ArticlePDF Available

Effects of seated and standing cold water immersion on recovery from repeated sprinting

Abstract

This study investigated the effects of two different hydrostatic pressures (seated or standing) during cold water immersion at attenuating the deleterious effects of strenuous exercise on indices of damage and recovery. Twenty four male well-trained games players (age 23 ± 3 years; body mass 81.4 ± 8.7 kg: O2max 57.5 ± 4.9 ml∙kg−1∙min−1) completed the Loughborough Intermittent Shuttle Test (LIST) and were randomly assigned to either a control, seated cold water immersion or a standing cold water immersion (14 min at 14°C). Maximal isometric voluntary contraction, counter-movement jump, creatine kinase, C-reactive protein, interleukin-6 and delayed onset muscle soreness (DOMS) were measured before and up to 72 h following the LIST. All dependent variables showed main effects for time (P < 0.05) following the LIST, indicating physiological stress and muscle damage following the exercise. There were no significant group differences between control and either of the cold water immersion interventions. Seated cold water immersion was associated with lower DOMS than standing cold water immersion (effect size = 1.86; P = 0.001). These data suggest that increasing hydrostatic pressure by standing in cold water does not provide an additional recovery benefit over seated cold water immersion, and that both seated and standing immersions have no benefit in promoting recovery following intermittent sprint exercise
This article was downloaded by: [GlaxoSmith Kline]
On: 13 January 2015, At: 03:44
Publisher: Routledge
Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House,
37-41 Mortimer Street, London W1T 3JH, UK
Click for updates
Journal of Sports Sciences
Publication details, including instructions for authors and subscription information:
http://www.tandfonline.com/loi/rjsp20
Effects of seated and standing cold water immersion
on recovery from repeated sprinting
Jonathan D. C. Leederab, Ken A. Van Somerenbc, Phillip G. Bellbc, John R. Spenceb, Andrew
P. Jewelld, David Gazee & Glyn Howatsonbf
a Physiology Department, English Institute of Sport, Manchester, UK
b Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, UK
c GSK Human Performance Lab, GlaxoSmithKline, Brentford, UK
d UCL Cancer Institute, London, UK
e Department of Chemical Pathology, St Georges Healthcare NHS Trust, London, UK
f Water Research Group, Northwest University, Potchefstroom, South Africa
Published online: 09 Jan 2015.
To cite this article: Jonathan D. C. Leeder, Ken A. Van Someren, Phillip G. Bell, John R. Spence, Andrew P. Jewell, David
Gaze & Glyn Howatson (2015): Effects of seated and standing cold water immersion on recovery from repeated sprinting,
Journal of Sports Sciences, DOI: 10.1080/02640414.2014.996914
To link to this article: http://dx.doi.org/10.1080/02640414.2014.996914
PLEASE SCROLL DOWN FOR ARTICLE
Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained
in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no
representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the
Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and
are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and
should be independently verified with primary sources of information. Taylor and Francis shall not be liable for
any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever
or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of
the Content.
This article may be used for research, teaching, and private study purposes. Any substantial or systematic
reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any
form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://
www.tandfonline.com/page/terms-and-conditions
Effects of seated and standing cold water immersion on recovery from
repeated sprinting
JONATHAN D. C. LEEDER
1,2
, KEN A. VAN SOMEREN
2,3
, PHILLIP G. BELL
2,3
,
JOHN R. SPENCE
2
, ANDREW P. JEWELL
4
, DAVID GAZE
5
& GLYN HOWATSON
2,6
1
Physiology Department, English Institute of Sport, Manchester, UK,
2
Department of Sport, Exercise and Rehabilitation,
Northumbria University, Newcastle, UK,
3
GSK Human Performance Lab, GlaxoSmithKline, Brentford, UK,
4
UCL Cancer
Institute, London, UK,
5
Department of Chemical Pathology, St Georges Healthcare NHS Trust, London, UK and
6
Water
Research Group, Northwest University, Potchefstroom, South Africa
(Accepted 7 December 2014)
Abstract
This study investigated the effects of two different hydrostatic pressures (seated or standing) during cold water immersion
at attenuating the deleterious effects of strenuous exercise on indices of damage and recovery. Twenty four male
well-trained games players (age 23 ± 3 years; body mass 81.4 ± 8.7 kg:
_
VO
2max
57.5 ± 4.9 mlkg
1
min
1
)completed
the Loughborough Intermittent Shuttle Test (LIST) and were randomly assigned to either a control, seated cold
water immersion or a standing cold water immersion (14 min at 14°C). Maximal isometric voluntary contraction,
counter-movement jump, creatine kinase, C-reactive protein, interleukin-6 and delayed onset muscle soreness
(DOMS) were measured before and up to 72 h following the LIST. All dependent variables showed main effects for
time (P< 0.05) following the LIST, indicating physiological stress and muscle damage following the exercise. There were
no signicant group differences between control and either of the cold water immersion interventions. Seated cold water
immersion was associated with lower DOMS than standing cold water immersion (effect size = 1.86; P= 0.001). These
data suggest that increasing hydrostatic pressure by standing in cold water does not provide an additional recovery benet
over seated cold water immersion, and that both seated and standing immersions have no benet in promoting recovery
following intermittent sprint exercise.
Keywords: muscle damage, hydrotherapy, performance
Introduction
There is a marked reduction in muscle function and
increase in perception of muscle soreness days after
intermittent sprint sport, such as football, rugby and
hockey, (Bailey et al., 2007; Gill, Beaven, & Cook,
2006; King & Dufeld, 2009;Montgomeryetal.,
2008). Ascensão et al. (2008) measured the effect of
a football match on markers of muscle damage and
recovery, and identied that sprint speed and both
hamstring and quadriceps torque were all lower than
baseline values 72 h after the match. The aetiology of
decreased muscular function and increased soreness
in repeated sprint exercise is likely twofold. First, the
large number of changes in direction and decelera-
tions provide a substantial eccentric component
(Akenhead, Hayes, Thompson, & French, 2013)
causing mechanical damage (Friden & Lieber,
2001). Second, repeated sprint sport can induce a
signicant metabolic stress due to long duration and
high metabolic intensity, potentially causing oxidative
damage (Andersson, Karlsen, Blomhoff, Raastad, &
Kadi, 2010; Ascensão et al., 2008). Additionally, it
appears well-trained athletes are not protected from
the repeated bout effect, advocating the necessity for
effective recovery strategies after this exercise type
(Leeder et al., 2014).
An in-house audit, conducted by the English
Institute of Sport on a range of elite sports, suggested
that cold water immersion was as a popular and fre-
quently used recovery modality. Popularity is further
advocated by research investigating the importance of
recovery in team sports (Nédélec et al., 2013;Venter,
2014). The effectiveness of cold water immersion is
believed to be related to temperature- and pressure-
induced changes in blood ow and reduced muscle
temperature (Bleakley & Davison, 2010;Gregson
et al., 2011) that subsequently reduce post-exercise
Correspondence: Jonathan D. C. Leeder, Physiology Department, English Institute of Sport, Sportcity, Gate 13, Rowsley Street, Manchester, M11 3FF, UK.
E-mail: jonathan.leeder@eis2win.co.uk
Journal of Sports Sciences, 2015
http://dx.doi.org/10.1080/02640414.2014.996914
© 2015 Taylor & Francis
Downloaded by [GlaxoSmith Kline] at 03:44 13 January 2015
inammation (Yanagisawa, Niitsu, Takahashi, Goto,
&Itai,2003; Yanagisawa, Niitsu, Yoshioka, et al.,
2003). It has been speculated that cold water immer-
sion can reduce oedema formation, potentially limit-
ing secondary hypoxic damage and reduce pressure
on nociceptors, therefore alleviating the magnitude of
soreness (Friden, Sfakianos, Hargens, & Akeson,
1988;Merrick,2002; Wilcock, Cronin, & Hing,
2006). Recent meta-analyses have identied that
cold water immersion may be an effective analgesic
(Bleakley et al., 2012), and potentially specicto
exercise incorporating a combination of metabolic
and mechanical stress (Leeder, Gissane, Van
Someren, Gregson, & Howatson, 2012).
Subsequently this study adopted a repeated sprint
sport model due to the popularity of cold water
immersion in these sports and the potential effective-
ness of cold water immersion highlighted by previous
work (Leeder et al., 2012) for this exercise modality.
The physiological effects of hydrostatic pressure
during cold water immersion have been extensively
reviewed by Wilcock et al. (2006); briey, during
thermo neutral water immersions to the neck, there
is a displacement of uid and gas from higher-pres-
sure areas at the ankle to low pressure areas at the
water surface. This squeezingeffect induces altera-
tions in uid within the intra-cellular, interstitial and
intra-vascular spaces. These uid shifts have been
associated with reducing oedema and subsequently
reducing perception of muscle soreness.
Investigations that have increased hydrostatic pressure
during cold water immersion by completing a stand-
ing immersion have repeatedly found positive effects
on recovery following both exercise-induced muscle
damage (Vaile, Halson, Gill, & Dawson, 2008b)and
high-intensity cycling paradigms (Vaile, Halson, Gill,
&Dawson,2008a). Given the potential inuence of
hydrostatic pressure on recovery, there is a strong
rationale for investigating whether water depth (and
hence hydrostatic pressure) could modulate the
recovery response from cold water immersion
(Wilcock et al., 2006). Consequently, it was hypothe-
sised that the cold water immersion would improve
recovery following strenuous repeated sprint activity,
and that recovery would be greater if hydrostatic
pressure was increased. Therefore the aim of this
investigation was to ascertain the effectiveness of
seated and standing cold water immersions in facil-
itating recovery from strenuous physical activity.
Methods
Participants
Twenty four male (age 21 ± 3 years; body mass 81.4
± 8.7 kg) well-trained team sport athletes players
(
_
VO
2max
57.8 ± 5.0 ml·kg
1
·min
1
), who frequently
took part in repeat sprint eld sports (rugby (n= 10),
hockey (n= 6) and football (n= 8)), volunteered for
the study (Table II). Participants were randomly
assigned to one of the three groups (control, seated
cold water immersion or standing cold water immer-
sion) using computer randomisation, and concealed
from their allocation until after the exercise bout.
Participants completed written informed consent
and a health-screening questionnaire prior to testing.
The study was approved by the local research ethics
committee in accordance with the Helsinki
Declaration.
Experimental design
Following familiarisation to all testing procedures,
participants completed the Loughborough
Intermittent Shuttle Test (LIST). The LIST is
described in full in Nicholas, Nuttall, & Williams,
2000; briey, the LIST comprised 5 sets of 15 min
varying intensity exercise, ranging from walking, jog-
ging (~55%
_
VO
2max
), running (95%
_
VO
2max
) and
sprinting (11 × 15 m sprints per set). Exercise inten-
sity for the LIST was determined from a prior
_
VO
2max
assessment. The LIST was completed in
an indoor sports complex with controlled environ-
mental conditions (19°C, 5060% relative humid-
ity). Subjective ratings of perceived exertion were
recorded at the end of each 15 min set, as well as
15 m sprint times (Brower Timing System,
Utah, USA).
