Effect of Immediate and Delayed Cold Water Immersion After a High Intensity Exercise Session on Subsequent Run Performance

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DOI: 10.1016/j.jsams.2011.11.238 · Source: PubMed
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The purpose of the study was to determine the effects of cold water immersion (CWI) performed immediately or 3 h after a high intensity interval exercise session (HIIS) on next-day exercise performance. Eight male athletes performed three HIIS at 90%VO2max velocity followed by either a passive recovery (CON), CWI performed immediately post-exercise (CWI(0)) or CWI performed 3 h post-exercise (CWI(3)). Recovery trials were performed in a counter balanced manner. Participants then returned 24 h later and completed a muscle soreness and a totally quality recovery perception (TQRP) questionnaire, which was then followed by the Yoyo Intermittent Recovery Test [level 1] (YRT). Venous blood samples were collected pre-HIIS and pre-YRT to determine C-Reactive Protein (CRP) levels. Significantly more shuttles were performed during the YRT following CWI(0) compared to the CON trial (p=0.017, ES = 0.8), while differences between the CWI(3) and the CON trials approached significance (p = 0.058, ES = 0.5). Performance on the YRT between the CWI(0) and CWI(3) trials were similar (p = 0.147, ES = 0.3). Qualitative analyses demonstrated a 98% and 92% likely beneficial effect of CWI(0) and CWI(3) on next day performance, compared to CON, respectively, while CWI(0) resulted in a 79% likely benefit when compared to CWI(3). CRP values were significantly lower pre-YRT, compared to baseline, following CWI(0) (p = 0.0.36) and CWI(3) (p = 0.045), but were similar for CON (p = 0.157). Muscle soreness scores were similar between trials (p = 1.10), while TQRP scores were significantly lower for CON compared to CWI(0) (p = 0.002) and CWI(3) (p = 0.024). Immediate CWI resulted in superior next-day YRT performance compared to CON, while delayed (3 h) CWI was also likely to be beneficial. Qualitative analyses suggested that CWI(0) resulted in better performance than CWI(3). These results are important for athletes who do not have immediate access to CWI following exercise.
©Journal of Sports Science and Medicine (2011) 10, 665-670
Received: 09 August 2011 / Accepted: 05 September 2011 / Published (online): 01 December 2011
Effect of immediate and delayed cold water immersion after a high intensity
exercise session on subsequent run performance
Ned Brophy-Williams, Grant Landers and Karen Wallman
School of Sport Science, Exercise & Health, the University of Western Australia, Australia
The purpose of the study was to determine the effects of cold
water immersion (CWI) performed immediately or 3 h after a
high intensity interval exercise session (HIIS) on next-day exer-
cise performance. Eight male athletes performed three HIIS at
90%VO2max velocity followed by either a passive recovery
(CON), CWI performed immediately post-exercise (CWI(0)) or
CWI performed 3 h post-exercise (CWI(3)). Recovery trials
were performed in a counter balanced manner. Participants then
returned 24 h later and completed a muscle soreness and a to-
tally quality recovery perception (TQRP) questionnaire, which
was then followed by the Yoyo Intermittent Recovery Test
[level 1] (YRT). Venous blood samples were collected pre-HIIS
and pre-YRT to determine C-Reactive Protein (CRP) levels.
Significantly more shuttles were performed during the YRT
following CWI(0) compared to the CON trial (p=0.017, ES =
0.8), while differences between the CWI(3) and the CON trials
approached significance (p = 0.058, ES = 0.5). Performance on
the YRT between the CWI(0) and CWI(3) trials were similar (p
= 0.147, ES = 0.3). Qualitative analyses demonstrated a 98%
and 92% likely beneficial effect of CWI(0) and CWI(3) on next
day performance, compared to CON, respectively, while
CWI(0) resulted in a 79% likely benefit when compared to
CWI(3). CRP values were significantly lower pre-YRT, com-
pared to baseline, following CWI(0) (p = 0.0.36) and CWI(3) (p
= 0.045), but were similar for CON (p = 0.157). Muscle sore-
ness scores were similar between trials (p = 1.10), while TQRP
scores were significantly lower for CON compared to CWI(0) (p
= 0.002 ) and CWI(3) (p = 0.024). Immediate CWI resulted in
superior next-day YRT performance compared to CON, while
delayed (3 h) CWI was also likely to be beneficial. Qualitative
analyses suggested that CWI(0) resulted in better performance
than CWI(3). These results are important for athletes who do not
have immediate access to CWI following exercise.
