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Original article
Br J Sports Med 2010;44:461–465. doi:10.1136/bjsm.2008.048173 461
1
Centre of Excellence
for Alzheimer’s Disease
Research and Care, Vario
Health Institute, Edith Cowan
University, Joondalup, WA,
Australia
2
School of Exercise,
Biomedical and Health
Sciences, Edith Cowan
University, Joondalup, WA,
Australia
3
Department of Physiology,
Australian Institute of Sport,
Belconnen, ACT, Australia
4
Division of Materials
Science and Engineering,
Commonwealth Scientifi c
and Industrial Research
Organisation, Belmont, Vic,
Australia
Correspondence to
Dr Jeremiah Peiffer, Vario
Health Institute, Edith Cowan
University, 270 Joondalup
Drive, Building 21, Joondalup,
WA, 6027, Australia;
j.peiffer@ecu.edu.au
Accepted 19 May 2008
Published Online First
6 June 2008
Effect of a 5-min cold-water immersion recovery on
exercise performance in the heat
J J Peiffer,
1,2
C R Abbiss,
2,3,4
G Watson,
2
K Nosaka, P B Laursen
2
ABSTRACT
cold-water immersion (14uC) recovery intervention on
repeated cycling performance in the heat.
min constant-paced (254 (22) W) cycling session
followed by a 4-km time trial in hot conditions (35uC, 40%
relative humidity). The two bouts were separated by
either 15 min of seated recovery in the heat (control) or
the same condition with 5-min cold-water immersion
(5th–10th minute), using a counterbalanced cross-over
design (CP
1
TT
1
R CWI or CON R CP
2
TT
2
). Rectal
temperature was measured immediately before and after
both the constant-paced sessions and 4-km timed trials.
Cycling economy and Vo
2
were measured during the
constant-paced sessions, and the average power output
and completion times were recorded for each time trial.
significantly lower (0.5 (0.4)uC) in cold-water immersion
before CP
2
until the end of the second 4-km timed trial.
However, the increase in rectal temperature (0.5 (0.2)uC)
during CP
2
was not significantly different between
conditions. During the second 4-km timed trial, power
output was significantly greater in cold-water immersion
(58.8) W), leading to a faster completion time in cold-
water immersion (6.1 (0.3) min) compared with control
(6.4 (0.5) min). Economy and Vo
2
were not influenced by
the cold-water immersion recovery intervention.
significantly lowered rectal temperature and maintained
endurance performance during subsequent high-intensity
exercise. These data indicate that repeated exercise
performance in heat may be improved when a short
period of cold-water immersion is applied during the
recovery period.
To maintain performance during sporting events
held in hot environmental conditions, athletes
must regulate their core temperature within a
relatively narrow (37u–40uC) range.
1
Increases in
core temperature of only 2uC above normal can
increase the perception of fatigue and result in
reduced exercise performance.
23
Many team sports
such as soccer require athletes to compete over
prolonged periods (60–90 min), at relatively high
intensities (ie, ,65% Vo
2
max), separated into
equal halves by a 10–15-min halftime break.
4
Time–motion analyses of soccer indicate that
both submaximal and sprint performance decrease
during the second half of competition.
45
When
games are played in the heat, elevated core
temperatures (.39uC) from the first half can
increase the level of fatigue experienced during the
second half of competition, leading to further
6
Therefore, a strategy to
reduce core temperature during halftime breaks
(,15 min) could minimise the reduction in
performance that is often observed during the
second half.
The high specific heat of water (ie, the ability to
absorb large amounts of heat before changing
temperature), coupled with waters’ ability to be
applied over a large surface area, makes cold-water
immersion an effective method to rapidly reduce
core body temperature.
7
The effectiveness of cold-
water immersion for decreasing core temperature
and increasing the heat storage capacity of
individuals during exercise has been quantified.
89
For example, after 30 min of 14uCtorso-onlycold-
water immersion, Marsh and Sleivert
8
reported an
average decrease in rectal temperature of 0.3uC during
9
observed a significant increase (158
2
2
30 min of constant-paced cycling following 58 min of
25uC whole-body cold-water immersion, when com-
pared with a control condition.
Despite the promise of using cold-water immer-
sion recovery to improve exercise performance in
the heat, controversy exists concerning its effec-
tiveness.
10–14
For example, Crowe et al
10
and
Schniepp et al
13
reported a decrease in cycling
sprint performance after a 15-min whole-body
cold-water immersion (14uC) intervention.
