Man in ice bath for recovery and man lifting bench press for growth
ice baths, muscle physiology, physiology, Sports Science

Ice Baths and Young Athletes: A Healthy Debate

In a previous post I discussed the ongoing debate around post-exercise ice baths and cold-water immersion (CWI) in athletes. The evidence for adults is already nuanced — but when we shift the focus to adolescent athletes, the picture becomes considerably more complex, and the caution warranted becomes considerably greater.

In 2015, together with my colleague Dr Andrew Murray (currently working with the NBA), we published a systematic review and meta-analysis examining the scientific rationale for cold applications in young athletes. The paper — published in Extreme Physiology & Medicine — asked a question that is surprisingly rarely posed: is the evidence base we use to justify ice baths in adult elite athletes in any way transferable to adolescents? The short answer, as you will see, was (and most probably still is) no (but I will let you make your mind up).

Why Adolescents Are Not Small Adults

The foundational assumption underlying most youth recovery practices is a straightforward (and wrong) transfer: if elite adult athletes use ice baths, then junior athletes should too. Coaches and parents, attracted by what they see in professional sport, replicate these practices without questioning the rationale, safety, or developmental implications. This is precisely the problem.

The physiological differences between adolescent and adult athletes are not trivial. Several lines of evidence point to the fact that young athletes are inherently less susceptible to exercise-induced muscle damage than adults — which fundamentally changes the cost-benefit calculation for cold water immersion.

Key finding: Pre-pubertal youths recover faster from high-intensity exercise than adults, partly due to lower relative power outputs, but also because of relatively greater muscle flexibility and compliance — making their muscles structurally less vulnerable to mechanical damage in the first place.

Adolescents have a higher proportion of type I (slow-twitch) muscle fibers, which are less susceptible to eccentric damage. They also show a more pronounced and rapid repeated-bout effect — the protective adaptation that reduces muscle damage from subsequent bouts of the same exercise — which occurs more readily in young males than in adults. Levels of creatine kinase (CK), the blood marker most commonly used to justify recovery interventions, are systematically lower in young athletes performing exercise of the same relative intensity compared to adults, even when body weight is accounted for.

These are not minor footnotes. They mean that the biological “need” for aggressive recovery interventions — however modest in adults — is even smaller in young athletes.

The Muscle Growth Problem

Perhaps the most important concern centres on one of the primary goals of training young athletes: building muscle. The mechanistic pathway from exercise to muscle hypertrophy depends critically on the post-exercise inflammatory cascade. This is not a side-effect to be suppressed — it is the signal.

After intense exercise, the inflammatory response — involving reactive oxygen species, cytokines such as IL-6, neutrophil accumulation and satellite cell activation — drives the remodeling of skeletal muscle tissue. Cold-water immersion blunts this entire cascade. In adult athletes who have already developed their muscular base, this trade-off may occasionally make sense in a competition context (where reducing soreness quickly matters more than maximising adaptation). But in adolescents still in the process of developing their muscular system, suppressing this physiological signal during training periods could directly impede the very adaptations that training is designed to produce.

⚠ Developmental concern

The evidence suggests that regular post-training cold-water immersion during the critical windows of adolescent development may attenuate the muscle remodeling adaptations that are the long-term objective of the training programme. In a population still building foundational physical capacity, this is a significant cost

What Our Review Found

Our systematic search at the time identified 17 articles meeting inclusion criteria for the review, with a further meta-analysis conducted on those studies reporting outcomes amenable to pooling. The evidence base for cold applications in adolescent athletic populations was found to be extremely limited — and the few studies that did exist were methodologically heterogeneous, with small samples, variable protocols and high risk of bias.

The meta-analysis of CWI effects on creatine kinase levels showed a statistically meaningful reduction in CK at 24 and 48 hours post-exercise. However, as our review carefully explains, reduced circulating CK does not straightforwardly equate to better recovery, faster adaptation, or improved performance. It reflects a blunting of the inflammatory marker — and in a young athlete, that blunting may come at the expense of downstream adaptation.

Evidence for improvements in perceived soreness, performance markers, or functional recovery in adolescent-specific populations was either absent or inconclusive. Crucially, no studies examined the long-term effects of regular CWI use on muscle development, hormonal milieu, or athletic adaptation in this age group.

