Effects of Cold Water Immersion and Heat Exposure on Post-Exercise Recovery and Training Adaptations: A Narrative Review
DOI:
https://doi.org/10.12775/QS.2026.67.74326Keywords
cold water immersion, hot water immersion, heat exposure, sauna, exercise recovery, exercise adaptations, sports performanceAbstract
Background: Cold water immersion (CWI) and heat exposure, including hot water immersion (HWI) and sauna bathing, are commonly used to enhance post-exercise recovery. Although both interventions are widely applied in sport, they elicit distinct physiological responses and may differently influence recovery and training adaptations.
Aim: This narrative review aimed to summarize current evidence on the effects of CWI and heat exposure on post-exercise recovery and training adaptations, focusing on physiological mechanisms and practical applications.
Materials and methods: A narrative review was conducted using publications retrieved from PubMed, Scopus, Web of Science, and Google Scholar. Original studies, randomized controlled trials, systematic reviews, and meta-analyses investigating CWI, HWI, and sauna bathing were included. Priority was given to studies published between 2023 and 2025, with earlier landmark studies providing physiological context.
Results: Current evidence indicates that CWI effectively reduces delayed-onset muscle soreness and perceived fatigue, supporting short-term recovery. However, regular post-exercise use after resistance training may attenuate hypertrophic adaptations by suppressing anabolic signaling. In contrast, HWI and sauna bathing promote thermoregulatory adaptations, increase plasma volume, and improve heat tolerance, although evidence for post-exercise recovery remains limited. Their effectiveness depends on training goals, exercise modality, timing, and treatment protocol.
Conclusions: Cold and heat exposure should be regarded as complementary rather than competing recovery strategies. CWI is primarily supported for short-term recovery, whereas HWI appears most beneficial for enhancing thermoregulatory adaptations and preparation for exercise in hot environments. Thermal therapies should be individualized according to the athlete's training goals and training phase.
References
Ahokas EK, Hennessy RS, Hanstock HG, Kyröläinen H, Ihalainen JK. Effects of post-exercise heat exposure on acute recovery and training-induced performance adaptations: A systematic review. Sports Medicine – Open. 2025;11:106. https://doi.org/10.1186/s40798-025-00910-0.
Ahokas EK, Hanstock HG, Kyröläinen H, Ihalainen JK. Effects of repeated use of post-exercise infrared sauna on neuromuscular performance and muscle hypertrophy. Frontiers in Sports and Active Living. 2025;7:1462901. https://doi.org/10.3389/fspor.2025.1462901.
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. Muscle regeneration is improved by hot water immersion but unchanged by cold following a simulated musculoskeletal injury in humans. The Journal of Physiology. 2025; 603(23):7603–7625. https://doi.org/10.1113/JP287777.
Fyfe JJ, Broatch JR, Trewin AJ, Hanson ED, Argus CK, Garnham AP, Halson SL, Petersen AC, Bishop DJ. Cold water immersion attenuates anabolic signaling and skeletal muscle fiber hypertrophy, but not strength gain, following whole-body resistance training. Journal of Applied Physiology. 2019; 127(5):1403–1418. https://doi.org/10.1152/japplphysiol.00127.2019.
Grgic J. Effects of post-exercise cold-water immersion on resistance training-induced gains in muscular strength: A meta-analysis. European Journal of Sport Science. 2023; 23(3):372–380. https://doi.org/10.1080/17461391.2022.2033851.
Gustafsson J, Montiel-Rojas D, Romare MGA, Johansson E, Folkesson M, Pernigoni M, Frolova A, Brazaitis M, Venckunas T, Ponsot E, Chaillou T, Edholm P. Cold- and hot-water immersion are not more effective than placebo for the recovery of physical performance and training adaptations in national level soccer players. European Journal of Applied Physiology. 2025; 125:3179–3194. https://doi.org/10.1007/s00421-025-05835-w.
Horgan BG, West NP, Tee N, Halson SL, Drinkwater EJ, Chapman DW, Haff GG. Effect of repeated post-resistance exercise cold or hot water immersion on in-season inflammatory responses in academy rugby players: A randomised controlled cross-over design. European Journal of Applied Physiology. 2024; 124:2615–2628. https://doi.org/10.1007/s00421-024-05424-3.
Hussain J, Cohen M. Clinical effects of regular dry sauna bathing: A systematic review. Evidence-Based Complementary and Alternative Medicine. 2018;2018:1857413. https://doi.org/10.1155/2018/1857413.
