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The Effects of Chronic Cold Water Immersion in Elite Rugby Players

Authors:
  • Sporting Clube de Portugal
  • Faculdade de Motricidade Humana, Universidade de Lisboa
  • High Performance Sport New Zealand, Chiefs Super Rugby

Abstract

Purpose: While the acute effects of cold water immersion (CWI) have been widely investigated, research analysing the effects of CWI over a chronic period in highly-trained athletes is scarce. The aim of this study was to investigate the effects of CWI during an intense three week pre-season phase in elite rugby athletes. Methods: Twenty-three elite male rugby union athletes were randomized to either CWI (10 min at 10 ºC, n = 11) or a passive recovery control (CON, n = 12) during three-weeks of high volume training. Athletes were exposed to either CWI or CON, after each training day (12 days in total). Running loads, conditioning and gym sessions were kept the same between groups. Measures of countermovement jump (CMJ), perceived muscle soreness and wellness were obtained twice a week, and saliva samples for determining cortisol and interleukin-6 (IL-6) were collected once per week. Results: Although no significant differences were observed between CWI and CON for any measure, CWI resulted in lower fatigue markers throughout the study, as demonstrated by the moderate effects on muscle soreness (d = 0.58 to 0.91) and IL-6 (d = -0.83), and the small effects (d = 0.23 to 0.38) on CMJ in comparison to CON. Conclusions: The results from this study demonstrate that CWI may provide some beneficial effect by reducing fatigue and soreness during an intense three week training phase in elite rugby athletes.
The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
International Journal of Sports Physiology and Performance
© 2018 Human Kinetics, Inc.
Note. This article will be published in a forthcoming issue of the
International Journal of Sports Physiology and Performance. The article
appears here in its accepted, peer-reviewed form, as it was provided by
the submitting author. It has not been copyedited, proofread, or formatted
by the publisher.
Section: Original Investigation
Article Title: The Effects of Chronic Cold Water Immersion in Elite Rugby Players
Authors: Francisco Tavares1,2, Martyn Beaven1, Júlia Teles3 , Dane Baker2, Phil Healey2, Tiaki
B Smith1,2 and Matthew Driller1,4
Affiliations: 1Faculty of Health, Sport and Human Performance, University of Waikato,
Hamilton, New Zealand. 2Chiefs Super Rugby, Hamilton, New Zealand. 3Faculty of Human
Kinetics & CIPER, University of Lisbon, Portugal. 4High Performance Sport New Zealand,
Auckland, New Zealand.
Journal: International Journal of Sports Physiology and Performance
Acceptance Date: June 14, 2018
©2018 Human Kinetics, Inc.
DOI: https://doi.org/10.1123/ijspp.2018-0313
The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
International Journal of Sports Physiology and Performance
© 2018 Human Kinetics, Inc.
The effects of chronic cold water immersion in elite rugby players
Submission type: Original investigation
Francisco Tavares1,2, Martyn Beaven1, Júlia Teles3 , Dane Baker2, Phil Healey2, Tiaki B Smith1,2
& Matthew Driller1,4
1Faculty of Health, Sport and Human Performance, University of Waikato, Hamilton, New
Zealand
2Chiefs Super Rugby, Hamilton, New Zealand
3Faculty of Human Kinetics & CIPER, University of Lisbon, Portugal
4High Performance Sport New Zealand, Auckland, New Zealand
Corresponding Author:
Francisco Tavares
Tavaresxico@gmail.com
+44 7507 391036
Running head: Cold water immersion in elite rugby athletes
Abstract word count: 229
Text-only word count: 3564
Number of figures and tables: tables = 5
International Journal of Sports Physiology and Performance
The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
International Journal of Sports Physiology and Performance
© 2018 Human Kinetics, Inc.
Abstract
Purpose: While the acute effects of cold water immersion (CWI) have been widely investigated,
research analysing the effects of CWI over a chronic period in highly-trained athletes is scarce.
The aim of this study was to investigate the effects of CWI during an intense three week pre-season
phase in elite rugby athletes. Methods: Twenty-three elite male rugby union athletes were
randomized to either CWI (10 min at 10 ºC, n = 10) or a passive recovery control (CON, n = 12)
during three-weeks of high volume training. Athletes were exposed to either CWI or CON, after
each training day (12 days in total). Running loads, conditioning and gym sessions were kept the
same between groups. Measures of countermovement jump (CMJ), perceived muscle soreness and
wellness were obtained twice a week, and saliva samples for determining cortisol and interleukin-
6 (IL-6) were collected once per week. Results: Although no significant differences were observed
between CWI and CON for any measure, CWI resulted in lower fatigue markers throughout the
study, as demonstrated by the moderate effects on muscle soreness (d = 0.58 to 0.91) and IL-6 (d
= -0.83), and the small effects (d = 0.23 to 0.38) on CMJ in comparison to CON. Conclusions:
The results from this study demonstrate that CWI may provide some beneficial effect by reducing
fatigue and soreness during an intense three week training phase in elite rugby athletes.
Keywords: Recovery, fatigue, chronic, acute, adaptation
International Journal of Sports Physiology and Performance
The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
International Journal of Sports Physiology and Performance
© 2018 Human Kinetics, Inc.
INTRODUCTION
At the elite level, rugby training often occurs two or more times daily over two or more
consecutive days during a week.1,2 An imbalance between training stress and recovery can lead to
an excessive level of accumulated fatigue over the training week1 and undesirable chronic fatigue
over a training phase.3 Increased fatigue over time can lead to the athlete being unable to train at a
required intensity or being unable to perform the desired training load.4 In order to reduce the
harmful effect of fatigue and allow athletes to recover faster, athletes regularly implement different
recovery modalities in their routines.1,2,5 Previous literature has identified cold-water modalities as
one of the most common recovery strategies implemented by elite rugby athletes.1,2 The exposure
to cold water decreases skin, core and muscle temperature,6 leading to vasoconstriction, and
consequently, it may decrease swelling and acute inflammation from muscle damage.7
Furthermore, the use of cold water immersion (CWI) contributes to a reduction in nerve conduction
properties and to a decrease in muscle spasm and pain.7 CWI in an acute rugby setting (<48 h post-
exercise) has been effective in increasing neuromuscular function8,9 , enhancing perceived
recovery,8 and decreasing both delayed onset muscle soreness (DOMS)9 and creatine kinase
levels.9
Given the beneficial effects of CWI in enhancing recovery in rugby, this modality has
become commonplace following both matches and training sessions.2,10 However, some
researchers argue that the use of CWI post-exercise in a chronic setting may blunt adaptations by
reducing muscle protein synthesis and therefore limiting muscle mass maintenance/growth.11
Mechanisms involved in the hypertrophy of the muscle cell are thought to be partially associated
with exercise-induced muscle damage (EIMD) and the consequent increases in the activity of
satellite cells and inflammatory cells as well as the increase in the cell swelling.11 These responses
International Journal of Sports Physiology and Performance
The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
International Journal of Sports Physiology and Performance
© 2018 Human Kinetics, Inc.
to EIMD are proposed to mediate various anabolic signalling pathways that ultimately increase the
rates of protein synthesis.11 Roberts et al.11 observed an acute decrease in the activity of selected
components of the mammalian target of rapamycin pathway and satellite cells after 10 minutes of
CWI at ~10 ºC performed post-resistance training. In the same study, the authors observed that
CWI attenuates muscle mass (but not type II fibre cross sectional area or myonuclear accretion)
after 12 weeks of lower body resistance training composed of two sessions per week.11
Interestingly though, when the recovery time was shorter (i.e. 6 h) the same authors report
that CWI enhances recovery of muscle function and allows athletes to complete more work during
subsequent training sessions.12 Furthermore, during an intensified training phase for elite cyclists,
Halson et al.5 found likely beneficial effects of CWI in the mean power of a four minute cycling
test and the one second maximum power in a sprint test. In this study the elite cyclist trained on a
daily basis, therefore, the time for recovery was shorter than the typical studies investigating the
effects of CWI on performance.5 Together, these findings demonstrate that when recovery time is
limited, CWI may provide a beneficial acute effect on performance that will reflect the chronic
adaptations to a training regime. Research on the effects of chronic exposure to CWI (i.e. during
consecutive training weeks) on rugby players, is limited to a single study performed on age-group
athletes, which found no differences in performance, DOMS and perceived recovery.13 Based on
the aforementioned findings, two theories have been proposed for the response to CWI: 1) These
modalities allow athletes to perform subsequent training sessions with a greater quality and/or
quantity (i.e. greater training load); or 2) These modalities may blunt selected muscular adaptations
to training (i.e. decrease protein synthesis).5
To the best of our knowledge, research investigating the training responses in elite athletes
when chronically exposed to CWI are limited to endurance athletes5 with no published studies on
International Journal of Sports Physiology and Performance
The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
International Journal of Sports Physiology and Performance
© 2018 Human Kinetics, Inc.
elite team-sport athletes. While research on chronic CWI in non-elite team sport athletes does
exist5, we believe these findings are unlikely to apply to elite team sport athletes as the training
load and training density is not comparable between settings. Therefore, the aim of the current
study was to investigate the effects of chronic exposure to CWI on physiological and perceptual
markers of fatigue in an elite rugby population during an intense three-week pre-season training
phase.