The Psychosocial Dimension

There is a dimension of this issue that is rarely discussed: the psychological and social dynamics that surround the use of ice baths in young athletes. Our review highlighted research suggesting that young athletes may endure ice baths not because of genuine physiological need but because of social expectation, peer pressure, or the desire to mimic what they perceive elite adult athletes do. Studies in young individuals have even shown a relationship between feelings of guilt and the ability to endure cold-water immersion — suggesting that some of the “benefit” may be bound up in a kind of ritual discomfort rather than physiology.

The placebo effect is also highly relevant. Research in adults has shown that thermoneutral water immersion produces similar perceived recovery outcomes — suggesting that the expectation of benefit is doing considerable work. Building a culture in youth sport where post-training pain and discomfort are seen as always requiring an intervention could have long-term implications for how young athletes relate to their bodies, their recovery, and their sport.

Figure 1. Schematic diagram of the post-exercise physiological cascade with and without cold-water immersion (CWI), from Murray & Cardinale (2015). The natural inflammatory response (left column) drives satellite cell activation, muscle protein synthesis and long-term adaptation. CWI (right column) blunts this cascade — reducing soreness but potentially impairing the very adaptations that make training effective. This concern is amplified in adolescent athletes whose musculature is still developing.
Abbreviations: ROS = reactive oxygen species; HR = heart rate; Q = cardiac output; IL-6 = interleukin-6; IL-10 = interleukin-10; WBC = white blood cells; CK = creatine kinase; DOMS = delayed onset muscle soreness.

The Evidence at a Glance

What Has Research Shown Since 2015?

A decade on from our review, the broader scientific picture has developed considerably — and rather than softening our concerns, the accumulating evidence from adult and mixed-age populations has, if anything, strengthened them. Here is a summary of the most important threads.

CWI blunts hypertrophy: the evidence has hardened

The most consequential developments since 2015 have come from studies directly examining how regular CWI affects the structural and molecular adaptations to resistance training. Fyfe and colleagues (2019, Journal of Applied Physiology) conducted a rigorous 12-week resistance training study and found that post-exercise CWI attenuated gains in type II muscle fibre cross-sectional area and myonuclear accretion — the very adaptations that underpin long-term strength and power development — without, interestingly, impairing maximal strength as measured by one-repetition maximum tests. The same group demonstrated that these structural blunting effects were paralleled by attenuated molecular markers of skeletal muscle anabolism and increased catabolism, providing a mechanistic explanation consistent with what we had hypothesised.

Roberts et al. (2015) — the landmark study using MRI to directly measure quadriceps muscle mass — found that 12 weeks of post-exercise CWI (10 min at 10°C) resulted in only ~2% increase in quadriceps mass compared to ~15% in the control group. This remains the most striking direct evidence of CWI-induced attenuation of hypertrophy in the literature to date.

A 2021 narrative review by Petersen and Fyfe (Frontiers in Sports and Active Living) synthesised this growing body of mechanistic and longitudinal evidence, concluding that the post-exercise anabolic signalling environment is measurably blunted by CWI, with downstream consequences for satellite cell function and myofibre growth. A 2023 meta-analysis by Grgic (European Journal of Sport Science) extended this to strength outcomes, finding that CWI may also attenuate resistance training-induced strength gains — a more practically alarming finding than the hypertrophy data alone. A further systematic review and meta-analysis published on SportRxiv (2023) — specifically focused on hypertrophy outcomes across eight controlled studies — confirmed meaningful blunting of muscle growth with post-exercise CWI, noting that no published studies to date have included adolescents or older adults in these designs.

The mode-dependency distinction: good news for endurance, bad news for strength

One of the more nuanced and practically useful advances in our understanding since 2015 comes from Ihsan, Abbiss and Allan’s 2021 review in Frontiers in Sports and Active Living — pointedly titled “Adaptations to post-exercise cold water immersion: friend, foe, or futile?” Their synthesis of the literature established a now fairly well-accepted mode-dependent picture: CWI appears to have little or no detrimental effect on adaptations to endurance training (and may in some contexts enhance mitochondrial biogenesis via PGC-1α pathways), while consistently impairing adaptations to resistance training. For sports that are primarily endurance-based, this nuance matters. For sports requiring the development of strength, power, and muscle mass — which describes the majority of youth sport contexts — the foe interpretation applies.

