In sports therapy, an ice bath, or sometimes cold-water immersion, Cold plunge or cold therapy, is a training regimen usually following a period of intense exercise [1] [2] in which a substantial part of a human body is immersed in a bath of ice or ice-water for a limited duration. [3]
The method is controversial, [4] with a risk of hypothermia, [5] with the possibility of shock [6] leading to sudden death. [5] [7] [8] Many athletes have used cold water immersion after an intense exercise workout in the belief that it speeds up bodily recovery; however, the internal physical processes are not well understood and remain elusive. [9] Evidence supporting cold water immersion as part of an athletic training has been mixed, [10] with some studies suggesting a mild benefit such as reducing muscle damage and discomfort [11] and alleviating delayed onset muscle soreness, [12] [13] [14] with other studies suggesting that cold water immersion may slow muscle growth and interfere with an overall training regimen. [15] [16] [17]
It is done by standing or sitting in a bucket or bath of icy water. One writer advised: "don't overdo it." [18] Wearing rubberized "dive booties" on the feet (to protect toes) as well as rubber briefs to warm the midsection have been recommended. Champion weightlifter Karyn Marshall, who won the world women's weightlifting championship in 1987, [19] described what it was like to take an ice bath after a day of competition at the CrossFit Games in 2011 in Los Angeles:
The first day I went in for twelve minutes, and the second day for fifteen minutes. They kept adding ice to keep the temperature at around 55 degrees (Fahrenheit) ... The hardest part was the first two minutes. Others who do it often told me to just hang in for two minutes and then it would be easier. After two minutes I was numb. Afterwards I was shivering for two hours in the hot California sun with a warm up jacket on.
— Karyn Marshall, 2011
One report suggested that if ice water is circulating, it is even colder such that the water will be colder than measured by a thermometer, and that athletes should avoid overexposure. [20] Physical therapist Nikki Kimball explained a way to make the bath more endurable:
Over those years, I've discovered tricks to make the ice bath experience more tolerable. First, I fill my tub with two to three bags of crushed ice. Then I add cold water to a height that will cover me nearly to my waist when I sit in the tub. Before getting in, I put on a down jacket and a hat and neoprene booties, make myself a cup of hot tea, and collect some entertaining reading material to help the next 15 to 20 minutes pass quickly.
— Runner's World, 2008 [21]
Some athletes use a technique known as contrast water therapy or contrast bath therapy, in which cold water and warmer water are alternated. [18] One method of doing this was to have two tubs––one cold (10–15 degrees Celsius) and another hot (37–40 degrees Celsius)––and to do one minute in the cold tub followed by two minutes in a hot tub, and to repeat this procedure three times. [18]
The temperature can vary, but is usually in the range of 50–59 degrees Fahrenheit [22] [21] or between 10 and 15 degrees Celsius. [18] [23] Some athletes wear booties to keep their toes warm [22] or rubberized coverings around their midsection while immersed. Some drink a warm beverage such as tea. [22] One report suggested that "ten minutes immersed in 15 degree Celsius water" was sufficient. [18]
Accounts vary about how long to be immersed and how often to do them. One adviser suggested that an athlete should take ten two-minute ice bath treatments over a two-week period. [24] One account suggested immersion times should be between ten and twenty minutes. [21] Another suggested that immersion run from five to ten minutes, and sometimes to twenty minutes. [18] There were no sources advocating being immersed for longer than twenty minutes.
