Thursday, June 14, 2018

The Effect of Cold Water Immersion On Recovery



Today we will talk about the CWI (cold water immersion) therapy recently it becomes one of the popular recovery protocol in swimming field. Before I talked more about the CWI let me give a small introduction about the recovery.

 Recovery is one of the most important things in training, it used to minimize the risk of overtraining, injuries and it boost the enhancement process for the muscles tissues. And it becomes so important during the hard training or competition to sustain an optimal state of performance (Mair SD, Seaber AV, Glisson RR, Garrett WE 1996).

Consequently, we came up with many recovery protocols like massage therapy, foam rolling, compression garments, hyperbaric oxygen therapy, electrical stimulation, whole-body vibration and water immersion therapy (including: cold water, warm water, and contrast bathing).

When I planned to write in this topic I found out many mixing opinions and studies about the effect of CWI therapy for recovery in general and more specific studies about swimming, in my opinion, we need more specific studies in this topic to proof the effect of CWI therapy.

Cold water immersion (CWI), otherwise known as ice-baths, plunges pools and cold water therapy is a recovery process involving the immersion of the body into cold water (≤15˚C/59˚F) immediately after exercise in an attempt to enhance the recovery process (Bleakley, C., McDonough, S., Gardner, E., Baxter, G.D., Hopkins, J.T., & Davison, G.W. 2012).

In a study for Hohenauer E, Taeymans J, Baeyens J-P, Clarys P, Clijsen R (2015) on The Effect of Post-Exercise Cryotherapy on Recovery, in this study they test the effectiveness of CWI by measuring different factors:

Subjective Measures

•    DOMS (Delayed Onset of Muscle Soreness)
•    Ratings of Perceived Exertion (RPE)

Objective Measures

•    Creatine-kinase (CK)
•    Blood lactate-levels
•    Interleukines
•    C-reactive protein (CRP)

in a large quantity of research, CWI has been shown to consistently reduce the effects of DOMS and RPE. In a recent systematic review and meta-analysis, it was concluded that CWI is an effective protocol for reducing the effects of DOMS 24hrs, 48hrs, and 96hrs post-exercise. Moreover, it was also shown to reduce the symptoms of RPE 24hrs post-exercise. These results are also supported by an extensive review conducted by Bleakley and colleagues in 2012.

Whilst numerous research supports the use of CWI for reducing the effects of subjective measures post-exercise (i.e. DOMS and RPE), its effects on objective measures are far less apparent. CWI fails to improve objective measures of recovery (listed above).
And in another study discussing the Effect of cold water immersion on 100-m sprint performance in well-trained swimmers. (Parouty J1, Al Haddad H, Quod M, Leprêtre PM, Ahmaidi S, Buchheit M. 2010)

Despite a subjective perception of improved recovery following CWI, this recovery intervention resulted in slower swimming times in well-trained athletes swimming in simulated competition conditions. (The study showed the swimmers who performed the cold water immersion between races performed worse than swimmers who did not perform cold water immersions between races.)

Summary:

There is many about the cold water immersion protocols need to be known and more studies need to done to know the best protocols to use in order to improve recovery there is also mixed opinions and studies about the optimal temperature to induce maximal recovery effects, in summary, vertical full-body immersion into cold (≤15˚C/59˚F) to thermoneutral temperatures 34-35˚C (93-95˚F) for 11-15 minutes’ post-exercise appears to have a positive effect upon recovery.

References:

1.    Mair SD, Seaber AV, Glisson RR, Garrett WE (1996). The Role of Fatigue in Susceptibility to Acute Muscle Strain Injury. American Journal of Sports Medicine.24:137–143. [PubMed]

2.    Bleakley, C., McDonough, S., Gardner, E., Baxter, G.D., Hopkins, J.T., & Davison, G.W. (2012). Cold-water immersion (cryotherapy) for preventing and treating muscle soreness after exercise. Cochrane Database Syst Rev. 15(2). CD008262. [PubMed]

3.    Hohenauer E, Taeymans J, Baeyens J-P, Clarys P, Clijsen R (2015) The Effect of Post-Exercise Cryotherapy on Recovery Characteristics: A Systematic Review and Meta-Analysis. PLoS ONE 10(9): e0139028. doi:10.1371/journal.pone.0139028 [PubMed]