A rare study in adolescent swimmers: useful but limited

One of the few studies to directly examine CWI in an adolescent athletic cohort since our review was published by Batista and colleagues in 2024 (European Journal of Applied Physiology). In a randomised crossover design, 20 competitive adolescent swimmers underwent a week-long protocol in which CWI (14°C), thermoneutral water immersion (27°C, acting as placebo), or passive recovery were applied between dry-land resistance training and swimming sessions. The study found no significant differences between conditions for 100m sprint or functional performance, with only trends — not reaching statistical significance — for reduced pain and tiredness with CWI. The authors note that when recovery time between sessions is limited, CWI may help athletes feel ready to perform again, and that possible hypertrophy decrements may be acceptable when strength gains are not the primary training goal. These are reasonable qualifications — but it is equally important to note that a single week is far too short a window to detect any impairment to long-term muscular development, and the study was not designed or powered to address that question.

⚠ The research gap remains

Across all the literature published in the decade since our 2015 review, not a single well-designed longitudinal study has examined the effects of regular CWI use on muscle development, hormonal adaptation, or long-term athletic development in pre- or peri-pubertal athletes. The gap we identified in 2015 remains unfilled. Coaches and practitioners are still extrapolating from adult data — a practice that is physiologically unjustified and potentially counterproductive.

The epigenetic dimension: a new frontier

A 2024/2025 narrative review by Normand-Gravier and colleagues (including researchers at Aspetar, Doha) published in the European Journal of Applied Physiology introduced an additional layer of complexity: the potential epigenetic effects of thermal interventions on skeletal muscle. The review highlights that cold interventions can influence DNA methylation patterns and histone modifications relevant to muscle protein synthesis and satellite cell function — signalling pathways that are particularly active and plastic during adolescent development. While this work is in its early stages and does not yet provide definitive conclusions specifically for young athletes, it adds a further mechanistic dimension to the concern that suppressing post-exercise inflammatory and thermal signalling during developmental years may have consequences that extend beyond the immediate training session.

The placebo narrative has strengthened

Since our 2015 review highlighted the potential role of placebo in mediating the perceived benefits of CWI, further work has continued to support this interpretation. Malta and colleagues’ 2021 meta-analysis in Sports Medicine — examining CWI effects on both strength and endurance adaptations — reinforced that a meaningful portion of the perceived recovery benefit appears to be psychologically mediated. For adolescent athletes who are still developing their relationship with effort, discomfort, and recovery, building a reliance on cold water as a perceived “reset” mechanism carries risks that go well beyond the immediate physiology.

Practical Recommendations

Based on the review’s findings, updated in light of the evidence accumulated since 2015, the following practical positions can be offered for coaches, practitioners and parents working with young athletes:

1. Do not use CWI routinely after training sessions

The training session is precisely the context where the post-exercise inflammatory response should be allowed to run its course. Blunting it systematically — especially during a young athlete’s developmental years — is difficult to justify given the available evidence.

2. In competition, context matters

When an adolescent athlete faces multiple competitive efforts in rapid succession (e.g. tournament heats and finals on the same day), there may be a role for brief cold exposure to reduce perceived soreness and help the athlete feel ready to compete again. Even here, the protocol should be conservative and the evidence understood to be modest.

3. Avoid using CK as a decision-making tool in this population

Circulating CK levels in young athletes are systematically lower than in adults performing comparable exercise. Using elevated CK as a trigger for cold recovery interventions in adolescents is likely to be misleading and to result in unnecessary intervention.

4. Educate, do not simply imitate

Coaches and parents should be encouraged to make evidence-based decisions about recovery modalities rather than simply replicating what professional adult athletes do. The professional athlete context — the intensity, the competitive calendar, the physiological maturity — is genuinely different.

5. Prioritise nutrition, sleep and active recovery

These remain the best-supported recovery strategies for any athlete at any age. For adolescents in particular, adequate sleep, appropriate carbohydrate and protein intake, and low-intensity movement are more likely to support both recovery and long-term development than cold water immersion.

Bottom Line

The enthusiasm for ice baths and cold-water immersion in sport has consistently outrun the evidence — and this is especially true when the athletes in question are adolescents. Our 2015 systematic review with Dr Andrew Murray found that the evidence base for CWI in young athletes is sparse, the physiological rationale is weaker than in adults, and the potential for harm to long-term muscle development is a genuine concern that deserves serious attention.