However, both of these studies were conducted
in non-hyperthermic conditions (,27uC), which
do not represent a practical scenario for applying a
cold-water immersion intervention. Conversely,
Yeargin et al
14
showed that 12 min of whole-body
cold-water immersion (14uC) after 90 min of
running in the heat significantly reduced the time
to complete a 2-mile running time trial compared
with a control condition. It should be noted that
the cold-water immersion periods (12–15 min)
used for these studies were not of practical
relevance and would not fit into a typical 15-min
halftime break. In a study from our laboratory,
5 min of cold-water immersion (14uC) after an
exhaustive bout of exercise in the heat resulted in
similar end rectal temperatures compared with two
longer immersion (10 and 20 min) durations
(Peiffer et al 2007, unpublished observations).
Therefore, we hypothesised that a 5-min cold-
water immersion intervention applied during a 15-
min recovery period would lower core temperature
and attenuate the exercise performance reduction
commonly observed during subsequent high-inten-
sity exercise in the heat.
To test this hypothesis, the present study used a
repeated cycling exercise model consisting of
decreases in performance.
2
a 15-min exercise session. Additionally, Kay et al
vs 84 (8.8 W m )) in heat storage capacity during
(13.1 W m )
(327.9 (55.7) W) compared with control (288.0
Background This study examined the effect of a 5-min
Methods 10 male cyclists performed two bouts of a 25-
Results Compared with control, rectal temperature was
Conclusion 5-min cold-water immersion recovery
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Original article
Br J Sports Med 2010;44:461–465. doi:10.1136/bjsm.2008.048173462
25 min of constant-paced cycling at the power output equal to
65% Vo
2
max, followed immediately by a high-intensity 4-km
(,6 min) cycling time trial. This simplistic cycling model was
chosen to examine how 5 min of cold-water immersion might
affect rectal temperature and both submaximal and maximal
exercise performance under hot conditions (35uC and 40%
relative humidity).
METHODS
Subjects
Ten well-trained male cyclists (age: 35 (7 years), height: 183
(7 cm), mass: 80.3 (9.7 kg), Vo
2
max: 60.5 (4.5 ml kg
21
min
21
),
peak power: 441 (32) W) volunteered to participate in this
study. All subjects had been training for at least 3 years and had
a weekly training volume that was greater than 250 km week
21
.
The current sample size was selected based on a power analysis
(a = 0.05 and power = 80%) using the SD of rectal temperature
responses to cold-water immersion from a previous investiga-
tion.
15
Subjects were given written instructions of the possible
risks and benefits of their participation in the study and gave
signed informed consent before study commencement. The
subjects were required to complete one graded exercise test, and
two experimental sessions separated by 4–7 days. The study
was approved by the Human Research Ethics Committee at
Edith Cowan University.
Graded exercise test
During the initial testing session, subjects completed a graded
exercise test on an electromagnetically braked Velotron cycle
ergometer (Racermate, Seattle, Washington, USA) at normal
room temperature (22uC). The subjects began the graded
exercise test at 70 W, and increases of 35 W min
21
were applied
until volitional fatigue. During exercise, average oxygen
consumption (Vo
2
) and carbon dioxide production (VCo
2
) were
recorded at 30-s intervals using a Medgraphics CPX gas analyser
system (Medical Graphics, St Paul, Minnesota, USA). The
power output associated with 65% of Vo
2
max was used as the
steady-state power output in the subsequent experimental
sessions.
Experimental sessions
During the two experimental sessions, subjects completed
25 min of constant-pace cycling on the Velotron cycle
ergometer at a power output (255 (22) W) that corresponded
to 65% of Vo
2
max in an environmental chamber maintained at
35uC and 40% relative humidity. The intensity and duration of
the constant-pace session were selected to provide an adequate
stimulus to increase core temperature
2
and induce fatigue.
3
The
first constant-pace session was followed 2 min later by a 4-km
cycling time trial. Subjects were not permitted to warm-up
before either the constant-pace session or the 4-km time trial.
The temperature and relative humidity selected for this study
were based on pilot work that determined the hottest
conditions that subjects could tolerate and still finish the
required workload. After the first time trial, subjects remained
in the environmental chamber for 15 min, and in a counter-
balanced cross-over order, were assigned to either a cold-water
immersion or a control condition. In the cold-water immersion
condition, subjects were immersed in water (14uC) for 5 min
between the 5th and 10th minutes of the 15-min recovery
period. To isolate the recovery benefits of cold-water immer-
sion, passive sitting occurred before and after the cold-water
immersion period. During the control condition, subjects were
seated for the entire 15 min in the 35uC heat chamber. After the
15-min recovery period, subjects performed a second 25-min
constant-pace cycling session (65% Vo
2
max) followed by a
second 4-km time trial. To simulate typical outdoor convective
environmental conditions, a custom-built fan (Kinetic
Performance Technologies, Mitchell, ACT, Australia) was
placed at a distance of 1 m in front of the bicycle to maintain
a constant wind velocity of 32 km h
21
at the point of the cyclist
for all cycling trials. Subjects’ rating of perceived exertion
(RPE)
16
was recorded at baseline and after both the constant-
pace sessions and 4-km time trials.
