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Influence of Contrast Shower and Water Immersion on Recovery in Elite Netballers

February 2014
The Journal of Strength and Conditioning Research 28(8)

DOI:10.1519/JSC.0000000000000417

Source
PubMed

Authors:

Laura E. Juliff

Netball Australia

Shona Halson

Australian Catholic University

Darrell Bonetti

New Zealand Defence Force

Nathan G Versey

Rowing Australia

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Contrast water therapy is a popular recovery modality in sport; however, appropriate facilities can often be difficult to access. Therefore, the present study examined the use of contrast showers as an alternative to contrast water therapy for team sport recovery. In a randomized, cross-over design ten elite female netball athletes (mean ± SD; age: 20 ± 0.6 y, height: 1.82 ± 0.05 m, body mass: 77.0 ± 9.3 kg) completed three experimental trials of a netball specific circuit followed by one of the following 14 min recovery interventions; (1) contrast water therapy (alternating 1 min 38°C and 1 min 15°C water immersion), (2) contrast showers (alternating 1 min 38°C and 1 min 18°C showers) or (3) passive recovery (seated rest in 20°C). Repeated agility, skin and core temperature and perception scales were measured pre, immediately post, 5 h and 24 h post-exercise. No significant differences in repeated agility were evident between conditions at any time point. No significant differences in core temperature were observed between conditions however, skin temperature was significantly lower immediately after contrast water therapy and contrast showers compared with the passive condition. Overall perceptions of recovery were superior following contrast water therapy and contrast showers compared with passive recovery. The findings indicate contrast water therapy and contrast showers did not accelerate physical recovery in elite netballers after a netball specific circuit; however, the psychological benefit from both interventions should be considered when determining the suitability of these recovery interventions in team sport.

Mean (6SD) repeated agility measured at baseline, immediately postexercise (PostEx), immediately postrecovery (acute), 5 hours postrecovery (delayed), and 24 hours postrecovery (24 h) in the contrast showers (C), contrast water therapy (-) and passive (:) recovery intervention groups. *PostEx significantly greater than all other time points.

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INFLUENCE OF CONTRAST SHOWER AND WATER

IMMERSION ON RECOVERY IN ELITE NETBALLERS

LAURA E. JULIFF,

1,2,3

SHONA L. HALSON,

DARRELL L. BONETTI,

NATHAN G. VERSEY,

MATTHEW W. DRILLER,

AND JEREMIAH J. PEIFFER

Performance Recovery, Australian Institute of Sport, Belconnen, Australian Capital Territory, Australia;

School of Psychology

and Exercise Science, Murdoch University, Western Australia, Australia; and

Department of Physiology, Australian Institute

of Sport, Belconnen, Australian Capital Territory, Australia

ABSTRACT

Juliff, LE, Halson, SL, Bonetti, DL, Versey, NG, Driller, MW,

and Peiffer, JJ. Inﬂuence of contrast shower and water

immersion on recovery in elite netballers. J Strength Cond

Res 28(8): 2353–2358, 2014—Contrast water therapy is

a popular recovery modality in sport; however, appropriate

facilities can often be difﬁcult to access. Therefore, the

present study examined the use of contrast showers as an

alternative to contrast water therapy for team sport recov-

ery. In a randomized, crossover design, 10 elite female

netball athletes (mean 6SD:age,2060.6 years; height,

1.82 60.05 m; body mass, 77.0 69.3 kg) completed

3 experimental trials of a netball speciﬁc circuit followed

by one of the following 14-minute recovery interventions:

(a) contrast water therapy (alternating 1 minute 388Cand

1minute158C water immersion), (b) contrast showers

(alternating 1 minute 388Cand1minute188C showers),

or (c) passive recovery (seated rest in 208C). Repeated

agility, skin and core temperature, and perception scales

were measured before, immediately after, 5 and 24 hours

postexercise. No signiﬁcant differences in repeated agility

were evident between conditions at any time point. No sig-

niﬁcant differences in core temperature were observed

between conditions; however, skin temperature was signif-

icantly lower immediately after contrast water therapy and

contrast showers compared withthepassivecondition.

Overall perceptions of recovery were superior after contrast

water therapy and contrast showers compared with passive

recovery. The ﬁndings indicate contrast water therapy and

contrast showers did not accelerate physical recovery in

elite netballers after a netball speciﬁc circuit; however, the

psychological beneﬁt from both interventions should be

considered when determining the suitability of these recov-

ery interventions in team sport.

KEY WORDS hydrotherapy, team sport, performance, core

temperature, fatigue

INTRODUCTION

The professionalization of sport allows elite athletes

to perform a greater volume of training and com-

petition; thus, resulting in the need for recovery

strategies to enable athletes to cope with increased

training load (27). In addition, sports that incorporate tour-

nament style competitions provide a challenge for athletes to

recover adequately before the next exercise bout (4). Hydro-

therapy, speciﬁcally cold water immersion, can enhance

recovery after both simulated and actual team-sport compe-

tition (9). Recently, Webb et al. (31) observed enhanced

recovery in rugby union players after contrast water therapy

(alternating hot and cold water immersion). The use of con-

trast water therapy has also been shown to beneﬁt athletic

recovery as evidenced by improved cycling sprint and time-

trial performances (28), decreases in rating of perceived exer-

tion and muscle soreness (13), and reductions in localized

edema (26). Furthermore, Vaile et al. (26) observed the res-

toration of dynamic power and isometric force after contrast

water therapy in individuals who completed a delayed onset

muscle soreness inducing leg press protocol. These ﬁndings

have increased the popularity of this recovery modality in

sport (5); yet, access to facilities can be difﬁcult, speciﬁcally

when athletes are traveling. Most sporting venues allow ath-

letes access to shower facilities, providing a possible alterna-

tive to contrast water therapy through the use of contrast

showers (alternating hot and cold showers). To the authors’

knowledge, no studies have examined the recovery beneﬁts

of contrast showers on athletic performance despite athletes

anecdotally using showers as a form of recovery.

The sport of netball is played worldwide with an

estimated 20 million participants and is characterized as

a fast moving team-sport placing high physical demands on

players through repeated jumps, lunges, and rapid acceler-

ations and decelerations (13,22). Furthermore, elite

Address correspondence to Dr. Jeremiah J. Peiffer, j.peiffer@murdoch.

edu.au.