4.    Bieuzen, F., Bleakley, C.M., and Costello, J.T. (2013). Contrast Water Therapy and Exercise Induced Muscle Damage: A Systematic Review and Meta-Analysis. PLoS One, 8(4): e62356. [PubMed]

5.    Gregson, W., Black, M.A., Jones, H., Milson, J., and Morton J. (2011). Influence of cold water immersion on limb and cutaneous blood flow at rest. American Journal of Sports Medicine, 39: 1316–1323. [PubMed]

6.    Lee, H., Natsui, H., Akimoto, T., Yanagi, K., Ohshima, N. (2005). Effects of Cryotherapy after Contusion Using Real-Time Intravital Microscopy. Medicine and Science in Sports and Exercise, 37: 1093–1098. [PubMed]

7.    Thorlacius, H., Vollmar, B., Westermann, S., Torkvist, L., Menger, M.D. (1998). Effects of local cooling on microvascular hemodynamics and leukocyte adhesion in the striated muscle of hamsters. J Trauma, 45: 715–719. [PubMed]

8.    Algafly AA, George KP (2007) The effect of cryotherapy on nerve conduction velocity, pain threshold and pain tolerance. Br J Sports Med 41: 365–369; discussion 369. [PubMed]

9.    Wilcock, I.M., Cronin, J.B., and Hing, W.A., (2006). Physiological response to water immersion: A method of recovery? Sports Medicine, 36(9), pp.747-765. [PubMed]

10.Eston R, Peters D (1999) Effects of cold water immersion on the symptoms of exercise-induced muscle damage. J Sports Sci 17: 231–238. [PubMed]

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

12.Kuligowski LA, Lephart SM, Giannantonio FP, Blanc RO (1998). Effect of whirlpool therapy on the signs and symptoms of delayed-onset muscle soreness. J Athl Train 33: 222–228. [PubMed]

13.Kraemer WJ, Bush JA, Wickham RB, Denegar CR, Gomez AL, et al. (2001) Influence of compression therapy on symptoms following soft tissue injury from maximal eccentric exercise. J Orthop Sports Phys Ther 31: 282–290. [PubMed]

14.Clarkson PM, Hubal MJ (2002) Exercise-induced muscle damage in humans. Am J Phys Med Rehabil 81: S52–69. [PubMed]

15.Leeder J, Gissane C, van Someren K, Gregson W, Howatson G (2012) Cold water immersion and recovery from strenuous exercise: a meta-analysis. Br J Sports Med 46: 233–240. [PubMed]

16.Torres-Ronda, L., & del Alcázar, X. S. i. (2014). The Properties of Water and their Applications for Training.Journal of Human Kinetics44, 237–248. [PubMed]

17.Yamane M, Teruya H, Nakano M, Ogai R, Ohnishi N, Kosaka M. Postexercise 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: 572–580. [PubMed]

18.Yamane M, Ohnishi N, Matsumoto T. Does Regular Post-exercise Cold Application Attenuate Trained Muscle Adaptation? Int J Sports Med 2015; 36: 647–653. [PubMed]

19.Frohlich, M, Faude, O, Klein, M, Pieter, A, Emrich, E, and Meyer, T. Strength training adaptations after cold-water immersion. J Strength Cond Res 28(9): 2628–2633, 2014. [PubMed]

20.Halson, S.L., Quod, M.J., Martin, D.T., Gardner, A.S., Ebert, T.R. & Laursen, P.B. (2008) Physiological responses to cold water immersion following cycling in the heat. International Journal of Sports Physiology and Performance. Vol. 3, No. 3: 331–46. [PubMed]

21.Ihsan M, Markworth JF, Watson G, Choo HC, Govus A, Pham T, Hickey A, Cameron-Smith D, Abbiss CR. Regular postexercise cooling enhances mitochondrial biogenesis through AMPK and p38 MAPK in human skeletal muscle. Am J Physiol Regul Integr Comp Physiol. 2015 Aug 1;309(3):R286-94. [PubMed]

22.Machado AF, Ferreira PH, Micheletti JK, Almeida AC, Lemes IR, Vanderlei FM, Junior JN, 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 Med (2016) 46:503–514. [PubMed]

23. Eur J Appl Physiol. 2010 Jun;109(3):483-90. doi: 10.1007/s00421-010-1381-2. Epub 2010 Feb 17. 
Effect of cold water immersion on 100-m sprint performance in well-trained swimmers.


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