Key words: Recovery, cold water immersion, C-Reactive Pro-
tein, yoyo test.
Recovery, the return of the body to its pre-exercise state
(Tomlin and Wenger, 2001), is an integral component of
every athlete's training programme (Cochrane, 2004).
Recovery is particularly relevant to athletes due to an
implied desire by these individuals to perform at optimal
capacity during subsequent sporting events. While many
athletes may participate in intermittent sporting events,
such as an individual track event, there may be times
when performance events are performed over a series of
days or even on the same day, such as when an athlete
enters into a number of events or when carnivals are held
(Montgomery et al., 2008). This makes the recovery proc-
ess between one sporting fixture and the next an ex-
tremely important process.
To date, numerous passive and active recovery
methods have been trialed, such as carbohydrate replen-
ishment, stretching and massage, with water immersion
representing a popular application (Cochrane, 2004; Hal-
son et al., 2008). Of relevance, a recent study by Ingram
et al. (2009) reported that cold water immersion (CWI), as
opposed to contrast (hot and cold) water therapy and a
control condition, resulted in a more rapid return to base-
line exercise (running) performance in male athletes.
Benefits of CWI on exercise recovery have been attrib-
uted to both the hydrostatic pressure of water, as well as
the water temperature, with both these factors reported to
evoke several mechanisms that can attenuate the physical
consequences of exercise (i.e., delayed onset of muscle
soreness), and in particular, reduce inflammation and
oedema (Wilcock et al., 2006). This is important, as in-
flammation and oedema cause stiffness, reduced range of
movement, loss of force generation and pain (Wilcock et
al., 2006), which in turn negatively affects physical
movement and hence exercise. Of relevance, an analgesic
effect is produced during CWI (Vaile et al., 2008), which
may further contribute to the benefits of its use as a re-
covery modality.
Currently, there have been only a few studies that
have investigated the effects of CWI on exercise per-
formed on a subsequent day (Bosak et al., 2006; Ingram et
al., 2009: Lane and Wenger, 2004; Vaile et al., 2008).
This is an important issue for athletes involved in events
that require exercise to be performed over a couple of
days. Furthermore, only one study is known to the authors
that examined the effects of a delayed recovery interven-
tion following exercise on subsequent exercise performed
24 h after the initial exercise session (Lum et al., 2009).
These investigators reported benefit of next day exhaus-
tive exercise performance associated with a swimming
based recovery period (compared to a passive control)
that was performed 10 h following an initial high intensity
exercise session. Further studies are needed to assess the
effect of delayed CWI, as it can be a number of hours
before an athlete has access to recovery procedures fol-
lowing exercise performance. This is demonstrated when
athletes compete in events that are a reasonable distance
from their home-base, as occurs in pennant tennis or
team-sport games, particularly those played in rural areas.
Therefore, the aim of this study was to investigate
the effects of CWI performed 3 h post a high intensity
exercise session, compared to immediate CWI or passive
recovery, on next-day running performance. It was hy-
Research article
Cold water immersion and performance
pothesised that immediate CWI would produce the most
beneficial results in relation to next day exercise perform-
ance due to the immediate consequences of CWI on the
inflammatory process. It was also hypothesised that CWI
performed 3 h post-exercise would result in better next
day performance than a passive recovery trial.
Eight well trained male athletes (Australian Rules foot-
ball, n = 7, hockey, n = 1), competing at the highest ama-
teur level of their chosen sport, were recruited for partici-
pation in this study. Mean (± standard deviation) age,
height, body mass and VO2max were 20.9 ± 1.2 y, 1.84 ±
0.05 m, 79.4 ± 6.0 kg and 56.1 ± 4.6 ml·kg-1·min-1, re-
spectively. Participants were in the mid-season phase of
competition and were injury free at the time of testing.