28(8)/2353–2358

Journal of Strength and Conditioning Research

Ó2014 National Strength and Conditioning Association

VOLUME 28 | NUMBER 8 | AUGUST 2014 | 2353

netballers can be required to train or compete multiple times

per day in tournament style competitions resulting in large

demands placed upon the cardiovascular, metabolic,

immune, and musculoskeletal systems (13). For athletes to

cope with these demands, appropriate recovery is essential

which has led many teams to adopt some form of recovery

strategy. In a recent survey of New Zealand sporting teams,

100% of elite New Zealand netball teams reported using

contrast water therapy as their recovery modality of choice

(12). When coupled with the large travel commitments asso-

ciated with many elite netball teams, it is likely that the

development of alternative contrast water modalities is nec-

essary. The purpose of the present study was to examine the

inﬂuence of contrast showers and contrast water therapy on

recovery after a netball speciﬁc exercise circuit. The ﬁndings

could provide a viable alternative for coaches, athletes, and

strength and conditioning specialists who wish to use con-

trast water therapy as a recovery modality; yet, are limited

by available facilities.

METHODS

Experimental Approach to the Problem

To determine the recovery beneﬁts of contrast water therapy

and contrast showers in elite level netballers, this study

examined the inﬂuence of 3 recovery conditions (passive,

contrast water therapy, and contrast showers) on perfor-

mance (repeated agility), physiological variables (core and

skin temperature and heart rate), and perceptions of

effectiveness at 3 time points (acute, delayed, and 24 hours)

after a netball speciﬁc exercise circuit. Data collection was

conducted in a pragmatic manner because participants were

currently visiting our laboratory setting to complete a pre-

season training camp. Consequently, repeated agility was

selected as the only performance variable because of its use

within netball as a key performance test and its strong

association with the physical demands of the sport. The

study was conducted using a crossover design in which all

participants completed each of the 3 recovery conditions on

different days. The order of conditions was randomized for

each participant to avoid any order effects that could bias the

data.

Subjects

Ten elite female netball athletes (mean 6SD: age, 20 61

years [range, 18.5–20.7 years]; height, 1.82 60.05 m; body

mass, 77.0 69.3 kg) volunteered to participate in this study.

All participants were Australian representative netballers at

either under 19 or under 21 years of age and were in pre-

season training. The sample size selected for this study was

based on a sample of convenience because all participants

were attending the laboratory settings as part of a preseason

training camp. Before data collection, participants were pro-

vided with written documentation of the risks and beneﬁts of

participation in the study and signed a document of

informed consent. Ethical approval was obtained from the

Murdoch University Human Ethics Committee (#2011/

015) and the Australian Institute of Sports Human Ethics

Committee (#20010206).

Procedures

This study required participants to complete 5 separate

sessions: 2 familiarization sessions of the netball circuit to

limit any learning or training effects, and 3 experimental

testing sessions, during a 4-week period. All experimental

and familiarization sessions were conducted in controlled

conditions (indoor netball courts and recovery facilities),

separated by a minimum of 2 days and were completed at

a similar time of day (61 hour) to control for circadian

variability (23). Training workloads prescribed by coaching

staff were identical between sessions. Twenty-four hours

before testing, participants were asked to refrain from caf-

feine and alcohol consumption and to ingest a similar diet.

All participants were familiar with the performance test pro-

tocols and recovery techniques used in this study.

Six hours before the start of each experimental trial,

participants ingested a core temperature pill (CorTemp

HT150002,HQ,Palmetto,FL,USA).Onarrivalatthenetball

courts, participants were ﬁtted with a heart rate monitor (Heart

Rate Team Pack; Suunto, Vantaa, Finland) and skin tempera-

ture sensors (iButton; Embedded Data Systems, Lawrence-

burg,KY,USA)to4sitesofthebody:chest,arm,thigh,and

calf and completed baseline psychometric measures. Partic-

ipants then commenced the exercise session (approximately at

08:45 hours) with a standardized 15-minute warm-up, which

consisted of running drills, dynamic stretches, and a series of

sprints and jumps. Immediately after the warm-up, participants

completed the baseline repeated agility test and commenced

the 15-minute simulated netball circuit. Immediately after the

simulated netball circuit, agility and psychometric measures

Figure 1. Mean (6SD) repeated agility measured at baseline,

immediately postexercise (PostEx), immediately postrecovery (acute),

5 hours postrecovery (delayed), and 24 hours postrecovery (24 h) in the

contrast showers (C), contrast water therapy (-) and passive (:)

recovery intervention groups. *PostEx signiﬁcantly greater than all other

time points.

Contrast Showers and Performance

2354

Journal of Strength and Conditioning Research

the

were repeated, followed 20 minutes later by one of the 3

designated recovery intervention (passive recovery, contrast

water therapy, or contrast showers). Ten minutes after

completion of the recovery intervention, participants re-

turned to the netball courts for repeated agility and

psychometric measures (acute) after which they completed

these tests again at 16:00 (delayed) and 09:00 hours the next

day (24 hours) to replicate a typical training day for the

athletes.

All recovery conditions were 14 minutes in duration

because this is consistent with previous contrast water

therapy research (2,30). During the passive recovery condi-

tion, participants remained seated with minimal movement

in a temperature-controlled room (20.0 60.78C). The

contrast water therapy condition consisted of participants

alternating between hot (38.0 60.48C) and cold water

(15.0 60.38C) full body immersion (excluding head and

neck; starting with hot immersion) every minute with

a 5-second transfer time between water baths. Water temper-

atures were controlled using a water tank and heater/chiller

pump system custom built as part of the Australian Institute of

Sport Recovery Center. Within the current contrast water

therapy literature, a multitude of temperatures and durations

have been used (2,30). The choice of temperature and dura-

tion selected for this recovery intervention is consistent with

previous contrast water therapy research within our labora-

tory (26,28,29). During the contrast showers, participants

started with exposure to the hot shower (38.0 61.28C) and

alternated between hot and cold showers (18.0 60.48C)

every minute. Participants immersed their entire body includ-

ing head under the shower. Participants were required to

alternate between 2 showers (one hot and one cold) to elim-

inate the need to adjust water temperatures. The temperature

of the cold shower represented the coldest water available

from a standard tap within the recovery center. During all

water-based recovery interventions, water temperature was

continuously monitored (1 Hz) using an iButton temperature

sensor.

