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How long to ice-bath for muscle soreness? And at what temperature?

The answer is 11-15 minutes immersed at a temperature of 11-15°C.

Our insight comes from a research paper that compiles the findings of key studies undertaken in cold water immersion (CWI). It is called Can Water Temperature and Immersion Time Influence the Effect of Cold Water Immersion on Muscle Soreness? A Systematic Review and Meta-Analysis conducted by Machado et al and published in Sports Medicine in 2015

This study set out to review the available evidence and establish whether CWI helps muscle soreness after exercise. And if so, which water temperature and duration is best.

[n.b Only soreness has been considered. We have seen that CWI can positively impact the recovery of performance without impacting soreness]

After duplications, the team started with a population of 136 studies for consideration. When the screening and selection criteria were applied, which also controlled for quality, 17 were selected for a full review although this paper ends up considering just 9 qualifying studies.

These 9 studies were from 3 countries (AUS, UK & USA), considered majority male athletes, were populated by athletes or physically active participants. The exercise damage inflicted varied from a sports match to downhill running to sprints to lab-based exercises.

The cold-water interventions ranged from just 5-15°C and the immersion times were also relatively narrow 5-20 minutes. Magnitude of immersion varied from lower limb only to full body immersion.

Eight of the 9 studies also considered delayed soreness. In 7 of these studies that peaked after 24 hours with the other peaking at 48 hours.

When the studies were analyzed the research, team considered CWI to be a beneficial intervention compared to rest.

The studies were grouped by temperature of immersion: Severe Cold (5-10°C) and Moderate Cold (11-15°C). Those studies with CWI in the Moderate temperature range performed better against their controls.

The studies were also grouped by duration of CWI: Short (less than 10 mins), Medium (11-15 mins) and Long (16-20 mins). The medium duration group performed the best against its control.    

Whilst they acknowledge the need for more work in this area, they conclude that CWI is generally positive in immediate and delayed muscle soreness. Further that there is evidence of a dose-response relationship such that the water temperature and immersion time is likely matter for the alleviation of muscle soreness.

Application for athletes: The suggestion that there is a temperature / time relationship when sitting in an ice bath is noteworthy. How practical achieving 11-15 minutes in an ice bath at 11-15°C in the immediate or short aftermath of damaging exercise warrants consideration.

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