Several sources suggest that cold baths (60–75 °F, 16–24 °C) were preferable to ice baths. Physiotherapist Tony Wilson of the University of Southampton said that extremely cold temperatures were unnecessary and a "cold bath" would be just as effective as an ice bath. [24] Another agreed that a mere cold bath is preferable to ice baths which are "unnecessary." [18] A third report suggested that cool water (60–75 °F, 16–24 °C) was just as good as water at a lower temperature (54–60 °F, 12–16 °C) and that eight to ten minutes should be sufficient time, and warned against exceeding ten minutes. [20]
After exercise, there is some evidence that taking an ice bath may reduce delayed onset muscle soreness and perceptions of fatigue, but no good evidence of any other benefit. [13] [25]
A 2024 meta-analysis of controlled trials concluded that cold water immersion immediately following resistance training may blunt the ensuing muscle hypertrophy, although the authors cautioned that their conclusion was uncertain due to the relatively fair to poor quality of the underlying studies. [26]
There is agreement in the medical and scientific communities that ice baths can pose serious risks to health. Risks include hypothermia, [5] shock [6] and the possibility of sudden cardiac death. [5] [7] [8] [27]
Marathon runner Paula Radcliffe won the 10,000m event at the 2002 European championships and attributed her victory to the use of ice baths. [28] She reportedly said "It's absolute agony, and I dread it, but it allows my body to recover so much more quickly." [29] She reported taking ice baths before racing and preferred her pre-race bath temperature to be "very cold." [24] After the Radcliffe comment, the technique has grown in popularity. [28] It is gaining in popularity among athletes, [22] [30] [28] such that some athletes "swear by it" [28] [31] [32] but other accounts suggest it may be a fad. [24] [28]
It has been used by athletes such as A. J. Soares [33] and Olympic swimmer Michael Phelps [34] as well as other celebrity endorsers [35] and is getting to become "common practice" among athletes [18] [32] [36] from different sports, including American football, [37] association football (soccer), [2] [33] long distance running, [22] [4] [21] rugby, [1] [28] tennis, [38] volleyball, [39] and other sports. There was a report that sports equipment manufacturers are considering different designs for ice baths. [40] In the summer of 2014, as a fundraising method, the nonprofit ALS Association, which raises money for research and public awareness of amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, began the Ice Bucket Challenge which involved donors filming themselves and challenging other donors to participate and then being doused with a bucket of ice cold water; as a fundraising effort, it raised $16 million over a 22-day period. [41] [42]
There are indications that ice baths may be gaining popularity with groups outside sports, such as dance. The Pittsburgh Post-Gazette reported that some Radio City Rockettes, a precision dance company performing in New York City, use ice baths after a long day of performing as a way to "unwind" and cope with "aches and pains." [43] One report suggested that entertainer Madonna used ice baths after her performances. [44] And there are indications that use of ice baths is spreading to amateur sports, such as high school football. [45]
Explorer and athlete Fiann Paul is known for using ice baths as part of his training routine. [46]
Ice baths are a part of a broader phenomenon known as cryotherapy—the Greek word cryo (κρυο) means cold—which describes a variety of treatments when cold temperatures are used therapeutically. Cryotherapy includes procedures where a person is placed in a room with "cold, dry air at temperatures as low as −135 °C" for short periods of time, and which has been used in hospitals in Poland as well as a center in London to treat not only muscular ailments, but psychological problems such as depression. [24] Basketball player Manny Harris reportedly used a Cryon-X machine featuring extreme low temperatures around minus 166 degrees Fahrenheit, but used it with wet socks resulting in a serious freezer burn. [47]
Occasionally ice baths have been an ill-advised treatment of fever in young children, but that doctors were counseled not to use this technique because of the risk of hypothermia. [48] Ice baths have been suggested as a way to prevent muscle soreness after shoveling snow. [30]
In addition, there have been instances of ice bathing as an extreme bodily test by persons vying for an endurance record, such as Dutch Iceman Wim Hof, [49] and Chinese record-holders Chen Kecai [50] and Jin Songhao. [51] According to reports, doctors and scientists are studying how these people can spend an hour and a half submerged in an ice bath, and survive.