METHODS
Participants
Twenty-nine professional male rugby athletes volunteered to participate in the current
study. Athletes were members of a team that made it to the semi-finals of the Super Rugby
competition in the same year as data collection took place. The Super Rugby competition is the
major competition in the southern hemisphere comprising of teams from Argentina, Australia,
Japan, New Zealand and South Africa. The attendance of at least 90% of the planned number of
training sessions, without missing two in a row, was a requirement for inclusion in the present
study. Athletes were matched by positional group and were randomly divided in one of two groups:
A CWI group and a control group (CON). From the initial sample size, six subjects were excluded
due to injury or illness. The 23 remaining athletes were included in the data analysis (CWI: n=10;
6 forwards [60%] 4 backs [40%]; CON: n=13; 8 forwards [61.5%] 5 backs [38.5%]) (Table 1).
Written informed consent was obtained from each participant, and ethical approval was obtained
from the Human Research Ethics Committee of the Institution.
Procedures
This study occurred during three weeks of the pre-season period and each week consisted
of four days of training as described in table 2. Immediately after each training day, the athletes in
International Journal of Sports Physiology and Performance
The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
International Journal of Sports Physiology and Performance
© 2018 Human Kinetics, Inc.
the CWI group were exposed to the recovery intervention. Therefore, athletes in the CWI group
were exposed to CWI four times in each week, totalling 12 CWI sessions over the duration of the
study. The CWI protocol consisted of athletes being immersed for 10 minutes to a level of the iliac
crest in an industrial tub filled with water at a fixed temperature of 10 ºC (Hayward® EnergyLine
pro ENP3M-13A, Dandenong South, VIC, Australia). The duration of the immersion and water
temperature used in the current study were based on that proposed in a recent literature review on
the effects of different recovery modalities in rugby which included CWI strategies for rugby
players.2 The athletes in the CON group followed their normal post-training routine and remained
at the training facilities until all athletes in the CWI group completed their CWI protocol.
Questionnaires and countermovement tests (CMJ) were implemented on the mornings of days one
and four for each of the three weeks. Saliva samples were collected prior to any food intake on
Day Four each week. The order and time of data collection were maintained throughout the study,
and individual wake times were monitored through questionnaires.
Training program
The training program consisted of four resistance training sessions (two for lower body and
two for upper body) designed to increase maximal strength and power (i.e. 3-5 sets of 1-6RM for
core exercises and 3-5 sets of 0-70% 1-RM for power exercises),14 seven rugby field sessions, two
speed sessions and three extra-conditioning sessions per week (Table 2). Given the schedule was
similar during the three weeks of the study, the duration of the sessions and the training load is
presented as the average of the three weeks in Table 2.
Perceptual measures
A wellness questionnaire and a lower-body soreness (LB soreness) questionnaire
previously used in rugby athletes was implemented on the morning of Day one and Day Four of
International Journal of Sports Physiology and Performance
The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
International Journal of Sports Physiology and Performance
© 2018 Human Kinetics, Inc.
each week during the period of the study.15 The wellness questionnaire comprised of five questions
to measure perceived fatigue, general muscle soreness, sleep quality, stress levels, and mood state.
The lower-body soreness questionnaire was designed to detect muscle soreness at five specific
lower-body sites.15 Both questionnaires used a 1-5 Likert-type scale with 0.5-point increments
where 1 represented a high score (e.g. no soreness) and 5 a low score (e.g. very sore).15 A total
measure of each questionnaire (i.e. wellness questionnaire and lower-body soreness questionnaire)
was calculated from the average of the items.15
Neuromuscular performance
In order to monitor neuromuscular fatigue, peak force (N) was measured during a CMJ test
performed each morning on Day one and Day four during the 3-week period (Table 2). Following
a standardized warm-up composed of dynamic stretches and movements (e.g. one-leg standing
knee flexion, bodyweight squats, bodyweight CMJ’s), athletes performed three maximal CMJ’s.
Two force plates (PASCO PS 2142, Roseville, CA, USA) were used to measure peak force (PF)
at a sample rate of 500 Hz. The force plates were connected to an analog-to-digital converter
(SPARKlink), which was then connected to a PC and the Pasco Capstone v1.4.0 software
(PASCO, Roseville, California, USA) through a USB port. Each trial started with the subjects
standing on the top of the force plates with their knees fully extended and their hands on hips to
eliminate the influence of arm swing. Subjects were then instructed to descend to a self-selected
depth and to jump as high and quickly as possible.16 The best trial, determined by peak force, was
retained for later analysis. Data obtained with 18 elite rugby athletes demonstrate that PF obtained
with the same setup and protocol has an acceptable level of test-retest reliability in a similar cohort
(ICC: 0.89; CV: 4.56%).17
International Journal of Sports Physiology and Performance
The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
International Journal of Sports Physiology and Performance
© 2018 Human Kinetics, Inc.
Saliva samples
Whole saliva samples were collected to monitor weekly changes in cortisol and IL-6.
Players expectorated a sample via passive drool into a 50-mL polyethylene tube, which was stored
at 20°C until assayed. Cortisol and IL-6 concentrations were determined in duplicate using
commercially available enzyme-linked immunosorbent assay kits (Salimetrics, State College, PA)
as per the manufacturer's instructions. Cortisol assay sensitivity was 3.5 pmol·L-1 with intra-assay
and inter-assay CV <3%. IL-6 assay sensitivity was 0.07 pg·mL-1 with intra- and inter-assay CV
<10%. Saliva samples for each participant were analyzed in the same assay to eliminate inter-assay
variance.
Training load
Locomotor activity of each participant was monitored during all technical-tactical training
sessions with a 15-Hz GPS unit (Viper Pod, STATSport, Belfast, UK) incorporated into the
players’ jersey on the upper thoracic spine between the scapulae. In order to decrease the between-
unit variability, the same GPS unit was used by each participant for subsequent sessions. The GPS
units were turned on before the warm-up and turned off after the completion of the training
sessions. After each training session, the raw data files were analyzed and individual sessions’
relative distance (m/min) and high metabolic load distance (HML; distance covered >5 m/s and/or
distance accelerating and decelerating over 2 m/s2) were obtained from the company’s software
(Viper PSA software, STATSports, Belfast, UK). The individual training RPE of the non-running
conditioning sessions and the gym training sessions were obtained between 15 and 30 minutes
after the completion of the session.18 The training load was then calculated as the product of the
individual session RPE (sRPE) and the duration of the session using the following formula:
Training load = sRPE (1-10) duration of the session (min).18 A total measure of perceived
International Journal of Sports Physiology and Performance
The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
International Journal of Sports Physiology and Performance
© 2018 Human Kinetics, Inc.
training load was calculated from the individual sum of the non-running conditioning sessions
sRPE coupled with the gym training sessions sRPE.
Statistical analysis
All statistical analyses were performed using SPSS 25.0 (IBM Corp., Armonk, NY, USA).
Independent samples T-tests or Mann-Whitney tests were conducted to verify the differences
between groups (CWI and CON) for the baseline measures (i.e. the first samples collected during
the experimental period) for CMJ, LB soreness, wellness, IL-6 and cortisol. These statistical tests
were also conducted to determine the differences between groups for athlete characteristics i.e.
age, body mass, height, sum of 8 skinfolds, squat 1-RM, bench press 1-RM, chin-ups 1-RM, speed
over 10-m, Yoyo intermittent recovery test level 1, all measured the week prior to the beginning
of the experimental period.
The differences from baseline measures in CMJ, LB soreness, wellness, cortisol and IL-6
were calculated. A repeated measures ANOVA was performed to determine the effect of different
treatments (CWI or CON) over time (day/week) on all measured variables. Analysis of the
studentized residuals was verified visually with histograms and also by the Shapiro-Wilk test of
normality.
In addition, effect-size statistics were performed for differences between groups from
baseline (Day one of Week one) for CMJ, IL-6, cortisol, LB soreness, and total wellness. For these
measures, the standardised change in the mean from baseline for each day was determined and
expressed as standardised (Cohen’s d) effects.19 Effect sizes were also determined to compare
differences between groups for the training load markers in each week. Magnitudes of the
standardised effects were interpreted using thresholds of 0.2, 0.6, 1.2 and 2.0 for small, moderate,
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The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
International Journal of Sports Physiology and Performance
© 2018 Human Kinetics, Inc.
large, and very large, respectively.20 An effect size <0.2 was considered trivial.20 Where the 90%
confidence limits overlapped small positive and negative values, the effect was deemed unclear.21
RESULTS
Subjects characteristics for age, bdy mass, height, sum of 8 skinfolds and performance
markers (i.e. maximum strength, speed and aerobic power) are included in Table 1 as means ± SD.