The netball speciﬁc circuit used in this study was modiﬁed

from Higgins et al. (10) and comprised of 5 stations spanning

the length of the netball court separated by 3.5 m. A “lap”

was characterized by running

through each station over the

length of the court and jogging

back in 30 seconds. The sta-

tions were comprised of move-

ments such as short explosive

sprints, agility, jumps, and

backward and sideways move-

ments. The completion of 1

circuit involved 5 laps of the

stations in 150 seconds (30 sec-

onds per lap) followed by 30

seconds to complete 5 maxi-

mal counter movement jumps

with any remaining time pro-

vided as rest. Two up and back

sprints from baseline to base-

line were then completed in

Figure 2. Mean (6SD) (A) skin temperature and (B) core temperature

after contrast showers (C), contrast water therapy (-), and passive

recovery (:) measured at baseline, postexercise (PostEx), start of

recovery (StartRec), end of recovery (EndRec), and 20 minutes

postrecovery (20minPost). *Contrast water therapy and contrast

showers signiﬁcantly less than passive condition; #Contrast showers

signiﬁcantly greater than contrast water therapy; **Selected time points

signiﬁcantly greater than baseline; +Selected time points signiﬁcantly

less than PostEx; ¥Signiﬁcantly less than StartRec.

TABLE 1. Mean (6SD) fatigue scores (units) measured at baseline, immediately

postexercise, immediately postrecovery, 5 hours (delayed recovery), and 24

hours after recovery in the contrast water therapy, contrast showers, and passive

recovery conditions.

Baseline* Postexercise†Postrecovery

Delayed

recovery

24 h

Recovery

Contrast water

therapyz

3.1 60.8 7.6 61.8 3.9 61.5 3.8 61.1 3.7 61.1

Contrast showers 3.7 61.2 7.8 61.4 4.0 61.0 4.7 61.3 4.1 61.4

Passive 3.6 60.7 7.9 61.3 4.3 61.0 4.7 61.1 4.0 61.1

*Baseline values signiﬁcantly less than all other time points.

†Postexercise values greater than all other time points.

zMain condition effect, contrast water therapy signiﬁcantly less than passive condition.

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VOLUME 28 | NUMBER 8 | AUGUST 2014 | 2355

24 seconds, followed immediately by 10 netball chest passes

at a wall. Five minutes were allocated to complete 1 circuit.

This circuit was completed 3 times, totaling 15 minutes.

The repeated agility test was used as the measure of physical

performance and was selected as it represents a measure

consistent with the primary physical demands of the sport.

Participants were required to start from a stationary position

and maneuver in and out of a series of 5 poles 2.5 m apart (21).

The test was performed 4 times with participants starting

every 20 seconds. The total time of each run was measured

by dual-beam electronic timing gates (Speedlight TT; Swift

Performance Equipment, Wacol, Australia). The laboratory

coefﬁcient of variation for the repeated agility test is 1.2%.

Throughout the netball circuit, mean and maximum heart

rates were recorded. Core and skin temperatures were

recorded at baseline, after warm-up, postexercise, before

recovery, and immediately and 20 minutes postrecovery.

Mean skin temperature (T

skin

) was calculated using the fol-

lowing equation derived by Ramanathan (19):

Tskin ¼0:33ðTchest þTarmÞþ0:23Tthigh þTleg :

Rating of perceived exertion was measured immediately

after the netball speciﬁc exercise using the Borg scale (3). In

addition, perceptions of fatigue were assessed at baseline, post-

exercise, immediately postrecovery, and at both delayed and

24 hours time point using a 10-point Likert scale (1 = no

fatigue and 10 = extreme fatigue) (3). To determine partici-

pants’ perception of the efﬁcacy of each recovery modality,

a preintervention and postintervention questionnaire was used.

Before recovery, participants were asked “Do you believe the

postexercise recovery modality will accelerate your recovery

in this trial?” Immediately postrecovery, participants were

asked “Do you believe the postexercise recovery modality

has accelerated your recovery in this trial?” Participants

answered on a visual analogue scale (100 mm in length) with

strongly agree (0 mm) and disagree (100 mm) at each end.

Statistical Analyses

Differences in performance, psychometric and physiological

measures between conditions over time were determined using

a linear mixed model analysis. Signiﬁcant main effects or

interactions were analyzed usinganadjustedFisher’sleastsig-

niﬁcant difference post hoc analysis. The results of the efﬁcacy

questions were analyzed using a 1-way analysis of variance to

test for differences within the 3 recovery conditions. A pre-post

t-test was conducted to analyze differences within each recov-

ery intervention. All statistical analysis was conducted using an

SPSS statistical software package (SPSS Statistics v.21, IBM,

New York, NY, USA) with the level of signiﬁcance set to p#

0.05. All data are presented as mean 6SD.

RESULTS

No signiﬁcant differences were observed for mean heart rate

during the netball speciﬁc exercise circuit between the

contrast water therapy (180 68b$min

), contrast showers

(181 67b$min

), or passive (182 68b$min

) recovery

conditions. Similarly, no signiﬁcant differences were

observed for the rating of perceived exertion during the net-

ball speciﬁc exercise in the contrast water therapy (18 62

units), contrast showers (18 61 units), and passive (19 61

units) recovery conditions.

A main effect for time was observed for the repeated

agility test. In all conditions, immediately after the netball

speciﬁc exercise, repeated agility times were slower when

compared with all other time points (Figure 1).

There was a signiﬁcant interaction between conditions for

skin temperature at the immediately and 20 minutes post-

recovery time points with a greater mean skin temperature

in the passive condition (31.2 61.18C and 30.6 60.88C,

respectively) when compared with contrast showers (27.4 6

1.58C and 25.4 61.78C, respectively) and contrast water

therapy (24.6 62.38C and 24.9 61.48C, respectively)

(Figure 2). No signiﬁcant differences between recovery inter-

ventions were observed for core temperature. Regardless,

theabsolutemagnitudeofchangeincoretemperaturemea-

sured from immediately to 20 minutes postrecovery was

greater after contrast water therapy (20.3 60.28C) and

contrast showers (20.4 60.28C) compared with the pas-

sive (20.1 60.18C) condition.