A prole of recovery from the LIST was assessed
using a range of dependent variables (Table II),
which were completed prior and up to 72 h following
the LIST. Nutritional intake was recorded for 2 d
before testing and for the 3 d of recovery following
the exercise. Participants were required to refrain
from exercise for 2 d prior to testing and to abstain
from any therapeutic interventions, such as non-ster-
oidal, anti-inammatory drugs or compression gar-
ments, throughout the experimental period.
Following completion of the LIST and the post-
LIST blood sample, participants were randomly
assigned to a control group (n= 8; remained seated
for 14 min) or to a seated cold water immersion
group (n= 8; 14°C for 14 min, hydrostatic pressure
at ankle approximately 40 mmHg) or standing cold
water immersion group (n= 8; 14°C for 14 min,
hydrostatic pressure at ankle approximately
111 mmHg). An increase in depth of 1 cm of water
increases pressure by 0.74 mmHg (Wilcock et al.,
2006). The duration and temperature of immersion
was selected based upon previous effective results
(Leeder et al., 2012; Vaile et al., 2008a,2008b).
The water temperature was controlled with a ther-
mostatically regulated instrument (iCool Sport,
2J. D. C. Leeder et al.
Downloaded by [GlaxoSmith Kline] at 03:44 13 January 2015
Australia). After the interventions, participants sat in
a quiet area until after the 1 h post-LIST blood
sample was taken to reduce potential inuences on
muscle temperature or blood ow.
Dependent variables
Neuromuscular function. Maximal isometric voluntary
contraction and counter-movement jump were
assessed before, immediately after, and 24, 48 and
72 h post-exercise. During the counter-movement
jump, participants stood on an electronic timing
mat, placed hands on hips and dropped down to a
self-selected level before jumping maximally. Flight
time was used to estimate jump height (KMS Switch
Mat, Australia). Knee extensor peak torque using
the dominant leg was assessed via a digital strain
gauge (MIE Digital Myometer, Leeds, UK) in a
seated position to ascertain maximal isometric
voluntary contraction. One end of the load cell was
attached to the ankle strap situated ~2 cm proximal
to the malleoli, with the other end attached to a
bespoke steel chair. Knee angle was standardised at
90° using a goniometer to minimise for error derived
from alteration in muscle length (Warren, Lowe, &
Armstrong, 1999). Assessment of both counter-
movement jump and maximal isometric voluntary
contraction followed a standardised warm-up of 5
incremental sub-maximal contractions and included
3 maximal efforts, each separated by 1 min, with the
average of the 3 measures used for statistical analy-
sis. Inter-day co-efcient of variation for counter-
movement jump and maximal isometric voluntary
contraction were 3.7 and 3.5%, respectively.
Muscle soreness. Delayed onset muscle soreness
(DOMS) was measured via a 200 mm visual analo-
gue scale with 0 mm representing no painand
200 mm extremely painful(Howatson, Van
Someren, & Hortobágyi, 2007; Leeder et al.,
2014). Participants placed hands on hips and bent
down in a squat position to a 90° knee angle prior to
completing the visual analogue scale. Muscle sore-
ness was assessed at baseline and 24, 48 and 72 h
post-exercise.
Blood markers. A venous blood sample (~20 mL) was
collected into lithium heparin tubes taken from the
antecubital fossa using standard venepuncture tech-
niques. Blood was immediately spun in a refrigerated
centrifuge (4°C) for 15 min at 2400 g. Plasma was
aspirated and stored at 80°C for further analysis.
The time of collection for all dependent variables
was based upon likely known time-course responses
(Table II). Plasma creatine kinase and C-reactive
Protein were derived using automated analysers
(Advia 2400 Chemistry System, Siemens
Healthcare Diagnostics, USA) with intra-sample
co-efcient of variation of <3% at low and high
concentrations. Normal baseline values, according
to manufacturer guidelines, for creatine kinase and
C-reactive protein, were 32294 IU·L
1
and
<3 mg·L
1
, respectively. Plasma interleukin-6 was
determined in duplicate using the quantitative sand-
wich enzyme immunoassay ELISA technique
(Quantikine, R&D Systems Europe Ltd.,
Abingdon, UK) with a spectrophotometric plate
reader (Biochrom Anthos 2010, Cambridge, UK).
Normal baseline values according to manufacturer
guidelines for interleukin-6 were <3 pg·mL
1
and
intra-sample co-efcient of variation was <3%.
Statistical analysis. All data are presented as mean ±
s. A two-way repeated measures analysis of variance
was used to analyse within participant effects,
3×groups (control, seated cold water immersion
and standing cold water immersion) and up to 4
time points dependent on the dependent variable
(Pre-, post-, 1, 6, 24, 48 and 72 h post-exercise).
Where assumptions of sphericity were violated,
GreenhouseGeisser corrections were used.
Signicant interactions were followed up with LSD
posthoc pair-wise comparisons. Where signicant
ndings or trends were identied, Cohensd-effect
size statistics were also calculated to provide magni-
tude of effects, and 0.2, 0.5 and >0.8 were consid-
ered to represent small, medium and large effects,
respectively (Durlak, 2009). Data were analysed
using SPSS for Windows (v. 19.0 software package)
and signicance was set at P= 0.05.
Results
All participants completed the investigation without
any drop-outs or side effects from the interventions.
There were no differences between groups for age,
mass,
_
VO
2max
, maximal isometric voluntary contrac-
tion or counter-movement jump (P> 0.05; Table I).
Mean ± sfor all other data is presented in Table III.
During the LIST, means for rate of perceived exer-
tion (16 ± 2) and sprint performance (2.52 ± 0.20 s)
were not different between groups (P> 0.05) and
comparable with other researches utilising LIST
(Bailey et al., 2007; Thompson et al., 2003).
Muscle soreness
The LIST caused an increase in DOMS over time
(F
3,63
=53.400,P< 0.001), which was observed to be
the highest at 24 h post-exercise for the control and
seated cold water immersion groups and at 48 h post-
exercise for the standing cold water immersion group.
A group × time interaction for DOMS (F
6,63
=2.330,
P= 0.043), and subsequent post hoc analysis,
Recovery from repeated sprints 3
Downloaded by [GlaxoSmith Kline] at 03:44 13 January 2015
Table II. List of dependent variables measured at specic time points.
Dependent variable Pre Immediately post 1 h post 6 h post 24 h post 48 h post 72 h post
MIVC ✓✓
CMJ ✓✓
Muscle soreness ✓✓
CK ✓✓
CRP ✓✓
IL-6 ✓✓ ✓
Note: MIVC = maximal voluntary contraction; CMJ = counter-movement jump; CK = creatine kinase; CRP = C-reactive protein;
IL-6 = interleukin-6.
Table I. Participant characteristics for control (n= 8), seated cold water immersion (n= 8) and standing cold water immersion (n= 8).
Values are mean ± s.
Group Age (years) Mass (kg)
_
VO
2max
(mL·kg·min
1
) MIVC (N) CMJ (cm)
Control 22 ± 3 83.5 ± 9.5 54.8 ± 4.6 675 ± 105 36.0 ± 3.5
Seated 22 ± 3 83.0 ± 10.3 59.1 ± 5.2 654 ± 98 36.0 ± 3.4
Standing 20 ± 2 79.9 ± 10.1 60.3 ± 3.8 591 ± 117 33.6 ± 3.6
Note: MIVC = maximum voluntary contraction; CMJ = counter-movement jump.
Table III. Descriptive statistics (mean ± s) for all dependent variables measured following LIST in all three groups.
MIVC (%Δ) CMJ (%Δ)
Time Control Seated Standing Control Seated Standing
Pre 100.0 ± 0.0 100.0 ± 0.0 100.0 ± 0.0 100.0 ± 0.0 100.0 ± 0.0 100.0 ± 0.0
Post
1h
6h
24 h 93.2 ± 6.8 94.1 ± 14.8 94.1 ± 9.9 93.4 ± 6.3 95.7 ± 9.0 96.9 ± 5.4
48 h 93.9 ± 8.8 98.5 ± 10.0 95.8 ± 18.0 98.4 ± 5.9 97.1 ± 9.3 97.9 ± 5.2
72 h 98.4 ± 5.2 103.2 ± 10.4 99.0 ± 14.0 101.3 ± 5.0 100.0 ± 6.2 99.2 ± 6.9
CK (IU·L
1
) CRP (mg·L
1
)
Time Control Seated Standing Control Seated Standing
Pre 249 ± 185 496 ± 920 136 ± 72 1.55 ± 1.38 0.97 ± 1.04 1.33 ± 1.10
Post
1h
6h
24 h 1375 ± 1247 1004 ± 671 813 ± 385 2.45 ± 2.24 1.44 ± 1.34 1.90 ± 1.30
48 h 721 ± 689 906 ± 1221 500 ± 371 1.56 ± 0.91 1.22 ± 1.04 1.61 ± 1.40
72 h 415 ± 327 423 ± 460 321 ± 237 2.53 ± 1.37 2.24 ± 0.93 2.34 ± 1.41
IL-6 (pg·mL
1
) Soreness (mm)
Time Control Seated Standing Control Seated Standing
Pre 0.3 ± 0.1 0.7 ± 1.1 1.8 ± 5.2 0 ± 0 5 ± 11 11 ± 17
Post 19.6 ± 15.9 10.6 ± 5.7 20.6 ± 9.0
1 h 16.8 ± 21.9 5.7 ± 4.2 7.6 ± 8.6
6 h 1.0 ± 1.2 1.5 ± 1.7 0.7 ± 1.9
24 h 110 ± 53 94 ± 54 97 ± 30
48 h 92 ± 38 65 ± 49 127 ± 19
72 h 29 ± 17 38 ± 56 65 ± 43
Note: MIVC = maximal voluntary contraction; CMJ = counter-movement jump; CK = creatine kinase; CRP = C-reactive protein;
IL-6 = interleukin 6.
4J. D. C. Leeder et al.
Downloaded by [GlaxoSmith Kline] at 03:44 13 January 2015
indicated that at 48 h post-LIST, the seated cold
water immersion group experienced lower DOMS
than the standing cold water immersion group
(mean difference ± 90% condence inter-
vals = 63 ± 34, effect size = 1.86; P= 0.001). At
48 h post-LIST, a trend existed for the standing cold
water immersion group having higher DOMS than
control (mean difference ± 90% condence inter-
vals = 35 ± 27, effect size = 1.25; P= 0.053), with
no signicant difference between seated cold water
immersion and control (mean difference ± 90% con-
dence intervals = 28 ± 39, effect size = 0.64;
P= 0.141).
Muscle function
Maximal isometric voluntary contraction
(F
2,42
= 5.216, P= 0.009) and counter-movement
jump (F
2,42
= 9.787, P< 0.001) both showed reduc-
tions over time; but there were no differences
between groups or interactions between groups and
time (P> 0.05). The reduction in muscle function
measures were observed as most pronounced at 24 h
post-LIST and returned close to baseline by 72 h.
