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Effect of Cold Shower on Recovery From High-Intensity Cycling in the Heat



Post-exercise cooling, e.g. cold water immersion has shown beneficial cardiovascular and hormonal effects during recovery from exercise in a hot environment. However, not much is known about the effects of a cold water shower (CWS) as a recovery intervention. This study examined the effects of a CWS on heart rate (HR), core temperature (Tc), salivary cortisol, and thermal comfort sensation (TCS) after exercise in the heat. Nine healthy male subjects (age, 21±1 years) performed 45 minutes of cycling in a hot environment (35°C, 40-60% relative humidity) at 65% of peak oxygen uptake. Thereafter, subjects underwent the CWS condition (15 min, 15°C water shower) or control (SIT25; 15 min passive recovery in 25°C room) in a randomized cross-over design. After each 15 min, subjects sat in a 25°C room for another 2h recovery. HR, Tc and TCS were recorded pre-and immediately post-exercise, immediately after CWS or SIT25, and at 30 min, 1h, and 2h during additional recovery. Salivary cortisol was collected at the same time points except at 30 min of the additional recovery period. TCS was higher immediately after CWS (+4; Very comfortable) than SIT25 (+1; Just comfortable). The change of HR decreased faster with CWS (-18.3±2.3%) than with SIT25 (-7.0±4.6%) at the first 30 min recovery time point (p <0.01). No differences between recovery conditions were observed for the Tc or salivary cortisol at any time point during the 2h recovery period. The findings demonstrate that a 15 min, 15°C CWS was not effective in reducing Tc or salivary cortisol during recovery from exercise in a hot environment. However, CWS can promote TCS by facilitating a faster HR recovery after 30 min post-intervention compared with passive recovery. The cooling benefits of a CWS could be only recommended to reduce cardiac stress after routine workout in a hot environment.
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Department of Sports Physiology, College of Sports Science and Technology, Mahidol University, Salaya, Nakhonpathom,
Thailand; and
Faculty of Sports and Health Science, Institute of Physical Education Phetchabun, Muang District,
Phetchabun, Thailand
Ajjimaporn, A, Chaunchaiyakul, R, Pitsamai, S, and Widjaja, W.
Effect of cold shower on recovery from high-intensity cycling in
the heat. J Strength Cond Res 33(8): 2233–2240, 2019—
Post-exercise cooling, e.g., cold water immersion has shown
beneficial cardiovascular and hormonal effects during recovery
from exercise in a hot environment. However, not much is
known about the effects of a cold water shower (CWS) as
a recovery intervention. This study examined the effects of
a CWS on heart rate (HR), core temperature (Tc), salivary
cortisol, and thermal comfort sensation (TCS) after exercise
in the heat. Nine healthy male subjects (age, 21 61 year)
performed 45 minutes of cycling in a hot environment (358C,
40–60% relative humidity) at 65% of peak oxygen uptake.
Thereafter, subjects underwent the CWS condition (15 mi-
nutes, 158C water shower) or control (SIT25; 15 minutes
passive recovery in 258C room) in a randomized crossover
design. After each 15 minutes, subjects sat in a 258C room
for another 2-hour recovery. Heart rate, Tc, and TCS were
recorded before and immediately after exercise, immediately
after CWS or SIT25, and at 30 minutes, 1, and 2 hours during
additional recovery. Salivary cortisol was collected at the same
time points except at 30 minutes of the additional recovery
period. Thermal comfort sensation was higher immediately after
CWS (+4; very comfortable) than SIT25 (+1; just comfort-
able). The change of HR decreased faster with CWS (218.3
62.3%) than with SIT25 (27.0 64.6%) at the first 30-minute
recovery time point (p,0.01). No differences between recov-
ery conditions were observed for the Tcor salivary cortisol at
any time point during the 2-hour recovery period. The findings
demonstrate that a 15-minute, 158C CWS was not effective in
reducing Tcor salivary cortisol during recovery from exercise in
a hot environment. However, CWS can promote TCS by facil-
itating a faster HR recovery after 30-minute postintervention
compared with passive recovery. The cooling benefits of
a CWS could be only recommended to reduce cardiac stress
after routine workout in a hot environment.
KEY WORDS cooling recovery intervention, core temperature,
salivary cortisol levels, high-intensity performance, a hot
Exercise in a hot environment provides a stress that
leads to rapid physiological responses, as evi-
denced by a faster rise in heart rate (HR), higher
core temperature (Tc), enhanced skin blood flow,
and an increased release of neuroendocrine hormones (15).
Fatigue in endurance-trained subjects during exercise in the
heat has been related to a higher body temperature (10),
generally believed to be the principle contributing factor that
stimulates the secretion of cortisol (20). Hosick et al. (12)
reported that during exercise in a hot environment (388C),
at 65% of peak oxygen uptake (V
peak), cortisol was
increased when Tcwas elevated by approximately 18C
above resting Tc, with a gradual decrease within 24 hours
after exercise in well-trained subjects. Prolonged elevation of
cortisol after high-intensity exercise is believed to be detri-
mental to health. Previous studies reported that the cortisol
released in response to increased Tcmay influence inflam-
mation and regeneration of tissue damaged after acute stress
(12,19). Therefore, faster decreases in Tcand cortisol levels
after strenuous exercise are believed to benefit recovery in
Cold-water immersion (CWI), ice massage, ice-vest, and
ice or cold gel pack application have been examined as post-
exercise cooling strategies to enhance recovery (25). Com-
pared with other cooling methods, CWI is the most efficient
recovery intervention after exercise in hot environments by
lowering Tc, HR, and cortisol levels (11,12,17,25). However,
the application of CWI requires ice, a large bathtub, and the
treatment space that may not be widely available. Hence, an
Address correspondence to Amornpan Ajjimaporn, amornpan.ajj@
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VOLUME 33 | NUMBER 8 | AUGUST 2019 | 2233
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accessible alternative cooling recovery, which imparts simi-
lar physiological responses to the CWI method, may be
Taking a shower is an activity that millions of people
partake in as part of their routine after exercise. Eglin and
Tipton (7) showed that initially undertaking repeated cold
showering of the upper body (1–3 minutes at 108C) may
partly habituate subjects to subsequent head out CWI at the
same water temperature. The authors suggested that the
similar rates of decrease in skin temperatures between the
cooling methods were associated with a reduced respiratory
drive (breathing frequency) during the CWI. In addition, Juliff
et al. (14) observed that in elite netball players, contrast
showering (alternating 1 minute at 388C and 1 minute at 158
C for 14 minutes) after a netball-specific circuit session
decreased skin temperatures compared with a passive recov-
ery condition. However, despite the contrast showers having
a psychological impact (recovery perception scale), there was
no effect on Tcor performance measures (repeated agility).