Participants’ perceptions of fatigue are displayed in Table 1.

A main effect for condition and time was observed for the

fatigue measures with greater fatigue reported in the passive

compared with the contrast water therapy conditions. Fur-

thermore, in all conditions, perceived fatigue was lower at

baseline and 24 hours compared with all other time points;

however, no differences were noted between conditions at

any time points. Perceived effectiveness before the recovery

intervention was greater for contrast water therapy (20 615)

compared with contrast showers (47 615) and passive (69 6

11) conditions. After recovery, participants perceived contrast

water therapy (19 614) and contrast showers (18 613) to

provide superior recovery beneﬁts compared with the passive

(73 614) condition. A change in positive perception prere-

covery to postrecovery intervention was observed for contrast

showers only.

DISCUSSION

This study examined the inﬂuence of contrast water therapy

and contrast showers on recovery after a netball speciﬁc

exercise circuit in elite netballers. The main ﬁndings were:

(a) despite inducing fatigue after the netball speciﬁc exercise

circuit in all conditions, no performance differences were

noted between recovery conditions at any time point, (b)

core temperature was not different between conditions at

any time point, although greater heat removal was observed

in both water recovery conditions compared with control

from immediately to 20 minutes postrecovery, (c) overall

positive perceptions of recovery were observed after contrast

water therapy and contrast showers compared with passive

Contrast Showers and Performance

2356

Journal of Strength and Conditioning Research

the

recovery, and (d) participants’ perceptions of contrast show-

ers changed positively preintervention to postintervention.

The use of either contrast water therapy or contrast

showers after the netball speciﬁc exercise did not enhance

the recovery of performance in comparison with the control

condition (Figure 1). Our ﬁndings are similar to previous

contrast water therapy research (6,13) during which an

inability to induce adequate fatigue was suggested as the

rational for the null ﬁndings. We do not believe this to be

the reason for our ﬁndings as postexercise increases in agility

times indicate fatigue. Furthermore, this netball speciﬁc cir-

cuit has previously shown to induce a high level of fatigue

(10). Contrast water therapy is associated with a reduction of

delayed onset muscle soreness after some team sports (e.g.,

rugby) that have been suggested to indicate recovery (31). It

is possible in this study, although not measured, that the

muscle damage may have been minimal that would have

limited the efﬁcacy of our recovery interventions. Further-

more, current literature indicates contrast water therapy can

enhance recovery after team-sport activity; however, this

was only observed .24 hours after the intervention (31).

As the present study ceased measures at 24 hours to deter-

mine the suitability of each recovery intervention in relation

to normal netball competition demands, it is possible any

recovery beneﬁt may have been missed. In the absence of

performance changes after either recovery intervention, we

suggest future research is warranted to examine the use of

contrast water therapy and contrast showers in netballers

after actual competition and repeated performance assess-

ments .24 hours after exercise (11,28).

To the authors’ knowledge, this is the ﬁrst study to exam-

ine differences in core and skin temperature responses to

both contrast water therapy and contrast showers. Regard-

less of the difference in the temperature of cold water used

during the contrast water therapy (15.0 60.38C) and con-

trast showers (18.0 60.48C); no differences were observed

in core temperature between modalities (Figure 2B). This

ﬁnding is not surprising because Proulx et al. (18) have re-

ported similar core temperatures during postexercise cold

water immersion in water ranging 8–208C. Consistent with

previous research (15,16,25), this study’s ﬁndings are likely

a product of peripheral blood vessel vasoconstriction (16,28)

upon cold water exposure limiting blood contact with the

cooler periphery. Although not observed during the recov-

ery interventions, we did observe a delayed cooling response

in contrast showers and contrast water therapy from post-

recovery to 20 minutes postrecovery compared with the

passive condition. Versey et al. (28) observed a delayed cool-

ing response in 11 trained male cyclists who completed a con-

trast water therapy intervention (alternating 1 minute hot,

388C; 1 minute cold, 158C for 6, 12, and 18 minutes) after

a 75-minute cycling protocol (28). This delayed cooling can

be explained by the “afterdrop” phenomena (1), the removal

of core body heat after exposure to cold conditions because of

sustained peripheral muscle cooling after rewarming.

It should be acknowledged that fatigue is a multidimen-

sional phenomena (1,14) consistent with both physiological

and psychological changes, which can inﬂuence athletic per-

formance (1). In this respect, the efﬁcacy of recovery tech-

niques should be evaluated at both physiological and

psychological levels. It is possible for athletes who feel less

pain and muscle soreness to have a heightened sense of well-

being after recovery and perform better (20). For this reason,

the placebo effect can have signiﬁcant inﬂuence on the suc-

cess of a recovery intervention (7,17). Our participants per-

ceived both contrast water therapy (19 614) and contrast

showers (18 613) to accelerate recovery when compared

with the passive condition (73 614). These ﬁndings are

likely due to the change in skin temperature associated with

both water interventions (Figure 2A) because skin tempera-

ture is an integral component of a human’s perception of

fatigue and comfort (8,24). An individual’s comfort level is

shown to improve when the environment allows the return

of body temperature toward homeostasis (8). Compared

with the contrast water therapy conditions, a perceptual

change was observed preintervention to postintervention

for contrast showers. The noted change in perception fur-

ther indicates the inﬂuence of skin temperature on percep-

tion, while the difference between conditions is likely due to

previous exposure. The current group of participants had

routinely been exposed to contrast water therapy, thus inﬂu-

encing the perceived beneﬁt; however, contrast showers

were not as customary, therefore perceptions of this modal-

ity changed only after the initial exposure.

