Cold Water Immersion in Athletic Recovery: A Narrative Review of Current Evidence
DOI:
https://doi.org/10.12775/QS.2026.65.74207Keywords
cold water immersion, post-exercise recovery, delayed onset muscle soreness, exercise-induced muscle damage, athletic performanceAbstract
Background. Cold water immersion (CWI) is widely used to enhance post-exercise recovery, although its mechanisms, effectiveness, and effects on long-term training adaptations remain debated.
Aim. To critically review current evidence on the physiological mechanisms, recovery effects, and practical applications of CWI in sport.
Material and methods. A narrative review of original studies, systematic reviews, and meta-analyses indexed in PubMed was conducted.
Results. Current evidence shows that CWI consistently reduces delayed onset muscle soreness and improves perceived recovery. However, its effects on muscle strength, biomarkers of muscle damage and inflammation, and overall performance remain inconsistent. The effectiveness of CWI depends on exercise type, immersion protocol, and recovery goals. Repeated use after resistance exercise may reduce myofibrillar protein synthesis and potentially attenuate training adaptations.
Conclusions. CWI is effective for short-term recovery, particularly when rapid return to performance is required. Routine use after resistance training should be applied cautiously, and further research should establish standardized protocols and clarify long-term effects.
References
1. Piercy KL, Troiano RP, Ballard RM, Carlson SA, Fulton JE, Galuska DA, George SM, Olson RD. The Physical Activity Guidelines for Americans. JAMA. 2018 Nov 20;320(19):2020-2028. https://doi.org/10.1001/jama.2018.14854.
2. Joanisse S, Nederveen JP, Snijders T, McKay BR, Parise G. Skeletal Muscle Regeneration, Repair and Remodelling in Aging: The Importance of Muscle Stem Cells and Vascularization. Gerontology. 2017;63(1):91-100. https://doi.org/10.1159/000450922.
3. Özdemir K, Demir Y. Biochemical markers of muscle damage and recovery: Insights from exercise physiology and molecular biology. Tissue Cell. 2026 Aug;101:103406. https://doi.org/10.1016/j.tice.2026.103406.
4. Kilic-Erkek O, Caner V, Abban-Mete G, Baris IC, Bor-Kucukatay M. Determination of the pathways of potential muscle damage and regeneration in response to acute and long-term swimming exercise in mice. Life Sci. 2021 May 1;272:119265. https://doi.org/10.1016/j.lfs.2021.119265.
5. Stefano Ciciliot and Stefano Schiaffino. Corrigendum: Regeneration of Mammalian Skeltal Muscle: Basic Mechanisms and Clinical Implications. Curr Pharm Des. 2015;21(31):4657. doi: 10.2174/138161282131151013181841. Erratum for: Curr Pharm Des. 2010;16(8):906-14. doi: 10.2174/138161210790883453.
6. Bleakley C, McDonough S, Gardner E, Baxter GD, Hopkins JT, Davison GW. Cold-water immersion (cryotherapy) for preventing and treating muscle soreness after exercise. Cochrane Database Syst Rev. 2012 Feb 15;2012(2):CD008262. https://doi.org/10.1002/14651858.CD008262.pub2.
7. Versey NG, Halson SL, Dawson BT. Water immersion recovery for athletes: effect on exercise performance and practical recommendations. Sports Med. 2013 Nov;43(11):1101-30. https://doi.org/10.1007/s40279-013-0063-8.
8. Fuchs CJ, Kouw IWK, Churchward-Venne TA, Smeets JSJ, Senden JM, Lichtenbelt WDVM, Verdijk LB, van Loon LJC. Postexercise cooling impairs muscle protein synthesis rates in recreational athletes. J Physiol. 2020 Feb;598(4):755-772. https://doi.org/10.1113/JP278996.
9. Freitag L, Clijsen R, Deflorin C, Taube W, Taeymans J, Hohenauer E. Intramuscular Temperature Changes in the Quadriceps Femoris Muscle After Post-Exercise Cold-Water Immersion (10°C for 10 min): A Systematic Review With Meta-Analysis. Front Sports Act Living. 2021 May 6;3:660092. https://doi.org/10.3389/fspor.2021.660092.