Ethics approval was obtained from the Human Research
Ethics Committee of the University of Western Australia
(UWA). Participants were informed of the risks and bene-
fits associated with the study and provided written in-
formed consent prior to participation.
Participants attended the human performance labo-
ratory at UWA on seven separate occasions, for a partial
familiarisation session and three trials, with each trial
requiring participants to return the next day for testing.
The three experimental trials consisted of a high intensity
interval session (HIIS), followed by one of three recovery
conditions, presented in a counter-balanced order so to
reduce any potential order effect. The next day (24 h
later), participants returned to undertake the Yoyo Inter-
mittent Recovery test [Level 1] (YRT) in order to assess
how well they had recovered from the previous day’s
All trials were performed at the same time of day,
but separated by at least one week. Participants were
asked to abstain from alcohol, caffeine and strenuous
exercise for the 24 h period prior to each testing session.
Participants were also required to complete a food diary
in the 24 h period prior to, and for the duration of, each
trial and requested to replicate dietary intake as closely as
possible for each trial. The food diary was monitored
weekly by the researchers to ensure compliancy, with this
resulting in no concerns.
The partial familiarisation session involved a
graded exercise test (GXT) to determine each partici-
pants’ VO2max and suitable exercise intensities for subse-
quent sessions. The GXT was conducted on a motorised
treadmill (Nury Tec VR3000, Germany) in a step-like
fashion, using 3 min work periods and 1 min rest periods.
An initial speed of 12 km·h-1 was used, with 1 km·h-1
increases for each 3 min work period until volitional ex-
haustion occurred. The treadmill was set at a 1% gradient
to replicate outdoor conditions (Jones and Doust, 1996).
Heart rate (HR) was recorded before testing and at the
completion of each work period (Polar Heart Rate Moni-
tor, Polar Electro, Finland), while capillary blood samples
were taken from the earlobe during each 1 min rest break
so to assess plasma blood lactate. Samples were subse-
quently analysed using a blood-gas analyser (ABL 625,
Radiometer Medical A/S, Copenhagen, Denmark). Ex-
pired air concentrations of O2 and CO2 were analysed
continuously during the GXT (Ametek Gas Analysers,
Applied Electrochemistry, SOV S-3A/1 and COV CD-
3A, Pittsburgh, PA). Gas analysers were calibrated using
gases of known concentrations (BOC Gases, Chatswood,
Australia) before and after each testing session. Ventila-
tion was recorded at 15 s intervals via a turbine venti-
lometer (Morgan, 225 A, Kent, England), which was
calibrated before and after exercise using a 1 L syringe, in
accordance with the manufacturer's specifications. The
sum of the four highest consecutive 15 s values of O2
recorded during the GXT was used to determine each
participant’s VO2max. The GXT was followed by 15 min
of cold water immersion (CWI) in order to familiarise
participants to this procedure.
Approximately a week after the familiarisation ses-
sion, participants arrived at the UWA exercise laboratory
at 1200 and were seated for 10 min so to allow for pos-
tural changes in blood plasma to occur before a venous
blood sample was collected. Venous blood was drawn
from the median cubital vein of the forearm in 8.5 ml
serum separator collection tubes (SST II Advance, BD
Vacutainer, UK) for the measurement of C-reactive pro-
tein (CRP) concentration. CRP is an acute-phase serum
protein that plays a regulatory role in inflammation and is
deposited at sites in the body where acute inflammation
occurs (Du Clos and Mold, 2004). CRP was subsequently
measured at a local hospital pathology laboratory using a
Roche Cobas Integra 800 analyser (Roche Diagnostics
Australia) and a particle enhanced immunoturbidimetric
assay kit. Absorbance was measured at 552 nM. The
analytical coefficient of variation for CRP determination
at 14.85 and 27.15 mg·L-1 was 1.76% and 2.19% respec-
Immediately following the drawing of blood for
CRP assessment, participants then performed a WUP
prior to the HIIS. The WUP consisted of participants
running on a treadmill for 5 min at 60% of their VO2max
velocity, followed by 5 min of range of motion stretching.