If you work with adolescent athletes, please think carefully before sending them to the ice bath after every training session. The short-term reduction in soreness may feel like a win. The long-term cost to adaptation — and to the culture we build around young athletes’ relationships with their bodies — may be considerably higher. 📄 Read the full review: Murray & Cardinale (2015), Extreme Physiology & Medicine

Key references cited in this post

  • Murray A & Cardinale M (2015). Cold applications for recovery in adolescent athletes: a systematic review and meta analysis. Extreme Physiology & Medicine, 4:17. 🔗 https://doi.org/10.1186/s13728-015-0035-8 · PubMed
  • Roberts LA, Raastad T, Markworth JF et al. (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. 🔗 https://doi.org/10.1113/JP270570 · PubMed
  • Fyfe JJ, Broatch JR, Trewin AJ et al. (2019). Cold water immersion attenuates anabolic signaling and skeletal muscle fiber hypertrophy, but not strength gain, following whole-body resistance training. Journal of Applied Physiology, 127(5):1403–1418. 🔗 https://doi.org/10.1152/japplphysiol.00127.2019 · PubMed
  • Petersen AC & Fyfe JJ (2021). Post-exercise cold water immersion effects on physiological adaptations to resistance training and the underlying mechanisms in skeletal muscle: a narrative review. Frontiers in Sports and Active Living, 3:660291. 🔗 https://doi.org/10.3389/fspor.2021.660291
  • Ihsan M, Abbiss CR & Allan R (2021). Adaptations to post-exercise cold water immersion: friend, foe, or futile? Frontiers in Sports and Active Living, 3:714148. 🔗 https://doi.org/10.3389/fspor.2021.714148 · PMC
  • Malta ES, Dutra YM, Broatch JR, Bishop DJ & Zagatto AM (2021). The effects of regular cold-water immersion use on training-induced changes in strength and endurance performance: a systematic review with meta-analysis. Sports Medicine, 51(1):161–174. 🔗 https://doi.org/10.1007/s40279-020-01362-0
  • Grgic J (2023). Effects of post-exercise cold-water immersion on resistance training-induced gains in muscular strength: a meta-analysis. European Journal of Sport Science, 23(3):372–380. 🔗 https://doi.org/10.1080/17461391.2022.2033851
  • Batista NP, de Carvalho FA, Rodrigues CRD et al. (2024). Effects of post-exercise cold-water immersion on performance and perceptive outcomes of competitive adolescent swimmers. European Journal of Applied Physiology, 124(8):2439–2450. 🔗 https://doi.org/10.1007/s00421-024-05462-x · PMC
  • Normand-Gravier T, Solsona R, Dablainville V et al. (2025). Effects of thermal interventions on skeletal muscle adaptations and regeneration: perspectives on epigenetics. European Journal of Applied Physiology, 125(2):277–301. 🔗 https://doi.org/10.1007/s00421-024-05642-9 · PMC

© Marco Cardinale · Sports Science & Performance · Follow-up to the ice & recovery series



Sports Science

Seventeen years later, I still think icing muscle injuries is a bad idea — and now I have even better data to prove it

Back in April 2008, I wrote a post on this blog asking a pretty simple question: is using ice and cold water after resistance exercise actually a good idea? At the time, the evidence pointing against routine cryotherapy was already there if you looked for it — but challenging the ice bath orthodoxy was not exactly a popular position. Athletes were plunging into ice baths after every hard session. Physios were recommending it. Teams were investing in cold tubs like they were mandatory kit.

My argument back then was straightforward: the inflammatory response triggered by training is not the enemy. It is the signal. It tells your muscles to rebuild stronger. Blunting it with ice might feel like recovery, but you may actually be interfering with the very process you are trying to support. The data at the time suggested cold water immersion did little to reduce DOMS, and there were real reasons to think it was getting in the way of training adaptations.

That post got some pushback, a few spirited comments, and then the world largely carried on icing things anyway.

Fast forward to 2025–2026, and I have been part of two research studies that, I think, put this debate on much firmer ground — particularly when it comes to actual muscle injury rather than just post-training soreness. And the bottom line is the same as it was in 2008, only sharper: if you have a muscle injury and you want it to heal well, heat is more likely to help you than cold.

“The inflammatory response is not the enemy. It is the signal.”