No significant differences (p < 0.05) were found between groups for athletes’ characteristics or
measures of training load. (Table 3).
Although results from ANOVA found no interaction for Time Group for any of the
measured variables (Table 4), the analysis of the effect sizes demonstrates a small effect in favour
of CWI on CMJ performance and a moderate effect on LB soreness (Table 5).
Moreover, a moderate effect of CWI attenuating increases in IL-6 in comparison to CON
was observed in the comparison from Week Three to baseline (Table 5). No differences between
or within groups were observed for Cortisol over the duration of the study (Table 5). Further
analysis of the effect sizes revealed that on Day Four of each week, the athletes in the CON group
demonstrated small reductions in CMJ performance and wellness scores, and moderate increases
in soreness, while the athletes in the CWI were able to maintain scores in comparison to baseline
(Table 5).
DISCUSSION
The main finding from the current study is that the chronic exposure to cold water
immersion over a pre-season phase in elite rugby athletes showed no detrimental effect to
performance or recovery. In fact, there was a moderate effect in favour of CWI for attenuating
increases in muscle soreness when compared to CON (Table 5). The beneficial effects of CWI
were also extended to performance in the CMJ and IL-6 values, as demonstrated by the small and
International Journal of Sports Physiology and Performance
The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
International Journal of Sports Physiology and Performance
© 2018 Human Kinetics, Inc.
moderate effects, respectively (Table 5). While the acute effects of CWI have been previously
investigated in elite rugby athletes,9 this study is the first to show the positive effects of chronic
exposure to CWI in elite rugby athletes in terms of neuromuscular performance and immune
function.2
Delayed onset of muscle soreness (DOMS) is a well-documented outcome occurring from
exercise-induced muscle damage, with a recent meta-analysis demonstrating that CWI is beneficial
for reducing DOMS after exercise strenuous enough to induce damage.22 Particularly in rugby,
previous research observed that CWI decreases muscle soreness and markers of muscle damage,
such as creatine kinase clearance, measured 1, 18 and 42 h post-match when compared to active
recovery.9 Although the ANOVA revealed no significant treatment interaction, our findings
support the beneficial effect of CWI reducing muscle soreness with moderate effects sizes
observed between groups (Table 5) over a three-week pre-season training phase. While athletes in
the CON reported higher scores of lower body soreness (i.e. small to moderate effect sizes) than
athletes in CWI (i.e. small negative effect sizes). It is important to mention that statistical
significance (p < 0.05) does not necessarily demonstrate that there is no worthwhile effects in the
athletic field, specifically at the elite level where sample sizes may be limited, and where small
changes in performance from training interventions can still yield meaningful results.21
Muscle soreness has been demonstrated to be related to reductions in neuromuscular
performance in rugby athletes,15,23 with skeletal muscle damage proposed as a causative factor.24
Exposure to cold, and CWI in particular, has been demonstrated to enhance recovery in
neuromuscular function in rugby.2 In our study, the beneficial effects of CWI attenuating
decrements in neuromuscular function (i.e. CMJ peak force) were demonstrated by a small effect
in favour of the CWI group (Table 5). These results are in concordance with previous literature
International Journal of Sports Physiology and Performance
The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
International Journal of Sports Physiology and Performance
© 2018 Human Kinetics, Inc.
demonstrating a beneficial effect of CWI enhancing neuromuscular performance for up to 48 h
after rugby training or competition.8,9 Moreover, our findings are consistent with findings from
Roberts et al.12 that demonstrated that CWI enhances the recovery in muscle function as
demonstrated by the capability to perform more volitional work in the squat exercise.
One of the key questions this study aimed to answer was whether CWI would attenuate the
fatigue accumulated in response to the high week-to-week training load experienced by elite rugby
athletes during a pre-season phase of training. Neuromuscular performance decreased for the CON
group on the first day of Week Three (i.e. post ~65h of no training) from baseline (-6.9%). In
contrast, for the CWI group, CMJ was only slightly decreased on the first day of Week Three (-
1.32%), with small effect being observed for the differences between groups (Table 5), suggesting
the athletes on Week Three were better recovered and able to maintain training intensity.
Moreover, a trend towards lower levels of IL-6, associated with a moderate effect size in favour
of CWI, demonstrates that CWI may attenuate IL-6 over the longer term. It has been suggested
that if high training loads occur without adequate recovery, a chronic increase of circulating
cytokines (e.g. IL-6) can occur, increasing the risk of maladaptation.25 For example, Anderson et
al.26 found a chronic elevation in IL-6 in collegiate American football athletes following a high
intensity 6-week period, demonstrating that when training loads are high, IL-6 can be chronically
increased. Together, with the decrement in CMJ performance observed in the CON group, the
moderate increase in IL-6 in the comparison between groups (i.e. CON > CWI) may suggest that
athletes were not able to positively respond to training load.25
Our findings are supported by those from Halson et al.5 whom observed a likely beneficial
effect of CWI on cycling performance in highly-trained endurance cyclists during a 21-day
intensification phase, followed by an 11-day taper period. In rugby, the investigation of the chronic
International Journal of Sports Physiology and Performance
The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
International Journal of Sports Physiology and Performance
© 2018 Human Kinetics, Inc.
effects of CWI is limited to the one study that observed no beneficial effects of CWI.13 However,
as previously discussed, the results from that study are not necessarily transferable to elite team-
sport athletes as the training load was relatively low. The participants of our study are professional
athletes that were exposed to a very dense training schedule (e.g. two or more training sessions
occurring every training day) (Tables 2 and 3). Therefore, CWI may aid in the maintenance of
high mechanical outputs (e.g. high values of force, power and speed) during periods with increased
training volume. Particularly in this study, on Day Four of each week, the athletes in CON had a
decrease in neuromuscular performance. This may suggest that athletes underperformed during
the speed session performed on Day Four, due to an increased level of fatigue. Moreover, when
CWI is implemented with athletes exposed to a high-density training schedule, it may prevent
maladaptive responses from training.
It is important to note some limitations of this study. Similarly to other research
investigating the effects of CWI in rugby, the small sample size (10 and 13 athletes in CWI and
CON, respectively) may be a limiting factor in the present study. The inference-based analysis
method used in this study is often used in research with small samples of elite athletes to overcome
this limitation.21 Given the limited access to a greater sample size, it was not possible to include a
placebo group in our study. Previous research has demonstrated that a thermoneutral water
immersion placebo is as effective as CWI on the improvement of acute muscle function and
perceptual measures. Therefore, the potential for placebo effect in the current study cannot be
discounted 27. Another limitation of the current study is that saliva was collected on day four of
each week where athletes had ~36 hours to recover from the previous training session. Previous
research has demonstrated that cortisol and IL-6 increase significantly after an elite rugby match,
but values decrease to baseline values 14 hours post-match.28 While the IL-6 and cortisol were
International Journal of Sports Physiology and Performance
The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
International Journal of Sports Physiology and Performance
© 2018 Human Kinetics, Inc.
likely to increase after exercise, it is unlikely that they would still be elevated 36 hours after
exercise (i.e. no training occurred between Days Two and Four), therefore changes in these
markers reflects a chronic (i.e. week to week) exposure to training loads.28 Another limitation was
fact that the temperature used for the CWI (10ºC) was not individualized. This approach was
necessitated by the practicalities of working in the elite sport environment but should be noted as
a potential limitation as differences in body composition (i.e. muscle mass and body fat) and the
ratio between body surface area and body mass (BSA:BM) lead to different responses in body
temperature.29 It could be expected that if CWI temperature was individualized (i.e. lower CWI
temperatures for subjects with a greater BSA:BM and fat mass), then the beneficial effects of CWI
on recovery could be increased.30
PRACTICAL APPLICATIONS
When athletes are exposed to high volumes of training with limited time to recover between
training sessions, practitioners should consider the implementation of CWI in order to speed up
recovery of neuromuscular performance and improve perceptions of lower body DOMS.
Furthermore, if high volume training is prolonged for several weeks (e.g. three or more weeks),
CWI may prevent maladaptive responses from training.
CONCLUSIONS
Our study is the first to demonstrate that CWI may provide a beneficial effect to recovery
in both the acute and chronic setting when elite team-sport athletes are exposed to high training
loads. As previously mentioned, chronic exposure to cold modalities has been reported to both
blunt acute anabolic pathways associated with adaptations to training,11 and enhance recovery of
submaximal muscle function.12 Here we demonstrate that CWI may enhance recovery in elite
rugby athletes, allowing the athletes to perform at greater intensities which may in turn, lead to a
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The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
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© 2018 Human Kinetics, Inc.
greater overall adaptive stimulus.5 Therefore, in order to further clarify this question, future
research investigating the chronic effects of CWI within an athletic population should include
measurements of muscle size or markers of hypertrophy simultaneously with measures of
performance over a longer period of time (e.g. >4 weeks).