In conclusion, the current study provides novel informa-

tion regarding contrast showers as a recovery modality and

its comparison to contrast water therapy in a simulated

team-sport setting. Although no improvements in perfor-

mance were observed, contrast water therapy and contrast

showers resulted in accelerated skin cooling and greater

perceptions of recovery. With the continued use of contrast

water therapy and possible use of contrast showers in

netball, future research is needed to determine the efﬁcacy

of these modalities using extended monitoring periods and

competition scenarios.

PRACTICAL APPLICATIONS

The large physical demands placed on athletes during both

training and competitions compel coaches and strength and

conditioning specialists to provide the most appropriate

recovery strategies to increase the chance of their athletes’

success. Past research indicates contrast water therapy can

be an effective recovery modality in a range of sports; yet,

practitioners may be limited in the ability to provide this

modality due to facilities and logistics. Findings from this

study showed 14 minutes of contrast showers (alternating

hot and cold each minute) used immediately after netball

training provided a similar perception of enhanced recovery

when compared with contrast water therapy. Although

neither modality resulted in enhanced physical recovery

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VOLUME 28 | NUMBER 8 | AUGUST 2014 | 2357

compared with the control condition, we would suggest that

the psychological beneﬁts observed could lead to greater

athletic success in some circumstances. With the increasing

use of contrast water therapy as a recovery modality in team

and individual sport, we propose contrast showers could

provide a more practical alternative because of the availabil-

ity of shower facilities at most sporting events.

ACKNOWLEDGMENTS

The authors thank all the participants for their participation

in the study and coaching staff for their cooperation during

the study. None of the authors of this article have any

professional relationships with companies or manufacturers

who would beneﬁt from the results of the present study.

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The Applied Sports Science and Medicine of Netball: A Systematic Scoping Review

Article

Full-text available

Jun 2021
SPORTS MED

Background Netball is the one of the most popular women’s sports in the world. Since gaining professional status in 2008 there has been a rapid growth in research in the applied sports science and medicine of the sport. A scoping review of the area would provide practitioners and researchers with an overview of the current scientific literature to support on-court performance, player welfare and reduce injury. Objective The primary objective was to identify the current research on the applied sports science and medicine of netball. Additionally, the article provides a brief summary of the research in each topic of sports science and medicine in netball and identifies gaps in the current research. Methods Systematic searches of PubMed, SPORTDiscus, MEDLINE and CINAHL were undertaken from earliest record to Dec 2020 and reference lists were manually searched. The PRISMA-ScR protocol was followed. Studies were eligible for inclusion if they investigated netball as a sport or the applied sport science and medicine of netball athletes. Results 962 studies were identified in the initial search, 150 of which met the inclusion criteria. Injury was the most highly investigated sport science and medicine topic ( n = 45), followed by physical qualities ( n = 37), match characteristics ( n = 24), biomechanics ( n = 15), psychology ( n = 13), fatigue and recovery ( n = 9), training load ( n = 4) and nutrition ( n = 3). A range of cohorts were used from school to elite and international standards. All cohorts were female netballers, except for one study. A rapid growth in studies over recent years was demonstrated with 65% of studies published in the last decade. There still remains gaps in the literature, with a low evidence base for nutrition, training load and fatigue and recovery. Conclusion This scoping review summarises the current evidence base and key findings that can be used in practice to enhance the applied sport science and medical support to netball athletes across a range of playing standards, and support the growth of the sport. It is evident that netball as a sport is still under-researched.

Comparison of the Effectiveness of Hydrotherapy and sport massage on fatigue recovery

Article

Mar 2023

Automatic Bathroom to beat laziness

Experiment Findings

Full-text available

Apr 2020

Bathing is activity that cleaning up our body from all filth that is obtained after doing some activities everyday, Human usually bathing twice a day i.e. Morrning bath and Evening bath. But not everybody can do morning bath. At least there's three fact why someones is lazy to takes a morningbath : The Cold, Laziness, Gadget. Kamar Mandi Pemalas is very helpful technology especially for student college which is unsual do morning bath. The existance of Kamar Mandi Pemalas expected can makes someone more productive everyday.

Gaelic Games Players’ and Practitioners’ Perceptions of Recovery Strategies

Article

Aug 2024

Purpose : This study both investigated and compared Gaelic games players’ and practitioners’ perceptions of the importance of postexercise recovery strategies. Methods : Gaelic players (n = 1178 [n = 574 female], age 24.6 [6.6] y) and practitioners (n = 148 [n = 29 female], age 35.9 [8.7] y) completed a questionnaire assessing their perceptions of various postexercise recovery strategies (importance ranked out of 5 [1 “not important at all” to 5 “extremely important”]). Players were further categorized by playing standard into developmental (club/collegiate; n = 869) and national (intercounty; n = 309) levels and by sport: Gaelic football (n = 813), camogie/hurling (n = 342), and Gaelic handball (n = 23). Practitioners were categorized as sport coaches (n = 67), strength and conditioning staff (n = 34), nutrition staff (n = 15), and athletic rehabilitation staff (n = 32). Results : Gaelic players prevalently perceived sleep (76.4%), rehydration (72.5%), postexercise meal (48.4%), stretching (47.6%), active cool-down (25.1%), foam rolling (23.1%), and massage by therapist (22.6%) as “extremely important.” Practitioners prevalently perceived sleep (90.1%), rehydration (83.6%), postexercise meal (76.6%), daytime naps (36.2%), stretching (25.4%), discussion with teammates (24.6%), and getting into nature (19.4%) as “extremely important.” Conclusions : While strategies with well-documented efficacy such as sleep, nutrition, and rehydration were rated as most important, a distinct and possibly problematic disconnect exists between the perceived importance of many strategies and their empirically demonstrated effectiveness. For instance, active cool-downs and stretching were perceived as highly important despite prevailing evidence suggesting that their effects are often small in magnitude. Collectively, work promoting optimal recovery practices and aligning player-practitioner perspectives would be beneficial to maximize time and resource allocation and enhance player buy-in.