Ice baths began to become extremely popular after being discussed extensively by Joe Rogan and his universe of scientist and comedians such as Dr. Andrew Huberman (Stanford) and Aubury Marcus (Onnit). [52]
Ice baths, an activity within the practice of cryotherapy, has been predominately utilised for multiple decades for therapeutic purposes, typically for exercise recovery for athletes, and more recently for perceived mental health benefits, such as the alleviation of symptoms of mental health problems such as depression. Cryotherapy can be tracked "as far back as the Egyptians in 3000 BCE" as a wound treatment [53]
Cryotherapy can be dated back to ancient Greece, its first mention in an ancient Egyptian medical text Edwin Smith Papyrus that is believed to date to around 3500 BCE, [54] and furthermore through Hippocrates's theory of the four humours. [55] Although, when applying a historical perspective,cold-water immersion was used first as a form of socialisation and relaxation, before its physiological and psychological benefits were noted. [56]
The main medical treatments that Ancient Greeks employed the use of cold-water immersion for were fever, as the cold was thought to counteract the body's heat, [54] and for pain relief. The use of cold-water immersion for medical treatments for physiological symptoms continued until the late 1950s. In fact, it was not utilised for post-exercise recovery until the 1960s, by D H Clarke. [54] However, the use of cold-water immersion for post-exercise recovery and treatment is by far the most popular and well-known use of the technique, despite being the most recent.
Hypothermia is defined as a body core temperature below 35.0 °C (95.0 °F) in humans. Symptoms depend on the temperature. In mild hypothermia, there is shivering and mental confusion. In moderate hypothermia, shivering stops and confusion increases. In severe hypothermia, there may be hallucinations and paradoxical undressing, in which a person removes their clothing, as well as an increased risk of the heart stopping.
The rotator cuff is a group of muscles and their tendons that act to stabilize the human shoulder and allow for its extensive range of motion. Of the seven scapulohumeral muscles, four make up the rotator cuff. The four muscles are:
Diuresis is the excretion of urine, especially when excessive (polyuria). The term collectively denotes the physiologic processes underpinning increased urine production by the kidneys during maintenance of fluid balance.
The diving reflex, also known as the diving response and mammalian diving reflex, is a set of physiological responses to immersion that overrides the basic homeostatic reflexes, and is found in all air-breathing vertebrates studied to date. It optimizes respiration by preferentially distributing oxygen stores to the heart and brain, enabling submersion for an extended time.
Hydrotherapy, formerly called hydropathy and also called water cure, is a branch of alternative medicine, occupational therapy, and physiotherapy, that involves the use of water for pain relief and treatment. The term encompasses a broad range of approaches and therapeutic methods that take advantage of the physical properties of water, such as temperature and pressure, to stimulate blood circulation, and treat the symptoms of certain diseases.
Delayed onset muscle soreness (DOMS) is the pain and stiffness felt in muscles after unaccustomed or strenuous exercise. The soreness is felt most strongly 24 to 72 hours after the exercise. It is thought to be caused by eccentric (lengthening) exercise, which causes small-scale damage (microtrauma) to the muscle fibers. After such exercise, the muscle adapts rapidly to prevent muscle damage, and thereby soreness, if the exercise is repeated.
Cryotherapy, sometimes known as cold therapy, is the local or general use of low temperatures in medical therapy. Cryotherapy can be used in many ways, including whole body exposure for therapeutic health benefits or may be used locally to treat a variety of tissue lesions.
Cooling down is the transition from intense physical activity to a more typical activity level. Depending on the intensity of the exercise, cooling down after a workout method, such as intense weightlifting, can involve a slow jog or walk.
Diving disorders, or diving related medical conditions, are conditions associated with underwater diving, and include both conditions unique to underwater diving, and those that also occur during other activities. This second group further divides conditions caused by exposure to ambient pressures significantly different from surface atmospheric pressure, and a range of conditions caused by general environment and equipment associated with diving activities.
A sitz bath or hip bath is a bathtub in which a person sits in water up to the hips. It is used to relieve discomfort and pain in the lower part of the body, for example, due to hemorrhoids (piles), anal fissures, perianal fistulas, rectal surgery, an episiotomy, uterine cramps, inflammatory bowel disease, pilonidal cysts and infections of the bladder, prostate or vagina. It works by keeping the affected area clean and increasing the flow of blood to it.
