . Ryan . Burke . Francesca . Augustin . Adam E. . Mohan . Kareen . DeJesus . Max . Sapuppo . Max . Weisenthal . Max . Coleman . Patroklos . Androulakis-Korakakis . Jozo . Grgic . Paul A. . Swinton . Brad J. . Schoenfeld . Throwing cold water on muscle growth: A systematic review with meta-analysis of the effects of postexercise cold water immersion on resistance training-induced hypertrophy . European Journal of Sport Science. February 5, 2024 . Early View . 2 . 177–189 . 10.1002/ejsc.12074 . free .
  23. Wittmers LE . Pathophysiology of cold exposure . Minnesota Medicine . 84 . 11 . 30–6 . 2001 . 11816961 .
  24. News: James Randerson . Study pours cold water on theory that ice aids recovery . The Guardian . But Australian scientists have discovered that not only does the modern treatment have no effect – it may do more harm than good. . 10 July 2007 . 2011-08-13 . London.
  25. News: Craig Smith . The cold benefits of ice baths . BBC News . In simple terms, it's about helping the muscles, tendons, bones, nerves and all the different tissues used in sport recover from their workout. . 2003-09-30 . 2011-08-14.
  26. News: George Guerin . Shoveling snow again? Try some of these tips to ease those aches and pains . Newark Star-Ledger . If you have been shoveling ... Ice Bath: An ice bath ... can help reduce muscle soreness. This is extremely popular in athletic locker rooms, sometimes even mandatory after rigorous exercise. . January 27, 2011 . 2011-08-13 . https://web.archive.org/web/20110130193610/http://blog.nj.com/fitness/2011/01/shoveling_snow_again_try_some_of_these_tips_to_ease_those_aches_and_pains.html . January 30, 2011 . dead .
  27. News: NewsCore . Experts Pour Cold Water on Athletes' Ice-Bath Remedy . Fox Boston . ... the grueling ritual of the ice bath could reduce the benefits of exercise. ... . 4 Nov 2010 . 2011-08-14.
  28. Vaile JM, Gill ND, Blazevich AJ . The effect of contrast water therapy on symptoms of delayed onset muscle soreness . Journal of Strength and Conditioning Research . 21 . 3 . 697–702 . 2007 . 17685683 . 10.1519/R-19355.1 . 26030186 .
  29. News: KAREN CROUSE . With One Last Gold, Phelps Caps Career That Inspired a Generation . The New York Times . ...It is because of Phelps that swimmers like Franklin think nothing of taking an ice bath to expedite their recovery. . August 4, 2012 . October 25, 2012.
  30. News: Sports star ice baths questioned . BBC News . British Journal of Sports Medicine now claims the opposite may be true. Out of 40 volunteers, those who took an icy plunge reported more pain after 24 hours than those who took a tepid bath. ... Ice baths have become one of the most fashionable ways of recovering after an intense game or marathon. From rugby to tennis players, the bath has a series of celebrity endorsers. . 10 July 2007 . 2011-08-14.
  31. News: Elizabeth Quinn . After Exercise – Does an Ice Water Bath Speed Recovery? . About.com . After Exercise Ice Bath – Does It Help Recovery? . September 30, 2008 . 2011-08-14.
  32. Gordon McKerrow Ryan Babel . Rough diamond: Liverpool's Babel reflects on Ajax, Benítez, ice baths . Sports Illustrated . ... After a match we have to stand in an ice bath for five minutes. ... . April 2, 2008 . 2011-08-14.
  33. News: Mike Brown . Survival in the heat: The ice age: On hot days, teams mandate ice baths for athletes. . Tulsa World . About half of TU's football players take daily dips in water cooled to between 50 and 55 degrees. ... The muscles start feeling a lot better. Aside from the obvious benefit of cooling down quickly from the heat, ice baths help the legs and muscles recover for the next practice. . August 15, 2007 . https://web.archive.org/web/20160222132937/https://www.highbeam.com/doc/1G1-167634653.html . dead. February 22, 2016 . October 25, 2012.
  34. News: Yael Averbuch . No Tweeting From the Ice Bath . The New York Times: Soccer . I tell my body to do a lot of things: Run one more sprint. Strike 50 balls. Push through just 15 more minutes. Warm up. Cool down. Sit in an excruciating ice bath. . 2011-04-28 . 2011-08-13.
  35. News: AJ Soares . This California boy welcomes opportunity to play in New England . The Boston Globe . Hello New England! I am AJ Soares, a new player, or employee as I tell people, at the New England Revolution. ... It's time for me to dip out, ice bath, and get ready to get to work again tomorrow with the team. . February 18, 2011 . 2011-08-14.
  36. Nikki Kimball . physical therapist . Ice Baths: Cold Therapy – Ice baths are one of the most effective ways to offset the damage done on a run. . Runner's World . One simple way to offset the risks inherent to long bouts of running is cold-water immersion, known to many runners as the ice bath. . August 1, 2008 . 2011-08-14 . dead. https://web.archive.org/web/20110823020734/http://www.runnersworld.com/article/0%2C7120%2Cs6-241-285--12810-0%2C00.html . August 23, 2011 .
  37. News: Photo Replay . The New York Times . Daniel Ianus of Romania's national rugby team took an ice bath after a training session ... . July 28, 2011 . 2011-08-13.