Cold-water immersion
During the 5-min cold-water immersion, subjects were sub-
merged in an inflatable water bath, in a seated position to the
mid-sternal level, wearing only their cycling shorts. Water
temperature was maintained at a constant 14uC by a specially
designed water refrigeration unit (iCool Portacovery, Gold
Coast, Australia). The water temperature selected for this
study (14uC) was chosen as it appears as the most commonly
used water temperature in previous cold-water immersion
studies
12–14 17 18
and is effective at lowering body temperature
and is tolerable for most subjects.
Rectal temperature
Before exercise, a disposable rectal thermometer (Monatherm
Thermistor, 400 Series; Mallinckrodt Medical, St Louis,
Missouri, USA) was self-inserted by the subject to ,12 cm
past the anal sphincter. Rectal temperature was recorded
throughout the experiment at a frequency of 1 Hz using a
data-logger (Grant Instruments, Shepreth, UK). For simplicity
and statistical analysis, rectal temperature data are presented as
the average of a 60-s sample measured before and immediately
after the first constant-pace session and 4-km time trial and
before and immediately after the second constant-pace session
and 4-km time trial.
Exercise economy during the constant-pace sessions
Breath-by-breath measurements of Vo
2
were recorded through-
out the first and second constant-pace sessions using a
Medgraphics CPX gas analyser system. To avoid additional
oxygen consumption not related to the exercise, subjects were
required to maintain a comfortable cadence .70 rpm, and to
refrain from standing during the measurement period; cadence
was recorded for later analysis. Exercise economy
(W l
21
o
2
min
21
) during the constant-pace session was calcu-
lated using the following equation:
Economy = Workload/Vo
2
where workload was the applied resistance (W), and Vo
2
was
measured in l min
21
.
The 4-km time trial performance
Subjects began the 4-km time trial from a standing start and
were instructed to complete the required distance in the
shortest time possible. During the time trial, external feedback
was limited to the distance completed. At the start of the
exercise, a timer was started, and the total time to finish the 4-
km was recorded. Power output was calculated via an algorithm
within the Velotron software and sampled at a rate of 1 Hz.
The average power output from the start to the finish of the
time trial was calculated and used for later analysis.
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Br J Sports Med 2010;44:461–465. doi:10.1136/bjsm.2008.048173 463
Statistical analysis
Changes in rectal temperature, RPE, Vo
2
, economy, cadence,
power output and completion time were analysed using a two-
way repeated measures analysis of variance (ANOVA).
Significant main effects and interactions were analysed using
paired t tests with Bonferroni adjustments for multiple
comparisons. Changes in Vo
2
, economy and cadence between
the first and second constant-pace sessions, and the completion
time and average power output during the first and second time
trials, were also analysed by a one-way ANOVA for each
condition separately. Statistical analyses were conducted using
SPSS data analysis software (SPSS V.15). The significance level
was set at p = 0.05, and all data are presented as mean (SD).
RESULTS
Rectal temperature
Figure 1 shows the change in rectal temperature over time. A
significant (p,0.01) interaction was found between the cold-
water immersion and control conditions. Compared with the
control condition, rectal temperature was significantly lower for
all time points in the cold-water immersion condition after the
15-min recovery period. Following the 15 min of recovery, rectal
temperature decreased from 38.6 (0.4)uC to 38.2 (0.2)uC for the
cold-water immersion condition, but no change in rectal
temperature was found (38.6 (0.4)uC vs 38.6 (0.5)uC) for the
control condition. Nevertheless, the magnitude of increase in
rectal temperature from before the second constant-pace session
to after the second 4-km time trial was not significantly
different (p = 0.07) between the cold-water immersion (0.5
(0.2)uC) and control (0.6 (0.1)uC) conditions (fig 1).
Exercise economy during constant-pace sessions
No differences in Vo
2
were found between the first and second
constant-pace sessions in the cold-water immersion (3.2
(0.3 l min
21
) and 3.2 (0.3 l min
21
), respectively) or control (3.3
(0.3 l min
21
) and 3.2 (0.3 l min
21
), respectively) conditions.