Blood markers
Creatine kinase changed over time (F
2,35
= 17.054,
P< 0.001), observed to be highest 24 h post-LIST in
all groups. There were no differences between
groups or interactions between group and time
(P> 0.05) for creatine kinase, despite a moderate
effect between standing cold water immersion and
control at 24 h post-LIST (mean difference ± 90%
condence intervals = 394 ± 859 IU·L
1
, effect
size = 0.69). C-reactive protein also changed over
time (F
3,54
= 4.526, P= 0.007), observed to be
highest at 24 h and then reducing towards baseline
values at 48 h followed by a second rise at 72 h post-
LIST. There were no differences between groups or
interactions between groups and time for C-reactive
protein (P> 0.05). Interleukin-6 changed over time
(F
2,35
= 15.142, P< 0.001), observed to be highest
immediately post-LIST before returning towards
baseline values at 6 h post-exercise. There were no
differences between groups (p= 0.153) or interac-
tions between groups and time (P= 0.259) for inter-
leukin-6. At 1 h post-LIST, a large effect existed
between the seated cold water immersion and con-
trol group for interleukin-6 (mean difference ± 90%
condence intervals = 11.1 ± 16.4 pg·mL
1
, effect
size = 0.85), compared to a moderate effect (mean
difference ± 90% condence intervals = 9.2 ± 16.7
pg·mL
1
, effect size = 0.60) between the standing
cold water immersion and control groups.
Discussion
This study investigated the effectiveness of two cold
water immersion protocols with different hydrostatic
pressures on recovery following simulated repeated
sprint sport. Contrary to our hypothesis, there were
no signicant positive effects of cold water immer-
sion regardless of the depth of immersion and hence
the signs and symptoms associated with exercise-
induced muscle damage and accelerated recovery
were not abated following repeated sprint exercise.
An unexpected nding in the current investigation
was the seated cold water immersion group experi-
encing reduced DOMS compared to standing cold
water immersion group at 48 h post-exercise; how-
ever there was no difference between either of the
cold water immersion groups and the control group.
These data contrast to Bailey et al. (2007) who mea-
sured the effect of a seated cold water immersion on
recovery from the LIST and found that a 10-min
immersion at 10°C had positive effects on perception
of muscle soreness, knee exion maximal isometric
voluntary contraction and myoglobin efux, yet had
no effect on recovery of vertical jump or knee exten-
sion maximal isometric voluntary contraction. The
divergent ndings between Bailey et al. (2007) and
the current investigation could be explained by the
slightly different cold water immersion protocols.
Interestingly, soreness peaked at 48 h in the standing
group, as it is more frequent to peak at 24 h follow-
ing this exercise type (Bailey et al., 2007; Thompson,
Nicholas, & Williams, 1999). In contrast,
Thompson et al. (1999) found that although general
soreness peaked at 24 h following the LIST, ham-
string specic soreness peaked at 48 h post-exercise.
Future research that investigates the muscle soreness
response to repeated sprint exercise is warranted to
ensure that both the temporal and anatomical local-
ity of the damage response is adequately captured.
Given the perceptual nature of DOMS assess-
ments and the inability to provide an effective sham
group, it is plausible that a placebo effect may have
an impact on the effectiveness of cold water immer-
sion as recovery modality (Beedie, 2007; Beedie,
Coleman, & Foad, 2007; Beedie & Foad, 2009;
Broatch, Petersen, & Bishop, 2014). Recent data
from Cook and Beaven (2013) investigated the rela-
tionship between athlete perception of recovery and
sprint performance. Following an intense condition-
ing session, the performance of a sprinting exercise
by elite male rugby players was signicantly corre-
lated to both a drop in core temperature and the
athletesperception of the efcacy of intervention.
These data conrm the important link between the
perception of effectiveness of a recovery modality
and its subsequent effects on recovery. Although
somewhat speculative, it is plausible that a lack of
Recovery from repeated sprints 5
Downloaded by [GlaxoSmith Kline] at 03:44 13 January 2015
belief in effectiveness of cold water immersion could
explain these soreness ndings. A more thorough
battery of subjective measures of recovery, and con-
tributions from both central and peripheral factors,
should be included in future research (Minett &
Dufeld, 2014; Stanley, Peake, & Buchheit, 2013).
The principle measure of any recovery modality in
a sport specic scenario is proposed to be muscle
function (Bailey, Williams, Betts, Thompson, &
Hurst, 2011; Warren et al., 1999). The results of
this investigation support the ndings of Bailey
et al. (2007) that cold water immersion has no effect
on recovery of knee extension maximal isometric
voluntary contraction or counter-movement jump
following the LIST. Rowsell, Coutts, Reaburn, and
Hill-Haas (2009) investigated the effect of a cold
(5 × 60 s at 10°C with 60 s between immersions)
or thermo neutral (5 × 60 s at 34°C with 60 s
between immersions) water immersion on recovery
from a 4 d simulated football tournament. The
authors found no difference between groups for
counter-movement jump or repeat sprint ability,
but found lower perception of soreness in the cold
water immersion group. A limitation of this study
was the lack of a true control group as all groups
received some form of intervention; therefore results
should be interpreted with caution. To our knowl-
edge, only studies which have used isolated eccentric
exercise (Vaile et al., 2008b) or repeated high inten-
sity cycling (Vaile et al., 2008a) have documented
improvements in recovery of muscular power
(Leeder et al., 2012). These data suggest that the
effectiveness of cold water immersion may be depen-
dent on the exercise mode or the number of repeated
exercise bouts. Although muscle function is consid-
ered an effective tool to assess the magnitude of
exercise-induced muscle damage (Warren et al.,
1999) and hence recovery, inclusion of other more
sport specic performance tests such as repeated
sprint ability are warranted (Byrne, Twist, & Eston,
2004). Whilst the markers of recovery in Table III
suggest exercise-induced muscle damage was pre-
sent, it is conceivable that the moderate reduction
in maximal isometric voluntary contraction and
counter-movement jump (~6% at 24 h post-LIST)
was not of sufcient magnitude for cold water
immersion to have an effect. It is speculated that
during tournament scenarios, if an aggregation of
exercise-induced muscle damage and therefore a
greater functional decline exists over time (Rowsell,
Coutts, Reaburn, & Hill-Haas, 2011; Spencer et al.,
2005; Vaile et al., 2008a), an increase in the oppor-
tunity for cold water immersion to be effective may
exist.
The creatine kinase response to the LIST was
similar in magnitude to other studies investigating
high intensity exercise, with the eccentric work
primarily elicited in the acceleration, deceleration
and changes in direction phases. Consequently, this
provides the dominant stimulus for exercise-induced
muscle damage and subsequent loss of Ca
2+
home-
ostasis, cellular membrane integrity, and hence lead-
ing to increases in systemic intra-cellular proteins
(Ascensão et al., 2008; Bailey et al., 2007;
Thompson et al., 1999). An additional mechanism
is that the muscle cells may release cytoplasmic con-
tents to reduce the magnitude of cell swelling and
subsequent lysis (Maglara, Vasilaki, Jackson, &
McArdle, 2003). A recent meta-analysis by Leeder
et al. (2012) suggested that cold water immersion
had a small, albeit signicant effect, on reducing
efux of creatine kinase post-exercise. The large
inter-individual variation in creatine kinase response
seen in many studies was also observed in this inves-
tigation, further challenging its use as a meaningful
marker of exercise-induced muscle damage
(Bleakley et al., 2012; Leeder et al., 2012; Warren
et al., 1999). Given the moderate effect size (0.69)
between cold water immersion and control groups at
24 h (when creatine kinase is at its peak), it is likely
that a far greater sample would be required to detect
any changes between intervention groups, avoiding
the risk of type-2 error due to the low sample size in
this investigation.
Vaile et al. (2008a) investigated the effect of chan-
ging immersion temperature by immersing partici-
pants up to the neck in a standing position, but used
three different temperatures (cold water immer-
sion = 14 min at 15°C; contrast water immer-
sion = alternating 1-min immersions at 15°C and
38°C for 14 min; hot water immersion = 14 min at
38°C) to analyse the effectiveness of water immer-
sions following a strenuous 5 d cycling protocol.
Vaile et al. (2008a) showed that both cold water
immersion and contrast water therapy were superior
to hot water immersion and control in maintaining
cycling output across the 5 d of cycling. The data
from Vaile et al. (2008a) suggests that whilst hydro-
static pressure may be an important mechanistic
factor given the positive ndings of both contrast
and cold water immersion, the effect of temperature
seemed integral to the effectiveness of water immer-
sions (seen by the lack of effect in a standing hot
water immersion). Corbett, Barwood, Lunt, Milner,
and Tipton (2012) tested the effectiveness of four
interventions (12 min standing at 12°C; 12 min
standing at 35°C; 2 min seated at 12°C; 12 min
walking at 5 km·h
1
), although with no true control
group, on recovery from the LIST. Corbett et al.
(2012) found no difference between groups in any
markers of recovery, suggesting that water immer-
sions were ineffective and a simple bout of active
recovery was equitable to water immersions as a
recovery tool following intermittent sprint exercise.
6J. D. C. Leeder et al.
Downloaded by [GlaxoSmith Kline] at 03:44 13 January 2015
Interestingly, Corbett et al. (2012) showed no differ-
ence between standing in cold (12°C) or thermo
neutral (35°C) water, further advocating the lack of
effect of both temperature and hydrostatic on recov-
ery from this exercise type.
The effectiveness of cold water immersion is
related to temperature and pressure-induced
changes in muscle temperature and blood ow
(Bleakley & Davison, 2010; Gregson et al., 2011;
Meeusen & Lievens, 1986); thereby potentially redu-
cing the post-exercise inammatory response
(Barnett, 2006; Smith, 1991; Yanagisawa, Niitsu,
Takahashi, et al., 2003; Yanagisawa, Niitsu,
Yoshioka, et al., 2003). It is therefore important to
discuss if the cold water immersion protocols used in
this investigation modulated muscle temperature
and blood ow given they were not directly mea-
sured. Following endurance exercise, a cold water
immersion of 22°C or 8°C for 10 min after exercise
was capable of reducing indices of blood ow and
tissue temperature compared to a control group
(Mawhinney et al., 2013). Whilst 8°C was more
effective, it seems reasonable to assume that if a
cold water immersion of 22°C is capable of modu-
lating intramuscular temperature and arterial blood
ow, the 14°C cold water immersion used in this
investigation should have inuenced these variables.
To optimise tissue temperature reduction and blood
ow, it may be important to individualise cold water
immersion strategies based on the factors such as
athlete body composition (Vaile et al., 2011), how-
ever these factors were not measured in this investi-
gation and therefore remain speculative. The LIST
is purported to induce a similar physiological stress,
based on similar rate of perceived exertion and sprint
data from this investigation, and from previous
research investigating the repeatability of the LIST
(Nicholas et al., 2000). However it is not known
whether faster and tter individuals respond differ-
ently to lesser trained counterparts due to higher
mechanical and metabolic stress experienced.