The results of the current study do not constitute endorsement of the product by the authors
or the journal.
International Journal of Sports Physiology and Performance
The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
International Journal of Sports Physiology and Performance
© 2018 Human Kinetics, Inc.
REFERENCES
1. Tavares F, Healey P, Smith TB, Driller M. The usage and perceived effectiveness of
different recovery modalities in amateur and elite Rugby athletes. Perform Enhanc Heal.
2017;5(4):142-146. doi:10.1016/j.peh.2017.04.002.
2. Tavares F, Smith TB, Driller M. Fatigue and Recovery in Rugby: A Review. Sport Med.
2017;47(8). doi:10.1007/s40279-017-0679-1.
3. Coutts AJ, Reaburn P, Piva TJ, Rowsell GJ. Monitoring for overreaching in rugby league
players. Eur J Appl Physiol. 2007;99(3):313-324. doi:10.1007/s00421-006-0345-z.
4. Barnett A. Using recovery modalities between training sessions in elite athletes: Does it
help? Sport Med. 2006;36(9):781-796. doi:10.2165/00007256-200636090-00005.
5. Halson SL, Bartram J, West N, et al. Does hydrotherapy help or hinder adaptation to
training in competitive cyclists? Med Sci Sports Exerc. 2014;46(8):1631-1639.
doi:10.1249/MSS.0000000000000268.
6. White GE, Wells GD. Cold-water immersion and other forms of cryotherapy: physiological
changes potentially affecting recovery from high-intensity exercise. Extrem Physiol Med.
2013;2(1):26. doi:10.1186/2046-7648-2-26.
7. Wilcock I, Cronin J, Hing W. Physiological response to water immersion. Sport Med.
2006;36(9):747-765. doi:10.2165/00007256-200636090-00003.
8. Garcia CA, da Mota GR, Marocolo M. Cold water immersion is acutely detrimental but
increases performance post-12 h in rugby players. Int J Sports Med. 2016;37(8):619-624.
doi:10.1055/s-0035-1565200.
9. Webb N, Harris N, Cronin J, Walker C. The relative efficacy of three recovery modalities
following professional rugby league matches. J Strength Cond Res. 2013;27(9):2449-2455.
doi:10.1519/JSC.0b013e31827f5253.
10. Highton J, Twist C. Recovery strategies for rugby. In: Twist C, Worsfold P, eds. The
Science of Rugby. New York: Routledge; 2015:101-116.
11. Roberts LA, Raastad T, Markworth JF, et al. Post-exercise cold water immersion attenuates
acute anabolic signalling and long-term adaptations in muscle to strength training. J
Physiol. 2015;593(18):4285-4301. doi:10.1113/JP270570.
12. Roberts LA, Nosaka K, Coombes JS, Peake JM. Cold water immersion enhances recovery
of submaximal muscle function after resistance exercise. Am J Physiol Regul Integr Comp
Physiol. 2014;307:R998-R1008.
13. Higgins TR, Heazlewood IT, Climstein M. A random control trial of contrast baths and ice
baths for recovery during competition in U/20 rugby union. J Strength Cond Res.
2011;25(4):1046-1051. doi:10.1519/JSC.0b013e3181cc269f [doi].
International Journal of Sports Physiology and Performance
The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
International Journal of Sports Physiology and Performance
© 2018 Human Kinetics, Inc.
14. McMaster DT, Gill N, Cronin J, McGuigan M. The development, retention and decay rates
of strength and power in elite rugby union, rugby league and american football: A
systematic review. Sport Med. 2013;43(5):367-384. doi:10.1007/s40279-013-0031-3.
15. Tavares F, Healey P, Smith TB, Driller M. The effect of training load on neuromuscular
performance, muscle soreness and wellness during an in-season non-competitive week in
elite Rugby athletes. J Sport Med Phys Fit. 2017;in press. doi:10.23736/S0022-
4707.17.07618-6.
16. Driller M, Mackay K, Mills B, Tavares F. Tissue flossing on ankle range of motion, jump
and sprint performance: A follow-up study. Phys Ther Sport. 2017;28.
doi:10.1016/j.ptsp.2017.08.081.
17. Tavares F, McMaster T, Healey P, Smith TB, Driller M. A Novel Method to Reduce the
Impact of Countermovement Jump Monitoring In Professional Rugby Athletes. J Athl
Enhanc. 2018;7(1).
18. Foster C, Florhaug JA, Franklin J, et al. A New Approach to Monitoring Exercise Training.
J Strength Cond Res. 2001;15(1):109-115.
19. Hopkins WG. Spreadsheets for analysis of controlled trials with adjustment for a predictor.
Sportscience. 2006:46-50.
20. Hopkins WG, Marshall SW, Batterham AM, Hanin J. Progressive statistics for studies in
sports medicine and exercise science. Med Sci Sports Exerc. 2009;41(1):3-12.
doi:10.1249/MSS.0b013e31818cb278.
21. Batterham AM, Hopkins WG. Making meaningful inferences about magnitudes. Int J
Sports Physiol Perform. 2006;1(1):50-57.
22. Leeder J, Gissane C, van Someren K, Gregson W, Howatson G. Cold water immersion and
recovery from strenuous exercise: a meta-analysis. Br J Sports Med. 2012;46(4):233-240.
doi:10.1136/bjsports-2011-090061.
23. McLean B, Coutts A, Kelly V, McGuigan M, Cormack S. Neuromuscular, endocrine, and
perceptual fatigue responses during different length between-match microcycles in
professional rugby league players. Int J Sport Physiol Perform. 2010;5:367-383.
24. MacIntyre DL, Reid WD, McKenzie DC. Delayed Muscle Soreness. Sport Med.
1995;20(1):24-40. doi:10.2165/00007256-199520010-00003.
25. Smith LL. Cytokine hypothesis of overtraining: a physiological adaptation to excessive
stress? Med Sci Sports Exerc. 2000;32(2):317-331. doi:10.1097/00005768-200002000-
00011.
26. Anderson T, Haake S, Lane AR, Hackney AC. Changes in resting salivary testosterone,
cortisol and interleukin-6 as biomarkers of overtraining. Balt J Sport Heal. 2016;101(2):61-
71.
International Journal of Sports Physiology and Performance
The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
International Journal of Sports Physiology and Performance
© 2018 Human Kinetics, Inc.
27. Broatch JR, Petersen A, Bishop DJ. Postexercise cold water immersion benefits are not
greater than the placebo effect. Med Sci Sports Exerc. 2014;46(11):2139-2147.
doi:10.1249/MSS.0000000000000348.
28. Cunniffe B, Hore AJ, Whitcombe DM, Jones KP, Baker JS, Davies B. Time course of
changes in immuneoendocrine markers following an international rugby game. Eur J Appl
Physiol. 2010;108(1):113-122. doi:10.1007/s00421-009-1200-9.
29. Stephens JM, Halson S, Miller J, Slater GJ, Askew CD. Cold Water Immersion for Athletic
Recovery: One Size Does Not Fit All. Int J Sports Physiol Perform. 2016;11(1):86-95.
doi:10.1123/ijspp.2016-0095.
30. Tavares F, Walker O, Healey P, Smith TB, Driller M. Practical applications of water
immersion recovery modalities for team sports. Strength Cond J. 2018;In press.
International Journal of Sports Physiology and Performance
The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
International Journal of Sports Physiology and Performance
© 2018 Human Kinetics, Inc.
TABLE 1 Participant characteristics. Data shown as means ± SD.
CWI group (n = 10)
Control group (n = 13)
Age (years)
22.9 ± 2.7
22.3 ± 1.9
Body mass (kg)
105.4 ± 16.3
110.2 ± 12.4
Height (cm)
185.6 ± 5.1
189.4 ± 7.3
8 skinfolds (mm)
80.2 ± 17.8
91.4 ± 28.4
Squat 1-RM (kg)
183.9 ± 30.1
184.5 ± 32.2
Bench Press 1-RM (kg)
140.5 ± 26.5
136.8 ± 28.5
Chin-ups 1-RM (kg)
144.0 ± 15.7
135.0 ± 32.2
Speed 10 m (s)
3.02 ± 0.19
2.95 ± 0.18
Yoyo IRTL1
18.2 ± 1.1
17.3 ± 1.1
One repetition maximum (1-RM), Intermittent recovery test level 1 (IRTL1)
TABLE 2 Weekly training schedule during the three weeks of the study. Resistance training,
conditioning and technical-tactical duration (minutes), and qualitative intensity or type of training
are described.
