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Does hot/cold therapy help recovery after exercise?

Yes. A study of the available literature found it helps reduce muscle soreness and strength loss after strenuous exercise when compared to groups of athletes who simply rested.

But is contrast water therapy better for recovery than other approaches?

Let’s dig in.

We considered a review of the available research entitled, Contrast Water Therapy and Exercise Induced Muscle Damage: A Systematic Review and Meta-Analysis, and undertaken by Bieuzen et al.

Exercise induced muscle damage (EIMD) is a common occurrence after strenuous bouts of sport or physical performance. The resulting soreness and depleted muscle function can impact subsequent performances.

The objective of the researchers was to review the available research which considered Contrast Water Therapy (CWT), and met the criteria of the authors, as a modality for recovery from EIMD.

After screening, 46 pieces of research were assessed and considered for inclusion. Of those, 18 met the standard for eligibility:

  • Randomised and controlled Human studies using CWT at least 1hr after exercise
  • A measure of soreness, muscle damage, inflammation, muscle strength or power reported
  • Outcomes measured immediately and then at 24, 48, 72, or 96 hours
  • Studies using CWT in conjunction with another modality were not considered

The team divided the 18 studies into six different groups where Contrast Water Therapy was compared with:

  1. Passive Intervention (no CWT or rest).
  2. Cold Water Immersion
  3. Active Recovery
  4. Compression Garment
  5. Warm Water Immersion
  6. Stretching

These studies observed different outcomes including:

  • Perceived soreness scores
  • Observed measures of Strength, Force, Strain or Power
  • Biomarkers of inflammation or of muscle damage

Findings Athletes Should Consider:

Contrast Water Therapy is an effective recovery modality when compared to rest.

The magnitude of benefits appears to be clinically relevant but may be most applicable to elite sports.

Other recovery modalities may be as effective, and possibly more convenient to administer for a given athletes circumstances.

More work is required to determine an optimal method of Contrast Therapy.

The researchers caution that some of the research include have small sample sizes and poor methodological quality.

Comparing Hot/Cold Therapy to Other Recovery Methods:

Here is the findings of the research review and meta-analysis when contrast therapy is compared to other common recovery approaches.

Contrast Water Therapy (CWT) vs Rest for Recovery:

  • Muscle Soreness     = CWT significantly reduced soreness at all points in time
  • Muscle Damage      = CWT significantly lower beyond 48 hours
  • Inflammation = No statistically significant difference
  • Muscle Strength      = CWT significant at all points in time
  • Muscle Power         = CWT significant at 24 hours and beyond

Contrast Water Therapy (CWT) or Cold Water Immersion (COLD) for Exercise Recovery:

  • Muscle Soreness = No significant differences at any time
  • Muscle Damage = Trends towards COLD but not reaching significance
  • Inflammation = No significant differences
  • Muscle Strength = Significant findings in favour of CWT (in 2 of the 4 studies that considered)
  • Muscle Power = No significant differences

Contrast Water Therapy (CWT) or Warm Water Immersion (WARM) for Recovery

  • Muscle Soreness = Significant findings at 24 & 96 hours favour CWT
  • Muscle Damage = No Significant findings. Trends towards WARM at 24, 48 & 72 hours
  • Muscle Strength = Significant findings for CWT in all timings except for 6 hrs
  • Muscle Power = WARM significantly better at 6hours and 72 hours. No significant difference at 24 or 48 hours.

Contrast Water Therapy (CWT) or an Active Recovery (AR)

  • Muscle Soreness = No significant difference. Trend towards CWT
  • Muscle Damage = AR significant only at 72 hours
  • Muscle Power = No significant difference

Contrast Water Therapy (CWT) or Compression (COMP) for Recovery

  • Muscle Soreness = No significant differences
  •  Muscle Damage = CWT significant at 24 and 48 hours

Contrast Water Therapy (CWT) or Stretching (STR) for Recovery

  • Muscle Soreness = No significant differences
  • Muscle Damage = No significant differences
  • Muscle Strength = No significant differences
  • Muscle Power = No significant differences

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