Buijze et al. (2) reported that regular hot-to-cold showering
(30, 60, 90 seconds at 10–128C) for at least 30 days could
reduce self-reported sickness absence in healthy adults. Fur-
thermore, a recent study by Butts et al. (3) demonstrated that
a 15-minute 208C cold shower, applied to treat exertional
hyperthermia, resulted in a greater rate of decrease in Tc
and HR, and lower ratings of thermal sensation, compared
with passive rest. Although past studies have determined the
effects of cold showering on several physiological parameters,
to our knowledge, the cortisol response after a cold shower
intervention has not been examined. Therefore, the aim of this
study was to investigate the magnitude of change in the sal-
ivary cortisol response between a cold shower intervention
and passive rest, applied after exercise under hot conditions.
Experimental Approach to the Problem
To determine the recovery benefits of a cold-water shower
(CWS) from high-intensity cycling in the heat, this study
examined the effects of 2 different interventions; a 15-minute
(158C, CWS) or passive recovery in 258C room (SIT25) on
HR, core temperature (Tc), salivary cortisol, and thermal
comfort sensation (TCS) after 45 minutes of cycling in
a hot environment (358C room temperature, 40–60% rela-
tive humidity) at 65% of peak oxygen uptake. This mode of
exercise and relative intensity has previously been shown to
significantly elevate Tc(.18C) and cortisol levels above
resting values under thermal stress (12). A similar cold
shower water temperature and duration of exposure (15 mi-
nutes at 208C) selected in our study has previously been
shown to reduce exercise-induced hypothermia through
greater rate of Tcreduction compared with passive rest (3).
The experimental design is shown in Figure 1. The study
used a randomized crossover design with the 2 recovery
interventions 7 days apart.
Nine healthy male subjects aged between 20 and 25 years
(mean 6SD;age:20.961.0 years; body mass: 70.3 611.2 kg;
height: 175.6 68.4 cm; body mass index = 22.9 61.8 kg$m
% body fat = 16.6 66.1, V
peak = 32.6 64.1
) participated in this study. Inclusion criteria
included being habitually active and typically engaged in at least
30 minutes of moderate exercise per day for a minimum of 3
days per week in the previous 3 months before the study. After
explanation of the testing procedures, and benefits and possible
risks of the study, informed consent forms were signed. Subjects
were instructed to refrain from additional exercise, alcohol and
caffeine intake for at least 48 hours before the testing sessions.
None of the participants were under pharmacological treatment
during the study. The experimental procedure was approved by
the Human Research Ethics Committee at Mahidol University
(MU-IRB 2014/12.2001).
Initial Session. In the first visit, anthropometric data were
collected; height (cm), body mass (kg), body mass index
), and % body fat. Peak oxygen uptake (V
was then assessed using an incremental cycling test to estab-
lish the exercise intensity of 65% V
peak for the experimen-
tal trials. During the incremental cycling test on a Monark
cycle ergometer (Ergomedic 828 E; Monark Exercise AB,
Vansbro, Sweden), expired air was sampled with a mouth-
piece attached to an online gas collection system (Moxus
modular oxygen uptake system; AEI Technologies, Inc.,
Pittsburg, PA, USA). The incremental cycling protocol began
at 0.5 kp at 60 rpm for 2 minutes; thereafter, the intensity
increased by 0.5 kp every 2 minutes until volitional fatigue.
peak was recorded as the highest 30-second average.
Experimental Procedure. For each experimental condition,
participants arrived at the laboratory at 07:00 hours.
Breakfast consisted of a tuna sandwich, 250 ml of water
and 250 ml of orange juice, which was provided 90 minutes
before the experiment. The testing session was divided into 3
main periods: (a) 45 minutes of cycling; (b) 15 minutes of
a randomized intervention period (CWS or SIT25); and (c)
2-hour recovery period in a 258C room. Before starting the
experiment, urine specific gravity (USG) was measured using
a handheld refractometer (model Master-SUR/NM; Atago
Co Ltd., Tokyo, Japan) to ensure the subjects were not de-
hydrated (USG .1.020). Participants were provided with an
individual water bottle (500 ml; temperature range between
20 and 228C) and were encouraged to drink water ad libi-
tum throughout the experiment. Exercise was commenced
after 30-minute rest in a controlled room (temperature = 25
61.08C; relative humidity (rh) range between 40 and 60%).
The participants completed 45 minutes of cycling in a hot
room (temperature = 35.7 61.08C; rh range between 40
and 60%) at a constant load of the individual’s predeter-
mined kilopond of 65% of V
peak. After 45 minutes of
Recovery Effects of Cold Shower
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cycling, participants underwent either a 15-minute CWS or
SIT25. In CWS, participants took a 15 62.08C water
shower on 2 areas (back and chest), alternating between
each area every 3 minutes for 15 minutes. The flow rate of
the shower was 5 L$min
. The angle of the shower stream
was individually adjusted to allow the water from the base of
the neck downward, ensuring the head was not showered.
After 15 minutes, participants used bath towels to dry them-
selves before sitting in a room set at a temperature of 258C
for a period of 2 hours (recovery period). In SIT25, the
participants sat passively in a controlled room (temperature
=2561.08C; rh range between 40 and 60%) throughout
the intervention and recovery periods (Figure 1).
Measurements. Thermal comfort was measured using a 9-
point thermal comfort scale ranging from very uncomfort-
able (24) to very comfortable (4), with 0 representing the
transition from discomfort to comfort (26).