Day 1
Day 2
Day 3
Day 4
Day 5
Day 6
Day 7
Before
CMJ+Q
CMJ+Q+Sal
Morning
Speed session
(30’)
Gym session (LB:
75’)
TT (45’;
Moderate)
Gym session
(UB: 75’)
TT (45’;
Moderate)
Theory
sessions
Speed session
(30’)
Gym session
(LB: 75’)
TT (45’;
Moderate)
Gym session
(UB: 60’)
TT (75’;
Moderate)
Day-
off
Day-
off
Afternoon
TT (90’; High)
Cond (30’; High)
TT (60’; High)
TT (60’; High)
Cond (30’;
High)
Cond (50’;
High)
Jumping performance (CMJ); Wellness and soreness questionnaires (Q); Saliva Sample (Sal); Lower body resistance
training (LB); Upper body resistance training (UB); Technical-tactical session (TT); Conditioning session (Cond).
International Journal of Sports Physiology and Performance
The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
International Journal of Sports Physiology and Performance
© 2018 Human Kinetics, Inc.
TABLE 3 Average weekly training loads for CWI and CON and differences between training
groups for weeks One, Two and Three. Data presented as means ± SD unless stated otherwise. No
significant differences observed between groups for any training load parameter.
Week One
Δ CON – Δ
CWI
(Mean
±90%
Confidence
Limit;
Effect
Sizes)
Week Two
Δ CON – Δ
CWI
(Mean
±90%
Confidence
Limit;
Effect
Sizes)
Week Three
Δ CON – Δ
CWI
(Mean
±90%
Confidence
Limit;
Effect
Sizes)
CWI
CON
CWI
CON
CWI
CON
Gym sRPE
(AU)
441 ±
61
415 ±
59
-25.8 ±43.7;
unclear (-
0.39)
440 ±
60
437 ±
45
-3.0 ±39.7;
unclear (-
0.05)
596 ±
66
606 ±
71
9.3 ±49.8;
unclear
(0.13)
Conditioning
sRPE (AU)
359 ±
29
355 ±
28
-3.3 ±20.7;
unclear (-
0.11)
269 ±
29
281 ±
22
-11.4 ±19.3;
unclear
(0.36)
302 ±
33
315 ±
37
13.4 ±25.2;
unclear
(0.37)
Total sRPE
(AU)
800 ±
84
770 ±
79
-29.1 ±59.8;
unclear (-
0.32)
709 ±
74
718 ±
29
8.4 ±47.5;
unclear
(0.10)
898 ±
89
921 ±
97
22.7 ±67.1;
unclear
(0.23)
HML (m)
838 ±
201
839 ±
139
0.9 ±130.4;
unclear
(0.00)
844 ±
184
915 ±
231
71.8
±149.4;
unclear
(0.36)
1130
± 304
1066
± 318
7.4 ±169.9;
unclear
(0.03)
Relative
distance
(m/min)
73.2
±
10.8
76.6 ±
5.3
3.4 ±6.6;
unclear
(0.29)
71.9 ±
8.5
76.0 ±
11.46
4.0 ±7.2;
unclear
(0.43)
82.1 ±
12.0
80.1 ±
9.0
-2.0 ±7.9;
unclear (-
0.15)
sRPE = Session rate of perceived exertion, AU = Arbitrary unit, HML = High metabolic load
International Journal of Sports Physiology and Performance
The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
International Journal of Sports Physiology and Performance
© 2018 Human Kinetics, Inc.
TABLE 4 Analysis of Variance for the variables of interest with Group (CWI vs CON) as the
between subjects’ factor and Day (CMJ, LB soreness and wellness) or Week (IL-6 and cortisol) as
within subjects’ factor. * represents significant difference.
Test
Source of
variation
(df, dferror)
F
p
CMJ Performance (N)
Day
(2,42)
3.666
0.034*
Group
(1,21)
2.647
0.119
Day*Group
(2,42)
0.555
0.578
LB soreness (AU)
Day
(2,42)
3.357
0.044*
Group
(1,21)
2.122
0.160
Day*Group
(2,42)
1.393
0.260
Wellness (AU)
Day
(2,42)
0.947
0.396
Group
(1,21)
0.178
0.677
Day*Group
(2,42)
2.400
0.103
IL-6 (uL)
Day
(1,17)
0.055
0.055
Group
(1,17)
2.845
0.110
Day*Group
(1,17)
0.232
0.636
Cortisol (uL)
Day
(1,16)
0.055
0.483
Group
(1,16)
2.845
0.882
Day*Group
(1,16)
0.232
0.337
International Journal of Sports Physiology and Performance
The Effects of Chronic Cold Water Immersion in Elite Rugby Players” by Tavares F et al.
International Journal of Sports Physiology and Performance
© 2018 Human Kinetics, Inc.
TABLE 5 Changes in measures of CMJ performance, perceptual soreness and wellness and saliva markers from Baseline (Day 1) to
the remaining testing days.
Week
CWI
(Mean ± SD; Effect Size)
CON
(Mean ± SD; Effect Size)
CON CWI
(Mean ±90% Confidence
Limit; Effect Size)
CMJ Performance (N)
Week 1
Baseline
2679.6 ± 434.8
2916.8 ± 489.4
237.2
Day 4 baseline
11.3 ± 179.4; trivial (0.02)
-175.8 ± 252.7; small (-0.36)
-187.1 ±155.5; small (0.38)
Week 2
Day 1 baseline
-96.4 ± 228.8; unclear (-0.20)
-148.8 ± 210.2; small (-0.20)
-52.4 ±161.1; unclear (0.11)
Day 4 baseline
-77.1 ± 224.1; trivial (-0.16)
-191.1 ± 265.2; small (-0.39)
-114.0 ±176.1; small (0.23)
Week 3
Day 1 baseline
-34.9 ± 234.4; trivial (-0.07)
-188.7 ± 289.4; small (-0.39)
-153.8 ±188.4; small (0.31)
Day 4 baseline
-95.6 ± 201.2; unclear (-0.20)
-263.1 ± 313.3; small (-0.54)
-167.5 ±185.7; small (0.34)
LB soreness (AU)
Week 1
Baseline
3.6 ± 0.5
3.6 ± 0.6
0.0
Day 4 baseline
0.2 ± 0.6; unclear (0.30)
0.5 ± 0.6; moderate (0.88)
0.3 ±0.4; small (0.58)
Week 2
Day 1 baseline
-0.2 ± 0.3; small (-0.42)
0.1 ± 0.5; small (0.20)
0.4 ±0.3; moderate (0.62)
Day 4 baseline
-0.2 ± 0.6; unclear (-0.32)
0.3 ± 0.6; moderate (0.60)
0.5 ±0.4; moderate (0.91)
Week 3
Day 1 baseline
-0.3 ± 0.3; small (-0.58)
0.1 ± 0.5; small (0.23)
0.5 ±0.3; moderate (0.81)
Day 4 baseline
0.2 ± 0.6; unclear (0.37)
0.4 ± 0.7; moderate (0.66)
0.2 ±0.5; unclear (0.29)
Wellness (AU)
Week 1
Baseline
3.9 ± 0.7
3.8 ± 0.4
0.0
Day 4 baseline
0.0 ± 0.4; unclear (0.01)
0.3 ± 0.4; small (0.53)
0.3 ±0.3; small (0.50)
Week 2
Day 1 baseline
0.0 ± 0.5; unclear (0.03)
0.1 ± 0.4; trivial (0.11)
0.0 ±0.3; unclear (0.08)
Day 4 baseline
0.2 ± 0.5; small (0.36)
0.2 ± 0.6; small (0.43)
0.0 ±0.4; unclear (0.07)
Week 3
Day 1 baseline
0.0 ± 0.3; unclear (0.07)
0.1 ± 0.3; trivial (0.11)
0.0 ±0.2; unclear (0.04)
Day 4 baseline
0.3 ± 0.6; small (0.55)
0.2 ± 0.4; small (0.42)
-0.1 ±0.4; unclear (-0.13)
IL-6 (uL)
Week 1
Baseline
18.3 ± 6.5
19.7 ± 7.8
1.4
Week 2
Day 4 baseline
-1.7 ± 6.8; unclear (-0.23)
2.6 ± 3.0; unclear (0.35)
4.2 ±6.0; unclear (-0.58)
Week 3
Day 4 baseline
-3.1 ± 5.4; small (-0.42)
3.0 ± 10.1; unclear (0.41)
6.1 ±6.5; -moderate (-0.83)
Cortisol (uL)
Week 1
Baseline
0.84 ± 0.36
0.61 ± 0.19
-0.23
Week 2
Day 4 baseline
-0.01 ± 0.32; unclear (-0.03)
0.06 ± 0.12; trivial (0.19)
0.07 ±0.22; unclear (-0.22)
Week 3
Day 4 baseline
0.01 ± 0.32; unclear (0.02)
-0.03 ± 0.16; trivial (-0.10)
0.04 ±0.23; unclear (-0.12)
International Journal of Sports Physiology and Performance
... Previous studies proposed that CWI attenuates secondary exercise-induced muscle damage on the basis of a reduced increase in creatine kinase concentration (8,9). Both techniques have also been found effective in decreasing the perception of muscle soreness and thus are proposed to attenuate delayed onset muscular soreness (10)(11)(12). By improving physical and perceptual states, CWI and WBC may accelerate neuromuscular function recovery (11)(12)(13) and limit functional performance decrements (8). ...