Ihsan M, Abbiss CR, Allan R, Watson G. Adaptations to post-exercise cold water immersion: Friend, foe, or futile? Frontiers in Sports and Active Living. 2021;3:714148. https://doi.org/10.3389/fspor.2021.714148
Ihsan M, Watson G, Choo HC, Lewandowski P, Papazzo A, Cameron-Smith D, Abbiss CR. Postexercise muscle cooling enhances gene expression of PGC-1α. Medicine & Science in Sports & Exercise. 2014; 46(10):1900–1907. DOI: 10.1249/MSS.0000000000000308
Jackman JS, Bell PG, van Someren K, Gondek MB, Hills FA, Wilson LJ, Cockburn E. Effect of hot water immersion on acute physiological responses following resistance exercise. Frontiers and Physiology. 2023;14:1213733. https://doi.org/10.3389/fphys.2023.1213733.
Kirby NV, Lucas SJE, Cable TG, Armstrong OJ, Weaver SR, Lucas RAI. Sex differences in adaptation to intermittent post-exercise sauna bathing in trained middle-distance runners. Sports Medicine – Open. 2021;7:51. https://doi.org/10.1186/s40798-021-00342-6.
Moore E, Fuller JT, Bellenger CR, Saunders S, Halson SL, Broatch JR, Buckley JD. Effects of cold-water immersion compared with other recovery modalities on athletic performance following acute strenuous exercise in physically active participants: A systematic review, meta-analysis, and meta-regression. Sports Medicine. 2023; 53(3):687–705. https://doi.org/10.1007/s40279-022-01800-1.
Normand-Gravier T, Solsona R, Dablainville V, Racinais S, Borrani F, Bernardi H, Sanchez AMJ. Effects of thermal interventions on skeletal muscle adaptations and regeneration: Perspectives on epigenetics. European Journal of Applied Physiology. 2025; 125:277–301. https://doi.org/10.1007/s00421-024-05642-9.
Piñero A, Burke R, Augustin F, Mohan AE, DeJesus K, Sapuppo M, Weisenthal M, Androulakis-Korakakis P, Grgic J, Swinton PA, Schoenfeld BJ. Throwing cold water on muscle growth: A systematic review with meta-analysis of the effects of post-exercise cold-water immersion on resistance training-induced hypertrophy. European Journal of Sport Science. 2024; 24(7):1004–1018. https://doi.org/10.1002/ejsc.12074.
Poręba K, Poręba M, Lewandowska-Mackiewicz A, Wasilczuk A, Peszt MJ, Szaryński M, Prokopczyk K, Rusiłowicz R, Jakubowska P, Matuszewska J. Cold Water Immersion After Training: Regeneration vs Adaptation - A Systematic Review. Quality in Sport. 2025;47:66734. https://doi.org/10.12775/QS.2025.47.66734.
Roberts LA, Raastad T, Markworth JF, Figueiredo VC, Egner IM, Shield A, Cameron-Smith D, Coombes JS, Peake JM. Post-exercise cold water immersion attenuates acute anabolic signalling and long-term adaptations in muscle to strength training. The Journal of Physiology. 2015; 593(18):4285–4301. https://doi.org/10.1113/JP270570.
Sautillet B, Bourdillon N, Millet GP, Billaut F, Hassar A, Moufti H, Ahmaïdi S, Costalat G. Hot but not cold water immersion mitigates the decline in rate of force development following exercise-induced muscle damage. Medicine & Science in Sports & Exercise. 2024; 56(12):2362–2371. https://doi.org/10.1249/MSS.0000000000003513.
Scoon GSM, Hopkins WG, Mayhew S, Cotter JD. Effect of post-exercise sauna bathing on the endurance performance of competitive male runners. Journal of Science and Medicine in Sport. 2007; 10(4):259–262. https://doi.org/10.1016/j.jsams.2006.06.009.
Solomon TPJ, Laye MJ. The effect of post-exercise heat exposure (passive heat acclimation) on endurance exercise performance: A systematic review and meta-analysis. BMC Sports Science, Medicine and Rehabilitation. 2025;17:4. https://doi.org/10.1186/s13102-024-01038-6.
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. Frontiers and Physiology. 2025;16:1525726. DOI: 10.3389/fphys.2025.1525726
Wellauer V, Clijsen R, Bianchi G, Riggi E, Hohenauer E. No acceleration of recovery from exercise-induced muscle damage after cold or hot water immersion in women: A randomised controlled trial. PLoS ONE. 2025; 20(5):E0322416. https://doi.org/10.1371/journal.pone.0322416.
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. Frontiers and Physiology. 2023;14:1006512. https://doi.org/10.3389/fphys.2023.1006512.
Zurawlew MJ, Walsh NP, Fortes MB, Potter C. Post-exercise hot water immersion induces heat acclimation and improves endurance exercise performance in the heat. Scandinavian Journal of Medicine & Science in Sports. 2015; 26(7):745-754. https://doi.org/10.1111/sms.12638.
Zurawlew MJ, Mee JA, Walsh NP. Post-exercise Hot Water Immersion Elicits Heat Acclimation Adaptations in Endurance Trained and Recreationally Active Individuals. Frontiers and Physiology. 2018;9:1824. https://doi.org/10.3389/fphys.2018.01824.
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