What we actually studied

The first study, published in The Journal of Physiology, looked at what happens to injured muscle tissue when you apply different thermal treatments every day for 10 days. We induced real muscle damage in 34 participants using electrically stimulated eccentric contractions — this is not just the kind of soreness you get from a hard leg session, but a protocol that causes genuine myofibre necrosis and triggers the full regenerative cascade, similar to what happens in a meaningful sports injury. We then assigned participants to daily lower body water immersion: cold (12°C for 15 minutes), thermoneutral (32°C for 30 minutes), or hot (42°C for 60 minutes). We took muscle biopsies before, and at 5 and 11 days post-damage, so we could see what was actually happening at the cellular level — not just what participants were reporting on a pain scale.

The second study, just published in Experimental Physiology, took a step back and asked a more practical question: if we want to apply heat before exercise — as part of a warm-up or return-to-play protocol — which of the commercially available heating devices actually gets the job done in terms of raising deep muscle temperature? We compared a water-perfused suit, short-wave diathermy, and hot water immersion.

What we found

In the injury study, hot water immersion came out clearly on top. Participants in the hot group reported less pain than those in the thermoneutral group. Their levels of circulating creatine kinase and myoglobin — two blood markers of ongoing muscle damage — were significantly lower than in both the cold and thermoneutral groups. At the molecular level, the picture was even more telling.

Hot water immersion significantly increased the expression of heat shock proteins (HSP27 and HSP70) — chaperone proteins that are known to play a key role in repairing damaged cells. NF-κB, a signalling molecule involved in inflammation, rose in all groups except the hot immersion group, while interleukin-10 — an anti-inflammatory cytokine — was upregulated only in the hot immersion group at day 11. This suggests that heat therapy may be actively modulating the inflammatory environment in a way that supports rather than suppresses the regenerative process.

Notably, cold water immersion — despite its popularity — did not improve chronic perceived pain, failed to reduce circulating markers of muscle damage, and appeared to blunt the very cellular recovery signals that the body relies on to rebuild damaged tissue.

Now, one important nuance: we did not see differences between groups in the recovery of force-generating capacity. So the case for heat is not that it gets you back on the pitch faster in terms of raw strength — it is that it appears to drive better biological repair of the tissue itself. Whether that translates to better long-term outcomes, reduced re-injury risk, or more complete structural restoration is a question that deserves further study.

Honestly — it is time to rethink the ice applications in professional sport

I am not going to pretend this is a radical finding that nobody has ever considered. The cracks in the cold therapy consensus have been visible for years, and several colleagues have been pushing back on routine cryotherapy for a while. But what I do think is that in professional sports, the default response to a muscle injury — reach for the ice, apply it immediately and repeatedly — deserves much more scrutiny than it typically gets.

Every season, in football, rugby, athletics, basketball and pretty much every sport you can name, athletes suffer muscle injuries that keep them out for weeks or months. The pressure to speed up return-to-play is enormous. And yet the treatments applied in those first critical days after injury often haven’t moved much beyond what was standard practice 30 years ago. Ice is convenient. It feels like you are doing something. It reduces pain, which looks like progress. But if it is also blunting the cellular signals your muscle needs to regenerate properly, the short-term comfort may come at a cost to the quality of repair.

“Ice is convenient. It feels like you are doing something. But feeling like recovery and being recovery are not always the same thing.”

The data from our study — taken at biopsy level, not just blood markers or self-reported pain — suggest that hot water immersion is doing something genuinely positive inside the injured muscle. That is a different and more meaningful finding than most of the cryotherapy literature, which has largely relied on subjective outcomes or superficial measures.

I am not saying ban the ice bath. For certain situations — acute swelling management, thermal comfort, sleep quality? — cold might have its uses. But reflexively applying it to every muscle injury in professional sport, as if it were evidence-based best practice, is increasingly hard to justify. I said something similar in 2008 with far less data. Seventeen years and two studies later, I feel more confident saying it.

A word on the practicalities

One question that comes up immediately when I talk about hot water immersion as a therapeutic tool is: how do you actually implement it? Forty-two degrees Celsius for sixty minutes, daily for ten days, is a specific and quite demanding protocol. It is not a warm bath at home. The second study we published addresses the adjacent question of heating before exercise — specifically which devices are most effective at raising deep muscle temperature — and the answer matters because getting heat into the target tissue, rather than just warming the skin, is the actual physiological objective. Not all devices achieve this equally well, and practitioners investing in heat therapy equipment should have access to comparative data rather than just marketing claims.

