As I mentioned in a previous post on this blog I am developing an interest in recovery strategies. I am amazed of how many tools/devices/procedures/methods are nowadays used to provide a "recovery" solution to athletes.
What I am most amazed of is the total lack of rationale behind many recovery strategies, not to mention the lack of scientific evidence for their effectiveness.
It seems to me that many strength and conditioning coaches, physiotherapists, sports scientists sometimes accept some practices without really questioning why they should be using them. Unfortunately most of the times a particular recovery strategy is used just because a winning team or athlete made extensive and public use of it.
Let’s talk about Ice Baths and cold water immersion. The following picture shows what happens typically after some heavy training session these days:
The reasons why athletes have to be exposed to this "torture" are the following as advocated by many S&C coaches and Physios:
- Helps in reducing DOMS and inflammation
- Helps in reducing swelling
- Helps in improving blood flow
- Helps in favouring recovery
In this article I will focus on the first point. There seems to be nowadays the need to make sure that Athletes have no DOMS (delayed onset of muscle soreness) after a training session and most of all there is a need to avoid inflammation.
With this approach, it seems that the focus of attention is now shifting away from what athletes normally do to improve performance: training!
What is training all about?
Athletes undergo gruelling training sessions to improve performance. They lift weights to get stronger, run/cycle/row to improve their endurance or speed. Simple!
The reason why they do it is to create an overload on their biological system to produce an adaptive response leading to a stronger muscle, a better cardio-respiratory system, stronger bones. They also do it to improve muscle biochemistry which then leads to better muscle function (i.e. buffering systems, metabolic enzymes).
In particular, when athletes lift heavy weights, they do it to determine muscle hypertrophy and to get stronger. The typical consequence of a weight lifting session is muscle damage then followed by an inflammatory phase and a regeneration phase able to determine a stronger muscle (for some interesting reading download this PDF of a review written by Prof. Priscilla Clarkson http://www.nmdinfo.net/Publications/Consensus%20Conf%202002%20Papers/Clarkson.pdf)
So, in simple terms, we want muscle damage, inflammation and swelling as their are the main signaling mechanisms triggering muscle remodelling (http://www.ncbi.nlm.nih.gov/pubmed/17887809?ordinalpos=7&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum).
Training-induced molecular and humoral adjustments, including muscle hyperthermia, are physiological, transient and essential for training effects (myofiber regeneration, muscle hypertrophy and improved blood supply). Stopping them may be not a good idea.
So, by reducing DOMS, swelling and inflammation are we stopping adaptations?
Maybe that’s the case. Recent studies have shown that applying cryotherapy to muscles after training reduces the training gains. Yamane et al. (2006) exposed two groups of volunteers to the same training programme and a different recovery strategy. One group was in fact asked to rest at room temperature, the other were asked to immerse the trained limbs in cold-water post training. The results showed that the group with a normal recovery improved more and the authors concluded that cooling generally attenuates the temperature-dependent processes generated by training, in particular, hyperthermia-induced HSP formation"
Is cryotherapy actually effective in reducing DOMS?
Science says that:Cryotherapy does not reduce DOMS symptoms (Cheung et al., Sports Med, 2003)
Cold water immersion had NO effect on perception of tenderness and strength loss (Eston & Peters, JSS, 1999)
The use of cryotherapy immediately following damaging eccentric exercise may not provide the same therapeutic benefits commonly attributed to cryotherapy following traumatic muscle injury (Paddon-Jones & Quigley ,1997 IJSM)
Recovery of muscle soreness, flexibility and power at 48 hr post-game was not significantly enhanced by performing an immediate post-game recovery beyond that achieved by performing only next day recovery training (Dawson et al., J Sci Med Sport, 2005)
Sellwood et al (2007) recently concluded that "The protocol of ice-water immersion used in their study was ineffectual in minimising markers of DOMS in untrained individuals (3 x 1min immersion in ice water). This study challenges the wide use of this intervention as a recovery strategy by athletes".
There are of course many others out there…
What can we conclude?
Using cryotherapy and cold water immersion with athletes is a very bad idea if you are training them to get stronger!
If you want to reduce pain and swelling and help with recovery in athletes performing at tournaments then you are better off with other strategies. But this is something to talk about in the next article!