Heart rate was measured every 15 minutes until the end of the
experimental trial through telemetry from a chest strap and
a wrist watch receiver (FS1; PolarElectroOy,Kempele,Finland).
Salivary samples were collected for cortisol analysis imme-
diately postintervention (Post-Int), and at 1 and 2 hours during
the recovery period. Before the first saliva collection, contam-
ination with food debris was avoided by rinsing the mouth
with water. Salivary samples were collected using a cotton
swab and saliva-collecting tube (Salivette; Sarstedt, Newton,
NC, USA). After saliva collection, saliva-collecting tubes were
centrifuged at 3,000 rpm for 15 minutes at 48Candthen
stored at 2808C. Saliva samples were assayed for cortisol
in duplicate using a highly sensitive enzyme immunoassay
(Salimetrics, State College, PA, USA) (20). The test used 25
mL of saliva per determination, which has a lower limit of
sensitivity of ,0.19 nmol/L, and average intra-assay and
inter-assay coefficients of variation of 4.13 and 8.89%,
Core temperature (Tc) was measured with an ingestible
temperature sensor with a radio transmitter to a data logger
(CoreTemp, HQ, Inc., Palmetto, FL, USA). Participants took
the capsule 5 hours before exercising (17).
Statistical Analyses
Statistical analysis was conducted using the Statistical
Package for Social Sciences (SPSS v17.0; SPSS Inc., Chicago,
IL, USA). As the data were normally distributed, all variables
were analyzed with repeated-measures analyses of variance
(condition 3time), where the between-group factor was
recovery condition (CWS vs. SIT25) and the within-
groups factor was time point for the exercise period (Pre-
Exercise vs. Post-Exercise), the intervention period (Post-
Exercise vs. Post-Int), and the recovery period (Post-Int, Post
30 min, Post 1 h, and Post 2 h). For cortisol, the 30-minute
time point during the recovery period was not presented
because we did not collect the samples at this time point.
To account for differences in the recovery period values
between conditions, HR, Tc, and cortisol values were ex-
pressed as percentage changes from the preceding recovery
time point value using the formula: [(recovery time point 2
preceding recovery time point)/recovery time point] 3100.
Significance was accepted at the p#0.05 level.
Pre-exercise to Post-exercise
Pre-exercise, there were no differences in HR, Tc,TCS,or
cortisol levels between conditions (p.0.05; Table 1). The
cycling exercise increased HR and Tcfrom pre-exercise val-
ues (p= 0.001) in both conditions to a similar extent (p.
0.05; Table 1). Thermal comfort sensation rating was signif-
icantly lower (p,0.001) at post-exercise (21; just
Figure 1. Experimental procedure and measurement.
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VOLUME 33 | NUMBER 8 | AUGUST 2019 | 2235
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uncomfortable) compared with pre-exercise (+2; slightly
comfortable) in both conditions (p,0.001; Table 1). Cor-
tisol levels did not significantly change from pre-exercise in
either condition (p.0.05; Table 1).
Post-exercise to Postintervention
Heart rate, Tc, and cortisol values were not different
between CWS and SIT25 conditions immediately Post-Int
(p.0.05); however, CWS elicited a higher TCS rating (+4;
very comfortable) compared with SIT25 (+1; just comfort-
able; p= 0.04; Table 1). Within-group comparisons found
that HR was significantly decreased from post-exercise val-
ues immediately after both interventions, but no significant
effect for time was observed in Tcor cortisol levels in either
condition over the same period (p.0.05; Table 1). Thermal
comfort sensation rating was significantly rated higher at
Post-Int compared with post-exercise in both conditions
(p,0.05; Table 1).
Postintervention to Post 2 h Recovery
There was no difference in HR between conditions at any
time point during the recovery period (p.0.05). Heart rate
values were similar after the Post-Int period in both condi-
tions (CWS, 90 63b$min
and SIT25, 84 63b$min
(p= 0.10). In the CWS condition, HR values were reduced
over time, immediately decreasing after 30-minute Post-Int
(73 62b$min
,p,0.0001) until the end of the 2-hour
recovery period. Whereas, in the SIT25 condition, signifi-
cant decreases in HR values were observed only after 1-
hour Post-Int (73 63b$min
,p= 0.001) until the end
of the 2-hour recovery period (Table 1).
Intestinal temperature was observed to be similar between
conditions throughout the recovery period (p.0.05). At 30-
minute Post-Int, Tcwas significantly decreased in both con-
ditions (CWS, 37.09 60.178C and SIT25, 37.34 60.118C, p
.0.05) and remained below Post-Int Tcvalues until the end
of the 2-hour recovery period in SIT25 (37.15 60.088C, p,
0.001) and CWS (37.03 60.048C, p,0.001), respectively
(Table 1). Cooling rates were also calculated through the
difference in Tcfrom Post-Int at 30-minute, 1-, and 2-hour
recovery (Tcdivided by the recovery time). However, no
main effect for condition was observed (p.0.41; data not
There was no difference in salivary cortisol between
conditions during the recovery period (p.0.05). In the
CWS condition, cortisol was observed to decrease at 2
hours after recovery from Post-Int (p= 0.04). However,
there was no change in the SIT25 condition (p= 0.13)
(Table 1).
There was no difference in TCS ratings (p.0.05)
between conditions at any time point during the recovery
period. Thermal comfort sensation ratings were significantly
improved at 1 h (+3; comfortable, p= 0.03) and 2 h (+3;
comfortable, p= 0.03) (p= 0.02) compared with Post-Int
TABLE 1. Heart rate (HR), core temperature (Tc), salivary cortisol levels, and thermal comfort scores (units) measure at pre-exercise, post-exercise, and
postintervention in the passive recovery in 258C room temperature (SIT25) and 158C water showers (CWS) conditions (n= 9, mean 6SEM).*
Parameters Condition Pre-exercise Post-exercise Postintervention
Recovery period
30 min 1 h 2h
SIT25 79 64 156 62z84 63z77 63736 69 6k
CWS 83 63 154 63z90 63z73 6 67 6 63 6k
Tc(8C) SIT25 37.25 60.14 38.34 60.11z38.08 60.16 37.34 60.11§ 37.26 60.08§ 37.15 60.08§
CWS 37.14 60.11 38.10 60.23z38.02 60.20 37.09 60.17§ 37.16 60.08§ 37.03 60.04§
levels (mg/dl)
SIT25 0.084 60.011 0.150 60.043 0.324 60.109 0.100 60.008 0.084 60.011
CWS 0.082 60.008 0.186 60.050 0.408 60.138 0.132 60.021 0.112 60.018§
TCS SIT25 +2 602160z+1 60z+2 60+36 +3 6
CWS +2 602160z+4 60z+3 60+360+360
*TCS = thermal comfort sensation.