A capillary blood sample was taken immediately prior to
the commencement of the high intensity interval session
(HIIS). The HIIS was performed in the laboratory and
consisted of eight intervals, each 3 min long, performed at
90% VO2max velocity. One minute passive rest periods
were performed between each set, while capillary blood
samples were taken upon completion of the 4th and 8th
repetitions. Heart rate was constantly monitored, with
readings taken at rest and at the end of each exercise in-
The recovery trials consisted of a control condition
[CON] performed immediately after the HIIS, cold water
immersion [CWI(0)] undertaken immediately after the
HIIS, or cold water immersion performed 3 h [CWI(3)]
following the HIIS. The CON trial required participants to
be seated for 15 min in laboratory conditions (~23°C,
43% relative humidity). Both CWI trials consisted of
submerging the body to the mid-sternum in water at a
temperature of 15°C (± 1°C) for 15 min. Heart rate was
recorded immediately prior to, and following, each condi-
Participants returned to the laboratory the next day,
Brophy-Williams et al.
24 h after the HIIS. On arrival, participants were seated
for 10 min prior to a venous blood sample being taken for
a second assessment of CRP levels. The percentage
changes in CRP from baseline levels (pre HIIS) to pre
YRT (24 h later) were calculated so to allow comparison
between the three trials.
The exercise session began with a standardised 10
min warm up that consisted of 200 m of jogging at a self-
selected pace, followed by two sets (20 m per set) of high
knee lifts, buttock kicks and sideways running. Five 20 m
run-throughs were then performed at progressively in-
creasing speeds, with this pace self-selected by the par-
ticipant. Participants then rated themselves on the Total
Quality Recovery Perception (TQRP) scale (Kentta and
Hassmen, 1998) and a 7-point Likert scale for muscle
soreness. Following this, participants undertook the YRT
(Veale et al., 2010). The test was performed indoors on a
wooden gymnasium floor.
The YRT is a shuttle run that is similar to the beep
test and involves high intensity running that is inter-
spersed with recovery periods, making it applicable to
track athletes as well as team sport athletes (Bangsbo et
al., 2008). The YRT consists of 2 x 20 m shuttles (20 m
out and 20 m back designates one shuttle) performed at a
speed designated by the Yo-Yo compact disk (Helle
Thompson, Dopenhagen, Denmark), with an active re-
covery undertaken between each shuttle. The active re-
covery requires participants to walk or jog (their wish) 2 x
5 m (out and back) and then to wait at the starting line for
the next signal to run again (10 s recovery time all up).
The YRT (level 1) starts at 10 km·h-1 with levels progres-
sively increasing in speed throughout the test, with the
test considered complete when the participant misses
performing two consecutive shuttles within the required
time. Upon completion of the test, the participants’ HR
was recorded and plasma blood lactate concentrations
were measured. Test- retest of the YRT (level 1) has been
previously performed by Thomas et al. (2006) in 16 team
sport and recreational athletes and resulted in an ICC of
0.95 (p < 0.01), a typical error of 0.26 (approximately 2
shuttles) and a CV% of 1.9%, respectively.
Statistical analyses
The mean ± standard deviations (SD) for all variables
were calculated. Repeated-measures ANOVAs were used
to compare next-day performance, blood parameters and
psychological outcomes between the three recovery con-
ditions. Post-hoc, pair wise comparisons were applied in
the event of a main effect so to accurately determine
where differences existed. The alpha level was set at p
0.05. Cohen’s d effect sizes (ES) and thresholds (< 0.5,
small; 0.5 - 0.79, moderate; 0.8, large) were also used to
compare the magnitude of the difference in change scores
between the three trials (Cohen, 1988). Only moderate to
large effects are reported. Further analysis was conducted
to identify the smallest worthwhile change in YRT per-
formance scores between the three recovery trials, using
the method outlined by Batterham and Hopkins (2006).
This approach represents a contemporary method of data
analysis that uses confidence intervals in order to calcu-
late the probability that an effect is clinically beneficial,
trivial or harmful (Batterham and Hopkins, 2006). The
smallest worthwhile value of change was set at a Cohen’s
effect size of 0.2, representing the hypothetical, smallest
change in next day YRT performance that would benefit
the athlete. Where the chance of benefit and harm were
both calculated to be 5%, the true effect was deemed
unclear (Batterham and Hopkins, 2006). When clear in-
terpretation was definitively possible, a qualitative de-
scriptor was assigned to the following quantitative
chances of benefit: 25-75%, benefit possible; 75-95%,
benefit likely; 95-99%, benefit very likely; > 99%, benefit
almost certain (Batterham and Hopkins, 2006).
