Cold water after exercise eased muscle soreness across 17 small trials
The 2012 Cochrane review of ice baths for muscle soreness pooled 17 trials with 366 participants and rated the evidence low in quality.
The paper
Cold-water immersion (cryotherapy) for preventing and treating muscle soreness after exercise
Bleakley C, McDonough S, Gardner E, Baxter GD, et al.. Cochrane Database of Systematic Reviews, 2012;2012(2).
See the study at a glance
- Design
- Cochrane systematic review with meta-analysis
- People
- 17 trials, 366 people
- Who they were
- People in 17 small trials who were made sore with exercise.
- What they did
- Trials immersed people in water colder than 15°C after exercise, and protocols varied from trial to trial. Fourteen trials compared cold water with passive rest.
- How long
- Up to 96 hours after exercise
These numbers came out of it
−0.55
Across 10 trials, cold water beat passive rest on soreness at 24 hours. Standardizing the difference lets trials that used different pain scales be pooled.
−0.93
Four trials that measured soreness at 72 hours put the standardized difference in favor of cold water at 0.93.
−1.70
In 2 studies, fatigue ratings right after exercise came out 1.70 points lower on a 10-point scale.
366
The 17 trials enrolled 366 people between them.
The researchers did this
The Cochrane team searched for trials of cold-water immersion after exercise up to November 2011 and found 17 small trials with 366 participants in total.Source 1 · Systematic reviewCold-water immersion (cryotherapy) for preventing and treating muscle soreness after exerciseBleakley C, McDonough S, Gardner E, et al.. Cochrane Database of Systematic Reviews, 2012.Read the paper ↗PubMed ↗ The water was colder than 15°C, and protocols varied from trial to trial. Most trials compared cold water with passive rest, and a few compared it with contrast baths, warm water, active recovery or compression.
Cold water left people less sore than passive rest. At 24 hours the standardized mean difference was −0.55 across 10 trials, and at 48 hours it was −0.66 across 8.Source 1 · Systematic reviewCold-water immersion (cryotherapy) for preventing and treating muscle soreness after exerciseBleakley C, McDonough S, Gardner E, et al.. Cochrane Database of Systematic Reviews, 2012.Read the paper ↗PubMed ↗ Four trials measured 72 hours and put it at −0.93, and five that went to 96 hours found −0.58. The trials didn't all agree. Two studies found fatigue ratings 1.70 points lower on a 10-point scale right after immersion.
Against contrast immersion or warm water, cold water did no better.Source 1 · Systematic reviewCold-water immersion (cryotherapy) for preventing and treating muscle soreness after exerciseBleakley C, McDonough S, Gardner E, et al.. Cochrane Database of Systematic Reviews, 2012.Read the paper ↗PubMed ↗ The authors rated the trials low in quality. Most trials didn't actively watch for side effects, so the review could say little about harms.
A 2016 meta-analysis later put similar soreness effects on a 0–10 scale and found cold water ahead of passive recovery by about 0.3 points.Source 2 · Meta-analysisCan Water Temperature and Immersion Time Influence the Effect of Cold Water Immersion on Muscle Soreness? A Systematic Review and Meta-AnalysisMachado AF, Ferreira PH, Micheletti JK, et al.. Sports Medicine, 2016.Read the paper ↗PubMed ↗
The study can't tell you these things
- The trials were small and low in quality, and people always knew whether they were in cold water.
- People rate their own soreness, so expectations can color the scores.
- Protocols varied too much for the review to name a best temperature or duration.
- Standardized differences don't convert directly into points of pain. A later analysis put the gain at about 0.3 points out of 10.Source 2 · Meta-analysisCan Water Temperature and Immersion Time Influence the Effect of Cold Water Immersion on Muscle Soreness? A Systematic Review and Meta-AnalysisMachado AF, Ferreira PH, Micheletti JK, et al.. Sports Medicine, 2016.Read the paper ↗PubMed ↗
People quote it like this
The review supports the idea that cold water eases soreness after exercise. Its authors rated the trials low in quality, and a later analysis put the benefit at about 0.3 points on a 0–10 scale.Source 2 · Meta-analysisCan Water Temperature and Immersion Time Influence the Effect of Cold Water Immersion on Muscle Soreness? A Systematic Review and Meta-AnalysisMachado AF, Ferreira PH, Micheletti JK, et al.. Sports Medicine, 2016.Read the paper ↗PubMed ↗
From our sister magazine
Sauna Monthly explains how to time a plunge around training
We cited these sources
- 01Bleakley 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 of Systematic Reviews. 2012;2012(2). doi:10.1002/14651858.CD008262.pub2 PMID 22336838
- 02Machado AF, Ferreira PH, Micheletti JK, de Almeida AC, Lemes ÍR, Vanderlei FM, et al.. Can Water Temperature and Immersion Time Influence the Effect of Cold Water Immersion on Muscle Soreness? A Systematic Review and Meta-Analysis. Sports Medicine. 2016;46(4):503-514. doi:10.1007/s40279-015-0431-7 PMID 26581833