Thursday, July 7, 2011


Water immersion is a popular means for recovery in football players. What is the scientific evidence behind it?

What is the aim of water immersion?
The aim of this strategy is to improve recovery after damaging exercise. There is also evidence that water immersion can minimize inflammation observed after exercise. Upright water immersion at the hip or chest level improves venous blood return and thus removal of metabolic by-products from the working legs. This is due to the external high pressure imposed to the legs vessels with upright immersion.

What do studies suggest?
Three main strategies are described in the literature: cold water, thermo-neutral water and contrast therapy (alternating cold and hot water immersion). Research findings are controversial. Some studies report an improvement in sprint performance 24 and 48 hours after exhaustive exercise by using cold water immersion immediately after exercise. Other studies fail to replicate these findings. The contradictory results could be due to several reasons: different subjects, protocols, level of damaging exercise, immersion protocol and water temperature etc. The common finding in most studies is that cold water immersion results in better feeling of legs pain after 24 and 48 hours of damaging exercise.

What is the suggested protocol for cold water immersion
Most of the studies suggest 5-15 min of water immersion at 10-15 oC immediately after exercise.

So far there is no strong evidence-based knowledge on the beneficial effect of cold water immersion on recovery and performance 24 and 48 hours after damaging exercise. It seems however, that players’ feeling of fatigue and muscle soreness is improved with this recovery strategy.

Simple means to improve recovery after damaging exercise
  1. COOL-DOWN. In my opinion this is important to speed up recovery. Ideally, 10-20 min of running at 60-70% of maximum heart rate is an effective way to increase blood flow at the legs.
  2. Additional strategies THAT SHOULD COMPLEMENT AND NOT REPLACE COOL-DOWN. These include water immersion, ice placement, nutritional interventions etc. I will come back on these strategies with a future post.

Questions with practical applications
  1. It seems that cold water immersion, at least of adequate duration, stimulates sympathetic nervous system. This will retard the recovery process. What is the appropriate water immersion or recovery strategy to avoid sympathetic stimulation and stimulate parasympathetic response instead?
  2. Cold water immersion minimizes inflammation due to exercise. This might suppress training adaptations since there is a link between exercise-induced inflammation and adaptations. What is the appropriate recovery strategy to improve performance recovery while not interfering with the adaptations process?
For more reading
Bleakley and Davison. Br J Sports Med 44: 179-187, 2010 (Review paper)
Vaile et al. Int J Sports Med 29: 539-544, 2008

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