Environmental conditions were similar between trials for
the HIIS and the recovery conditions (23.5 ± 1.2°C, RH =
40.7 ± 6.1 %), which were both performed in a perform-
ance laboratory. Furthermore, environmental conditions
were similar between trials for the YRT (16.3 ± 1.5°C;
RH 50.1 ± 5.9%), which was performed outdoors.
Results showed that physiological measures of ef-
fort for the HIIS were similar between trials, in that there
were no significant differences in final exercise values for
HR (p = 0.206) and plasma blood lactate concentrations
(p = 0.353). Final HR and plasma blood lactate values
were 188 ± 8, 186 ± 5 and 189 ± 7 bpm and 8.0 ± 2, 8.2 ±
2.3, and 8.7 ± 2.2 mmol·L-1 for the CWI(0), CWI(3) and
the CON trials, respectively.
Table 1 illustrates the difference in the number of
shuttles completed in the YRT following the CON,
CWI(0) and CWI(3) trials. There was a significant main
effect of trial on YRT performance (p = 0.010), with the
average number of completed shuttles following CWI(0)
being significantly greater than the CON trial (p = 0.017).
Further, CWI(0) resulted in the completion of 5.5 addi-
tional shuttles. This outcome was supported by qualitative
analysis that resulted in a large ES and a 98% ‘very
likely’ beneficial effect associated with CWI(0), com-
pared to CON (Table 2). In addition, the difference in
next-day YRT performance scores between the CWI(3)
and the CON trials approached significance (p = 0.058),
with qualitative analyses resulting in a 92% ‘likely bene-
fit’ associated with CWI(3), as well as a moderate ES
(Table 2). However, there was no significant difference in
shuttles completed (p = 0.147) between the CWI(0) and
Table 1. Yoyo Intermittent Recovery Test (level 1) results for completed shuttles, blood lactate and heart rate
following the control (CON), cold water immersion performed immediately after exercise (CWI(0)) and cold
water immersion performed 3 h following exercise (CWI(3)) trials. Values are means (±SD, n = 8).
Shuttles completed 32.4 (5.0) 37.9 (8.6) * 35.7 (7.8)
Plasma blood lactate (mmol·L-1) 7.4 (1.6) 7.3 (1.4) 7.5 (1.2)
Heart rate (bpm) 185 (9) 187 (10) 186 (7)
* significantly (p < 0.05) different from CON
Cold water immersion and performance
Table 2. Qualitative analysis of shuttles completed following the control trial (CON), cold water immersion performed im-
mediately after exercise (CWI(0)) and cold water immersion performed three hours after the exercise trial (CWI(3)) (n = 8).
CON vs CWI(0) CON vs CWI(3) CWI(0) vs CWI(3)
Cohen’s d Effect Size .80 .50 .30
Mean Change ± 90% confidence limits 5.5 (.7) 3.3 (.6) 2.2 (.5)
% chance that effect is beneficial (trivial/harmful) 98 (2/0) 92 (7/1) 79 (18/2)
CWI(3) trials, qualitative analysis suggested that CWI(0)
had a 79% more beneficial effect. Furthermore, plasma
blood lactate and HR were similar between all three trials
at the conclusion of the YRT (BLa, p = 0.956, HR, p =
0.578; Table 1).
Scores for perceived recovery (as defined by the
TQRP) exhibited a significant main effect of trial (p =
0.003). Ratings were significantly lower after the CON
trial compared to both the CWI(0) and CWI(3) trials (p =
0.002 and p = 0.024, respectively). Scores for the TQRP
were 12.6 ± 1.7, 15.2 ± 2.0 and 14.2 ± 1.6 for the CON,
CWI(0) and CWI(3) trials, respectively. In respect to
muscle soreness, no significant main effect of trial was
apparent (p = 0.110). Scores for muscle soreness were
4.2 ± 1.7, 5.6 ± 1.3 and 5.0 ± 1.2, for the CON, CWI(0)
and CWI(3) trials, respectively.