Significant difference between conditions at the same time point.
zSignificant difference from the preceding time point.
§Significant difference from the Post-Int.
kSignificant difference from the 30-minute recovery period (p,0.05).
Recovery Effects of Cold Shower
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Figure 2. Percent change from postintervention (Post-Int) in (A) heart rate, (B) core temperature, and (C) salivary cortisol at 30-minute, 1-, and 2-hour recovery
period for passive recovery in 258C room temperature (SIT25, solid line) and the 158C water shower (CWS, broken line) conditions (n= 9, mean 6SEM).
Significant difference between conditions at the same time point; *significant difference from the Post-Int; #significant difference from the 30-minute recovery
period; and +significant difference from the 1-hour recovery period (p,0.05).
Journal of Strength and Conditioning Research
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(+1, just comfortable) in the SIT25 condition, but there was
no change in the CWS condition (p.0.99) (Table 1).
As shown in Figure 2A, %change in HR values for the CWS
condition demonstrated a faster decrease after 30-minute Post-
Int compared with those for the SIT25 condition (CWS, 18.34
62.35% and SIT25, 7.03 64.65%, p,0.01). Whereas, there
was no difference observed for %change in Tc
or salivary cortisol at any time point between conditions
(p.0.05) (Figure 2B, C). Within-group comparisons
found that % change in HR values were gradually
increased after 30 minutes until the end of 2-hour recovery
period in the CWS condition (p,0.02), but there was no
change at any time point in the SIT25 condition (p.0.05)
(Figure 2A). Percent change in Tcvalues were decreased at
30-minute Post-Int (p,0.01) and then increased until 2
hours after recovery for both conditions (p,0.05)
(Figure 2B). For % change in salivary cortisol, there was
a significant decrease after 1-hour Post-Int (p,0.01). Then,
the values were increased until the end of the 2-hour recovery
period (p,0.05) (Figure 2C).
This study investigated the effects of a CWS intervention on
recovery after cycling in a hot (;368C) environment. The
major findings were that taking a 158C CWS for 15 minutes
could promote a positive thermal comfort sensation imme-
diately at the end of the intervention period and facilitate
HR recovery within the first 30 minutes after showering.
However, the CWS protocol in our study had no effect on
Tcor salivary cortisol responses in healthy male subjects.
The TCS results demonstrated that CWS could induce
a comfortable rating sensation compared with SIT25 at the
end of the intervention period. Our findings may partly be
explained by the participants’ TWS rating improving
through return of their body temperature toward resting
values, upon removal from the cold exposure (9). Moreover,
the rating of temperature change, as pleasant or unpleasant,
is dependent on the preferable homeostatic state. For exam-
ple, a cold stimulus applied to the skin when the Tcis ele-
vated is likely to be identified as pleasant, whereas under
hypothermic conditions, the same stimulus may be judged
as unpleasant (4,18). Therefore, a reduced skin temperature
during the CWS intervention after exercise in the heat may
have resulted in a satisfied rating (3). Our findings are con-
sistent with previous studies that observed changes in TCS
after taking a cold shower, which suggested an associated
psychological impact (14,22). It is possible that CWS stim-
ulated the temperature-sensory receptors on the skin, send-
ing afferent thermal input signals to specific brain areas,
resulting in an improvement in the participants’ thermal
comfort sensation (8).
This study did not observe a difference in HR response
between CWS and SIT25 during the preintervention to
postintervention period (CWS = 64 b$min
and SIT25 =
72 b$min
). This outcome contrasts to that of Butts et al.
(3) whom reported lower HR values at 5 and 10 minutes
during a 20.88C CWS compared with passive rest in a heat
chamber (CWS = 45 b$min
and control = 27 b$min
). A
possible explanation for the discrepancy in our findings may
be that the passive control in Butts et al.’s (3) study was
undertaken in a heat chamber (33.4 62.18C), which was
at a temperature somewhat higher than the control used in
our study (25 61.08C). This may likely explain the con-
trasting HR responses between our studies (25).
Our study showed that the recovery effects of CWS were
present after the first 30 minutes during the recovery period,
with CWS eliciting faster recovery of HR than SIT25. The
present findings revealed that a CWS can lower HR by 18%
(;17 b$min
) compared with 7% (;7b$min
0.013) for a SIT25 intervention. Our data compare favorably
with those of Buchheit et al. (1) who observed that CWI (148
C for 5 minutes) can decrease HR by 15% (;13 b$min
7 minutes after removal from CWI compared with being
seated in a heat chamber (33.4 62.18C). Therefore, our
results seem to indicate that CWS has a recovery cooling
effect by reducing cardiovascular strain after exercise in the
heat similar to that observed with CWI (6,25). We would
highlight that this effect was only observed at 30 minutes
after the CWS intervention and not beyond this time point.