Nonetheless, it is likely that participants in this inves-
tigation experienced a similar elevated stress stimu-
lus, and the cold water immersion protocol provided
an adequate intervention to modulate the recovery
process.
Cold water immersion is proposed to reduce
inammation, which may be a key mechanism
related to attenuating DOMS and enhancing recov-
ery of muscle function (Barnett, 2006; Cheung,
Hume, & Maxwell, 2003; Swenson, Swärd, &
Karlsson, 1996; Yanagisawa, Niitsu, Yoshioka,
et al., 2003). Table III indicated that although both
inammatory markers (interleukin-6 and C-reactive
protein) signicantly changed over time, suggesting
inammation was present, there was no signicant
group effect of either cold water immersion
intervention on these markers. However trends did
exist towards seated and standing cold water immer-
sion reducing interleukin-6 at 1 h post-LIST. It has
been speculated that cold water immersion could
reduce inammation by reducing post-exercise
blood ow to damaged areas. The rationale being
that exercise-induced muscle damage increases the
release of cellular debris, instigating chemotactic sig-
nalling which initiates neutrophil demargination and
diapedesis from the blood stream (Muller, 2003;
Peterson & Pizza, 2009). If cold water immersion
was effective at reducing the magnitude of neutro-
phil invasion, secondary damage may be alleviated.
Despite non-signicant trends towards reduced
interleukin-6 at 1 h post-LIST, the 14 min seated
and standing cold water immersions appeared to be
ineffective at reducing the magnitude of the inam-
matory response. Conceivably, a more comprehen-
sive battery of inammatory indices might have been
useful to detect subtle changes, however the markers
in the current study have been successfully used in
previous work (Andersson, Bøhn, et al., 2010; Bell,
Walshe, Davison, Stevenson, & Howatson, 2014;
Howatson et al., 2010; Ingram, Dawson,
Goodman, Wallman, & Beilby, 2009). Additionally,
the technique of proteomics combined with immu-
nohistochemistry is a potentially powerful tool and
could be an effective method to understand if cold
water immersion has any anti-inammatory effects at
a molecular level (Malm & Yu, 2012).
Conclusion
Altering the hydrostatic pressure by using a seated or
standing cold water immersion was no more effective
at reducing indices of exercise-induced muscle
damage and accelerating recovery compared to a
control group, as indicated by markers of inamma-
tion, muscle damage and muscle function. It is con-
ceivable that the stress induced from a one-off bout
of repeat sprint exercise is not sufcient for cold
water immersion to be effective, and that cold
water immersion may have more potential inuence
on recovery when there is a greater magnitude of
physiological stress. However, based on these data,
recovery from repeated sprint activity is not
improved by either seated or standing cold water
immersion, questioning the use of these interven-
tions in applied settings.
References
Akenhead, R., Hayes, P. R., Thompson, K. G., & French, D.
(2013). Diminutions of acceleration and deceleration output
during professional football match play. Journal of Science and
Medicine in Sport,16, 556561.
Andersson, H., Bøhn, S. K., Raastad, T., Paulsen, G., Blomhoff,
R., & Kadi, F. (2010). Differences in the inammatory plasma
Recovery from repeated sprints 7
Downloaded by [GlaxoSmith Kline] at 03:44 13 January 2015
cytokine response following two elite female soccer games
separated by a 72-h recovery. Scandinavian Journal of Medicine
and Science in Sports,20(5), 740747.
Andersson, H., Karlsen, A., Blomhoff, R., Raastad, T., & Kadi, F.
(2010). Plasma antioxidant responses and oxidative stress fol-
lowing a soccer game in elite female players. Scandinavian
Journal of Medicine and Science in Sports,20(4), 600608.
Ascensão, A., Rebelo, A., Oliveira, E., Marques, F., Pereira, L., &
Magalhães, J. (2008). Biochemical impact of a soccer match
Analysis of oxidative stress and muscle damage
markers throughout recovery. Clinical Biochemistry,41(1011),
841851.
Bailey, D. M., Erith, S. J., Grifn, P. J., Dowson, A., Brewer, D.
S., Gant, N., & Williams, C. (2007). Inuence of cold-water
immersion on indices of muscle damage following prolonged
intermittent shuttle running. Journal of Sports Sciences,25(11),
11631170.
Bailey, D. M., Williams, C., Betts, J. A., Thompson, D., & Hurst,
T. L. (2011). Oxidative stress, inammation and recovery of
muscle function after damaging exercise: Effect of 6-week
mixed antioxidant supplementation. European Journal of
Applied Physiology,111(6), 925936.
Barnett, A. (2006). Using recovery modalities between training
sessions in elite athletes: Does it help? Sports Medicine,36(9),
781796.
Beedie, C. J. (2007). Placebo effects in competitive sport:
Qualitative data. Journal of Sports Science and Medicine,6,2128.
Beedie, C. J., Coleman, D. A., & Foad, A. J. (2007). Positive and
negative placebo effects resulting from the deceptive adminis-
tration of an ergogenic aid. International Journal of Sport
Nutrition and Exercise Metabolism,17(3), 259269.
Beedie, C. J., & Foad, A. J. (2009). The placebo effect in sports
performance: A brief review. Sports Medicine,39(4), 313329.
Bell, P. G., Walshe, I. H., Davison, G. W., Stevenson, E., &
Howatson, G. (2014). Montmorency cherries reduce the oxi-
dative stress and inammatory responses to repeated days high-
intensity stochastic cycling. Nutrients,6(2), 829843.
Bleakley, C., McDonough, S., Gardner, E., Baxter, G. D.,
Hopkins, J. T., & Davison, G. W. (2012). Cold-water immer-
sion (cryotherapy) for preventing and treating muscle soreness
after exercise. Cochrane Database of Systematic Reviews,2,
CD008262.
Bleakley, C. M., & Davison, G. W. (2010). What is the biochem-
ical and physiological rationale for using cold-water immersion
in sports recovery? A systematic review. British Journal of Sports
Medicine,44(3), 179187.
Broatch, J. R., Petersen, A., & Bishop, D. J. (2014). Postexercise
cold-water immersion benets are not greater than the placebo
effect. Medicine and Science in Sports and Exercise,46(11), 2139
2147.
Byrne, C., Twist, C., & Eston, R. (2004). Neuromuscular func-
tion after exercise-induced muscle damage: Theoretical and
applied implications. Sports Medicine,34(1), 4969.
Cheung, K., Hume, P., & Maxwell, L. (2003). Delayed onset
muscle soreness: Treatment strategies and performance factors.
Sports Medicine,33(2), 145164.
Cook, C. J., & Beaven, C. M. (2013). Individual perception of
recovery is related to subsequent sprint performance. British
Journal of Sports Medicine,47, 705709.
Corbett, J., Barwood, M. J., Lunt, H. C., Milner, A., & Tipton,
M. J. (2012). Water immersion as a recovery aid from inter-
mittent shuttle running exercise. European Journal of Sport
Science,12(6), 509514.
Durlak, J. A. (2009). How to select, calculate, and interpret effect
sizes. Journal of Pediatric Psychology,34(9), 917928.
Friden, J., & Lieber, R. L. (2001). Eccentric exercise-induced
injuries to contractile and cytoskeletal muscle bre compo-
nents. Acta Physiologica Scandinavica,171(3), 321326.
Friden, J., Sfakianos, P. N., Hargens, A. R., & Akeson, W. H.
(1988). Residual muscular swelling after repetitive eccentric
contractions. Journal of Orthopaedic Research,6(4), 493498.
Gill, N. D., Beaven, C. M., & Cook, C. (2006). Effectiveness of
post-match recovery strategies in rugby players. British Journal
of Sports Medicine,40(3), 260263.
Gregson, W., Black, M. A., Jones, H., Milson, J., Morton, J.,
Dawson, B., Green, D. J. (2011). Inuence of cold water
immersion on limb and cutaneous blood ow at rest. The
American Journal of Sports Medicine,39(6), 13161323.
Howatson, G., McHugh, M. P., Hill, J. A., Brouner, J., Jewell, A.
P., Van Someren, K. A., Howatson, S. A. (2010). Inuence
of tart cherry juice on indices of recovery following marathon
running. Scandinavian Journal of Medicine and Science in Sports,
20(6), 843852.
Howatson, G., Van Someren, K., & Hortobágyi, T. (2007).
Repeated bout effect after maximal eccentric exercise.
International Journal of Sports Medicine,28(7), 557563.
Ingram, J., Dawson, B., Goodman, C., Wallman, K., & Beilby, J.
(2009). Effect of water immersion methods on post-exercise
recovery from simulated team sport exercise. Journal of Science
and Medicine in Sport,12(3), 417421.
King, M., & Dufeld, R. (2009). The effects of recovery interven-
tions on consecutive days of intermittent sprint exercise.
Journal of Strength and Conditioning Research,23(6), 17951802.
Leeder, D. C., Van Someren, K. A., Gaze, D., Jewell, A.,
Deshmukh, I. K., Shah, I., Howatson, G. (2014).
Recovery and adaptation from repeated intermittent-sprint
exercise. International Journal of Sports Physiology and
Performance,9(3), 489496.
Leeder, J., Gissane, C., Van Someren, K., Gregson, W., &
Howatson, G. (2012). Cold water immersion and recovery
from strenuous exercise: A meta-analysis. British Journal of
Sports Medicine,46(4), 233240.
Maglara, A. A., Vasilaki, A., Jackson, M. J., & McArdle, A.
(2003). Damage to developing mouse skeletal muscle myo-
tubes in culture: protective effect of heat shock proteins. The
Journal of Physiology,548(Pt 3), 837846.
Malm, C., & Yu, J.-G. (2012). Exercise-induced muscle damage
and inammation: Re-evaluation by proteomics. Histochemistry
and Cell Biology,138(1), 8999.
Mawhinney, C., Jones, H., Joo, C. H., Low, D. A., Green, D. J.,
& Gregson, W. (2013). Inuence of cold-water immersion on
limb and cutaneous blood ow after exercise. Medicine and
Science in Sports and Exercise,45(12), 22772285.
Meeusen, R., & Lievens, P. (1986). The use of cryotherapy in
sports injuries. Sports Medicine,3(6), 398414.
Merrick, M. A. (2002). Secondary injury after musculoskeletal
trauma: A review and update. Journal of Athletic Training,37
(2), 209217.
Minett, G. M., & Dufeld, R. (2014). Is recovery driven by central
or peripheral factors? A role for the brain in recovery following
intermittent-sprint exercise. Frontiers in Physiology,5,24.
Montgomery, P. G., Pyne, D. B., Hopkins, W. G., Dorman, J.
C., Cook, K., & Minahan, C. L. (2008). The effect of recov-
ery strategies on physical performance and cumulative fatigue
in competitive basketball. Journal of Sports Sciences,26(11),
11351145.
Muller, W. A. (2003). Leukocyte-endothelial-cell interactions in
leukocyte transmigration and the inammatory response.
Trends in Immunology,24(6), 326333.
