As physical therapists at Made 2 Move, we get asked all the time: "Should I be doing cryotherapy or taking ice baths?"
Does cold therapy speed up or inhibit recovery?
Cryotherapy, cold water immersion, ice baths - this new trend is EVERYWHERE! If you haven’t already tried it yourself, you probably have a friend that’s been begging you to join them.
With claims that cold water immersion and cryotherapy actually “speed up” recovery - there’s some *cool* evidence about the short term effects (hours after exercise) of cold therapy.
But what about the long term effects?
Disclaimer: There’s a lot of different reasons people use cold therapy, and we’re big believers in becoming more resilient to stress and learning how to modify our responses in stressful situations, so let’s approach this from a strictly muscle recovery/strength perspective when using cold water immersion after exercise.
Like anything in health, it’s complicated, and it always depends on the situation, the individual, and the goal of the treatment.
Let’s get into it.
The whole basis of the claims behind cold therapy for recovery purposes is that it “reduces inflammation” and speeds up recovery in the short term.
Cold water immersion has been shown to reduce soreness after exercise - and the reason is because it decreases our body’s post-exercise inflammatory and immune responses.
The thing is… after a workout, that acute inflammation process is a natural, necessary, and helpful thing that our body does, so we don’t want to halt it.
Post-exercise inflammatory and immune responses are what lead to long term repair, recovery, and adaptation.
Sooo… the things that make cold therapy supposedly great for muscle soreness and recovery in the short term may actually be hurting us in the long term. Oops.
This study found that “cold water immersion during recovery from resistance-type exercise reduces myofibrillar protein synthesis rates and, as such, probably impairs muscle conditioning” and that “individuals aiming to improve skeletal muscle conditioning should reconsider applying cooling as a part of their post-exercise recovery strategy.” (Fuchs 2o2o).
Another long term study claims that “The regular use of CWI associated with exercise programs has a deleterious effect on resistance training adaptations.” (deleterious does not sound good huh?) (Malta 2021).
If you’re trying to reduce short-term soreness, markers of muscle damage/high intensity exercise, and inflammation with cold water baths during competitions, then keep at it.
But… those short term effects may be just that - short term.
If you’re using these treatments long-term, as a regular part of training…
You may actually be halting your adaptation response… which is probably a huge part of why we’re training - to get a result.
Remember: Stress + Recovery = Adaptation, meaning that by exposing ourselves to controlled, dosed amounts of stress (strength training, for example) followed by ADEQUATE RECOVERY, our bodies adapt to become more prepared for that stress (aka you get stronger)
Personally…if I’m putting in WORK in the gym… I don’t want to do anything that decreases my chances of adaptation. I worked hard for this! There’s a reason our bodies respond the way they do, and it seems like everything these days is trying to “speed up” a natural process just so they can get back to training or push harder.
While recovering quicker may get you back in the gym for another session, trying to speed up recovery might actually be hurting you in the long term. Another short cut that may be too good to be true. Now I can already hear it…
“Cold therapy allows me to push harder in the gym without getting injured”
Okayyy so now we’re admitting to purposefully placing more stress on our bodies than they’re prepared for, and hoping a quick ice bath saves us from our sins. Sounds like a really amazing hangover cure tbh. Instead, what if we dose exercise and stress appropriately so that you feel good, can keep training forever, reduce injuries, and get results without feeling beat up all the time. Hmm..
All in all, if you swear by your cryotherapy or cold water immersion, that’s totally fine! Just be aware of the potential long term effects and if possible, space it out far away from your resistance training sessions.
It is NOT something you “have” to do to be healthy. There are other ways to become resilient to stress. There are other ways to promote recovery. Plus… it might actually decrease your adaptation in the long term.
If you’re going to use something, it’s always important to be aware of its true long term effects.
Fuchs, Cas J., et al. "Postexercise cooling impairs muscle protein synthesis rates in recreational athletes." The Journal of physiology 598.4 (2020): 755-772.
Malta ES, Dutra YM, Broatch JR, Bishop DJ, Zagatto AM. The Effects of Regular Cold-Water Immersion Use on Training-Induced Changes in Strength and Endurance Performance: A Systematic Review with Meta-Analysis. Sports Med. 2021 Jan;51(1):161-174. doi: 10.1007/s40279-020-01362-0. PMID: 33146851.