... By improving physical and perceptual states, CWI and WBC may accelerate neuromuscular function recovery (11)(12)(13) and limit functional performance decrements (8). In the context of performance, a few studies have demonstrated CWI to efficiently attenuate muscle soreness and limit performance decrements after intermittent-sprint exercises and/or team sports (10,14,15). CWI in combination with compression garments and sleep hygiene recommendations was likewise confirmed by a recent study to alleviate muscle soreness in an ecological tennis setting (16), with subsequent increase in playing time and lower body power-generating capacity after one day of repeated on-court tennis training (16). ...
... Regarding recovery modalities, WBC and CWI similarly attenuated muscle soreness throughout the consecutive days of the experiment with no differences between the modalities (Figure 4b). Although the observed analgesic effect of CWI is consistent with previous studies (10,14,16), the present work is the first to demonstrate a similar result with WBC in practical settings (37). Both CWI and WBC have been proposed to limit inflammation, edema and the appearance of blood markers of muscle damage through 205 cold-induced vasoconstriction, likely reducing delayed onset muscle soreness (7,19,38). ...
Thesis
Full-text available
L’organisation du circuit professionnel impose actuellement au joueur de tennis de haut niveau une planification annuelle des entraînements et des compétitions très dense. Ainsi, une gestion appropriée et équilibrée de la fatigue et de la récupération apparait primordiale afin de permettre au joueur de tennis élite d’être performant lors des compétitions mais aussi d’éviter la survenue d’épisodes de fatigue sévère, de surmenage, de blessures ou de maladies. Les connaissances issues de la littérature scientifique incitent à adapter et planifier spécifiquement la récupération en fonction du contexte (discipline, période d’entraînement, type de fatigue, statut de l’athlète). Pourtant, les joueurs ont actuellement recours de façon relativement empirique à des stratégies de récupération diverses, incluant l’application de froid. Cependant, peu d’études se sont intéressées aux effets de ces méthodes de récupération sur les réponses à la charge induite par le tennis pratiqué à haut niveau. Il semble nécessaire de déterminer l’efficacité de chaque technique de récupération dans ce contexte afin d’identifier quelles stratégies répondent le mieux à la nécessité de récupérer. La première partie de ces travaux de thèse a donc eu pour objectif de décrire, sur une période de 15 mois et dans un cadre écologique, les contenus et la charge de travail induite par l’entraînement, les pratiques de récupération et leurs impacts sur la fatigue subjective des joueurs de tennis élites. À court terme, il apparait que les contenus d’entraînement, regroupés et leur charge associée n’impactent pas différemment la fatigue perceptive rapportée. Au sein des stratégies de récupération utilisées par les joueurs, les techniques par le froid (cryothérapie corps entier, immersion en eau froide, bain contrasté) sont les plus représentées. Les modèles statistiques utilisés montrent que ces techniques de récupération par le froid sont les seules associées à une diminution significative des sensations de douleurs musculaires 12-16h post-entraînement. Notre seconde étude a comparé l’efficacité de ces différentes techniques de récupération par le froid dans des conditions de fatigue accumulée, simulant celles induites lors de compétitions professionnelles de tennis. Ces travaux montrent que l’enchaînement de trois jours de matchs de tennis d’1h30, induit une fatigue significative mais modérée. En effet, les paramètres de fatigue neuromusculaire (centrale et périphérique), physiologique diminuent significativement lors du premier jour, mais ne sont pas modifiés en réponse aux matchs de tennis des jours suivants. Au cours des quatre jours de protocole, l’immersion en eau froide et de la cryothérapie corps entier permettent de limiter l’augmentation des sensations de douleurs musculaires. Ces résultats valident l’intérêt d’utiliser les techniques de récupération par le froid pour diminuer les sensations de douleurs musculaires de joueurs de tennis élites en période d’entraînement. Dans le cadre précis de compétitions réalisées sur surface dure (hors Grands Chelems), l’utilisation quotidienne des techniques de récupération par le froid seront alors conseillées pour limiter l’accumulation des sensations de douleurs musculaires.
... However, in an elite athlete setting, Halson et al. [32] reported that chronic CWI use in endurance trained cyclists, similar to the current study, allowed performance and perceptual recovery to be better maintained in the CWI group when compared with CON. Similarly, Tavares et al. [33] investigated the effects of daily chronic CWI during a 3-week pre-season period (12 days in total) on elite rugby players, and found that chronic use of CWI supported a moderate beneficial effect on muscle soreness when compared with a control group. Both Halson et al. [32] and Tavares et al. [33] did not report any detrimental effects to performance, but suggested long term benefits to adaptation and reducing fatigue and soreness from chronic application of CWI in the specific context of athletes with high training volumes and density. ...
... Similarly, Tavares et al. [33] investigated the effects of daily chronic CWI during a 3-week pre-season period (12 days in total) on elite rugby players, and found that chronic use of CWI supported a moderate beneficial effect on muscle soreness when compared with a control group. Both Halson et al. [32] and Tavares et al. [33] did not report any detrimental effects to performance, but suggested long term benefits to adaptation and reducing fatigue and soreness from chronic application of CWI in the specific context of athletes with high training volumes and density. Thus, the use of recovery intervention is especially important given that the early recovery phase involves the overlapping process of inflammation and the occurrence of secondary muscle damage [22] that will negatively impact on subsequent training and adaptive stimulus. ...
Article
Full-text available
Background: Previous studies have shown that compression garments may aid recovery in acute settings; however, less is known about the long-term use of compression garments (CG) for recovery. This study aimed to assess the influence of wearing CG on changes in physical performance, subjective soreness, and sleep quality over 6 weeks of military training. Methods: Fifty-five officer-trainees aged 24 ± 6 y from the New Zealand Defence Force participated in the current study. Twenty-seven participants wore CG every evening for 4-6 h, and twenty-eight wore standard military attire (CON) over a 6-week period. Subjective questionnaires (soreness and sleep quality) were completed weekly, and 2.4 km run time-trial, maximum press-ups, and curl-ups were tested before and after the 6 weeks of military training. Results: Repeated measures ANOVA indicated no significant group × time interactions for performance measures (p > 0.05). However, there were small effects in favour of CG over CON for improvements in 2.4 km run times (d = -0.24) and press-ups (d = 0.36), respectively. Subjective soreness also resulted in no significant group × time interaction but displayed small to moderate effects for reduced soreness in favour of CG. Conclusions: Though not statistically significant, CG provided small to moderate benefits to muscle-soreness and small benefits to aspects of physical-performance over a 6-week military training regime.
... To the best of our knowledge, studies investigating the longerterm effects of CWI in a highly-trained athletic population are limited to two; one study performed in endurance-trained cyclists and the other in professional rugby union athletes (Tavares et al., 2019a). In the cycling study, highly trained cyclists were exposed to CWI four times a week during a 21-days intensification phase followed by a 11-days taper. ...
... A likely beneficial effect was also observed in the 1-s maximum mean sprint power in the CWI group when compared to the control. In the rugby study (Tavares et al., 2019a), 23 elite male rugby union athletes were randomized to either CWI (10 min at 10 • C, n = 10) or a passive recovery control (CON, n = 13) during 3 weeks of high-volume training. Although no significant differences were observed between CWI and CON for any measure, CWI resulted in lower fatigue markers throughout the study as demonstrated by the moderate effects on muscle soreness (d = 0.58-0.91) ...
... To the best of our knowledge, studies investigating the longerterm effects of CWI in a highly-trained athletic population are limited to two; one study performed in endurance-trained cyclists and the other in professional rugby union athletes (Tavares et al., 2019a). In the cycling study, highly trained cyclists were exposed to CWI four times a week during a 21-days intensification phase followed by a 11-days taper. ...
... A likely beneficial effect was also observed in the 1-s maximum mean sprint power in the CWI group when compared to the control. In the rugby study (Tavares et al., 2019a), 23 elite male rugby union athletes were randomized to either CWI (10 min at 10 • C, n = 10) or a passive recovery control (CON, n = 13) during 3 weeks of high-volume training. Although no significant differences were observed between CWI and CON for any measure, CWI resulted in lower fatigue markers throughout the study as demonstrated by the moderate effects on muscle soreness (d = 0.58-0.91) ...
... Indeed, the amount of exposure to CWI is likely to be of substantial practical importance (Ihsan et al., 2021). For example, one study used a 3-week high-volume training programme (12 total exercise sessions) where rugby players were randomized to post-exercise CWI or passive rest (Tavares et al., 2019). This study observed a positive effect of CWI on muscle soreness and countermovement jump performance. ...