Nédélec, M., McCall, A., Carling, C., Legall, F., Berthoin, S., &
Dupont, G. (2013). Recovery in soccer: Part II recovery
strategies. Sports Medicine,43(1), 922.
Nicholas, C. W., Nuttall, F. E., & Williams, C. (2000). The
Loughborough Intermittent Shuttle Test: A eld test that simu-
lates the activity pattern of soccer. Journal of Sports Sciences,18
(2), 97104.
8J. D. C. Leeder et al.
Downloaded by [GlaxoSmith Kline] at 03:44 13 January 2015
Peterson, J. M., & Pizza, F. X. (2009). Cytokines derived from
cultured skeletal muscle cells after mechanical strain promote
neutrophil chemotaxis in vitro. Journal of Applied Physiology,
106(1), 130137.
Rowsell, G. J., Coutts, A. J., Reaburn, P., & Hill-Haas, S. (2009).
Effects of cold-water immersion on physical performance
between successive matches in high-performance junior male
soccer players. Journal of Sports Sciences,27(6), 565573.
Rowsell, G. J., Coutts, A. J., Reaburn, P., & Hill-Haas, S. (2011).
Effect of post-match cold-water immersion on subsequent
match running performance in junior soccer players during
tournament play. Journal of Sports Sciences,29(1), 16.
Smith, L. L. (1991). Acute inammation: the underlying mechan-
ism in delayed onset muscle soreness? Medicine and Science in
Sports and Exercise,23(5), 542551.
Spencer, M., Rechichi, C., Lawrence, S., Dawson, B., Bishop, D.,
& Goodman, C. (2005). Time-motion analysis of elite eld
hockey during several games in succession: A tournament sce-
nario. Journal of Science and Medicine in Sport,8(4), 382391.
Stanley, J., Peake, J. M., & Buchheit, M. (2013). Consecutive
days of cold water immersion: Effects on cycling performance
and heart rate variability. European Journal of Applied Physiology,
113(2), 371384.
Swenson, C., Swärd, L., & Karlsson, J. (1996). Cryotherapy in
sports medicine. Scandinavian Journal of Medicine and Science in
Sports,6(4), 193200.
Thompson, D., Nicholas, C. W., & Williams, C. (1999). Muscular
soreness following prolonged intermittent high-intensity shuttle
running. Journal of Sports Sciences,17(5), 387395.
Thompson, D., Williams, C., Garcia-Roves, P., McGregor, S. J.,
McArdle, F., & Jackson, M. J. (2003). Post-exercise vitamin C
supplementation and recovery from demanding exercise.
European Journal of Applied Physiology,89(34), 393400.
Vaile, J., Halson, S., Gill, N., & Dawson, B. (2008a). Effect of
hydrotherapy on recovery from fatigue. International Journal of
Sports Medicine,29(7), 539544.
Vaile, J., Halson, S., Gill, N., & Dawson, B. (2008b). Effect of
hydrotherapy on the signs and symptoms of delayed onset
muscle soreness. European Journal of Applied Physiology,102
(4), 447455.
Vaile, J., OHagan, C., Stefanovic, B., Walker, M., Gill, N., &
Askew, C. D. (2011). Effect of cold water immersion on
repeated cycling performance and limb blood ow. British
Journal of Sports Medicine,45(10), 825829.
Venter, R. E. (2014). Perceptions of team athletes on the impor-
tance of recovery modalities. European Journal of Sport Science,
Suppl 14(1), S69S76.
Warren, G. L., Lowe, D. A., & Armstrong, R. B. (1999).
Measurement tools used in the study of eccentric contraction-
induced injury. Sports Medicine,27(1), 4359.
Wilcock, I. M., Cronin, J. B., & Hing, W. A. (2006). Physiological
response to water immersion: A method for sport recovery?
Sports Medicine,36(9), 747765.
Yanagisawa, O., Niitsu, M., Takahashi, H., Goto, K., & Itai, Y.
(2003). Evaluations of cooling exercised muscle with MR ima-
ging and 31P MR spectroscopy. Medicine and Science in Sports
and Exercise,35(9), 15171523.
Yanagisawa, O., Niitsu, M., Yoshioka, H., Goto, K., Kudo, H.,
& Itai, Y. (2003). The use of magnetic resonance imaging to
evaluate the effects of cooling on skeletal muscle after stren-
uous exercise. European Journal of Applied Physiology,89(1),
5362.
Recovery from repeated sprints 9
Downloaded by [GlaxoSmith Kline] at 03:44 13 January 2015
... Efficacy of CWI for post-exercise recovery has previously been considered equivocal [10] likely due to inconsistency in CWI protocols, with different temperatures [11][12][13], durations [14,15], depths [16,17] and even time applied after exercise [18] being utilised in research and applied practice [19]. Meta-analyses suggest a protocol of 10-15 °C for 10-15 min [20] can effectively promote recovery. ...
... Current Use/prescription of CWI The second section (Q. [8][9][10][11][12][13][14][15][16][17][18] ...
... However, no difference was noted between whole and partial body CWI for markers of fatigue and muscle damage. Similarly, Leeder et al. [17] suggests the depth of immersion has little influence on recovery, with no noted differences between seated vs. standing CWI. In contrast, the time at which CWI is applied following the cessation of exercise might play an important role in its effectiveness. ...
Article
Full-text available
This survey sought to establish current use, knowledge and perceptions of cold-water immersion (CWI) when used for recovery. 111 athletes, coaches and support practitioners completed the anonymous online survey, answering questions about their current CWI protocols, perceptions of benefits associated with CWI and knowledge of controlling mechanisms. Respondents were largely involved in elite sport at international, national and club level, with many having used CWI previously (86%) and finding its use beneficial for recovery (78%). Protocols differed, with the duration of immersion one aspect that failed to align with recommendations in the scientific literature. Whilst many respondents were aware of benefits associated with CWI, there remains some confusion. There also seems to be a gap in mechanistic knowledge, where respondents are aware of benefits associated with CWI, but failed to identify the underlying mechanisms. This identifies the need for an improved method of knowledge transfer between scientific and applied practice communities. Moreover, data herein emphasises the important role of the ‘support practitioner’ as respondents in this role tended to favour CWI protocols more aligned to recommendations within the literature. With a significant number of respondents claiming they were made aware of CWI for recovery through a colleague (43%), the importance of knowledge transfer and context being appropriately applied to data is as important as ever. With the firm belief that CWI is useful for recovery in sport, the focus should now be on investigating the psychophysiological interaction and correct use of this methodology.
... The type of participants varied between studies, involving both amateur athletes of basketball (n = 1), 34,38 rugby (n = 4), 39,44,47,48 football (n = 1), 38 and other team sports (n = 4), 36,41,53,54 and professional athletes of basketball (n = 1), 51 rugby (n = 5), 35,37,49,50,52 football (n = 3), 40,42,43 futsal (n = 1), 45 and mixing team sports (n = 1). 46 The type of intervention varied among studies in terms of temperature, duration, and immersion method: (1) water temperature ranged between 5 and 10°C in 13 studies [35][36][37][39][40][41][42][43][44]49,50,52,54 and between 11 and 15°C in 8 studies, 34,41,[45][46][47][48]51,53 (2) the duration of water immersion ranged between 1 and 10 minutes in 12 studies [35][36][37][38][39][40]44,47,[49][50][51]54 and between 11 and 15 minutes in 9 studies, 34,[41][42][43]45,46,48,52,53 and (3) the immersion method was continuous in 15 studies 34,[36][37][38][39][40][41][42][43][44][45][46][47][48]53 and intermittent (ie, 2 × 5 min) in 6 studies. 35,[49][50][51][52]54 The study's methodological quality score ranged from 42.9% to 85.7% for physical performance, 28.5% to 60.7% for physiological, and 42.9% to 67.9% for perceptive parameters, as well as the levels of evidence ranged from 2+ to 1++ (physical), 2− to 1+ (physiological), and 2+ to 1+ (perceptive). ...
... The type of participants varied between studies, involving both amateur athletes of basketball (n = 1), 34,38 rugby (n = 4), 39,44,47,48 football (n = 1), 38 and other team sports (n = 4), 36,41,53,54 and professional athletes of basketball (n = 1), 51 rugby (n = 5), 35,37,49,50,52 football (n = 3), 40,42,43 futsal (n = 1), 45 and mixing team sports (n = 1). 46 The type of intervention varied among studies in terms of temperature, duration, and immersion method: (1) water temperature ranged between 5 and 10°C in 13 studies [35][36][37][39][40][41][42][43][44]49,50,52,54 and between 11 and 15°C in 8 studies, 34,41,[45][46][47][48]51,53 (2) the duration of water immersion ranged between 1 and 10 minutes in 12 studies [35][36][37][38][39][40]44,47,[49][50][51]54 and between 11 and 15 minutes in 9 studies, 34,[41][42][43]45,46,48,52,53 and (3) the immersion method was continuous in 15 studies 34,[36][37][38][39][40][41][42][43][44][45][46][47][48]53 and intermittent (ie, 2 × 5 min) in 6 studies. 35,[49][50][51][52]54 The study's methodological quality score ranged from 42.9% to 85.7% for physical performance, 28.5% to 60.7% for physiological, and 42.9% to 67.9% for perceptive parameters, as well as the levels of evidence ranged from 2+ to 1++ (physical), 2− to 1+ (physiological), and 2+ to 1+ (perceptive). ...
... The type of participants varied between studies, involving both amateur athletes of basketball (n = 1), 34,38 rugby (n = 4), 39,44,47,48 football (n = 1), 38 and other team sports (n = 4), 36,41,53,54 and professional athletes of basketball (n = 1), 51 rugby (n = 5), 35,37,49,50,52 football (n = 3), 40,42,43 futsal (n = 1), 45 and mixing team sports (n = 1). 46 The type of intervention varied among studies in terms of temperature, duration, and immersion method: (1) water temperature ranged between 5 and 10°C in 13 studies [35][36][37][39][40][41][42][43][44]49,50,52,54 and between 11 and 15°C in 8 studies, 34,41,[45][46][47][48]51,53 (2) the duration of water immersion ranged between 1 and 10 minutes in 12 studies [35][36][37][38][39][40]44,47,[49][50][51]54 and between 11 and 15 minutes in 9 studies, 34,[41][42][43]45,46,48,52,53 and (3) the immersion method was continuous in 15 studies 34,[36][37][38][39][40][41][42][43][44][45][46][47][48]53 and intermittent (ie, 2 × 5 min) in 6 studies. 35,[49][50][51][52]54 The study's methodological quality score ranged from 42.9% to 85.7% for physical performance, 28.5% to 60.7% for physiological, and 42.9% to 67.9% for perceptive parameters, as well as the levels of evidence ranged from 2+ to 1++ (physical), 2− to 1+ (physiological), and 2+ to 1+ (perceptive). ...
