Key Takeaway
Cold-water immersion is more effective than active recovery, contrast water therapy, and warm water immersion for post-exercise recovery, particularly for reducing muscle soreness.
Summary
This systematic review and meta-analysis of 28 studies compared cold-water immersion (CWI) against other common recovery modalities following acute strenuous exercise in physically active participants. Seven databases were searched through September 2022.
CWI demonstrated superior effectiveness for muscle soreness recovery compared to active recovery, contrast water therapy, and warm-water immersion. For muscular power and flexibility recovery, CWI was comparable to other methods. Air cryotherapy outperformed CWI for strength recovery and immediate post-exercise power recovery.
Meta-regression revealed that water temperature and exposure duration rarely emerged as significant moderating factors, suggesting CWI's benefits are relatively robust across typical protocol variations. The authors conclude CWI is an effective approach for promoting recovery following acute strenuous exercise.
Methods
- Systematic review with meta-analysis and meta-regression
- 28 studies included comparing CWI to alternative recovery methods
- Searched 7 databases: MEDLINE, SPORTDiscus, Scopus, Web of Science, Cochrane Library, EmCare, Embase
- Physically active participants only
- Outcomes: muscular power, strength, flexibility, soreness, creatine kinase
Key Results
- CWI superior to active recovery, contrast water therapy, and warm-water immersion for muscle soreness
- CWI comparable to other modalities for muscular power and flexibility
- Air cryotherapy outperformed CWI for strength recovery and immediate power recovery
- Water temperature and exposure duration were not significant moderators
Limitations
- Heterogeneous exercise protocols across included studies
- Primarily physically active populations — may not generalize to elite athletes or sedentary individuals
- Limited number of studies for some comparison pairs
- English-language studies only