Cold water immersion (CWI) is the process of fully or partially submersing the area of soreness into a relatively cold bath (4-8 degrees C). We all know the acronym RICE (Rest Ice Compression and Elevation) but should the I be taken out? Icing a sore or injured muscle area has been used for years, but is it as affective as we think?
During CWI we are constricting the vasculature in the area, therefor decreasing the overall blood flow to the muscles. This is great for preventing short term muscle soreness by decreasing the inflammatory response and delayed-onset muscle soreness (DOMS). Icing helps decrease muscle soreness usually only from 36-72 hour post exercise; after that it does not help nearly as much.
What about injured muscles, should we continue to ice them? Muscle injuries start mending as soon as possible, but if we are constricting the blood flow to the muscle this process will take much longer. In fact we should heat during muscle injuries to increase blood flow to get nutrients there faster. All in all it is a safe bet to use a mixture of heat and ice after exercising to reduce inflammation and soreness.
http://fitness.mercola.com/sites/fitness/archive/2012/04/13/cold-water-immersion-for-muscle-soreness.aspx
This is super interesting- as a former athlete, RICE was the answer to every injury. Rest, Ice, Compress and Elevate was to be tried before anything else. Icing was a daily part of my routine- anywhere from pre and post compression packs to full on ice baths (YUCK!). I've always known that the reason we ice is to decrease the immediate inflammatory response and thus delaying muscle soreness later on. It does this by decreasing the local temperature of the tissues and therefore the vasoconstriction of local vessels. This means that the area will supposedly have less of an inflammatory response. I agree that we should be concerned about icing already injured muscles, but we never ice pre-workout. I agree with your statement that we need to be heating muscles to increase blood flow and allow nutrients and blood to get there faster- however we do already do this. Using heating pads pre-workout is a very common treatment, with icing as a follow up after a work-out. This allows the injured muscle to "warm up" before doing more exercise and then using ice after to reduce the induced inflammatory response after.
ReplyDeleteBut the next question is, can icing ever be inhibitory or a bad idea?
We actually just did a research paper on CWI for our exercise physiology class and ice can definitely be inhibitory and a bad idea. Through the research for the paper we found that when researchers looked at actual symptoms a person feels (pain, fatigue, muscular strength) ice baths are almost always good for recovery but the research focused on the underlying mechanisms seem to show that CWI is not good for recovery. I know it feels like the right thing to do after training is to reduce this pain and fatigue while allowing for instant return of strength but what if this is actually causing greater long term effects that will actually hinder athletic performance in the future? One researcher showed that that anabolic signaling and kinase pathways can be significantly decreased by CWI compared to active recovery, which can then in turn lead to less gains over the long-term in muscles strength and hypertrophy. I think all athletes when considering CWI need to be worried more about these underlying physiological factors that can limit ability then just worrying about relieving these uncomfortable symptoms.
ReplyDeleteOn a side note, in recent research they have been looking at how an athletes mental state pre and post exercise affects the time of recovery. One article in particular that related to this topic looked at the differences between CWI and a placebo vs. a normal water bath. the researchers found that the recovery of isometric leg strength and rate of torque development (RTD) during the 48-h post exercise period followed the same pattern in the CWI and CWI placebo (TWP) conditions, with no significant differences between groups and both conditions demonstrating a favorable return to baseline when compared with that in thermoneutral water immersion control condition (TWI). As such, when compared with TWP, a significantly colder water immersion and greater reduction in muscle temperature (approximately 3- C) in the CWI condition were not associated with greater recovery of muscle strength and RTD during an maximal voluntary isometric contraction. This is the first reported evidence that the manipulation of one’s expectation of recovery via a TWP can have a similar beneficial influence on the recovery of muscle strength as that of CWI itself. This study doesn’t determine how cold water immersion actually elicits a physiological response that benefits recovery time, but it does show that the cooling of the muscles is not responsible for these benefits. The psychological factors associated with the idea of CWI might actually be more beneficial to recovery than CWI itself.
When you take into account the placebo affect and the actual physiological responses that might be hindered by CWI, I think the idea that CWI is the best form of recovery for athletes really needs to be reconsidered and more emphasis needs to be placed on what is happening that you can't feel over the immediate satisfaction of pain, stiffness, and fatigue alleviation.
Here are the references to the two articles I talked about in the last comment incase anyone wants to read them.
ReplyDeleteBroatch, J. R., Petersen, A., & Bishop, D. J. (2014). Post exercise cold water immersion benefits are not greater than the placebo effect. Medicine And Science In Sports And Exercise, 46(11), 2139-2147. doi:10.1249/MSS.0000000000000348
Roberts, L. A., Raastad, T., Markworth, J. F., Figueiredo, V. C., Egner, I. M., Shield, A., & ... Peake, J. M. (2015). Post‐exercise cold water immersion attenuates acute anabolic signalling and long‐term adaptations in muscle to strength training. The Journal Of Physiology, 593(18), 4285-4301. doi:10.1113/JP270570