Article
Background: Sleep, nutrition, active recovery, cold-water immersion, and massage were recently reported as the most used postmatch recovery methods in professional football. However, the recommendations concerning the effect of these methods remain unclear. Purpose: To systematically review the literature regarding the effectiveness of the most common recovery methods applied to male and female football players (or other team sports) 72 hours postmatches and to provide graded recommendations for their use. Methods: A systematic search of the literature was performed, and the level of evidence of randomized and nonrandomized studies was classified as 1 or 2, respectively, with additional ++, +, and - classification according to the quality of the study and risk of bias. Graded recommendations were provided regarding the effectiveness of recovery methods for physical, physiological, and perceptive variables. Results: From the 3472 articles identified, 39 met the inclusion criteria for analysis. The studies' levels of evidence varied among methods (sleep: 2+ to 1++; nutrition: 2- to 1+; cold-water immersion: 2- to 1++; active recovery: 2- to 1+; and massage: 1- to 1+). Different graded recommendations were attributed, and none of them favored the effective use of recovery methods for physiological and physical parameters, whereas massage and cold-water immersion were recommended as beneficial for perceptive variables. Conclusions: Cold-water immersion and massage can be recommended to recover up to 72 hours postmatch at a perceptive level. However, there is a current need for high-quality research that identifies effective recovery strategies that enhance recovery at the physical and physiological levels.
... Based upon the agreed criteria of the SIGN RCT checklist, reviewers deemed 11 (21%) studies to be high quality [42,50,51,54,57,58,60,66,77,79,89], 37 (69%) to be acceptable quality [39-41, 43-49, 52, 53, 55, 56, 59, 61, 64, 65, 67-76, 78, 80-84, 86-88] and four (10%) studies to be low quality [62,63,85,90]. The noteworthy results from the risk of bias analysis indicated that concealment of the treatment groups from the research group was rarely completed; only four studies concealed treatment groups from the research team [50,57,66,89]. ...
... The noteworthy results from the risk of bias analysis indicated that concealment of the treatment groups from the research group was rarely completed; only four studies concealed treatment groups from the research team [50,57,66,89]. Reporting of randomisation protocols of treatment groups was also poor for most studies; only 11 studies adequately reported randomisation protocols [42,50,51,54,57,58,60,66,77,79,89]. Results of the risk of bias analysis for each individual study can be found in Online Supplement 1 of the electronic supplementary material (ESM). ...
Article
Full-text available
Background Studies investigating the effects of cold-water immersion (CWI) on the recovery of athletic performance, perceptual measures and creatine kinase (CK) have reported mixed results in physically active populations. Objectives The purpose of this systematic review was to investigate the effects of CWI on recovery of athletic performance, perceptual measures and CK following an acute bout of exercise in physically active populations. Study Design Systematic review with meta-analysis and meta-regression. Methods A systematic search was conducted in September 2021 using Medline, SPORTDiscus, Scopus, Web of Science, Cochrane Library, EmCare and Embase databases. Studies were included if they were peer reviewed and published in English, included participants who were involved in sport or deemed physically active, compared CWI with passive recovery methods following an acute bout of strenuous exercise and included athletic performance, athlete perception and CK outcome measures. Studies were divided into two strenuous exercise subgroups: eccentric exercise and high-intensity exercise. Random effects meta-analyses were used to determine standardised mean differences (SMD) with 95% confidence intervals. Meta-regression analyses were completed with water temperature and exposure durations as continuous moderator variables. Results Fifty-two studies were included in the meta-analyses. CWI improved the recovery of muscular power 24 h after eccentric exercise (SMD 0.34 [95% CI 0.06–0.62]) and after high-intensity exercise (SMD 0.22 [95% CI 0.004–0.43]), and reduced serum CK (SMD − 0.85 [95% CI − 1.61 to − 0.08]) 24 h after high-intensity exercise. CWI also improved muscle soreness (SMD − 0.89 [95% CI − 1.48 to − 0.29]) and perceived feelings of recovery (SMD 0.66 [95% CI 0.29–1.03]) 24 h after high-intensity exercise. There was no significant influence on the recovery of strength performance following either eccentric or high-intensity exercise. Meta-regression indicated that shorter time and lower temperatures were related to the largest beneficial effects on serum CK (duration and temperature dose effects) and endurance performance (duration dose effects only) after high-intensity exercise. Conclusion CWI was an effective recovery tool after high-intensity exercise, with positive outcomes occurring for muscular power, muscle soreness, CK, and perceived recovery 24 h after exercise. However, after eccentric exercise, CWI was only effective for positively influencing muscular power 24 h after exercise. Dose–response relationships emerged for positively influencing endurance performance and reducing serum CK, indicating that shorter durations and lower temperatures may improve the efficacy of CWI if used after high-intensity exercise. Funding Emma Moore is supported by a Research Training Program (Domestic) Scholarship from the Australian Commonwealth Department of Education and Training. Protocol registration Open Science Framework: 10.17605/OSF.IO/SRB9D.
... hydrostatic pressure (Leeder et al., 2015). This is relevant to mention, given that varying hydrostatic pressure in CWI protocols has been reported to influence markers of delayed onset muscle soreness (Leeder et al., 2015). ...
... hydrostatic pressure (Leeder et al., 2015). This is relevant to mention, given that varying hydrostatic pressure in CWI protocols has been reported to influence markers of delayed onset muscle soreness (Leeder et al., 2015). Furthermore, CWI protocols applied to the limb influence signaling markers both in the immersed and in the non-immersed limb, likely resulting from systemic increases in noradrenaline . ...
Article
The aim of this review was to perform a meta-analysis examining the effects of CWI coupled with resistance training on gains in muscular strength. Four databases were searched to find relevant studies. Their methodological quality and risk of bias were evaluated using the PEDro checklist. The effects of CWI vs. control on muscular strength were examined in a random-effects meta-analysis. Ten studies (n = 170; 92% males), with 11 comparisons across 22 groups, were included in the analysis. Studies were classified as of good or fair methodological quality. The main meta-analysis found that CWI attenuated muscular strength gains (effect size [ES]: –0.23; 95% confidence interval [CI]: –0.45, –0.01; p = 0.041). In the analysis of data from studies applying CWI only to the trained limbs, CWI attenuated muscular strength gains (ES: –0.31; 95% CI: –0.61, –0.01; p = 0.041). In the analysis of data from studies using whole-body CWI, there was no significant difference in muscular strength gains between CWI and control (ES: –0.08; 95% CI: –0.53, 0.38; p = 0.743). In summary, this meta-analysis found that the use of CWI following resistance exercise sessions attenuates muscular strength gains in males. However, when CWI was applied to the whole body, there was no significant difference between CWI and control for muscular strength. Due to the attenuated gains in muscular strength found with single limb CWI, the use and/or timing of CWI in resistance training should be carefully considered and individualized.
... The studies used different protocols that included cold water immersion techniques, ice packs, ice massage, and ice compression for cryotherapy. Thus, in 18 studies (Abaïdia et al., 2017;Adamczyk et al., 2016;Ascensão et al., 2011;Denegar & Perrin, 1992;Doungkulsa et al., 2018;Elias et al., 2012;Ferreira-Junior et al., 2015;Fonseca et al., 2016;Glasgow et al., 2014;Leeder et al., 2015;Machado et al., 2017;Malmir et al., 2017;Marquet et al., 2015;Pointon et al., 2011;Selkow et al., 2015;Siqueira et al., 2018;Vaile et al., 2008;Wiewelhove et al., 2018) significant effects were described, while14 studies showed no effects (Behringer et al., 2018;de Paiva et al., 2016;Guilhem et al., 2013;Hassan, 2011;Howatson et al., 2005Howatson et al., , 2008Howatson & Van Someren, 2003;Isabell et al., 1992;Jajtner et al., 2015;Johar et al., 2012;Micheletti et al., 2019;Paddon-Jones & Quigley, 1997;Sellwood et al., 2007;Tseng et al., 2013). ...
... The methodological evaluation of the quality of the studies has yielded an average of 4.7 points on the PEDro scale. Sixteen studies were considered "high quality" (Aaron et al., 2017;Aytar et al., 2008;Chang et al., 2019;Craig et al., 1999b;de Paiva et al., 2016;Ferreira-Junior et al., 2015;Fleckenstein et al., 2016Fleckenstein et al., , 2017 R.L. Nahon, J.S. Silva A. Monteiro de Magalhães Neto Physical Therapy in Sport 52 (2021) 1e12 et al., 2002;Mikesky & Hayden, 2005;Selkow et al., 2015;Sellwood et al., 2007;Vinck et al., 2006); 42 studies were considered "moderate quality" (Adamczyk et al., 2016;Andersen et al., 2013;Butterfield et al., 1997;Changa et al., 2020;Craig et al., 1996b;Curtis et al., 2010;Doungkulsa et al., 2018;Elias et al., 2012;Glasgow et al., 2014;Guilhem et al., 2013;Hart et al., 2005;Hasson et al., 1990;Hazar Kanik et al., 2019;Hoffman et al., 2016;Howatson et al., 2008;Jayaraman et al., 2004;Jeon et al., 2015;Johar et al., 2012;Kirmizigil et al., 2019;Kong et al., 2018;Law & Herbert, 2007;Leeder et al., 2015;Macdonald et al., 2014;Machado et al., 2017;Malmir et al., 2017;McLoughlin et al., 2004;Micheletti et al., 2019;Naderi et al., 2020;Paddon-Jones & Quigley, 1997;Rey et al., 2012;Rocha et al., 2012;Romero-Moraleda et al., 2019;Siqueira et al., 2018;Smith et al., 1994;Tourville et al., 2006;Wang et al., 2006;Weber et al., 1994;Wiewelhove et al., 2018;Xie et al., 2018;Zebrowska et al., 2019;Zhang et al., 2000) and 63 studies were considered "low quality" (Akinci et al., 2020;Behringer et al., 2018;Boobphachart et al., 2017;Carling et al., 1995;Ferguson et al., 2014;Haksever et al., 2016;Hill et al., 2017;Imtiyaz et al., 2014;Jakeman et al., 2010aJakeman et al., , 2010bKraemer et al., 2001;Lau & Nosaka, 2011;Northey et al., 2016;Ozmen et al., 2017;Pearcey et al., 2015;Prill et al., 2019;Rhea et al., 2009;Timon et al., 2016;Vaile et al., 2007Vaile et al., , 2008Visconti et al., 2020;Wheeler & Jacobson, 2013) , (Ascensão et al., 2011;Hassan, 2011;Hilbert et al., 2003;Howatson & Van Someren, 2003;Jajtner et al., 2015;Kargarfard et al., 2016;Lightfoot et al., 1997;Marquet et al., 2015;Micklewright, 2009;Tiidus & Shoemaker, 1995;Torres et al., 2013;Weber et al., 1994;Wessel & Wan, 1994;Xiong et al., 2009;Zainuddin et al., 2005) , (Abaïdia et al., 2017;Barlas et al., 2000;Cardoso et al., 2020;Craig et al., 1996aCraig et al., , 1999aHowatson et al., 2005;Itoh et al., 2008;Mankovsky-Arnold et al., 2013;Minder et al., 2002;Parker & Madden, 2014;Petrofsky et al., 2012;Plaskett et al., 1999;Shankar et al., 2006;Taylor et al., 2015;Tseng et al., 2013;Tufano et al., 2012;Vanderthommen et al., 2007;Zainuddin et al., 2006) (See details in Appendix 3). The overall analysis results showed that there was "low quality evidence" (according to GRADE classification). ...