Health problem surveillance at the 17/U & 19/U Australian national netball championships

Article

Oct 2022

Objective Surveillance of health problems at the 2019 17/U & 19/U Australian Netball National Championships (ANNC) and compare this data with the 2018 17/U & 19/U ANNC. Determine the rate for risk of low energy availability and poor sleep quality in athletes competing at the 2019 ANNC. Design Prospective observational cohort study. Method One hundred and ninety-two netball athletes were observed during a six-day tournament. Injuries were defined in three ways: 1) self-reported, 2) medical attention, and 3) sports incapacity. Medical attention health problems were recorded prospectively by the 16 team physiotherapists during the tournament and athlete self-reported health problem data was collected on four occasions (pre-tournament, post-tournament, 1-week post tournament and 4-weeks post tournament) using their smartphones. The same method was also used for health problem surveillance at the 2018 17/U & 19/U ANNC. Athletes also completed the Low Energy Availability in Females Questionnaire (LEAF-Q) and Pittsburgh Sleep Quality Index (PSQI). Results Ninety-five medical attention injuries were sustained by 73 athletes, at an incidence rate of 82.5 injuries/1000 player competition hours. Ankle sprains (n = 16) and lumbar pain (n = 12) had the highest incidence of medical attention injuries. Thirty per cent of athletes started the tournament with a self-reported health problem. Twelve sports incapacity injuries were recorded, with concussion (n = 5) and ACL rupture (n = 4) the most frequent. Fifty percent of athletes who completed the LEAF-Q were identified as being at risk of having low energy availability and 57% of PSQI respondents demonstrated poor sleep quality. There was no association between injury and athletes who were identified as being at risk of low energy availability or having poor sleep quality. Conclusions Ankle sprains, lumbar pain, and foot blisters are the most frequent medical attention injury and concussion, and ACL rupture were the most frequent sports incapacity injuries in pre-elite netball athletes. Also, a high number of athletes were identified as being at risk of low energy availability (n = 76, 50%) and poor sleep quality (n = 74, 57%). These athletes were not at higher risk of injury compared to those that were not identified as being at risk of low energy availability and poor sleep quality.

Comparison of active and passive recovery using local heat in lactate removal in cyclists

Article

Full-text available

Mar 2022

Purpose: To determine the comparative effect on lactatemia of active and passive recovery using local heat in male cyclists. Methods: Two recovery protocols applied on 24 cyclists were compared. One protocol consisted of active recovery of 15 min pedaling at 40% of V̇O2max followed by 15 min rest. The other protocol consisted of 30 min of passive recovery with hot packs on thighs for 15 min. Blood lactate was measured at maximal effort and during recovery. Results: Changes in lactatemia over time were not equivalent across the two protocol groups (p = .000). Lactatemia differences averaged across time were significant (p = .000). The mean values of lactatemia decreased over time but more so in the active recovery group. Conclusions: Active recovery exercising at 40% of V̇O2max after an intense effort results in a more effective decrease of blood lactate levels than passive recovery with local heat.

The use of contrast therapy in soft tissue injury management and post-exercise recovery: a scoping review

Article

Full-text available

Dec 2020
Phys Ther Rev

Contrast therapy is the alternation of thermotherapy and cryotherapy. Commonly used modalities of contrast therapy include contrast water therapy (CWT) and cold/hot packs. Despite a lack of research, it is widely used in clinical and sporting settings, particularly to aid recovery. The scoping review aims to provide a comprehensive overview of research surrounding the use of contrast therapy for soft tissue injury management and recovery. Twenty-nine full text papers were included, following a search of the databases listed: PubMed, Cochrane, SPORTDiscus, EBSCO, CINHAL and MEDLINE (via OVID). The majority of research on contrast therapy focuses on recovery, using contrast water therapy. Despite a consensus for contrast therapy temperatures of 10-15 °C (cold) and 38-40 °C (hot), significant variation amongst recovery protocols still exists, with temperatures ranging from 8-15 °C and 35.5-45 °C and duration ranging from 6 to 31 min. Generally, beneficial effects are reported to subjective measures such as self-reported perception of recovery, fatigue and muscle soreness following contrast therapy. However, the evidence is less clear regarding the influence on physiological measures and performance. Contrast therapy appears to be most commonly used in the form of contrast water therapy for post-exercise recovery purposes. There remains a significant lack of research surrounding the efficacy of contrast therapy for soft tissue injury management and the use of alternative modalities.

Scientific Assessment of Contrast Therapy in Exercise Recovery: A Meta-Analytical Approach

Article

May 2024

Contrast therapy’s effects have varied across studies, necessitating an examination of its effect size. Therefore, this study aimed to validate the efficacy of contrast therapy on post-exercise recovery through a meta-analysis of exercise performance and physiological variables. Searches were conducted in electronic databases with the keywords "contrast therapy," "exercise performance," and "recovery”. Then articles were screened according to PRISMA guidelines. Fifteen articles were included in the meta-analysis. The results indicated significant differences in sprint (g=0.3811, p

Comparison of 4 Different Cooldown Strategies on Lower-Leg Temperature, Blood Lactate Concentration, and Fatigue Perception After Intense Running

Article

Jul 2022

Context: Although active recovery (AR) and cold application is recommended, many people take a shower after exercise. Therefore, a direct comparison between a shower and other recommended methods (AR and/or cold-water immersion) is necessary. To compare immediate effects of 4 postexercise cooldown strategies after running. Design: A crossover design. Methods: Seventeen young, healthy males (23 y; 174 cm; 73 kg) visited on 4 different days and performed a 10-minute intense treadmill run (5 km/h at a 1% incline, then a belt speed of 1 km/h, and an incline of 0.5% were increased every minute). Then, subjects randomly experienced 4 different 30-minute cooldown strategies each session-AR (10-min treadmill walk + 10-min static stretch + 10-min shower), cold-water walk (10-min shower + 20-min walk in cold water), cold-water sit (10-min shower + 20-min sit in cold water), and passive recovery (10-min shower + 20-min passive recovery). Across the cooldown conditions, the water temperatures for immersion and shower were set as 18 °C and 25 °C, respectively. Lower-leg muscle temperature, blood lactate concentration, and fatigue perception were statistically compared (P < .001 for all tests) and effect sizes (ES) were calculated. Results: The cold-water walk condition (F135,2928 = 69.29, P < .0001) was the most effective in reducing muscle temperature after running (-11.6 °C, ES = 9.46, P < .0001), followed by the cold-water sit (-8.4 °C, ES = 8.61, P < .0001), passive recovery (-4.5 °C, ES = 4.36, P < .0001), and AR (-4.0 °C, ES = 4.29, P < .0001) conditions. Blood lactate concentration (F6,176 = 0.86, P = .52) and fatigue perception (F6,176 = 0.18, P = .98) did not differ among the 4 conditions. Conclusions: While the effect of lowering the lower-leg temperature was different, the effect of reducing blood lactate concentration and fatigue perception were similar in the 4 cooldown strategies. We suggest selecting the appropriate method while considering the specific goal, available time, facility, and accessibility.