Similarly, the exercise economy was not different between
bouts in either the cold-water immersion (75.2
(4.2 W l
21
min
21
) and 75.3 (4.3 W l
21
min
21
), respectively) or
control (74.1 (4.2 W l
21
min
21
) and 76.1 (5.1 W l
21
min
21
),
respectively) conditions. A significant interaction (p,0.01)
was evident for cadence. During the second constant-pace
session, cadence was significantly higher (p,0.05) in the cold-
water immersion (88 (6 rpm)) compared with the control (85
(7 rpm)) condition.
The 4-km time trial performance
The 4-km time trial completion time increased significantly
(p,0.05) from the first to second time trial for the cold-water
immersion (+6.0 (5.4 s)) and control (+24 (12 s)) conditions
(fig 2A). A significant interaction (p,0.01) was observed
between the cold-water immersion and control conditions.
The average completion time for the second 4-km time trial was
significantly less (218.0 (11.5 s); p,0.05) after cold-water
immersion compared with the control condition (fig 2A).
Average power output during the first and second 4-km time
trials are shown in fig 2B. There was a significant (p,0.05)
decrease in average power output from the first to second time
trial in the control (220 (6.0)%) and cold-water immersion
(23.0 (3.0)%) conditions. A significant interaction (p,0.01) was
observed between conditions, with a greater (p,0.05) average
power output recorded during the second time trial for cold-
water immersion compared with the control condition (fig 2B).
Rating of perceived exertion
Table 1 shows the RPE measured following both constant-pace
and time trial exercise phases. Compared with the first
constant-pace session, RPE was significantly greater after the
second constant-pace session in the control condition; however,
no difference was observed in the cold-water immersion
condition. A significant (p,0.01) interaction effect was also
found, identifying that RPE was significantly (p,0.05) lower
after the second constant-pace session for cold-water immersion
compared with the control condition.
Figure 1 Rectal temperature measured before (CP
1pre
,CP
2pre
) and
immediately after (CP
1post
,CP
2post
) the 25-min constant-pace cycling
phase and before (TT
1pre
,TT
2pre
) and immediately after (TT
1post
,TT
2post
)
the 4-km time trial in the cold-water immersion (?) and control (
l
l
)
conditions.*Significantly (p,0.05) different between conditions.
Figure 2 Completion time (A) and average power (B) for the first (TT
1
)
and second (TT
2
) 4-km time trial measured in the cold-water immersion
(?) and control (
l
l
) conditions. *Significantly (p,0.05) different from
control; #significantly (p,0.05) different than TT
1
in both conditions.
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DISCUSSION
The main findings of the present study were that: (1) compared
with the control condition, cold-water immersion significantly
lowered rectal temperature after the recovery phase and
throughout the second 4-km time trial; (2) no significant
differences in Vo
2
or economy were observed between the
constant-pace phases for both conditions; and (3) cold-water
immersion resulted in a significantly higher average power
output and a significantly shorter completion time during the
second 4-km time trial compared with the control condition.
Cold-water immersion applied after a bout of exercise in the
heat can decrease core temperature at a rate that is faster than
heat loss occurring under normal convective conditions.
14 15 17 19
Most studies that have examined this aspect of post-exercise
cold-water immersion have used cold-water immersion dura-
tions that ranged between 12 and 15 min.
14 15 17
These durations
do not accurately represent a practical cold-water immersion
duration that could be applied during a common half time
scenario (ie, 15 min). In our study, 5 min of cold-water
immersion resulted in a significant reduction in rectal tempera-
ture at the start of the second constant-pace session, and this
reduction persisted until completion of the second time trial
(fig 1). These results indicate that immersing hyperthermic
(.38.5uC) athletes in cold water for 5 min after exercise can
significantly decrease rectal temperature.
Exposure to a cold-water immersion intervention can rapidly
decrease muscle temperature and muscular force output.
20 21
Under these cooler muscle temperatures, additional motor units
must be recruited to produce similar levels of muscular force
output.
22
These additionally recruited motor units must arise
from the less efficient type II muscle fibres, resulting in a
decreased economy of motion.
23
For these reasons, we hypothe-
sised that after our cold-water immersion intervention, oxygen
consumption would be elevated, and cycling economy would be
lowered during the second constant-pace cycling session. While
we did not directly measure motor unit recruitment levels, the
fact that Vo
2
was not different between conditions suggests
that motor unit recruitment levels were not significantly altered
after the cold-water immersion intervention.