Article
Objective To evaluate the impact of interventions on pain associated with DOMS. Data sources PubMed, EMBASE, PEDro, Cochrane, and Scielo databases were searched, from the oldest records until May/2020. Search terms used included combinations of keywords related to “DOMS” and “intervention therapy”. Eligibility criteria Healthy participants (no restrictions were applied, e.g., age, sex, and exercise level). To be included, studies should be: 1) Randomized clinical trial; 2) Having induced muscle damage and subsequently measuring the level of pain; 3) To have applied therapeutic interventions (nonpharmacological or nutritional) and compare with a control group that received no intervention; and 4) The first application of the intervention had to occur immediately after muscle damage had been induced. Results One hundred and twenty-one studies were included. The results revealed that the contrast techniques (p = 0,002 I² = 60 %), cryotherapy (p = 0,002 I² = 100 %), phototherapy (p = 0,0001 I² = 95 %), vibration (p = 0,004 I² = 96 %), ultrasound (p = 0,02 I² = 97 %), massage (p < 0,00001 I² = 94 %), active exercise (p = 0,0004 I² = 93 %) and compression (p = 0,002 I² = 93 %) have a better positive effect than the control in the management of DOMS. Conclusion Low quality evidence suggests that contrast, cryotherapy, phototherapy, vibration, ultrasound, massage, and active exercise have beneficial effects in the management of DOMS-related pain.
... Current recommendations for the use of CWI derived from these meta-analyses suggest a protocol of 10-15 min at 10-15 °C (Machado et al. 2016) to promote effective recovery, whilst a dose of 1.1 (i.e., 11 min at 10 °C) is required to significantly reduce muscle tissue temperature (Vromans et al. 2019). Elsewhere, it has been established that immediate immersion is preferable versus delayed immersion (Brophy-Williams et al. 2011), whilst the depth of immersion is unlikely to play a significant role (Leeder et al. 2015). ...
Article
Full-text available
For centuries, cold temperatures have been used by humans for therapeutic, health and sporting recovery purposes. This application of cold for therapeutic purposes is regularly referred to as cryotherapy. Cryotherapies including ice, cold-water and cold air have been popularised by an ability to remove heat, reduce core and tissue temperatures, and alter blood flow in humans. The resulting downstream effects upon human physiologies providing benefits that include a reduced perception of pain, or analgesia, and an improved sensation of well-being. Ultimately, such benefits have been translated into therapies that may assist in improving post-exercise recovery, with further investigations assessing the role that cryotherapies can play in attenuating the ensuing post-exercise inflammatory response. Whilst considerable progress has been made in our understanding of the mechanistic changes associated with adopting cryotherapies, research focus tends to look towards the future rather than to the past. It has been suggested that this might be due to the notion of progress being defined as change over time from lower to higher states of knowledge. However, a historical perspective, studying a subject in light of its earliest phase and subsequent evolution, could help sharpen one's vision of the present; helping to generate new research questions as well as look at old questions in new ways. Therefore, the aim of this brief historical perspective is to highlight the origins of the many arms of this popular recovery and treatment technique, whilst further assessing the changing face of cryotherapy. We conclude by discussing what lies ahead in the future for cold-application techniques.
... The magnitude of this effect is affected by body position and depth of immersion, with increase effects when more body volume being immersed (Wilcock et al., 2006). However, in a study comparing standing with seated immersion versus control, no differences were found in exercise recovery after a high-intensity interval training (Leeder et al., 2015), suggesting that hydrostatic pressure by itself had little effect on muscle recovery. Water temperature during immersion is known to affect both core temperature and muscle temperature. ...
Article
The aim of this study was to compare the immediate effects of cold-water immersion (CWI) and hot-water immersion (HWI) versus passive resting after a fatigue-induced bout of exercise on the muscle contractile properties of the Vastus Medialis (VM). We conducted a randomised cross-over study involving 28 healthy active men where muscle contractile properties of the VM wer recorded using Tensiomyography (TMG) before and after CWI, HWI or passive resting and up to one-hour post-application. The main outcomes obtained were muscle displacement and velocity of deformation according to limb size (Dmr and Vdr). Our results showed a significant effect of time (F(3.9,405) =32.439; p <0.001; η²p =0.29) and the interaction between time and temperature (F(7.9,405) =5.814; p <0.001; η²p=0.13) on Dmr but no for temperature alone (F(2,81) =2.013; p =0.14; η²p=0.04) while for Vdr, both time (F(5.2,486) =23.068; p <0.001 η²p = 0.22) and temperature (F(2,81) =4.219; p = 0.018; η²p= 0.09) as well as the interaction (F(10.4,486) =7.784; p <0.001; η²p =0.16) were found significant. Compared to CWI, HWI increased Dmr post-application and Vdr both post-application as well as 15 and 45ʹ thereafter. These findings suggest that applying HWI could be a valid alternative to CWI to promote muscle recovery.
... Many strategies have been studied to treat or even prevent muscle soreness [14][15][16][17][18][19][20][21]; however, it is unknown if muscular strength or . VO 2 max values are associated with muscle soreness after exercise. ...
Article
Full-text available
Background: Muscle soreness after a competition or a training session has been a concern of runners due to its harmful effect on performance. It is not known if stronger individuals present a lower level of muscle soreness after a strenuous physical effort. The aim of this study was to investigate whether the pre-race muscle strength or the V˙O2max level can predict muscle soreness 24, 48 and 72 h after a full marathon in men. Methods: Thirty-one marathon runners participated in this study (age, 40.8 ± 8.8 years old; weight, 74.3 ± 10.4 kg; height, 174.2 ± 7.6 cm; maximum oxygen uptake, V˙O2max, 57.7 ± 6.8 mL/kg/min). The isokinetic strength test for thigh muscles and the V˙O2max level was performed 15-30 days before the marathon and the participants were evaluated for the subjective feeling of soreness before, 24, 48 and 72 h after the marathon. Results: The participants presented more pain 24 h after the race (median = 3, IQR = 1) than before it (median = 0, IQR = 0) (p < 0.001), and the strength values for the knee extensor muscles were significantly associated with muscle soreness assessed 24 h after the race (p = 0.028), but not 48 (p = 0.990) or 72 h (p = 0.416) after the race. The V˙O2max level was not associated with the muscle pain level at any moment after the marathon. Conclusions: Marathon runners who presented higher muscular strength for the knee extensor muscles presented lower muscle soreness 24 h after the race, but not after 48 h or 72 h after the race. Therefore, the muscle soreness level 3 days after a marathon race does not depend on muscle strength.
Article
Full-text available
Objective: To comprehensively compare the effectiveness of cold and heat therapies for delayed onset muscle soreness using network meta-analysis. Methods: Eight Chinese and English databases were searched from date of establishment of the database to 31 May 2021. Cochrane risk-of-bias tool was used to analyse the included randomized controlled trials. Potential papers were screened for eligibility, and data were extracted by 2 independent researchers. Results: A total of 59 studies involving 1,367 patients were eligible for this study. Ten interventions were examined: contrast water therapy, phase change material, the novel modality of cryotherapy, cold-water immersion, hot/warm-water immersion, cold pack, hot pack, ice massage, ultrasound, and passive recovery. Network meta-analysis results showed that: (i) within 24 h after exercise, hot pack was the most effective for pain relief, followed by contrast water therapy; (ii) within 48 h, the ranking was hot pack, followed by the novel modality of cryotherapy; and (iii) over 48 h post-exercise, the effect of the novel modality of cryotherapy ranked first. Conclusion: Due to the limited quality of the included studies, further well-designed research is needed to draw firm conclusions about the effectiveness of cold and heat therapies for delayed onset muscle soreness.
Article
Full-text available
Despite a general lack of understanding of the underlying mechanisms, cold-water immersion (CWI) is widely used by athletes for recovery. This study examined the physiological merit of CWI for recovery from high-intensity exercise, by investigating if the placebo effect is responsible for any acute performance or psychological benefits. Thirty males (mean ± SD; age 24 ± 5 y; V[Combining Dot Above]O2peak 51.1 ± 7.0 mL·kg·min) performed an acute high-intensity interval training (HIT) session, comprised of 4 x 30-s sprints, immediately followed by one of three 15-min recovery conditions; CWI (10.3 ± 0.2°C), thermo-neutral water immersion placebo (TWP; 34.7 ± 0.1°C) or thermo-neutral water immersion control (TWI; 34.7 ± 0.1°C). An intramuscular thermistor was inserted during exercise and recovery to record muscle temperature. Swelling (thigh girth), pain threshold/tolerance, interleukin-6 concentration, and total leukocyte, neutrophil, and lymphocyte count were recorded at baseline, post-exercise, post-recovery, and 1, 24 and 48 h post-exercise. A maximal voluntary isometric contraction (MVC) of the quadriceps was performed at the same time-points, with the exception of post-exercise. Self-assessments of readiness for exercise, fatigue, vigour, sleepiness, pain, and belief of recovery effectiveness were also completed. Leg strength following the MVC, and ratings of readiness for exercise, pain and vigour, were significantly impaired in TWI compared with CWI and TWP, which were similar to each other. A recovery placebo administered after an acute HIT session is superior in the recovery of muscle strength over 48 h as compared with TWI, and as effective as CWI. This can be attributed to improved ratings of readiness for exercise, pain and vigour, suggesting that the commonly-hypothesised physiological benefits surrounding CWI are at least partly placebo related.
Article
Full-text available
This investigation examined the impact of Montmorency tart cherry concentrate (MC) on physiological indices of oxidative stress, inflammation and muscle damage across 3 days simulated road cycle racing. Trained cyclists (n = 16) were divided into equal groups and consumed 30 mL of MC or placebo (PLA), twice per day for seven consecutive days. A simulated, high-intensity, stochastic road cycling trial, lasting 109 min, was completed on days 5, 6 and 7. Oxidative stress and inflammation were measured from blood samples collected at baseline and immediately pre- and post-trial on days 5, 6 and 7. Analyses for lipid hydroperoxides (LOOH), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), interleukin-8 (IL-8), interleukin-1-beta (IL-1-β), high-sensitivity C-reactive protein (hsCRP) and creatine kinase (CK) were conducted. LOOH (p < 0.01), IL-6 (p < 0.05) and hsCRP (p < 0.05) responses to trials were lower in the MC group versus PLA. No group or interaction effects were found for the other markers. The attenuated oxidative and inflammatory responses suggest MC may be efficacious in combating post-exercise oxidative and inflammatory cascades that can contribute to cellular disruption. Additionally, we demonstrate direct application for MC in repeated days cycling and conceivably other sporting scenario's where back-to-back performances are required.