Basic physiological mechanisms and adaptation reactions in the cold training of the organism in cold climate areas

Article

Sep 2020

The article presents the most significant literature data on the influence of hardening of a person on the possibilities of adaptive reactions of the body to low ambient temperatures. The most important functions of temperature receptors as an afferent link in the transmission of information, its correct processing and an adequate response of the body to the action of unfavorable environmental factors are shown. The review considers the main physiological reactions of the body to short-term and long-term exposure to cold. The processes of metabolic, vegetative, hormonal changes that help a person to adapt in terms of professional activity and living in harsh climatic conditions are described. The main principles of the hardening and training influence of environmental factors on a person are highlighted. The analysis of the literature data on the methods and methods of training the body’s resistance in case of its various dysfunctions in cold conditions is given. The positive effect of cold on the human body was studied. The article analyzes modern health-improving and cold training technologies. Methods are presented that combine cold training procedures with the use of drugs and physical exercises for faster and more effective adaptation to low temperatures.

Borg's Perceived Exertion and Pain Scales

Article

Full-text available

Jan 2001

Water Immersion Recovery for Athletes: Effect on Exercise Performance and Practical Recommendations

Article

Full-text available

Jun 2013
SPORTS MED

Water immersion is increasingly being used by elite athletes seeking to minimize fatigue and accelerate post-exercise recovery. Accelerated short-term (hours to days) recovery may improve competition performance, allow greater training loads or enhance the effect of a given training load. However, the optimal water immersion protocols to assist short-term recovery of performance still remain unclear. This article will review the water immersion recovery protocols investigated in the literature, their effects on performance recovery, briefly outline the potential mechanisms involved and provide practical recommendations for their use by athletes. For the purposes of this review, water immersion has been divided into four techniques according to water temperature: cold water immersion (CWI; ≤20 °C), hot water immersion (HWI; ≥36 °C), contrast water therapy (CWT; alternating CWI and HWI) and thermoneutral water immersion (TWI; >20 to

Contrast Water Therapy and Exercise Induced Muscle Damage: A Systematic Review and Meta-Analysis

Article

Full-text available

Apr 2013
PLOS ONE

The aim of this systematic review was to examine the effect of Contrast Water Therapy (CWT) on recovery following exercise induced muscle damage. Controlled trials were identified from computerized literature searching and citation tracking performed up to February 2013. Eighteen trials met the inclusion criteria; all had a high risk of bias. Pooled data from 13 studies showed that CWT resulted in significantly greater improvements in muscle soreness at the five follow-up time points (<6, 24, 48, 72 and 96 hours) in comparison to passive recovery. Pooled data also showed that CWT significantly reduced muscle strength loss at each follow-up time (<6, 24, 48, 72 and 96 hours) in comparison to passive recovery. Despite comparing CWT to a large number of other recovery interventions, including cold water immersion, warm water immersion, compression, active recovery and stretching, there was little evidence for a superior treatment intervention. The current evidence base shows that CWT is superior to using passive recovery or rest after exercise; the magnitudes of these effects may be most relevant to an elite sporting population. There seems to be little difference in recovery outcome between CWT and other popular recovery interventions.

Acute Response to Hydrotherapy After a Simulated Game of Rugby

Article

Full-text available

Jan 2013
J STRENGTH COND RES

Despite lacking clear scientific evidence, hydrotherapies (water treatments) are accepted techniques to help team sport athletes recover from the physical effects of games. The purpose of this study was to assess the comparative effectiveness of cold water immersions and hot-and-cold contrast baths on athletes' recovery following a simulated game of rugby union. Twenty-four experienced, well trained, male rugby union players were divided into three groups to receive recovery interventions: cold water immersion for one group, contrast baths for a second group, and passive recovery for a third (control) group. Pre- and post-game measurements included a counter-movement jump (CMJ, normalised as a ratio to body weight), a sit-and-stretch flexibility test (cm), thigh circumference (to detect swelling; cm), as well as participants' perception of delayed-onset muscular soreness (DOMS, 100mm visual analogue scale). Statistical analysis included analysis of variance, as well as the calculation of omnibus effect sizes for each group (ηp2) and the magnitudes of change within and between groups (Cohen's d). Participants in the contrast baths group reported statistically significantly greater measures of DOMS than participants in the control group at one hour post intervention (p=0.05, control group d = 1.80; contrast bath d = 4.75), and than participants in the cold water immersion group at 48 hours post intervention (p=0.02, cold water immersion d = 1.17; contrast bath d = 1.97). These findings provide modest evidence that contrast baths are a less effective strategy for recovery from rugby union than are cold water immersion or passive recovery. Specifically, 2 × 5-minute cold water immersion is superior to both contrasts baths and passive recovery in alleviating DOMS after exercise-induced muscle damage. Our recommendation for rugby union players aiming to attenuate the effects of DOMS post games is to take 2 × 5 minute cold water immersions baths immediately after the game.