It seems possible that these results are due to either one or
both of the following reasons. First, this study demonstrated
a comfortable sensation of CWS over SIT25 after 15 minutes
of the intervention period. This finding provides evidence
that the faster HR recovery may also be due to cold show-
ering causing the reduction of HR by a larger parasympa-
thetic activity to counteract exercise-induced sympathetic
dominance (14,22). Second, it is well known that cold water
temperatures can cause the vasoconstriction of cutaneous
blood vessels to maintain core temperature, which in turn
increases peripheral resistance and arterial blood pressure,
consequently enhancing venous return and increasing
venous pressure with a corresponding decrease in HR
In this study, the CWS was shown to have no recovery
effect on reducing Tcvalues after cycling in a hot environ-
ment. This finding supports previous research performed by
Juliff et al. (14), which also observed no differences in Tc
values between contrast showers and a passive recovery
intervention. A previous study by Butts et al. (3) also re-
ported no significant changes in rectal temperature (T
after cold showering compared with a passive recovery after
a 15-minute intervention. However, the authors reported
a significantly faster cooling rate over the first 5 minutes of
showering. In our study, we did not record Tcvalues over 5-
minute segments during the intervention period, but the
cooling rate values at the end of the 15-minute intervention
period were not different between conditions. Although we
also calculated cooling rate throughout the recovery period,
we did not observe a difference between the CWS and con-
trol conditions. Our findings contrast with Halson et al. (11),
Recovery Effects of Cold Shower
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who reported that CWI (11.5 60.38C for 60 seconds 33)
can decrease Tcvalues faster than sitting in a 24.28C room
temperature at 20 minutes after intervention. In line with
Halson et al.’s (11) findings, CWI (14.03 60.288C for 12 mi-
nutes) has been shown to be 38% more effective in Tccool-
ing after immersion than a passive recovery intervention (5).
Therefore, our results indicate that the CWS did not have
a recovery cooling effect on Tcvalues that is comparable
with CWI (5,10,11). A possible explanation for this may be
the different mechanisms of heat loss between showering
and immersion. During CWS, heat loss occurs through run-
ning water over the skin and is dependent on the water
temperature and water flow through a convection mecha-
nism (15). Alternatively, during CWI, conduction is the pri-
mary mechanism for heat loss when the skin or body parts
are immersed in cold water (16). Indeed, the conductive
cooling effect can cause a substantial reduction in Tcboth
during and after cold exposure, whereas convective heat loss
is relatively minimal in comparison (24). In addition, the
body surface area (BSA) of subjects exposed to the cold
stimulus during CWI is considerably larger than during
CWS (approximately 90% of the BSA in CWI vs. 34% of
the BSA in CWS) (7).
Cortisol, a stress hormone, is an indicator of the physical
stress and inflammatory response after strenuous exercise
(12,20). To the authors’ knowledge, this is the first study that
has reported on the effects of cold showers on the salivary
cortisol response after cycling in a hot environment. This
study did not identify any changes in measures of salivary
cortisol between 158C CWS and SIT25, indicating that
CWS was not effective in reducing cortisol during recovery
after exercising in the heat. A few studies have used CWI to
investigate the changes in cortisol levels on recovery after
body cooling (17,23). Minett et al. (17) showed that a 20-
minute exposure to 108C CWI decreased Tcvalues (1 h post
CWI ;1.78C) and cortisol levels at 1 hour after exercise
compared with sitting in a hot room (358C). However, in
contrast to these CWI findings, we observed no evidence
that cortisol secretion was affected by CWS. The contradic-
tory results may be due to the strong association between
reductions in cortisol levels with reductions in Tc(12). There-
fore, the lack of a cortisol response in our study is likely due to
the lack of a Tcchange (1 h post = ;0.948C) after CWS (21).
Our results indicate that a 158C cold shower for a duration
of 15 minutes is an adequate cooling intervention for pro-
moting a positive thermal comfort sensation by facilitating
HR recovery at 30 minutes after cold showering. However,
cold showering was not effective in reducing Tcor salivary
cortisol during post-exercise recovery as observed with
CWI. Consequently, the application of cold showering
may have limited benefits as a cooling treatment for patients
suffering from heat stress and as a recovery intervention for
elite athletes regaining sports performance from subsequent
exercise bouts. Because cold showering is energizing, easy to
use, hygienic, and has some perceptual beneficial effects, it
could be recommended as a post-exercise practice to refresh
the body and recover somewhat from the associated cardiac
stress, in healthy individuals.
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Recovery Effects of Cold Shower
Journal of Strength and Conditioning Research
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... Il est important de noter qu'au cours d'un exercice physique, les stratégies externes sont plus difficilement utilisables, soit à cause de durées limitées d'utilisations possibles (e.g., serviettes humides ou poches de glace lors des tempsmorts, des changements de côtés ou d'adversaires), soit à cause des règlements des compétitions qui interdisent l'usage de certaines techniques comme les gilets, cagoules réfrigérantes et limitent ainsi les possibilités d'obtenir un refroidissement externe efficace[40,81] ou uniquement sur des surfaces limitées (e.g., bandeau frontal réfrigéré, bandanas) comme évoqué par[7]. Enfin, les stratégies de refroidissement comme l'immersion en eau froide ou les douches froides peuvent être utilisées après les efforts (i.e., post-refroidissement ou postcooling), notamment lors des périodes de récupération pour améliorer les performances répétées d'endurance en condition de TE[82][83][84]. De même, des travaux de recherche en cours s'intéressent aux potentiels bénéfices des matelas réfrigérés : ils permettraient d'augmenter la durée et qualité du sommeil et ainsi favoriser la récupération des athlètes. ...
Objectives: This article sheds light on the different heat stress management strategies, common or innovative, in order to analyze those that would be the most suitable and effective for athletes who have to compete in humid and/or hot environments.News: The Paris summer Olympics Games in 2024 will take place from July 26th to September 8th with a high risk for athletes to practice their sport at high temperatures, thereby imposing physiological (cardiovascular, ventilatory, thermoregulatory, etc.) and psychological (early mental fatigue, decreased motivation, discomfort, etc.) which can have a major negative impact on their performance.Prospects and projects: To perform in a hot environment, it is now recommended to use strategies, in particular active acclimatization which promotes physiological but also psychological adaptations. Similarly, fluid management and cooling techniques have potentially beneficial effects on physiological factors but their psychological consequences are still poorly understood and need to be investigated. Finally, mental strategies (goal setting, mental imagery, positive self-talk, music, etc.) or cognitive training in the heat can limit poor performance in this condition. The effects of combining physical and mental techniques, as well as innovative strategies such as cold suggestion, are also being investigated.Conclusion: For each strategies presented, the scientific work has enabled the development of practical recommendations for athletes, coaches and mental trainers in order to allow them to physiologically and psychologically anticipate the effects of high relative humidity and/or high temperature.