Article
Full-text available
Prolonged intermittent-sprint exercise (i.e., team sports) induce disturbances in skeletal muscle structure and function that are associated with reduced contractile function, a cascade of inflammatory responses, perceptual soreness, and a delayed return to optimal physical performance. In this context, recovery from exercise-induced fatigue is traditionally treated from a peripheral viewpoint, with the regeneration of muscle physiology and other peripheral factors the target of recovery strategies. The direction of this research narrative on post-exercise recovery differs to the increasing emphasis on the complex interaction between both central and peripheral factors regulating exercise intensity during exercise performance. Given the role of the central nervous system (CNS) in motor-unit recruitment during exercise, it too may have an integral role in post-exercise recovery. Indeed, this hypothesis is indirectly supported by an apparent disconnect in time-course changes in physiological and biochemical markers resultant from exercise and the ensuing recovery of exercise performance. Equally, improvements in perceptual recovery, even withstanding the physiological state of recovery, may interact with both feed-forward/feed-back mechanisms to influence subsequent efforts. Considering the research interest afforded to recovery methodologies designed to hasten the return of homeostasis within the muscle, the limited focus on contributors to post-exercise recovery from CNS origins is somewhat surprising. Based on this context, the current review aims to outline the potential contributions of the brain to performance recovery after strenuous exercise.
Article
Full-text available
The paper examines the placebo effect in sports performance. The possibility that the placebo effect is a more common phenomenon than the quantity of published research would suggest is briefly addressed. It is suggested that the placebo control design often used in sports performance research masks any placebo effects and thus presents a false picture of the mechanisms underlying performance-enhancing interventions in the real world. An electronic survey was sent to 48 competitive, international and professional athletes. Questions related to the placebo effect in competitive sport. Thirty responses were received. Data indicate that the majority (97%) of respondents believe that the placebo effect can exert an influence on sports performance, and that a significant number (73%) have experienced what they defined as a placebo effect. Inductive content analysis reveals that these experiences fall into several categories such as explicit placebo effects, inadvertent false beliefs, ritual and reverse placebo effects. Furthermore, 10 respondents (33%) offer explanations as to the nature of the placebo effect. Again, inductive content analysis reveals that these explanations fall into several categories including deliberate changes in competitive strategy, belief/expectancy, faith in a third party, and marketing. Overall, responses support previous experimental research and anecdotal reports that have found a relationship between belief and sports performance. It is suggested that further research be structured to not simply control for the placebo effect, but to elucidate it. Key pointsA survey of 30 athletes revealed that 73% have experienced a placebo effect in sport.Athletes suggest several potential explanations for these effects.Findings support the idea that placebo effects might be common in sport.Researchers and practitioners should be aware of the possible impact of these effects on research findings and competitive performance.
Article
Full-text available
The placebo effect, with its central role in clinical trials, is acknowledged as a factor in sports medicine, although until recently little has been known about the likely magnitude and extent of the effect in any specific research setting. Even less is known about the prevalence of the effect in competitive sport. The present paper reviews 12 intervention studies in sports performance. All examine placebo effects associated with the administration of an inert substance believed by subjects to be an ergogenic aid. Placebo effects of varying magnitudes are reported in studies addressing sports from weightlifting to endurance cycling. Findings suggest that psychological variables such as motivation, expectancy and conditioning, and the interaction of these variables with physiological variables, might be significant factors in driving both positive and negative outcomes. Programmatic research involving the triangulation of data, and investigation of contextual and personality factors in the mediation of placebo responses may help to advance knowledge in this area.
Article
Full-text available
Delayed onset muscle soreness (DOMS) is a familiar experience for the elite or novice athlete. Symptoms can range from muscle tenderness to severe debilitating pain. The mechanisms, treatment strategies, and impact on athletic performance remain uncertain, despite the high incidence of DOMS. DOMS is most prevalent at the beginning of the sporting season when athletes are returning to training following a period of reduced activity. DOMS is also common when athletes are first introduced to certain types of activities regardless of the time of year. Eccentric activities induce micro-injury at a greater frequency and severity than other types of muscle actions. The intensity and duration of exercise are also important factors in DOMS onset. Up to six hypothesised theories have been proposed for the mechanism of DOMS, namely: lactic acid, muscle spasm, connective tissue damage, muscle damage, inflammation and the enzyme efflux theories. However, an integration of two or more theories is likely to explain muscle soreness. DOMS can affect athletic performance by causing a reduction in joint range of motion, shock attenuation and peak torque. Alterations in muscle sequencing and recruitment patterns may also occur, causing unaccustomed stress to be placed on muscle ligaments and tendons. These compensatory mechanisms may increase the risk of further injury if a premature return to sport is attempted. A number of treatment strategies have been introduced to help alleviate the severity of DOMS and to restore the maximal function of the muscles as rapidly as possible. Nonsteroidal anti-inflammatory drugs have demonstrated dosage-dependent effects that may also be influenced by the time of administration. Similarly, massage has shown varying results that may be attributed to the time of massage application and the type of massage technique used. Cryotherapy, stretching, homeopathy, ultrasound and electrical current modalities have demonstrated no effect on the alleviation of muscle soreness or other DOMS symptoms. Exercise is the most effective means of alleviating pain during DOMS, however the analgesic effect is also temporary. Athletes who must train on a daily basis should be encouraged to reduce the intensity and duration of exercise for 1–2 days following intense DOMS-inducing exercise. Alternatively, exercises targeting less affected body parts should be encouraged in order to allow the most affected muscle groups to recover. Eccentric exercises or novel activities should be introduced progressively over a period of 1 or 2 weeks at the beginning of, or during, the sporting season in order to reduce the level of physical impairment and/or training disruption. There are still many unanswered questions relating to DOMS, and many potential areas for future research.
Article
Full-text available
Purpose: This investigation aimed to ascertain a detailed physiological profile of recovery from intermittent-sprint exercise of athletes familiar with the exercise and to investigate if athletes receive a protective effect on markers of exercise-induced muscle damage (EIMD), inflammation, and oxidative stress after a repeated exposure to an identical bout of intermittent-sprint exercise. Methods: Eight well-trained male team-sport athletes of National League or English University Premier Division standard (mean ± SD age 23 ± 3 y, VO2max 54.8 ± 4.6 mL ·kg-1 · min-1) completed the Loughborough Intermittent Shuttle Test (LIST) on 2 occasions, separated by 14 d. Maximal isometric voluntary contraction (MIVC), countermovement jump (CMJ), creatine kinase (CK), C-reactive protein (CRP), interleukin-6 (IL-6), F2-isoprostanes, and muscle soreness (DOMS) were measured before and up to 72 h after the initial and repeated LISTs. Results: MIVC, CMJ, CK, IL-6, and DOMS all showed main effects for time (P < .05) after the LIST, indicating that EIMD was present. DOMS peaked at 24 h after LIST 1 (110 ± 53 mm), was attenuated after LIST 2 (56 ± 39 mm), and was the only dependent variable to demonstrate a reduction in the second bout (P = .008). All other markers indicated that EIMD did not differ between bouts. Conclusion: Well-trained games players experienced EIMD after exposure to both exercise tests, despite being accustomed to the exercise type. This suggests that well-trained athletes receive a very limited protective effect from the first bout.
Article
SMITH, L. L. Acute inflammation: the underlying mechanism in delayed onset muscle soreness? Med. Sci. Sports Exerc., Vol. 23, No. 5, pp. 542-551, 1991. It is well documented in animal and human research that unaccustomed eccentric muscle action of sufficient intensity and/or duration causes disruption of connective and/or contractile tissue. In humans, this appears to be associated with the sensation of delayed onset muscle soreness (DOMS). During the late 1970's, it was proposed that this sensation of soreness might be associated with the acute inflammatory response. However, subsequent research failed to substantiate this theory. The present article suggests that the results of much of the research concerning DOMS reflect events typically seen in acute inflammation. Similarities between the two events include: the cardinal symptoms of pain, swelling, and loss of function; evidence of cellular infiltrates, especially the macrophage; biochemical markers such as increased lysosomal activity and increased circulating levels of some of the acute phase proteins; and histological changes during the initial 72 h. In the final section of this paper, a theoretical sequence of events is proposed, based on research involving acute inflammation and DOMS. (C)1991The American College of Sports Medicine
Article
Abstract The aim of this study was to determine how elite team athletes perceive the importance of various recovery modalities. Differences between men and women, players from various team sports and different levels of participation were determined. A total of 890 athletes who volunteered to participate in the study were team players from field hockey (n=213; mean age 21.8±3.3 years), netball (n=215; mean age 22.0±4.0 years), rugby union (n=317; mean age 23.2±3 years) and soccer (n=145; mean age 21.3±2.2 years). The total group of players consisted of 507 (57%) men and 383 (43%) women. At the time of the study, players who participated in the study competed at the highest level of the major competitions and tournaments in their sport, both locally and internationally. Data were collected by means of a questionnaire specifically designed for the study. A one-page, alphabetical list consisted of 32 words or phrases relating to physiological, psychological, social as well as complimentary and alternative strategies, which could be used for the recovery of athletes. Recovery modalities that were rated as important by all players, regardless of gender, type of sport or level of participation, were sleep, fluid replacement and socialise with friends. Gender differences could play a role in how the importance of recovery modalities was perceived. Men rated an ice bath and supplements as significantly more important (P<0.001) than women. Women rated discussions with their teammates and coaches after training and matches as significantly more important (P<0.001) than men. Significant differences were also found between the different sport codes and levels of participation in regard to the perceived importance of various modalities that could affect recovery of team sport players.
Article
This study aimed to determine the influence of cold (8°C) and cool (22°C) water immersion on femoral artery and cutaneous blood flow after exercise. Twelve men completed a continuous cycle exercise protocol at 70% peak oxygen uptake until a core temperature of 38°C was attained. Subjects were then immersed semireclined into 8°C or 22°C water to the iliac crest for 10 min or rested. Rectal and thigh skin temperature, deep and superficial muscle temperature, thigh and calf skin blood flow (laser Doppler flowmetry), and superficial femoral artery blood flow (duplex ultrasound) were measured before and up to 30 min after immersion. Indices of vascular conductance were calculated (flux and blood flow/mean arterial pressure). Reductions in rectal temperature were similar (0.6°C-0.7°C) in all three trials (P = 0.38). The mean ± SD thigh skin temperature during recovery was 25.4°C ± 3.8°C in the 8°C trial, which was lower than the 28.2°C ± 1.4°C and 33.78°C ± 1.0°C in the 22°C and control trials, respectively (P < 0.001). Recovery muscle temperature was also lowest in the 8°C trial (P < 0.01). Femoral artery conductance was similar after immersion in both cooling conditions and was lower (∼55%) compared with the control condition 30 min after immersion (P < 0.01). Similarly, there was greater thigh (P < 0.01) and calf (P < 0.05) cutaneous vasoconstriction during and after immersion in both cooling conditions relative to the control condition. Colder water temperatures may be more effective in the treatment of exercise-induced muscle damage and injury rehabilitation by virtue of greater reductions in muscle temperature and not muscle blood flow.