Figure 1 shows the percentage change in CRP lev-
els from immediately prior to the HIIS (baseline) to 24 h
later prior to YRT for CON, CWI(0) and CWI(3). A main
effect was revealed (p = 0.046), with post hoc testing
indicating that CWI(0) was significantly different to the
CON trial (p = 0.018) 24 h after the HISS. The difference
between the CON and CWI(3) approached significance (p
= 0.073), while there was no significant difference be-
tween the two CWI trials (p = 0.464). Within trials CRP
values were significantly lower following HIIS than base-
line levels following CWI (CWI(0), p = 0.036 and
CWI(3), p = 0.045), whereas no changes were noted be-
tween the CRP levels in the CON trial (p = 0.157).
The aim of this study was to investigate the effects of
CWI performed either immediately or 3 h after a HIIS on
next-day YRT performance, compared to a passive con-
trol condition. Results showed that immediate CWI sig-
nificantly improved next-day YRT performance when
compared to the CON trial, while differences between
delayed (3 h) CWI and the CON trial approached signifi-
cance. These results were supported by qualitative analy-
ses that suggested a ‘very likely benefit’ and a ‘likely
benefit’ associated with CWI[0] and CWI[3], respec-
tively, compared to CON, as well as moderate to large
ES. Furthermore, significantly lower CRP levels meas-
ured pre-YRT compared to pre-HIIS (baseline) following
CWI, provide evidence for benefit associated with this
form of recovery. While there was no significant differ-
ence observed in YRT performance following CWI(0)
and CWI(3), qualitative analysis indicated that CWI(0)
had a 79% more beneficial effect. Furthermore, similar
HR and plasma blood lactate values recorded at the end of
the YRT between trials (Table 2), despite improved exer-
cise performance following both CWI trials, further sup-
ports benefits associated with either immediate or delayed
(3 h) CWI.
Similar to the current study, other researchers have
reported that CWI performed immediately post-exercise
resulted in benefit to subsequent exercise performed ~1 h
(compared to active recovery; Vaile et al., 2010) and 24 h
(compared to passive control; Bosak et al., 2006; Lane
and Wenger, 2004) post immersion. In addition, Ingram
et. al. (2009) reported improved repeated sprint perform-
ance performed 48 h after CWI that was performed both
immediately and 24 h following exhaustive exercise
(compared to contrast water immersion and a control
condition), while Vaile et al. (2008), found improved
cycle performance undertaken over five consecutive days
that was immediately followed by CWI, compared to
passive recovery and hot water immersion.
Of importance, this current study also demon-
strated that delayed (3 h) CWI may have provided a bene-
fit to next day exercise performance compared to a con-
trol trial. These results are consistent with Lum et al.
(2009), who required participants to perform a high inten-
sity interval exercise session, which was followed 10 h
later by either a swimming-based recovery session or a
Figure 1. Percentage change for levels of C-Reactive Protein (CRP) pre the high intensity interval training session
(baseline) and 24 h later prior the Yoyo Intermittent Recovery test in the control (CON: 4.1 ± 10.6 %), cold water im-
mersion performed immediately after exercise (CWI(0): -15.5 ± 18.8 %) and cold water immersion performed three
hours after the exercise (CWI(3): -9.8 ± 14.1 %) trials. N = 8. a Denotes significant difference from CON (p < 0.05).
Brophy-Williams et al.