I will write more about the practical implementation side of all this in a future post. For now, the headline message is simple: the science on thermal therapy is moving fast, and heat is looking increasingly like the underused tool in the sports medicine toolkit. Critical thinking is key.

Addendum

A recent review/opinion paper from Dr Chris Bleakley confirms some of the views expressed here. You can read the paper here: https://pmc.ncbi.nlm.nih.gov/articles/PMC12925164/

References:

1. Dablainville V, et al. Muscle regeneration is improved by hot water immersion but unchanged by cold following a simulated musculoskeletal injury in humans. J Physiol. 2025 Dec;603(23):7603–7625. PMID: 40437768

2. Nasir N, Townsend N, Cardinale M, Labidi M, Racinais S. Applying thermal therapy: Comparison of different commercially available heating devices to increase muscle temperature. Exp Physiol. 2026 Jan 18. PMID: 41548103

3 Bleakley C. Does ice affect healing after muscle injury? Ask me again next century. J Sport Health Sci. 2025 Dec 4;15:101107. doi: 10.1016/j.jshs.2025.101107. Epub ahead of print. PMID: 41352452; PMCID: PMC12925164.

Empty stadium at sunset with overlaid environmental and structural analysis data
Sports Science

Let’s try to restart again

I realised a lot of time has passed since the last blog article. It is incredible how time flies! A lot has been happening and will try to fill the gaps, I am also learning a lot about agentic AI and implementing quite a few things and so, now it may be the time to renew the blog a bit and try to have a more constant production of hopefully useful short articles on the usual topics.

The Olympic Games in Paris passed, the Winter Olympics in Milano-Cortina also finished and we all saw incredible performances and as always amazing stories from the athletes involved. Sports Science keeps moving, nowadays, together with the exponential increase in scientific publications (maybe I should write a blog article about it at some point…), paralleled by the online production of blogs, podcasts, YouTube channels, newsletters, self produced e-books, social media short clips, social media channels and now AI bots, we have moved from an era where information was difficult to access (confined in university libraries and costly subscriptions) to many things easily accessible online (and unfiltered). While we can argue that the process of peer review is painful and far from perfect (you just need to spend some time reading https://retractionwatch.com to realise how broken the system is), the reality is also the proliferation of a lot of non-sense (or as experts in the field termed ‘pseudo-profound bullshit here) mostly driven by commercial interests. Now more than ever, academic institutions should focus on developing critical skills to make sure that the practitioners of tomorrow do not follow those traps and learn what is appropriate rather than falling for the latest fad.

I am a huge fan of making science accessible to everyone, making it easier to understand making it available for free as well as using the new media to write opinions and stimulate thinking (hence the blog). A blog article has much more reach than a scientific publication behind a paywall, despite the pain each researcher has to get through from getting all the necessary institutional and regulatory approvals to even start a data collection (it is getting more and more painful everywhere…), to then write and submit papers (in this day and age I struggle to understand why every journal has its own formatting requirements and has not developed easier platforms to transform the manuscript files and figures facilitating our work…) and finally go through painful (but necessary) hurdles of reviewer’s rounds to then be greeted with an expensive invoice for open access. Maybe this deserves a post in itself at some point. However, despite the pain, I still think that in principle peer review could make things better (if egos are parked at the door) and at least provide some sort of ‘quality check’ before the cat gets out of the bag. Time will tell us how this will develop.

For now, I will just update the readers in what has been happening. On a personal front, I am still very active training and racing triathlon races (completed a T100 last December, loved every minute of the pain 😀) despite a bad injury at the beginning of last year (4c Hamstring tear, pretty neat injury and not done sprinting or jumping, turns out that swim to run transitions post cold swim, can cause some damage in ‘experienced’ athletes 🤦). At work we run a pretty successful conference (see some highlights here), and next year we will run it again to celebrate the 20 years anniversary of our institution. We have been pretty busy publishing some incredible issues of our Aspetar Sports Medicine Journal (link here) where you can access some pretty amazing content completely for free. Our You Tube channel provides access to the pretty amazing Tuesday lectures we host (https://www.youtube.com/playlist?list=PLkeoBd4A272NvTlC5lxdws55q2aTv0GT2), so make sure you pay a visit.