... : bandeau frontal réfrigéré, bandanas) comme évoqué par Coudevylle et al. [7]. Enfin, les stratégies de refroidissement comme l'immersion en eau froide ou les douches froides peuvent être utilisées après les efforts (c'est-à-dire, post-refroidissement ou post-cooling), notamment lors des périodes de récupération pour améliorer les performances répétées d'endurance en condition de TE [80][81][82]. De même, des travaux de recherche en cours s'intéressent aux potentiels bénéfices des matelas réfrigérés : ils permettraient d'augmenter la durée et qualité du sommeil et ainsi favoriser la récupération des athlètes. ...
Cet article apporte un éclairage sur les différentes stratégies de gestion de la chaleur, usuelles ou innovantes, afin d'analyser celles qui seraient les plus adaptées et les plus efficaces chez des athlètes devant participer à des compétitions dans des environnements humides et/ou chauds. Actualités.-Les Jeux olympiques de Paris en 2024 se dérouleront du 26 juillet au 8 septembre avec un risque élevé pour les athlètes de pratiquer leur sport à des températures élevées, imposant de fait des contraintes physiologiques (cardiovasculaires, ventilatoires, thermorégu-latoires, etc.) et psychologiques (fatigue mentale précoce, baisse de motivation, inconfort, etc.) pouvant ainsi largement impacter négativement leur performance. Perspectives et projets.-Pour « performer » en environnement chaud, il est aujourd'hui recommandé d'avoir recours à des stratégies, notamment une acclimatation active qui favorise des adaptations physiologiques mais aussi psychologiques. De même, les techniques de gestion de fluides et de refroidissement « physiques » ont des effets potentiellement bénéfiques sur des facteurs physiologiques mais leurs conséquences psychologiques sont encore peu connues et doivent être investiguées. Enfin, des stratégies mentales (fixation d'objectifs, imagerie men-tale, dialogue interne positif, musique, etc.) ou entraînements cognitifs en environnement chaud peuvent limiter les contre-performances dans ces conditions. Les effets de la combi-naison de techniques physiques et mentales, ainsi que des stratégies innovantes comme la suggestion au froid, sont également en cours d'investigation. Conclusion Pour chacune des stratégies présentées, les travaux scientifiques ont permis l'élaboration de recommandations pratiques à l'intention des athlètes, des entraîneurs et des préparateurs mentaux, afin de leur permettre d'anticiper physiologiquement et psychologiquement les effets d'une hygrométrie et ou d'une température élevée.
Context: Although active recovery (AR) and cold application is recommended, many people take a shower after exercise. Therefore, a direct comparison between a shower and other recommended methods (AR and/or cold-water immersion) is necessary. To compare immediate effects of 4 postexercise cooldown strategies after running. Design: A crossover design. Methods: Seventeen young, healthy males (23 y; 174 cm; 73 kg) visited on 4 different days and performed a 10-minute intense treadmill run (5 km/h at a 1% incline, then a belt speed of 1 km/h, and an incline of 0.5% were increased every minute). Then, subjects randomly experienced 4 different 30-minute cooldown strategies each session-AR (10-min treadmill walk + 10-min static stretch + 10-min shower), cold-water walk (10-min shower + 20-min walk in cold water), cold-water sit (10-min shower + 20-min sit in cold water), and passive recovery (10-min shower + 20-min passive recovery). Across the cooldown conditions, the water temperatures for immersion and shower were set as 18 °C and 25 °C, respectively. Lower-leg muscle temperature, blood lactate concentration, and fatigue perception were statistically compared (P < .001 for all tests) and effect sizes (ES) were calculated. Results: The cold-water walk condition (F135,2928 = 69.29, P < .0001) was the most effective in reducing muscle temperature after running (-11.6 °C, ES = 9.46, P < .0001), followed by the cold-water sit (-8.4 °C, ES = 8.61, P < .0001), passive recovery (-4.5 °C, ES = 4.36, P < .0001), and AR (-4.0 °C, ES = 4.29, P < .0001) conditions. Blood lactate concentration (F6,176 = 0.86, P = .52) and fatigue perception (F6,176 = 0.18, P = .98) did not differ among the 4 conditions. Conclusions: While the effect of lowering the lower-leg temperature was different, the effect of reducing blood lactate concentration and fatigue perception were similar in the 4 cooldown strategies. We suggest selecting the appropriate method while considering the specific goal, available time, facility, and accessibility.
Pregnancy is a major stage of many women’s lives within their reproductive years and the incorporation of exercise can be vastly beneficial. However, to a large majority, exercise during pregnancy has been long believed to be detrimental to the developing fetus. However, an abundance of literature has indicated that exercising while pregnant may benefit both the mother and unborn child, such as improvements in physical fitness, mental well-being, and a reduced duration of labor and delivery. This article will briefly discuss the physiological and psychological adaptations and review general guidelines for beginning aerobic and resistance training exercise during pregnancy.
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Purpose: The aim of this study was to determine the cumulative effect of a routine (hot-to-) cold shower on sickness, quality of life and work productivity. Methods: Between January and March 2015, 3018 participants between 18 and 65 years without severe comorbidity and no routine experience of cold showering were randomized (1:1:1:1) to a (hot-to-) cold shower for 30, 60, 90 seconds or a control group during 30 consecutive days followed by 60 days of showering cold at their own discretion for the intervention groups. The primary outcome was illness days and related sickness absence from work. Secondary outcomes were quality of life, work productivity, anxiety, thermal sensation and adverse reactions. Results: 79% of participants in the interventions groups completed the 30 consecutive days protocol. A negative binomial regression model showed a 29% reduction in sickness absence for (hot-to-) cold shower regimen compared to the control group (incident rate ratio: 0.71, P = 0.003). For illness days there was no significant group effect. No related serious advents events were reported. Conclusion: A routine (hot-to-) cold shower resulted in a statistical reduction of self-reported sickness absence but not illness days in adults without severe comorbidity. Trial registration: Netherlands National Trial Register NTR5183.
