Cold Water Immersion After Training: Regeneration vs Adaptation — A Systematic Review

Abstract

Background

Cold water immersion (CWI) is widely used to aid post-exercise recovery in athletes. It can reduce soreness and accelerate readiness, but routine use may blunt hypertrophic adaptations after resistance training. The effects on acute recovery, neuromuscular function and long-term adaptations remain debated.

Aim

This study reviews physiological and functional outcomes of post-exercise CWI, focusing on recovery and adaptation across training modalities.

Materials and methods

A systematic search in PubMed and Google Scholar identified studies on post-exercise CWI in healthy participants (2008–2023). Included studies were mechanistic, acute, longitudinal interventions and meta-analyses. Outcomes assessed were soreness, perceived recovery, neuromuscular performance, anabolic signaling and long-term adaptations in resistance and endurance training. Data extracted included participants, exercise type, CWI protocol (temperature, duration, site, timing), comparators and outcomes. Findings emphasized randomized trials and meta-analyses.

Results

Meta-analyses show that CWI reduces delayed-onset muscle soreness (DOMS) at 24–96 h and improves perceived recovery. Markers of muscle damage or inflammation are inconsistent. CWI aids short-term performance, especially with limited recovery or heat stress. In hypertrophy-focused resistance training, regular use may reduce muscle growth and type II fiber adaptations. In endurance training, effects are largely neutral. Responses vary according to sex, training status and context; protocol differences and expectancy effects add variability.

Conclusions

CWI should be used strategically: most useful for rapid recovery (e.g., tournaments, multiple sessions, heat stress), but avoided after hypertrophy-focused resistance training. In endurance phases, CWI is adaptation-neutral and may support day-to-day recovery.