Cold-water immersion in football

Recovery from games or simply (intense periods of) from training is a major focus for footballers. One part of recover is colloquially called “ice-bath” or “cold-water immersion”.

A more scientific/medical term used is “cryotherapy” which originates from the Greek “cryo” (meaning cold) and “therapy” (meaning cure).

Cryotherapy does not necessarily imply the usage of cold-water only, ice packs as well as cold-air chambers are also categorized under cryotherapy. However, and from a practical perspective in football teams, I will focus on cold-water immersion as this is the most practical (and probably the most utilized) form of cryotheraphy.


Cold-water immersion and its physiological mechanism

A major component of cold-water immersion is vasoconstriction, the constriction of blood vessels and therefore a limited amount of blood flow to the tissue. Inherent, cell growth and reproduction will be limited as well as decrease inflammation, pain and spasm.


The scientific knowledge of cold-water immersion in (team sports &) football

Several investigations utilized cold-water immersion immediately after training and protocols used throughout the literature were as follows:


#, Reference
Total exposure time
Exposure time/set
Number of sets
Water temperature
Body position & Water level
1, (14)
5 min
1 minute
5
11 degrees
Sitting
2, (19)
5 min
1 minute
5
10 degrees
Sitting, sternum height
3, (1, 2)
10 min
1 minute
1
10 degrees
Sitting, iliac crest
4, (10)
10 min
5 minute
2
10 degrees

5, (7)
14 min
14 minutes
1
12 degrees
Sitting, sternum height
6, (20)
14 min
14 minutes
1
15 degrees
Entire body incl. head & neck
7, (18)
15 min
15 minutes
1
10 degrees Sitting, iliac crest
8, (8)
16 min
4 minutes
4
4 degrees Sitting, iliac crest


The protocols affected positively:
    •    maximal strength (1, 2, 10)
    •    sprint ability (10)

Furthermore it reduced
    •    muscle soreness (1, 2, 7, 10, 19)
    •    perception of fatigue (6)
    •    muscle contraction velocity (16)

Generally, the success of cold-water immersion seems to be based on the water temperature and not on the hydro-static pressure (15). Also a dose-response effect seemed to be present in muscle contraction velocity (8). Professional footballers showed a steady decrease in contraction velocity with each set (4 minutes at 4 degree temperature). Furthermore, evidence suggesting a (total) duration (such as 1 x 10 minutes or 2 x 5 minutes) of cold-water immersion greater than 10 minutes (7) might be more efficient.

Some research suggests that cold-water immersion is more effective compared to passive recovery, contrast water immersion (7, 10) and hot water immersion (20). It is also suggested that cold-water immersion is more effective compared to thermoneutral water immersion with regards decreasing creatine kinase, myoglobin, strength and muscle soreness after a one-off football match in professional footballers (1). Kinugasa et al. (11) suggested that cold water in combination with active recovery showed the best perceived recovery in youth footballers. Similar success with regards to perceived of recovery was shown in the study by Roswell et al. (19) in which the authors stated that the cold-water immersion group indicated a lower perceived general fatigue and leg soreness between matches. However, no differences in physical performance was prominent with different recovery procedures.

Other literature

There is a great more research in different populations with regards to its efficacy, short-term effect on consecutive physical performance, or with regards to different issues of cold-water immersion.

For example, male volunteers (unknown fitness level) did not show any differences between cold-water immersion (12 minutes standing at 12 degree temperature or 2 minutes seated at 12 degree temperature), thermoneutral water immersion or active recovery in muscle soreness, maximal voluntary contraction, creatine kinase (4) after shuttle running.

There was no difference in the efficacy of recovery (active recovery, massage and cold-water immersion) on the total work during cycling after 24-hours of recovery (12).

The short-term effect (within 1-hour) of cold-water immersion was seen in anerobic performance (30-seconds maximal cycling). The second set showed decreased performance after cold-water immersion (15 minutes in 13-14 degree temperature) in active participants (5). Another short-term effect study (of a single 20-minute cold-water immersion for calfs), showed significant decrease of anaerobic power (CMJ, sprint and COD) for at least 32 minutes in a mixed gender healthy adult population (16).

Additional thoughts

Poppendieck et al. (17) reviewed the literature regarding cold-water immersion and stated that whole-body immersion seemed to be superior compared to procedures submerging limbs only.

Furthermore, it seems that the effect of cold-water immersion is more effective in weight-bearing sports, including eccentric muscle actions and therefore possible muscle damage (9, 22).

Additionally, and in cases when accumulation of fatigue is desired, cold-water immersion might be contra productive (9).

Interestingly it seems that the rapidly increasing popularity of water immersion recovery strategies, despite a lack of evidence to support their use, it is quite possible that participants believed and expected a positive outcome, thereby influencing the measure of DOMS (13). Considering the perceptual nature of DOMS assessment it seems plausible that placebo may have an impact on recovery strategy (3) (Ice bath will help in recovery – YES of course, don’t you feel it?).

Conclusion

It seems that cold-water immersion seems to be a popular recovery method in footballers, disregarding age (youth and seniors).

The majority of literature suggests successful (and enhanced) recovery utilizing cold-water immersion, however the mechanisms remains elusive. Considering muscle soreness and furthermore the perceived muscle soreness (whether there is a true effect of not), it seems that footballers will benefit from cold-water immersion after intense training resulting in possible muscle damage, especially in warm/hot conditions.

During tournaments and inherent congested schedule (2-3 games per week), cold-water immersion might help in recovery, while the short term effect of the recovery strategy in anaerobic performances (for example rest between sets/sprints for 60 minutes) seems questionable.

Disregarding the evidence it seems necessary to “train” cold-water immersion, as authors suggest that a water temperature below 15 degrees enables sensation of cold pain, in addition to player’s possible inability to withstand cold discomfort for as little as 30 seconds (21).

References

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2. Bailey, D.M., et al., Influence of cold-water immersion on indices of muscle damage following prolonged

intermittent shuttle running. J Sports Sci, 2007. 25(11): 1163-1170.


3. Beedie, C.J., Placebo effects in competitive sport: qualitative data. J Sports Sci Med, 2007. 6(1): 21-8.


4. Corbett, J.O., et al., Water immersion as a recovery aid from intermittent shuttle running exercise. European

Journal of Sport Science, 2011: 1-6.


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