10. Srámek P, Simecková M, Janský L, Savlíková J, Vybíral S. Human physiological responses to immersion into water of different temperatures. Eur J Appl Physiol. 2000 Mar;81(5):436-42. https://doi.org/10.1007/s004210050065.
11. Hohenauer E, Douzi W, Burtscher J. Potential health benefits of cold-water immersion: the central role of PGC-1α. J Physiol. 2025 Oct 29. https://doi.org/10.1113/JP289536.
12. Moore E, Fuller JT, Buckley JD, Saunders S, Halson SL, Broatch JR, Bellenger CR. Impact of Cold-Water Immersion Compared with Passive Recovery Following a Single Bout of Strenuous Exercise on Athletic Performance in Physically Active Participants: A Systematic Review with Meta-analysis and Meta-regression. Sports Med. 2022 Jul;52(7):1667-1688. https://doi.org/10.1007/s40279-022-01644-9.
13. Wang Y, Li S, Zhang Y, Chen Y, Yan F, Han L, Ma Y. Heat and cold therapy reduce pain in patients with delayed onset muscle soreness: A systematic review and meta-analysis of 32 randomized controlled trials. Phys Ther Sport. 2021 Mar;48:177-187. https://doi.org/10.1016/j.ptsp.2021.01.004 .
14. Machado AF, Ferreira PH, Micheletti JK, de Almeida AC, Lemes ÍR, Vanderlei FM, Netto Junior J, Pastre CM. Can Water Temperature and Immersion Time Influence the Effect of Cold Water Immersion on Muscle Soreness? A Systematic Review and Meta-Analysis. Sports Med. 2016 Apr;46(4):503-14. https://doi.org/10.1007/s40279-015-0431-7.
15. Benoît S, Nicolas B, Grégoire MP, François B, Abdellah H, Hicham M, Saïd A, Guillaume C. Hot But Not Cold Water Immersion Mitigates the Decline in Rate of Force Development Following Exercise-Induced Muscle Damage. Med Sci Sports Exerc. 2024 Dec 1;56(12):2362-2371. French, English. https://doi.org/10.1249/MSS.0000000000003513.
16. Leeder J, Gissane C, van Someren K, Gregson W, Howatson G. Cold water immersion and recovery from strenuous exercise: a meta-analysis. Br J Sports Med. 2012 Mar;46(4):233-40. https://doi.org/10.1136/bjsports-2011-090061.
17. Yeung SS, Ting KH, Hon M, Fung NY, Choi MM, Cheng JC, Yeung EW. Effects of Cold Water Immersion on Muscle Oxygenation During Repeated Bouts of Fatiguing Exercise: A Randomized Controlled Study. Medicine (Baltimore). 2016 Jan;95(1):e2455. https://doi.org/10.1097/MD.0000000000002455.
18. Xiao F, Kabachkova AV, Jiao L, Zhao H, Kapilevich LV. Effects of cold water immersion after exercise on fatigue recovery and exercise performance--meta analysis. Front Physiol. 2023 Jan 20;14:1006512. https://doi.org/10.3389/fphys.2023.1006512.
19. Eimonte M, Eimantas N, Daniuseviciute L, Paulauskas H, Vitkauskiene A, Dauksaite G, Brazaitis M. Recovering body temperature from acute cold stress is associated with delayed proinflammatory cytokine production in vivo. Cytokine. 2021 Jul;143:155510. https://doi.org/10.1016/j.cyto.2021.155510.
20. Peake JM, Roberts LA, Figueiredo VC, Egner I, Krog S, Aas SN, Suzuki K, Markworth JF, Coombes JS, Cameron-Smith D, Raastad T. The effects of cold water immersion and active recovery on inflammation and cell stress responses in human skeletal muscle after resistance exercise. J Physiol. 2017 Feb 1;595(3):695-711. https://doi.org/10.1113/JP272881.
21. Wang H, Wang L, Pan Y. Impact of different doses of cold water immersion (duration and temperature variations) on recovery from acute exercise-induced muscle damage: a network meta-analysis. Front Physiol. 2025 Feb 26;16:1525726. https://doi.org/10.3389/fphys.2025.1525726.
22. Broatch JR, Petersen A, Bishop DJ. Postexercise cold water immersion benefits are not greater than the placebo effect. Med Sci Sports Exerc. 2014 Nov;46(11):2139-47. https://doi.org/10.1249/MSS.0000000000000348.
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