Alternating hot and cold water immersion for athlete recovery: A review

Article

Full-text available

Feb 2004
PHYS THER SPORT

Darryl Cochrane

Objectives. The aim of this review was to investigate whether alternating hot – cold water treatment is a legitimate training tool for enhancing athlete recovery. A number of mechanisms are discussed to justify its merits and future research directions are reported. Alternating hot– cold water treatment has been used in the clinical setting to assist in acute sporting injuries and rehabilitation purposes. However, there is overwhelming anecdotal evidence for it's inclusion as a method for post exercise recovery. Many coaches, athletes and trainers are using alternating hot – cold water treatment as a means for post exercise recovery. Design. A literature search was performed using SportDiscus, Medline and Web of Science using the key words recovery, muscle fatigue, cryotherapy, thermotherapy, hydrotherapy, contrast water immersion and training. Results. The physiologic effects of hot – cold water contrast baths for injury treatment have been well documented, but its physiological rationale for enhancing recovery is less known. Most experimental evidence suggests that hot– cold water immersion helps to reduce injury in the acute stages of injury, through vasodilation and vasoconstriction thereby stimulating blood flow thus reducing swelling. This shunting action of the blood caused by vasodilation and vasoconstriction may be one of the mechanisms to removing metabolites, repairing the exercised muscle and slowing the metabolic process down. Conclusion. To date there are very few studies that have focussed on the effectiveness of hot– cold water immersion for post exercise treatment. More research is needed before conclusions can be drawn on whether alternating hot– cold water immersion improves recuperation and influences the physiological changes that characterises post exercise recovery.

Effect of Contrast Water Therapy Duration on Recovery of Running Performance

Article

Full-text available

Dec 2011

To investigate whether contrast water therapy (CWT) assists acute recovery from high-intensity running and whether a dose-response relationship exists. Ten trained male runners completed 4 trials, each commencing with a 3000-m time trial, followed by 8 × 400-m intervals with 1 min of recovery. Ten minutes postexercise, participants performed 1 of 4 recovery protocols: CWT, by alternating 1 min hot (38°C) and 1 min cold (15°C) for 6 (CWT6), 12 (CWT12), or 18 min (CWT18), or a seated rest control trial. The 3000-m time trial was repeated 2 h later. 3000-m performance slowed from 632 ± 4 to 647 ± 4 s in control, 631 ± 4 to 642 ± 4 s in CWT6, 633 ± 4 to 648 ± 4 s in CWT12, and 631 ± 4 to 647 ± 4 s in CWT18. Following CWT6, performance (smallest worthwhile change of 0.3%) was substantially faster than control (87% probability, 0.8 ± 0.8% mean ± 90% confidence limit), however, there was no effect for CWT12 (34%, 0.0 ± 1.0%) or CWT18 (34%, -0.1 ± 0.8%). There were no substantial differences between conditions in exercise heart rates, or postexercise calf and thigh girths. Algometer thigh pain threshold during CWT12 was higher at all time points compared with control. Subjective measures of thermal sensation and muscle soreness were lower in all CWT conditions at some post-water-immersion time points compared with control; however, there were no consistent differences in whole body fatigue following CWT. Contrast water therapy for 6 min assisted acute recovery from high-intensity running; however, CWT duration did not have a dose-response effect on recovery of running performance.

Asca current trends and practices-recovery review-science vs Practice

Article

Jan 2010

Effects of Electrostimulation Therapy on Recovery From Acute Team-Sport Activity

Article

May 2013

Purpose: To assess the efficacy of a 1-off electrostimulation treatment as a recovery modality from acute team-sport exercise, directly comparing the benefits to contrast water therapy. Methods: Ten moderately trained male athletes completed a simulated team-game circuit (STGC). At the conclusion of exercise, participants then completed a 30-min recovery modality of either electrostimulation therapy (EST), contrast water therapy (CWT), or a passive resting control condition (CON). Twenty-four hours later, participants were required to complete a modified STGC as a measure of next-day performance. Venous blood samples were collected preexercise and 3 and 24 h postexercise. Blood samples were analyzed for circulating levels of interleukin-6 (IL-6) and C-reactive protein (CRP). Results: The EST trial resulted in significantly faster sprint times during the 24-h postrecovery than with CON (P < .05), with no significant differences recorded between EST and CWT or between CWT and CON (P > .05). There were no differences in IL-6 or CRP across all trials. Finally, the perception of recovery was significantly greater in the EST trial than in the CWT and CON (P < .05). Conclusions: These results suggest that a 1-off treatment with EST may be beneficial to perceptual recovery, which may enhance next-day performance.

The Relative Efficacy of Three Recovery Modalities After Professional Rugby League Matches

Article

Dec 2012
J STRENGTH COND RES

This study investigated the relative efficacy of post-game recovery modalities on jump height performance, subjective ratings of muscle soreness and muscle damage at 1, 18, and 42 hours following professional rugby league competition games. Twenty-one professional rugby league players performed three different post-match recovery modalities; cold water immersion (CWI), contrast water therapy (CWT) and active recovery (ACT)). The effects of the recovery treatments were analyzed with mixed modeling including a covariate (fatigue score) to adjust for changes in the intensity of each match on the post-match values of the dependent variables of interest. Standardization of effects was used to make magnitude-based inferences, presented as mean; ±90% confidence intervals. CWI and CWT clearly recovered jump height performance (CWI 2.3; ±3.7%, CWT 3.5%; ±4.1%), reduced muscle soreness (CWI -0.95; ±0.37, CWT -0.55; ±0.37), and decreased creatine kinase (CWI -11.0; ±15.1%, CWT 18.2; ±20.1% ) by 42 hours post-game compared to ACT. CWT was however clearly more effective compared to CWI on the recovery of muscle soreness and creatine kinase by 42 hours post game. Based on these findings, CWT recovery is recommended post-match for team rugby sports.

The effect of backward training on the speed, agility and power in netball players

Article

Sep 2009

This study investigated the effect of a backward training programme on the speed, agility and power of well-trained netball players. Seventeen women club netball players (aged 19 – 20 years) were divided into an experimental (n=10) and a control group (n=7) and participated in a six-week backward (BW) and forward (FW) training programme after the competitive season. Before and after the intervention, all the subjects completed the following tests: agility-505 test, agility-T, ladder-test, sprint test (5, 10 and 20 meters) and a vertical jump test. The experimental group showed a statistically significant improvement in the agility-505 test, both for the right leg (p=0.03) and left leg (p=0.03), the agility-T test (p=0.01), as well as the ladder-test (p=0.001). No statistically significant differences were found between the experimental and control groups with regards to straight-line speed and leg power. Although it is not uncommon for coaches to include backward running exercises in the conditioning programmes of team sport players, the actual value of this type of training may have been underestimated in the past. Our findings suggest that netball specific exercises, performed backwards, can be successfully included in the conditioning and skills training programmes of team sport players.