From a research standpoint, I have been busy with my colleagues producing quite a lot of work. A list of papers and links is here:

Longitudinal Analysis of Variations in Daily Step Counts and Long-Term Implications of COVID-19 Waves and Restriction Phases in Qatar’s Step Into Health Program: Mixed Methods Study.

Majed L, Sayegh S, Dalansi F, Al-Mohannadi AS, Cardinale M, Farooq A.JMIR Public Health Surveill. 2026 Mar 23;12:e76860. doi: 10.2196/76860.PMID: 41871338 Free PMC article.2Cite 

Applying thermal therapy: Comparison of different commercially available heating devices to increase muscle temperature.

Nasir N, Townsend N, Cardinale M, Labidi M, Racinais S.Exp Physiol. 2026 Jan 18. doi: 10.1113/EP092921. Online ahead of print.PMID: 415481033Cite 

Dental health status of professional football players during the Qatar 2023 AFC Asian Cup: a preliminary study.

Alsaey M, Almasri D, Tabben M, Cardinale M, Alkuwari A, Singh GSA, Hashem A.Res Sports Med. 2025 Dec 8:1-13. doi: 10.1080/15438627.2025.2599859. Online ahead of print.PMID: 41360744 Free article.4Cite 

Real-Time Monitoring of Biometric Responses During a 200-km Ultra-Endurance Race Across the Desert.

Esh CJ, Pitsiladis Y, Racinais S, Taylor L, Dablainville V, Belfekih T, Bendimerad F, Pitsiladis A, Verdoukas P, Willems M, Nader N, Dalansi F, Grandjean P, Al-Mulla M, Aldous N, Dossou J, Hassanein YE, Khater N, Miranda H, Cardinale M.Eur J Sport Sci. 2025 Sep;25(9):e70026. doi: 10.1002/ejsc.70026.PMID: 40788281 Free PMC article.5Cite 

Lessons Learned from Implementing Injury and Illness Surveillance in Professional Football: Introducing a New Implementation Framework.

Tabben M, Hassanmirzaei B, Singh G, Miladi R, Chaabane M, McCourt P, Serner A, Clarsen B, Ellouze Z, Mokrani M, Whiteley R, D’Hooghe P, Cardinale M, Schumacher YO, Bahr R.Sports Med. 2025 Oct;55(10):2375-2385. doi: 10.1007/s40279-025-02276-5. Epub 2025 Jul 11.PMID: 40646402 Free PMC article.6Cite 

The Prevalence, Size, and Anatomic Location of Cartilage and Osteochondral Lesions in Athletes With an Acute Ligamentous Ankle Injury.

Baltes TPA, Dalansi F, Al-Naimi MR, Bordalo M, Holtzhausen L, Whiteley R, Cardinale M, D’Hooghe P, Kerkhoffs GMMJ, Tol JL.Am J Sports Med. 2025 Jul;53(9):2173-2180. doi: 10.1177/03635465251344187. Epub 2025 Jun 12.PMID: 40503595 Free PMC article.7Cite 

Muscle regeneration is improved by hot water immersion but unchanged by cold following a simulated musculoskeletal injury in humans.

Dablainville V, Mornas A, Normand-Gravier T, Al-Mulla M, Papakostas E, Olory B, Fermin TM, Zampeli F, Nader N, Alhammoud M, Bayne F, Sanchez AMJ, Cardinale M, Candau R, Bernardi H, Racinais S.J Physiol. 2025 Dec;603(23):7603-7625. doi: 10.1113/JP287777. Epub 2025 May 28.PMID: 40437768 Free PMC article.8Cite 

Differences in Sprinting and Jumping Performance Between Maturity Status Groups in Youth: A Systematic Review and Meta-analysis.

Baker J, Read P, Graham-Smith P, Cardinale M, Jones TW.Sports Med. 2025 Jun;55(6):1405-1427. doi: 10.1007/s40279-025-02198-2. Epub 2025 Mar 25.PMID: 40131714

I also wrote a book chapter for the new FIMS book on the young athlete with colleagues from around the world https://www.researchgate.net/publication/396224540_The_Young_Athlete

I will try to be more active on this blog in the following months, with more topics to discuss and few things to present/share. Keep reading!