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.
... CWI should be programmed in as part of a periodized plan; it is recommended that CWI should be prioritized during periods of intensified competition and avoided when strength adaptations are a priority. A recent study by Tavares et al. [48] showed that, when programmed appropriately, CWI can be regularly used during a preseason training phase without having a negative impact on strength adaptations. The effect of CWI on performance recovery and training adaptations is influenced by many factors, and it is recommended that practitioners use an individualized and periodized approach when programming sessions to optimize performance benefits and minimize risks of negatively impacting adaptations. ...
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Basketball players face multiple challenges to in-season recovery. The purpose of this article is to review the literature on recovery modalities and nutritional strategies for basketball players and practical applications that can be incorporated throughout the season at various levels of competition. Sleep, protein, carbohydrate, and fluids should be the foundational components emphasized throughout the season for home and away games to promote recovery. Travel, whether by air or bus, poses nutritional and sleep challenges, therefore teams should be strategic about packing snacks and fluid options while on the road. Practitioners should also plan for meals at hotels and during air travel for their players. Basketball players should aim for a minimum of 8 h of sleep per night and be encouraged to get extra sleep during congested schedules since back-to back games, high workloads, and travel may negatively influence night-time sleep. Regular sleep monitoring, education, and feedback may aid in optimizing sleep in basketball players. In addition, incorporating consistent training times may be beneficial to reduce bed and wake time variability. Hydrotherapy, compression garments, and massage may also provide an effective recovery modality to incorporate post-competition. Future research, however, is warranted to understand the influence these modalities have on enhancing recovery in basketball players. Overall, a strategic well-rounded approach, encompassing both nutrition and recovery modality strategies, should be carefully considered and implemented with teams to support basketball players’ recovery for training and competition throughout the season.
... Post-exercise water immersion has long been used by athletes in an attempt to improve recovery and to enhance exercise capacity (Versey et al., 2013;Machado et al., 2017;Broatch et al., 2018;Chow et al., 2018;Tavares et al., 2018). Cold water immersion (CWI: 5-16 • C) has been shown to stimulate metabolic regulators such as mitochondrial biogenesis (Broatch et al., 2018). ...
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We investigated whether substituting the final half within 60-min bouts of exercise with passive warm or cold water immersion would provide similar or greater benefits for cardiometabolic health. Thirty healthy participants were randomized to two of three short-term training interventions in a partial crossover (12 sessions over 14–16 days, 4 week washout): (i) EXS: 60 min cycling 70% maximum heart rate (HRmax), (ii) WWI: 30 min cycling then 30 min warm water (38–40°C) immersion, and/or (iii) CWI: 30 min cycling then 30 min cold water (10–12°C) immersion. Before and after, participants completed a 20 min cycle work trial, V.O2max test, and an Oral Glucose Tolerance Test during which indirect calorimetry was used to measure substrate oxidation and metabolic flexibility (slope of fasting to post-prandial carbohydrate oxidation). Data from twenty two participants (25 ± 5 year, BMI 23 ± 3 kg/m2, Female = 11) were analyzed using a fixed-effects linear mixed model. V.O2max increased more in EXS (interaction p = 0.004) than CWI (95% CI: 1.1, 5.3 mL/kg/min, Cohen’s d = 1.35), but not WWI (CI: −0.4, 3.9 mL/kg/min, d = 0.72). Work trial distance and power increased 383 ± 223 m and 20 ± 6 W, respectively, without differences between interventions (interaction both p > 0.68). WWI lowered post-prandial glucose ∼9% (CI −1.9, −0.5 mmol/L; d = 0.63), with no difference between interventions (interaction p = 0.469). Substituting the second half of exercise with WWI provides similar cardiometabolic health benefits to time matched exercise, however, substituting with CWI does not.
... However, as Hyldahl and Peake (2020) suggested, these findings generally indicate that regular cooling attenuates chronic gains in strength following traditional resistance training, whereas it has no influence on short-term adaptation after muscle-damaging exercise. It has even been shown that during weeks with an intense training load, the cold immersion can reduce the risks of maladaptation to training (Tavares et al., 2019). These cold baths might even be recommended in the phases of intense training where there is not enough time to recover. ...
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Recovery after exercise is a crucial key in preventing muscle injures and in speeding up processes to return at the homeostasis level. There are several ways of developing a recovery strategy with the use of different kinds of traditional and up-to date techniques. The use of cold has traditionally been used after physical exercise for recovery purposes. In the recent years, the use of whole-body cryotherapy/cryostimulation (an extreme cold stimulation lasting 1-4 min and given in a cold room at a temperature comprised from -60 to -195°C) has tremendously increased for such purposes. However, there are controversies about the benefits that the use of this technique may provide. Therefore, this paper describes what is whole body cryotherapy/cryostimulation, reviews and debates the benefits that its use may provide, presents practical considerations and applications, and emphasizes the need of customization depending on the context, the purpose, and the subject characteristics. This review is written by international experts from the working group on whole body cryotherapy/cryostimulation from the International Institute of Refrigeration.
... Recent work (Table 1) examining the longer-term effects of CWI on training performance and recovery amongst professional and semi-professional athletes provides invaluable insights regarding CWI programming and recovery-adaptation interaction throughout training/competition phases (Lindsay et al., 2016;Tavares et al., 2019Tavares et al., , 2020Seco-Calvo et al., 2020). These studies collectively demonstrate no impairments in strength gains despite administering frequent post-exercise CWI over 2.5 weeks to 8 months. ...
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In the last decade, cold water immersion (CWI) has emerged as one of the most popular post-exercise recovery strategies utilized amongst athletes during training and competition. Following earlier research on the effects of CWI on the recovery of exercise performance and associated mechanisms, the recent focus has been on how CWI might influence adaptations to exercise. This line of enquiry stems from classical work demonstrating improved endurance and mitochondrial development in rodents exposed to repeated cold exposures. Moreover, there was strong rationale that CWI might enhance adaptations to exercise, given the discovery, and central role of peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α) in both cold-and exercise-induced oxidative adaptations. Research on adaptations to post-exercise CWI have generally indicated a mode-dependant effect, where resistance training adaptations were diminished, whilst aerobic exercise performance seems unaffected but demonstrates premise for enhancement. However, the general suitability of CWI as a recovery modality has been the focus of considerable debate, primarily given the dampening effect on hypertrophy gains. In this mini-review, we highlight the key mechanisms surrounding CWI and endurance exercise adaptations, reiterating the potential for CWI to enhance endurance performance, with support from classical and contemporary works. This review also discusses the implications and insights (with regards to endurance and strength adaptations) gathered from recent studies examining the longer-term effects of CWI on training performance and recovery. Lastly, a periodized approach to recovery is proposed, where the use of CWI may be incorporated during competition or intensified training, whilst strategically avoiding periods following training focused on improving muscle strength or hypertrophy.
... In rugby union, preseason training aims to enhance physical capacities, including power, speed, strength, aerobic and anaerobic fitness and body composition [12][13][14]. To achieve this, athletes are required to train multiple times a day over consecutive days, which results in a period of intensified training. ...
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COLD THERAPIES ARE WIDELY USED MODALITIES TO ENHANCE RECOVERY WITHIN AN ATHLETIC POPULATION IN ADDITION TO OTHER ESSENTIAL COMPONENTS OF RECOVERY. ALTHOUGH THE BENEFITS OF COLD THERAPIES ARE DOCUMENTED IN THE SCIENTIFIC LITERATURE, RECENT RESEARCH HAS DEMONSTRATED SOME POTENTIAL HARMFUL EFFECTS OF SUCH MODALITIES AS WELL AS INDIVIDUAL RESPONSES TO SIMILAR PROTOCOLS. THIS ARTICLE REVIEWS THE CURRENT KNOWLEDGE ON THE DIFFERENT PROTOCOL CHARACTERISTICS AND INDIVIDUAL FACTORS THAT MAY CONTRIBUTE TO RESPONSES OF COLD THERAPIES, PROVIDING PRACTICAL RECOMMENDATIONS BASED ON EXTERNAL FACTORS, SUCH AS THE PHASE OF THE SEASON, THE DENSITY OF THE WEEKLY SCHEDULE, AND THE ATHLETES' GOALS.