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Functional brain imaging of responses to thermal challenge in humans provides a viable method to implicate widespread neuroanatomical regions in the processes of thermoregulation. Thus far, functional neuroimaging techniques have been used infrequently in humans to investigate thermoregulation, although preliminary outcomes have been informative and certainly encourage further forays into this field of enquiry. At this juncture, sustained regional brain activations in response to prolonged changes in body temperature are yet to be definitively characterised, but it would appear that thermoregulatory regions are widely distributed throughout the hemispheres of the human brain. Of those autonomic responses to thermal challenge investigated so far, the loci of associated brainstem responses in human are homologous with other species. However, human imaging studies have also implicated a wide range of forebrain regions in thermal sensations and autonomic responses that extend beyond outcomes reported in other species. There is considerable impetus to continue human functional neuroimaging of thermoregulatory responses because of the unique opportunities presented by the method to survey regions across the whole brain in compliant, conscious participants.
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Context: Exercise conducted in hot, humid environments increases the risk for exertional heat stroke (EHS). The current recommended treatment of EHS is cold-water immersion; however, limitations may require the use of alternative resources such as a cold shower (CS) or dousing with a hose to cool EHS patients. Objective: To investigate the cooling effectiveness of a CS after exercise-induced hyperthermia. Design: Randomized, crossover controlled study. Setting: Environmental chamber (temperature = 33.4°C ± 2.1°C; relative humidity = 27.1% ± 1.4%). Patients or other participants: Seventeen participants (10 male, 7 female; height = 1.75 ± 0.07 m, body mass = 70.4 ± 8.7 kg, body surface area = 1.85 ± 0.13 m(2), age range = 19-35 years) volunteered. Intervention(s): On 2 occasions, participants completed matched-intensity volitional exercise on an ergometer or treadmill to elevate rectal temperature (Tre) to ≥39°C or until participant fatigue prevented continuation (reaching at least 38.5°C). They were then either treated with a CS (20.8°C ± 0.80°C) or seated in the chamber (control [CON] condition) for 15 minutes. Main outcome measure(s): Tre, calculated cooling rate, heart rate, perceptual measures (thermal sensation and perceived muscle pain). Results: The Tre (P = .98), heart rate (P = .85), thermal sensation (P = .69), and muscle pain (P = .31) were not different during exercise for the CS and CON trials (P > .05). Overall, the cooling rate was faster during CS (0.07°C/min ± 0.03°C/min) than during CON (0.04°C/min ± 0.03°C/min; t16 = 2.77, P = .01). Heart-rate changes were greater during CS (45 ± 20 beats per minute [bpm]) compared with CON (27 ± 10 bpm; t16 = 3.32, P = .004). Thermal sensation was reduced to a greater extent with CS than with CON (F3,45 = 41.12, P < .001) . Conclusions: Although the CS facilitated cooling rates faster than no treatment, clinicians should continue to advocate for accepted cooling modalities and use CS only if no other validated means of cooling are available.
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Objectives: This paper discusses the use of saliva analysis as a tool for monitoring steroid, peptide, and immune markers of sports training. Design: Salivary gland physiology, regarding the regulation and stimulation of saliva secretion, as well as methodological issues including saliva collection, storage and analysis are addressed in this paper. The effects of exercise on saliva composition are then considered. Method: Exercise elicits changes in salivary levels of steroid hormones, immunoglobulins, antimicrobial proteins and enzymes. Cortisol, testosterone and dehydroepiandrosterone can be assessed in saliva, providing a non-invasive option to assess the catabolic and anabolic effects of exercise. Validation studies using blood and salivary measures of steroid hormones are addressed in this paper. Effects of acute exercise and training on salivary immunoglobulins (SIgA, SIgM, SIgG) and salivary antimicrobial proteins, including-amylase, lysozyme and lactoferrin, are also discussed. Results: Analysis of cortisol and testosterone in saliva may help detect the onset of non-functional overreaching and subsequently may help to prevent the development of overtraining syndrome. Assessment of salivary immunoglobulins and antimicrobial proteins has been shown to successfully represent the effects of exercise on mucosal immunity. Increases in SIgA and antimicrobial proteins concentration and/or secretion rate are associated with acute exercise whereas conversely, decreases have been reported in athletes over a training season leaving the athlete susceptible for upper respiratory tract infections. Conclusions: The measurement of physiological biomarkers in whole saliva can provide a significant tool for assessing the immunological and endocrinological status associated with exercise and training.
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Contrast water therapy is a popular recovery modality in sport; however, appropriate facilities can often be difficult to access. Therefore, the present study examined the use of contrast showers as an alternative to contrast water therapy for team sport recovery. In a randomized, cross-over design ten elite female netball athletes (mean ± SD; age: 20 ± 0.6 y, height: 1.82 ± 0.05 m, body mass: 77.0 ± 9.3 kg) completed three experimental trials of a netball specific circuit followed by one of the following 14 min recovery interventions; (1) contrast water therapy (alternating 1 min 38°C and 1 min 15°C water immersion), (2) contrast showers (alternating 1 min 38°C and 1 min 18°C showers) or (3) passive recovery (seated rest in 20°C). Repeated agility, skin and core temperature and perception scales were measured pre, immediately post, 5 h and 24 h post-exercise. No significant differences in repeated agility were evident between conditions at any time point. No significant differences in core temperature were observed between conditions however, skin temperature was significantly lower immediately after contrast water therapy and contrast showers compared with the passive condition. Overall perceptions of recovery were superior following contrast water therapy and contrast showers compared with passive recovery. The findings indicate contrast water therapy and contrast showers did not accelerate physical recovery in elite netballers after a netball specific circuit; however, the psychological benefit from both interventions should be considered when determining the suitability of these recovery interventions in team sport.