Electrical muscle stimulation (EMS), also known as neuromuscular electrical stimulation (NMES) or electromyostimulation, is the elicitation of muscle contraction using electric impulses. EMS has received an increasing amount of attention in the last few years for many reasons: it can be utilized as a strength training tool for healthy subjects and athletes; it could be used as a rehabilitation and preventive tool for people who are partially or totally immobilized; it could be utilized as a testing tool for evaluating the neural and/or muscular function in vivo. EMS has been proven to be more beneficial before exercise and activity due to early muscle activation. Recent studies have found that electrostimulation has been proven to be ineffective during post exercise recovery and can even lead to an increase in Delayed onset muscle soreness (DOMS).
Heat therapy, also called thermotherapy, is the use of heat in therapy, such as for pain relief and health. It can take the form of a hot cloth, hot water bottle, ultrasound, heating pad, hydrocollator packs, whirlpool baths, cordless FIR heat therapy wraps, and others. It can be beneficial to those with arthritis and stiff muscles and injuries to the deep tissue of the skin. Heat may be an effective self-care treatment for conditions like rheumatoid arthritis.
Cold compression therapy, also known as hilotherapy, combines two of the principles of rest, ice, compression, elevation to reduce pain and swelling from a sports or activity injury to soft tissues and is recommended by orthopedic surgeons following surgery. The therapy is especially useful for sprains, strains, pulled muscles and pulled ligaments.
RICE is a mnemonic acronym for the four elements of a treatment regimen that was once recommended for soft tissue injuries: rest, ice, compression, and elevation. It was considered a first-aid treatment rather than a cure and aimed to control inflammation. It was thought that the reduction in pain and swelling that occurred as a result of decreased inflammation helped with healing. The protocol was often used to treat sprains, strains, cuts, bruises, and other similar injuries. Ice has been used for injuries since at least the 1960s, in a case where a 12-year-old boy needed to have a limb reattached. The limb was preserved before surgery by using ice. As news of the successful operation spread, the use of ice to treat acute injuries became common.
Contrast bath therapy is a form of treatment where a limb or the entire body is immersed in hot water followed by the immediate immersion of the limb or body in cold ice water. This procedure is repeated several times, alternating hot and cold. The only evidence of benefit is anecdotal and no plausible mechanism has been confirmed.
Aquatic therapy refers to treatments and exercises performed in water for relaxation, fitness, physical rehabilitation, and other therapeutic benefit. Typically a qualified aquatic therapist gives constant attendance to a person receiving treatment in a heated therapy pool. Aquatic therapy techniques include Ai Chi, Aqua Running, Bad Ragaz Ring Method, Burdenko Method, Halliwick, Watsu, and other aquatic bodywork forms. Therapeutic applications include neurological disorders, spine pain, musculoskeletal pain, postoperative orthopedic rehabilitation, pediatric disabilities, pressure ulcers, and disease conditions, such as osteoporosis.
Cold shock response is a series of neurogenic cardio-respiratory responses caused by sudden immersion in cold water.
Heat stroke or heatstroke, also known as sun-stroke, is a severe heat illness that results in a body temperature greater than 40.0 °C (104.0 °F), along with red skin, headache, dizziness, and confusion. Sweating is generally present in exertional heatstroke, but not in classic heatstroke. The start of heat stroke can be sudden or gradual. Heatstroke is a life-threatening condition due to the potential for multi-organ dysfunction, with typical complications including seizures, rhabdomyolysis, or kidney failure.
A hypothermia cap is a therapeutic device used to cool the human scalp. Its most prominent medical applications are in preventing or reducing alopecia in chemotherapy, and for preventing cerebral palsy in babies born with neonatal encephalopathy caused by hypoxic-ischemic encephalopathy (HIE). It can also be used to provide neuroprotection after cardiac arrest, to inhibit stroke paralysis, and as cryotherapy for migraine headaches.