passive recovery session, with a time to fatigue run per-
formed 24 h later. Results showed that the swimming
recovery session resulted in a significantly longer time to
fatigue in next day exercise performance (830 ± 198 s vs
728 ± 183 s, p = 0.005). Benefits associated with subse-
quent exercise performance following the swim recovery
session were proposed to be a result of the hydrostatic
pressure of water that resulted in a decreased inflamma-
tory response, as determined by a significant reduction in
circulating CRP levels measured 24 h following the initial
exercise session (Lum et al., 2009). According to Wilcock
et al. (2006), hydrostatic pressure can reduce the severity
of exercise-induced oedema, as well as the infiltration of
monocytes and leukocytes into the cell, resulting in re-
duced levels of inflammatory cells/muscle enzymes into
the blood. It is also likely that the temperature of the wa-
ter had a positive effect on subsequent exercise perform-
ance. Cold water immersion is proposed to reduce in-
flammation by evoking vasoconstriction (Peiffer et al.,
2009) and decreasing peripheral blood flow (Sramek et
al., 2000; Vaile et al., 2010). Vasoconstriction reduces the
permeability of cellular, lymphatic and capillary vessels,
which slows fluid diffusion into the interstitial space,
therefore limiting oedema (Eston and Peters, 1999). In
addition, CWI has also been reported to induce an in-
crease in stroke volume and cardiac output (Gabrielsen et
al., 2002; Lollgen et al., 1981; Sramek et al., 2000), with
the resulting increased blood flow assisting in the mainte-
nance of core temperature. This process has been pro-
posed to attenuate blood flow to the traumatised muscle
(Thorsson et al., 1985; Vaile et al., 2010), resulting in
reduced inflammation, and hence improved recovery.
Therefore, the application of CWI should attenuate oe-
dema (Arnheim and Prentice, 1993). Importantly, reduced
inflammation and hence swelling, also results in reduced
pain and the loss of force generation that is associated
with inflammation (Wilcock et al., 2006).
Similar to the study by Lum et al. (2009), a de-
crease in circulating CRP levels 24 h after the initial exer-
cise session was also seen in the current study following
CWI, suggesting that both the positive effects of hydro-
static pressure and cold water resulted in a reduced in-
flammatory response, with this most likely resulting in
improved subsequent exercise performance. These effects
of CWI provide some insight into the small difference
(ns) in next day exercise performance between the
CWI(0) and CWI(3) trials, as CWI performed straight
after HIIS would have acted to limit oedema almost im-
mediately, whereas delayed CWI would have resulted in
some inflammation and hence oedema occurring in the 3
h period between the HIIS and the immersion.
A reduced inflammatory response in the current
study (as determined by lower circulating CRP levels
following both CWI trials) may also explain the signifi-
cantly higher perceived recovery scores (TQRP) recorded
following the CWI(0) and CWI(3) trials, compared to the
control trial. This result is similar to that by Suzuki et al.
(2004) who reported improved psychological ratings
(Profile of Mood State questionnaire) related to an aquatic
exercise recovery compared to complete rest, following a
game of rugby. In contrast, Lum et al., (2009) found no
significant difference in perceived recovery scores as
determined by the TQRP between a swim and a passive
recovery trial that followed high intensity interval exer-
cise. However this result may be due to the longer delay
in performing the swim-based recovery session compared
to the current study (10 h vs 3 h),which may have been
perceived by the participants to be too long to result in
benefit. Furthermore, as few publications have used the
TQRP scale to date, it is difficult to identify trends be-
tween studies.
In agreement with several previous investigations
using CWI after exercise (Bosak et al., 2006; Eston and
Peters, 1999; Sellwood et al., 2007), muscle soreness
ratings did not differ significantly between trials in the
current study. These results differ to other studies that
reported reduced sensations of muscle soreness following
CWI (Bailey et al., 2007; Ingram et al., 2009). Differ-
ences in results between studies may be due to use of
different muscle soreness scales (i.e., varying visual ana-
logue scales), the different initial exercise protocols used
(i.e., various durations, modes and major muscle groups
employed), the temperature of the water (range of 5 to
15°C), body parts exposed to immersion (i.e., elbows or
legs as opposed to immersion to the umbilicus or to the
level of the anterior superior spines), as well as the dura-
tion of immersion (range of 3 x 1 min sessions to a con-
tinuous 15 min session). Of relevance, results from the
current study demonstrate that sensations of muscle sore-
ness have minimal effect on subsequent exercise perform-
In summary, quantitative and qualitative analyses demon-
strated that immediate CWI performed after a HIIS re-
sulted in better next day running performance (YRT),
while delayed (3 h) CWI was also likely to result in im-
proved YRT performance, compared to no CWI. Impor-
tantly, greater benefit was associated with immediate
CWI. This information is pertinent to athletes, particu-
larly if they do not have immediate access to recovery
facilities following exercise performance.