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High-intensity exercise is associated with mechanical and/or metabolic stresses that lead to reduced performance capacity of skeletal muscle, soreness and inflammation. Cold-water immersion and other forms of cryotherapy are commonly used following a high-intensity bout of exercise to speed recovery. Cryotherapy in its various forms has been used in this capacity for a number of years; however, the mechanisms underlying its recovery effects post-exercise remain elusive. The fundamental change induced by cold therapy is a reduction in tissue temperature, which subsequently exerts local effects on blood flow, cell swelling and metabolism and neural conductance velocity. Systemically, cold therapy causes core temperature reduction and cardiovascular and endocrine changes. A major hindrance to defining guidelines for best practice for the use of the various forms of cryotherapy is an incongruity between mechanistic studies investigating these physiological changes induced by cold and applied studies investigating the functional effects of cold for recovery from high-intensity exercise. When possible, studies investigating the functional recovery effects of cold therapy for recovery from exercise should concomitantly measure intramuscular temperature and relevant temperature-dependent physiological changes induced by this type of recovery strategy. This review will discuss the acute physiological changes induced by various cryotherapy modalities that may affect recovery in the hours to days (<5 days) that follow high-intensity exercise.
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Our aim was to evaluate the recovery effects of hydrotherapy after aerobic exercise in cardiovascular, performance and perceived fatigue. A pragmatic controlled repeated measures; single-blind trial was conducted. Thirty-four recreational sportspeople visited a Sport-Centre and were assigned to a Hydrotherapy group (experimental) or rest in a bed (control) after completing a spinning session. Main outcomes measures including blood pressure, heart rate, handgrip strength, vertical jump, self-perceived fatigue, and body temperature were assessed at baseline, immediately post-exercise and post-recovery. The hypothesis of interest was the session*time interaction. The analysis revealed significant session*time interactions for diastolic blood pressure (P=0.031), heart rate (P=0.041), self perceived fatigue (P=0.046), and body temperature (P=0.001); but not for vertical jump (P=0.437), handgrip (P=0.845) or systolic blood pressure (P=0.266). Post-hoc analysis revealed that hydrotherapy resulted in recovered heart rate and diastolic blood pressure similar to baseline values after the spinning session. Further, hydrotherapy resulted in decreased self-perceived fatigue after the spinning session. Our results support that hydrotherapy is an adequate strategy to facilitate cardiovascular recovers and perceived fatigue, but not strength, after spinning Identifier: NCT01765387.
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The combined thermal load created by exercise and a hot environment is associated with an exaggerated core temperature response. The elevated core temperature is believed to increase the total stress of the exercise. Increased stress during exercise has been associated with increased levels of cortisol. The association of cortisol with increased inflammatory responses following exercise in the heat is equivocal. Thus, the purpose of the current investigation was to explore the relationship between increases in rectal temperature (Tre) and TNFa and cortisol. To induce Tre changes, 8 male subjects (mean7SD, age¼23.672 yr, VO2max¼52.873.7 mL/kg/min, BMI¼24.271.9) participated in two 40 min trials of cycle ergometry at 65% of VO2peak immersed to chest level in cool (25 1C) and warm (38.5 1C) water. Tre was monitored throughout each trial, with blood samples taken immediately pre and post of each trial. Neither cortisol nor TNFa changed significantly during exercise in the cool water; however, in the warm trial, both cortisol and TNFa significantly increased (po0.004). Concordance correlations (Rc) between D cortisol and D TNFa indicated a strong but non-significant correlation (Rc¼0.833, p¼0.135). In conclusion, changes in core temperature may be impacting the relationship between exercise induced changes in cortisol and TNFa. Therefore, acute moderateintensity exercise (40 min or less) in warm water impacts the stress and inflammatory response. Understanding this is important because exercise load may need to be adjusted in warm and hot environments to avoid the negative effects of elevated stress and inflammation response.
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This study examined the effects of post-exercise cooling on recovery of neuromuscular, physiological, and cerebral hemodynamic responses after intermittent-sprint exercise in the heat. Nine participants underwent three post-exercise recovery trials, including a control (CONT), mixed-method cooling (MIX), and cold-water immersion (10 °C; CWI). Voluntary force and activation were assessed simultaneously with cerebral oxygenation (near-infrared spectroscopy) pre- and post-exercise, post-intervention, and 1-h and 24-h post-exercise. Measures of heart rate, core temperature, skin temperature, muscle damage, and inflammation were also collected. Both cooling interventions reduced heart rate, core, and skin temperature post-intervention (P < 0.05). CWI hastened the recovery of voluntary force by 12.7 ± 11.7% (mean ± SD) and 16.3 ± 10.5% 1-h post-exercise compared to MIX and CONT, respectively (P < 0.01). Voluntary force remained elevated by 16.1 ± 20.5% 24-h post-exercise after CWI compared to CONT (P < 0.05). Central activation was increased post-intervention and 1-h post-exercise with CWI compared to CONT (P < 0.05), without differences between conditions 24-h post-exercise (P > 0.05). CWI reduced cerebral oxygenation compared to MIX and CONT post-intervention (P < 0.01). Furthermore, cooling interventions reduced cortisol 1-h post-exercise (P < 0.01), although only CWI blunted creatine kinase 24-h post-exercise compared to CONT (P < 0.05). Accordingly, improvements in neuromuscular recovery after post-exercise cooling appear to be disassociated with cerebral oxygenation, rather reflecting reductions in thermoregulatory demands to sustain force production.
In this review, we focus on significant developments in our understanding of the mechanisms that control the cutaneous vasculature in humans, with emphasis on the literature of the last half-century. To provide a background for subsequent sections, we review methods of measurement and techniques of importance in elucidating control mechanisms for studying skin blood flow. In addition, the anatomy of the skin relevant to its thermoregulatory function is outlined. The mechanisms by which sympathetic nerves mediate cutaneous active vasodilation during whole body heating and cutaneous vasoconstriction during whole body cooling are reviewed, including discussions of mechanisms involving cotransmission, NO, and other effectors. Current concepts for the mechanisms that effect local cutaneous vascular responses to local skin warming and cooling are examined, including the roles of temperature sensitive afferent neurons as well as NO and other mediators. Factors that can modulate control mechanisms of the cutaneous vasculature, such as gender, aging, and clinical conditions, are discussed, as are nonthermoregulatory reflex modifiers of thermoregulatory cutaneous vascular responses. © 2014 American Physiological Society. Compr Physiol 4:33-89, 2014.