  38. News: Geoff Macdonald . How Do You Recover From 163 Games? . The New York Times: Tennis . ...the next smart move would be to take a full body ice bath. ... . June 24, 2010 . 2011-08-13.
  39. News: Tilman von der Linde . Speeding Up Muscle Recovery – Ice Bath Benefits . The Vancouver Sun . Many athletes ... have also discovered the benefits of the icy plunge. Pro Beach Volleyball Players and Marathon Runners have been asked to go stand in the ocean for a few minutes. ... . 25 Feb 2009 . 2011-08-14 . https://web.archive.org/web/20100506053749/http://communities.canada.com/VANCOUVERSUN/blogs/sunrunexperts/archive/2009/02/25/speeding-up-muscle-recovery-ice-bath-benefits.aspx . 6 May 2010 . dead .
  40. News: Cool ice bath innovation makes waves in sporting circles . The Irish Times . ... However the design of conventional ice baths leaves something to be desired. . June 24, 2011 . https://web.archive.org/web/20160225160541/https://www.highbeam.com/doc/1P2-28980865.html . dead. February 25, 2016 . October 25, 2012.
  41. August 14, 2014, Campbell North, Pittsburgh Post-Gazette, People around the country have ALS challenge down cold, Retrieved Aug. 18, 2014, "...Those who forgo the ice bath are asked to donate to an ALS organization..."
  42. Bill Saporito, Aug. 18, 2014, Time magazine, How the ALS Ice Bucket Challenge Could Change Fundraising Forever, Retrieved Aug. 18, 2014, "...Never mind the ice bath; you could have just written the check...."
  43. News: Sara Bauknecht . Rockettes manager strives to keep troupe fit and healthy . Pittsburgh Post-Gazette . How do the 200 Radio City Rockettes ... Taking ice baths ... some Rockettes take ice baths to unwind after a long day. . November 15, 2009 . 2011-08-13.
  44. News: Madonna sits in ice bath after concerts . Hindustan Times . After her live shows, Pop diva Madonna ... bath of ice to soothe the pain her body has endured after hours of performing on stage. . October 19, 2009 . https://web.archive.org/web/20161018231226/https://www.highbeam.com/doc/1P3-1882084821.html . dead. October 18, 2016 . October 25, 2012.
  45. News: Josh Rosenfeld . Westfield 30, Elizabeth 20 (High school Football scores and results) . The Star Ledger . Long after most of his teammates had departed Gary Kehler Stadium, A.J. Murray sat in a well-deserved ice bath in a large plastic tub while basking in the sunlight outside the Westfield training room. . October 2, 2010 . 2011-08-14.
  46. News: Darren Rovell of CNBC.com . Did a mistake in New Age ice bath set back NBA player? . . In November, Cleveland Cavaliers guard Manny Harris got into a Cryon-X machine on Nike's campus in Beaverton, Ore. When he came out, he had a nasty freezer burn on the side of his right foot. ... In just three minutes, the company that makes it, Millennium ICE, says the machine cranks the temperature inside to minus 166 degrees Fahrenheit, thus oxygenating the blood, helping to reduce fatigue and muscle soreness. . January 1, 2012 . October 25, 2012.
  47. News: Julie Deardorff . Health myths your doctor may believe . . 5 percent said children can be given an ice bath to treat a fever – Risk: hypothermia . May 2, 2010 . 2011-08-13 . 2018-10-09 . https://web.archive.org/web/20181009034533/http://featuresblogs.chicagotribune.com/features_julieshealthclub/myths/ . dead .
  48. Web site: Iceman on Everest: 'It Was Easy'. Angier. Joseph. ABC News. 14 April 2009. 18 March 2020.
  49. Web site: Young. Trystan. 4 January 2011. Chilly Chinese compete for world ice bathing record. 18 March 2020. BBC News. Adobe Flash video.
  50. News: Ice bath for 120 minutes. Xinhua News Agency. Sina Corp. 4 January 2011. 18 March 2020.
  51. Web site: danrawdon . 2023-01-06 . Why Dr. Huberman, Joe Rogan and Aubury Marcus Love Cold Therapy Ice Baths . 2023-01-18 . Ice Bath Info . en-US.
  52. Maranda . Eric . Simmons . Brian J. . Romanelli . Paolo . 2016-06-01 . Cryotherapy—As Ancient as the Pharaohs . JAMA Dermatology . en . 152 . 6 . 730 . 10.1001/jamadermatol.2015.1616 . 27276355 . 2168-6068.
  53. Wang . H. . Olivero . W. . Wang . D. . Lanzino . G. . May 2006 . Cold as a therapeutic agent . Acta Neurochirurgica . en . 148 . 5 . 565–570 . 10.1007/s00701-006-0747-z . 16489500 . 25885634 . 0001-6268.
  54. Web site: 2021-05-11 . The strange history of therapeutic hypothermia . 2023-08-26 . www.medicalnewstoday.com . en.
  55. Allan . Robert . Malone . James . Alexander . Jill . Vorajee . Salahuddin . Ihsan . Mohammed . Gregson . Warren . Kwiecien . Susan . Mawhinney . Chris . May 2022 . Cold for centuries: a brief history of cryotherapies to improve health, injury and post-exercise recovery . European Journal of Applied Physiology . en . 122 . 5 . 1153–1162 . 10.1007/s00421-022-04915-5 . 1439-6319 . 9012715 . 35195747.

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