23
There was
however, a significant (p,0.05) increase (3.0 (3.0)%) in cycling
cadence during the second constant-pace session after cold-
water immersion. The increase in pedalling rate was likely a
consequence of the cooler core body temperatures (fig 1),
resulting in a lowered perception of fatigue.
24
To our knowledge,
this study is the first to report a change in cycling cadence after
a post-exercise cooling intervention.
Elevations in core temperature can increase thermal fatigue
leading to a reduction in exercise performance.
232526
Indeed,
during constant-pace cycling in the heat, Nybo and Nielsen
24
reported a strong correlation (r = 0.95) between fatigue-related
decreases in frontal cortex beta-wave activity and increases in
RPE. In our study, RPE during the second constant-pace session
was significantly lower after cold-water immersion compared
with the control condition (table 1). This reduced RPE paralleled
the reduction in rectal temperatures found after the recovery
intervention (fig 1). During exercise in the heat performed at a
fixed RPE level, exercise intensity is decreased in response to the
need to reduce internal heat storage accumulation.
27
In the
present study, the lower RPE value observed before the second
time trial in the cold-water immersion condition (table 1) likely
permitted the higher exercise intensity shown during the second
4-km time trial (fig 2).
Yeargin et al (2006) showed that 15 min of cold-water immersion
(14uC) after 90 min of running in the heat can significantly improve
subsequent 2-mile running time trial performance. The improved
running performance occurred with a mean rectal temperature that
was 0.5uC lower than in the control condition. We found a
comparable 0.6uC reduction in rectal temperature before thesecond
time trial after our cold-water immersion intervention. These
findings imply that a core temperature reduction of approximately
0.5uC may be needed to elicit improvements in performance under
hot conditions. Future research is required to ascertain the smallest
worthwhile difference in rectal temperature needed for improved
endurance performance in the heat.
While findings from the present study are promising for
practitioners, the findings are not without limitations. Our
inability to blind subjects to the recovery treatment highlights
an intrinsic limitation of cold-water immersion research. While
the lower rectal temperatures found in the cold-water immer-
sion condition before the second time trial were the most
plausible cause of the performance improvements, a placebo
effect cannot be ruled out. Nevertheless, the improved
Table 1 Comparison between control (CON) and cold-water immersion (CWI) conditions for average ratings
of perceived exertion after the first (CP
1
) and second (CP
2
) constant-pace cycle session, and the first (TT
1
) and
second (TT
2
) 4-km time trial
CP
1
TT
1
CP
2
TT
2
CON 13.2 (1.3) 18.0 (0.7) 16.8 (1.1){ 18.9 (1.1)
CWI 12.8 (1.1) 18.5 (1.3) 14.3 (2.3)* 18.2 (1.1)
Note, data are 6–20 scale Borg units for rating of perceived exertion.
16
*Significantly (p, 0.05) different from the CON condition.
{Significantly (p,0.05) different from CP
1
.
What is known on this topic
c During exercise in the heat, increases in rectal temperature
significantly reduce exercise performance.
c Cold water immersion recovery interventions used after
exercise in the heat can significantly lower rectal temperature.
c Fifteen minutes of 14uC cold water immersion after exercise in
the heat can improve subsequent exercise performance.
What this study adds
c Five minutes of cold water immersion during a 15 minute
recovery session can significantly lower rectal temperature.
c Subsequent submaximal exercise economy is not affected by
a 5 minute cold water immersion recovery intervention.
c
enhanced after a 5 minute cold water immersion recovery
intervention.
High-intensity endurance performance in the heat can be
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performance shown after the cold-water immersion interven-
tion should be of interest to practitioners regardless of the
underpinning mechanisms. Finally, while the present study
used a simplistic cycling model to examine the submaximal and
maximal exercise response, future studies are needed to confirm
the effectiveness of a cold-water immersion intervention using a
protocol that mimics team sport performance.
In summary, our data indicate that 5 min of cold-water
immersion during a 15-min recovery session can decrease rectal
temperature and attenuate the decline in high-intensity exercise
performance without affecting submaximal economy of motion in
hot environmental conditions. Athletes performing multiple
exercise bouts in hot environmental conditions should consider
using a cold-water immersion intervention to reduce the
deleterious effects that hyperthermia has on exercise performance.
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Competing interests None.
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doi: 10.1136/bjsm.2008.048173
2008
2010 44: 461-465 originally published online June 6,Br J Sports Med
J J Peiffer, C R Abbiss, G Watson, et al.
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