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The physical demands and combative nature of rugby lead to notable levels of muscle damage. In professional rugby, athletes only have a limited timeframe to recover following training sessions and competition. Through the implementation of recovery strategies, sport scientists, practitioners and coaches have sought to reduce the effect of fatigue and allow athletes to recover faster. Although some studies demonstrate that recovery strategies are extensively used by rugby athletes, the research remains equivocal concerning the efficacy of recovery strategies in rugby. Moreover, given the role of inflammation arising from muscle damage in the mediation of protein synthesis mechanisms, some considerations have been raised on the long-term effect of using certain recovery modalities that diminish inflammation. While some studies aimed to understand the effects of recovery modalities during the acute recovery phase (<48 h post-match), others investigated the effect of recovery modalities during a more prolonged timeframe (i.e. during a training week). Regarding the acute effectiveness of different recovery modalities, cold water immersion and contrast baths seem to provide a beneficial effect on creatine kinase clearance, neuromuscular performance and delayed onset of muscle soreness. There is support in the literature concerning the effect of compression garments on enhancing recovery from delayed onset of muscle soreness; however, conflicting findings were observed for the restoration of neuromuscular function with the use of this strategy. Using a short-duration active recovery protocol seems to yield little benefit to recovery from rugby training or competition. Given that cold modalities may potentially affect muscle size adaptations from training, their inclusion should be treated with caution and perhaps restricted to certain periods where athlete readiness is more important than increases in muscle size.
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Background: Overtraining (OVT) is a concern for many athletes. Immunological (increased interleukin-6 [IL-6]) and hormonal (increased cortisol [C], decreased free testosterone [fT]) biomarkers have been analyzed during training to detect OVT development. Methods: This study determined if resting levels of salivary IL-6, T, and C change during a pre-season resistance training (RT) program in 20 Division I American football players (mean ± SD: age = 19.1 ± 1.1 years; height = 185.4 ± 6.7 cm; mass = 102.0 ± 22.2 kg; body fat = 14.7 ± 7.6%). 1RM squat, bench press and Olympic-style clean, IL-6, C and T were assessed at baseline (WK1), week 4 (WK4), week 6 (WK6) along with psychological status (PS) to determine affective state. Results: 1RM (bench press: 121.6 ± 36.3 kg vs. 127.4 ± 35.9 kg, squat: 187.2 ± 30.2 kg, 190.9 ± 28.1 kg, clean: 116.8 ± 14.6 kg, vs. 119.2 ± 14.5 kg), IL-6 (1.42 ± 1.77 pg/mL vs. 5.60 ± 12.57 pg/mL) and C (2.57 ± 2.46 nmol/L vs. 5.33 ± 4.94) increased signihcantly from WK1 to WK6 (p < .05), fT decreased signihcantly (417.44 ± 83.63 pmol/Lvs. 341.10 ± 87.79 pmol/L) from WK1 to WK6 (p < .05). PS was minimally affected during the study. Signihcant biomarker changes were detected, but no OVT was induced (i.e. performance improved). Conclusion: Therefore, directional changes in these biomarkers may not be sufficiently reflective of OVT in RT programs.
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Abstract: The use of cold water immersion (CWI) for post-exercise recovery has become increasingly prevalent in recent years, however there is a dearth of strong scientific evidence to support the optimisation of protocols for performance benefits. While the increase in practice and popularity of CWI has led to multiple studies and reviews in the area of water immersion, this research has predominantly focused on performance outcomes associated with post-exercise CWI. Studies to date have generally shown positive results with enhanced recovery of performance. However, there are a small number of studies which have shown CWI to have either no effect or a detrimental effect on the recovery of performance. The rationale for such contradictory responses has received little attention but may be related to nuances associated with the individual which may need to be accounted for in optimising prescription of protocols. In order to recommend optimal protocols to enhance athletic recovery, research must provide a greater understanding of the physiology underpinning performance change and the factors which may contribute to the varied responses currently observed. This review focuses specifically on why some of the current literature may show variability and disparity in the effectiveness of CWI for recovery of athletic performance by examining the body temperature and cardiovascular responses underpinning CWI and how these are related to performance benefits. This review also examines how individual characteristics (such as physique traits), differences in water immersion protocol (depth, duration, temperature) and exercise type (endurance vs maximal) interact with these mechanisms.
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The countermovement jump (CMJ) is widely used to monitor jump performance, with greater interest being demonstrated in the propulsive phase. When landing from a CMJ, high forces are produced; this can increase the risk of injury. The present study aimed to test the validity and reliability of a countermovement jump to a box (CMBJ) where the forces associated with the landing are reduced. Eighteen professional rugby athletes (age=22 ± 2 years; body mass=104.2 ± 13.0 kg; height=187.4 ± 7.1 cm) performed 3 CMJ’s and 3 CMBJ’s on 3 different occasions. Net impulse (N.s), peak and mean absolute and relative force (N; N/kg) were obtained from a force plate system. The kinetic validity of the CMBJ was assessed by calculating the intraclass correlation coefficient, Pearson product-moment correlation, Cohen’s effect sizes and statistical hypothesis testing (paired t-test) in comparison to the CMJ. Intraday and interday reliability was assessed for each variable for both jumping conditions by calculating typical error, within subject coefficient of variation and intraclass correlation coefficient. Nonsignificant, trivial differences between the CMJ and CMBJ were observed for all jump variables. Low within-subject variability was observed between the CMJ and CMBJ for all variables. Interday and intraday variability showed good reliability and an almost perfect interday agreement score. In conclusion, net impulse, peak and mean force and relative peak and mean force obtained from a CMBJ are valid and reliable to monitor jump performance. This data demonstrates that the CMBJ is a viable alternative to monitor jump performance in athletes.
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Objectives: Previous results from our laboratory suggest that band flossing results in increased ankle range of motion (ROM) and jump performance 5-min following application. However, the time-course of such benefits is yet to be examined. Design: Parallel group design. Setting: University laboratory. Participants: 69 recreational athletes (32 male/37 female). Main outcome measures: Participants performed a weight-bearing lunge test (WBLT), a counter-movement jump (CMJ) and a 15 m sprint test (SPRINT) pre and up to 45-min post application of a floss band to both ankles (FLOSS) or without flossing of the ankle joints (CON). Results: There was a significant intervention × time interaction in favour of FLOSS when compared to CON for the WBLT (p < 0.05). These results were associated with trivial to small effect sizes at all time points. Small, but non-significant (p > 0.05) benefits were seen for FLOSS when compared to CON for CMJ force (mean ± 90%CI: 89 ± 101 N) and 15 m SPRINT times (-0.06 ± 0.04 s) at 45-min post. Conclusion: There is a trend towards a benefit for the use of floss bands applied to the ankle joint to improve ROM, jump and sprint performance in recreational athletes for up to 45-min following their application.
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Background: The use of recovery modalities to help enhance recovery is popular among athletes. However, little is known about the usage of various recovery modalities and the perception of their benefit amongst different level athletes. Therefore, the purpose of this study was to compare the usage and perceptual understanding of different recovery modalities between elite and amateur Rugby athletes. Methods: Fifty-eight amateur (n = 26) and elite (n = 32) Rugby union athletes completed a questionnaire designed to determine the usage and the perception of 15 different recovery modalities. A 5-point Likert scale was used to examine the perceived importance of recovery and effectiveness of each recovery modality. The number of different recovery modalities, and the number of times each player used each recovery modality per week was also obtained through the questionnaires. The total number of times an athlete used a recovery modality was calculated by summing the number of times each recovery modality was used per week. Results: No differences were found between groups (elite: 5.0. ±. 0.2; amateur: 4.9. ±. 0.3) for the perceived importance of recovery to enhance performance. When comparing the effectiveness of each recovery modality, the elite group perceived active recovery, massage, pool recovery, additional sleep and stretching to be significantly (p. <. 0.05) more effective in comparison to the amateur group. No significant differences were found for any other recovery modality. There was a significantly greater amount of recovery modalities used and also a higher frequency of use per week in the elite group (p. >. 0.05). Conclusion: Although no differences were found for the perception of the importance of recovery, elite Rugby athletes used significantly more recovery modalities and implemented recovery modalities more often in comparison to amateur Rugby athletes.
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We evaluated the effectiveness of cold water immersion on recovery of performance (i. e., the ability of repetitively performing a physical test) in rugby players acutely and 12 h later. 8 male rugby union players (23±4.7 years; 176.9±4.5 cm; 87.5±8.6 kg) performed a rugby-specific exercise protocol (40 min) followed by recovery strategies: cold water immersion (8.9±0.6°C; 9 min with 1 min out of water, repeated twice) or control (players remained seated for 20 min) in a random order. The players underwent performance tests (countermovement and 30 s continuous jumps and agility T) at 4 time points: at baseline, immediately after rugby-specific exercise, post-recovery strategies and 12 h later. The performance of the agility and countermovement jump test were not different between cold water immersion and control immediately post rugby-specific exercises and 12 h thereafter. However, the 30 s continuous jump test performance decreased immediately but increased 12 h later after cold water immersion compared with control. Perception of recovery was better in the cold water immersion group compared with controls post 12 h exercise. Cold water immersion improves 30 s continuous jump performance, total quality recovery and seems to be an easy and practical tool for coaches and players, especially during congested periods of the season when fast recovery (~12 h) for the following activity is essential. © Georg Thieme Verlag KG Stuttgart · New York.