We wish to acknowledge the financial support we received from UWA.
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Key points
Performance of cold water immersion as a recovery
procedure following exercise is better than perform-
ing no recovery procedure
Athletes, coaches and sport trainers should imple-
ment cold water immersion post-exercise irrespec-
tive of the time of administration.
Where possible, cold water immersion should be
performed immediately post-exercise to gain maxi-
mal recovery benefits.
School of Sport Science, Exercise & Health, the University of
Western Australia, Australia
Bachelor in Science (Hons)
Research interests
Exercise and recovery modalities
Ass. Prof., School of Sport Science, Exercise & Health, the
University of Western Australia, Australia
Research interests
Exercise and recovery modalities
Prof., School of Sport Science, Exercise & Health, the Univer-
sity of Western Australia, Australia
Research interests
Ergogenic aids, recovery modalities and exercise in chronic
E-mail: karen.wallman@uwa.edu.au
Karen Wallman
School of Sport Science, Exercise & Health, the University of
Western Australia, Australia
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  • Article
    Full-text available
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  • Article
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  • Article
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    Cold water immersion (CWI) has become a popular means of enhancing recovery from various forms of exercise. However, there is minimal scientific information on the physiological effects of CWI following cycling in the heat. To examine the safety and acute thermoregulatory, cardiovascular, metabolic, endocrine, and inflammatory responses to CWI following cycling in the heat. Eleven male endurance trained cyclists completed two simulated approximately 40-min time trials at 34.3 +/- 1.1 degrees C. All subjects completed both a CWI trial (11.5 degrees C for 60 s repeated three times) and a control condition (CONT; passive recovery in 24.2 +/- 1.8 degrees C) in a randomized cross-over design. Capillary blood samples were assayed for lactate, glucose, pH, and blood gases. Venous blood samples were assayed for catecholamines, cortisol, testosterone, creatine kinase, C-reactive protein, IL-6, and IGF-1 on 7 of the 11 subjects. Heart rate (HR), rectal (Tre), and skin temperatures (Tsk) were measured throughout recovery. CWI elicited a significantly lower HR (CWI: Delta 116 +/- 9 bpm vs. CONT: Delta 106 +/- 4 bpm; P = .02), Tre (CWI: Delta 1.99 +/- 0.50 degrees C vs. CONT: Delta 1.49 +/- 0.50 degrees C; P = .01) and Tsk. However, all other measures were not significantly different between conditions. All participants subjectively reported enhanced sensations of recovery following CWI. CWI did not result in hypothermia and can be considered safe following high intensity cycling in the heat, using the above protocol. CWI significantly reduced heart rate and core temperature; however, all other metabolic and endocrine markers were not affected by CWI.
  • The purpose of the study was to determine the reliability of yo-yo intermittent recovery test (yo-yo) scores and their degree of association with a 20-m shuttle run (20MSR) and VO(2max) values. Subjects were elite (Australian Football League [AFL], n = 23), state-level (hockey, n = 15, and cricket, n = 27), and recreational team-sport players (n = 33). All performed a 20MSR and the yo-yo at either level 1 (recreational and state level) or level 2 (AFL). A recreational subgroup (n = 19) also performed a treadmill VO(2max) test. Test-retest results found the yo-yo (levels 1 and 2) to be reliable (ICC = .86 to .95). The 20MSR and yo-yo level 1 scores correlated (P < .01) in the recreational (r = .81 to .83) and state-level groups (r = .84 to .86), and 20MSR and yo-yo level 2 scores, in the elite (r = .86) and recreational groups (r = .55 to .57). The VO(2max) and yo-yo level 1 scores in the recreational group correlated (P < .01, r = .87), but no association was found with yo-yo level 2 (r = .40 to .43, nonsignificant). We conclude that level 1 (recreational and state level) and level 2 (elite) yo-yo scores were both strongly associated with 20MSR scores and VO(2max) (level 1: recreational subjects only). The yo-yo appears to measure aerobic fitness similarly to the 20MSR but may also be used as a field test of the ability to repeat high-intensity efforts.