Ice Baths as an aid to Recovery

ICE BATHS AS AN AID TO RECOVERY

In simple terms, it's about helping the muscles, tendons, bones, nerves and all the different tissues used in sport recover from their workout.

Just like Michael Schumacher's car needs a complete overhaul with new parts and tyres after a Formula One race, the body needs to service itself and its parts for the next day, next race or next match.

The body does this with the help of the blood vessels that bring oxygen to the tissues and remove the waste products of exercise, the most common being lactic acid.

Too much lactic acid build up can cause the muscles to function poorly and over a long period of time feelings of fatigue, heavy legs and general tiredness can set in.

So how do ice baths help to boost the body's recovery processes and prevent injury?

The Scientific Theory

The theory behind ice baths is related the fact that intense exercise actually causes microtrauma, or tiny tears in muscle fibers. This muscle damage not only stimulates muscle cell activity and helps repair the damage and strengthen the muscles ( muscle hypertrophy), but it is also linked with delayed onset muscle pain and soreness (DOMS) , which occurs between 24 and 72 hours after exercise.

 The ice bath is thought to:

• Constrict blood vessels and flush waste products, like lactic acid, out of the affected tissues
• Decrease metabolic activity and slow down physiological processes
• Reduce swelling and tissue breakdown

Then, with rewarming, the increased blood flow speeds circulation, and in turn, improves the healing process. Although there is no current protocol regarding the ideal time and temperature for cold immersion routines, most athletes or trainers who use them recommend a water temperature between 12 to 15 degrees Celsius and immersion times of 5 to 10 and sometimes up to 20 minutes.

So, while that’s the theory behind the cold water immersion for exercise recovery, conclusive research about the pros, cons and ideal time and temperatures is still a ways off.

The Scientific Research

Of the studies that have looked at the effects of ice baths, cold water immersion and contrast water therapy on exercise recovery and muscle soreness, most offer inconclusive or contradictory findings.

One study from the July 2008 issue of the International Journal of Sports Medicine found cold water immersion and contrast water therapy may help recovery from short maximal efforts, or during events like stage races where athletes repeat high-intensity efforts on successive days. In this study, researchers had cyclists complete a week of intense daily training routines. After each workout, they used one of four different recovery methods and took nine days off between each week of workouts.

The four recovery methods included:

1. Immersion in a 15 degree C (59 degree F) pool for 14 minutes;
2. Immersion in 38 degree C (100.4 degree F) water for 14 minutes;
3. Alternating between cool and hot water every minute for 14 minutes;
4. 14 minutes of complete rest.

They reported that the cyclists performed better in the sprint and time trial after cool water immersion and contrast water therapy, but their performance declined with both hot water baths and complete rest.

Another study published in the 2007 British Journal of Sports Medicine found that ice-water immersion offered no real benefit and, in fact, may increase post-exercise muscle soreness after heavy weight training. In this study the researchers compared 1-min immersions in either an ice bath (5 degrees Celsius) or a tepid bath (24 degrees Celsius) following an intense workout.

They found that the athletes who used the ice baths reported no difference in physical pain measurements such as swelling or tenderness. The athletes did, however, report more leg pain the following day, when going from a sitting to a standing position than those who had the tepid water bath treatment. According to the researchers, "Ice-water immersion offers no benefit for pain, swelling, isometric strength and function, and in fact may make more athletes sore the next day."

In 2007, a study from the Journal of Strength and Conditioning Research looked at the effect of contrast water therapy on delayed onset muscle soreness after intense leg press exercise. They found a smaller reduction, and faster restoration, of strength and power in athletes using contrast water therapy than those using passive recovery.

Real World Recommendations

It's clear that more research is needed before a real conclusion can be made, but so far the information that is available indicates the following:

• Cold water immersion after a hard workout won't hurt and may, in fact, help recovery.
• Alternating Cold water and warm water baths (contract water therapy) may also help athletes recover.
• Ice baths are not necessary; cold water baths (24 degrees Celsius) are as good and perhaps better, than ice baths.
• Active recovery may be as good as cold water immersion for exercise recovery.
• Passive recovery is not an effective way to recover.
• Hot baths after hard exercise may decrease recovery time.

Cold Water Therapy - How to Do It

Cold Water Immersion 
If you are going to try cool or cold water immersion after exercise, don't overdo it. Ten minutes immersed in 15 degree Celsius water should be enough time to get the benefit and avoid the risks. Because cold can make muscles tense and stiff, it's a good idea to fully warm up about 30 to 60 minutes later with a warm shower or a hot drink.

Contrast Water Therapy (Hot-Cold Bath)
If you prefer alternating hot and cold baths, the most common method includes one minute in a cold tub (10-15 degrees Celsius) and two minutes a hot tub (about 37-40 degrees Celsius), repeated about 3 times.

Whether the science supports the ice bath theory or not, many athletes swear that an ice bath after intense training helps them recover faster, prevent injury and just feel better.

DO'S and DON'TS

• DO: Be conservative with water temperature as you get started. Most rehabilitation specialists recommend a water temperature between 54-60 degrees Fahrenheit. Consider starting a bit higher and inch this downward a degree or two each exposure.
• DO: Recognize that each individual will have his or her own cold threshold. Play within your personal comfort zone, and consider investing in booties (toe warmers made of wetsuit material) as your toes are likely the most sensitive body part to be submerged.
• DON'T: Overexpose! At the recommended temperature range above, 6-8 minutes should be sufficient. Unless supervised or you have history with ice baths, do not exceed 10 minutes.
• DON'T: Assume colder is better. Spending a prolonged period of time in water colder than 54 degrees could be dangerous.
• DO: Be aware that moving water is colder water. Much like the wind chill created when you ride, if there are jets in your ice bath and the water that is warmed at the skin's surface gets pushed away, the resulting impact of the water will be cooler than measured by the thermometer.
• DON'T: Assume 54-60 degrees or bust. Cool water (say, 60-75 degrees) can still be beneficial -- as can active recovery (very light exercise to facilitate blood flow to musculature)
• DO: Seek to simplify. Building a personal ice bath daily can be a daunting task. Look for a gym that has a cold plunge, or if you live close to a river, lake or the ocean, keep tabs on the current water temperature.
• DON'T: Rush to take a warm shower immediately after the ice bath. The residual cooling effect and gradual warming are ideal. Consider initial warming options of a sweatshirt, blanket and/or warm drink... but DO take the shower if you are unable to warm yourself.