Skin temperature is the temperature of the outermost surface of the body. Normal human skin temperature on the trunk of the body varies between 33.5 and 36.9 °C, though the skin's temperature is lower over protruding parts, like the nose, and higher over muscles and active organs. Recording skin temperature presents extensive difficulties. Although it is not a clear indicator of internal body temperature, skin temperature is significant in assessing the healthy function of skin. Some experts believe the physiological significance of skin temperature has been overlooked, because clinical analysis has favoured measuring temperatures of the mouth, armpit, and/or rectum. Temperatures of these parts typically are consistent with internal body temperature.
Daniel Ianus of Romania's national rugby team took an ice bath after a training session ...
I tell my body to do a lot of things: Run one more sprint. Strike 50 balls. Push through just 15 more minutes. Warm up. Cool down. Sit in an excruciating ice bath.
... many of my RW colleagues swear by ice baths after a long run or race. Not me. I still maintain that ice baths are an elaborate practical joke being played on runners ...
DO: Be aware that moving water is colder water.
One simple way to offset the risks inherent to long bouts of running is cold-water immersion, known to many runners as the ice bath.
...you want to keep those tired muscles limber.
... First, immersion allows controlled, even constriction around all muscles, effectively closing microscopic damage that cannot be felt and numbing the pain that can. ...
Not only has recent research from the Scripps Research Institute in California shown that reducing the core body temperature of mice makes them live for longer...
But Australian scientists have discovered that not only does the modern treatment have no effect – it may do more harm than good.
In simple terms, it's about helping the muscles, tendons, bones, nerves and all the different tissues used in sport recover from their workout.
If you have been shoveling ... Ice Bath: An ice bath ... can help reduce muscle soreness. This is extremely popular in athletic locker rooms, sometimes even mandatory after rigorous exercise.
... the grueling ritual of the ice bath could reduce the benefits of exercise. ...
Hello New England! I am AJ Soares, a new player, or employee as I tell people, at the New England Revolution. ... It's time for me to dip out, ice bath, and get ready to get to work again tomorrow with the team.
...It is because of Phelps that swimmers like Franklin think nothing of taking an ice bath to expedite their recovery.
British Journal of Sports Medicine now claims the opposite may be true. Out of 40 volunteers, those who took an icy plunge reported more pain after 24 hours than those who took a tepid bath. ... Ice baths have become one of the most fashionable ways of recovering after an intense game or marathon. From rugby to tennis players, the bath has a series of celebrity endorsers.
... After a match we have to stand in an ice bath for five minutes. ...
About half of TU's football players take daily dips in water cooled to between 50 and 55 degrees. ... The muscles start feeling a lot better. Aside from the obvious benefit of cooling down quickly from the heat, ice baths help the legs and muscles recover for the next practice.
...the next smart move would be to take a full body ice bath. ...
Many athletes ... have also discovered the benefits of the icy plunge. Pro Beach Volleyball Players and Marathon Runners have been asked to go stand in the ocean for a few minutes. ...
... However the design of conventional ice baths leaves something to be desired.
How do the 200 Radio City Rockettes ... Taking ice baths ... some Rockettes take ice baths to unwind after a long day.
After her live shows, Pop diva Madonna ... bath of ice to soothe the pain her body has endured after hours of performing on stage.
Long after most of his teammates had departed Gary Kehler Stadium, A.J. Murray sat in a well-deserved ice bath in a large plastic tub while basking in the sunlight outside the Westfield training room.
In November, Cleveland Cavaliers guard Manny Harris got into a Cryon-X machine on Nike's campus in Beaverton, Ore. When he came out, he had a nasty freezer burn on the side of his right foot. ... In just three minutes, the company that makes it, Millennium ICE, says the machine cranks the temperature inside to minus 166 degrees Fahrenheit, thus oxygenating the blood, helping to reduce fatigue and muscle soreness.
5 percent said children can be given an ice bath to treat a fever – Risk: hypothermia