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  • Writer's pictureDr. Jen

Cold water therapy aka Cold water immersion

Why did I get in the Maumee River multiple times this winter?

Cold therapy and I have bene embracing it for the last few years- it’s addicting! #getcoldwithdrjen

It started with a polar bear plunge and cold showers. When you are submersed in the cold you are forced to focus on your breath. You forget the to do list or if you forgot to sign a kid’s field trip form, it’s just you, the cold and your breath.

There are different types of cold therapy:

Cold showers are an easy way to start out. They aren’t as cold as cold baths with ice and it’s not uniform, however they can still be very effective.

Ice baths are sitting in a bath with ice in them- the temperature usually ranges from 25 - 60 degrees F.

Cold plunge pools are cold therapy pools that have built in filtration and the water is moving which makes the water feel colder. The temperatures range from 39-50 degrees F.

Cryotherapy is a little different as you are exposed to cold air for 3 minutes but to get the benefits of cold therapy you would need to do this multiple times a week.

What are the benefits? (Why the heck do people do this?)

It can help with many things such as reducing inflammation, improving circulation, improve muscles recovery and performance.

Improved immune response is another benefits which is why I am so confused why doctors always look at me like I am crazy when I tell them what I like do in my spare time.

What about the controversy of the timing of cold water therapy?

Before or after lifting?

Let's break down the science:

While CWT (cold water therapy) or CWI (cold water immersion) is used to help muscle recovery some studies have shown that it can influence the anabolic response post lifting session.

It appears as though CWT after aerobic or sprinting could have an anti-inflammatory and recovery response but not helpful with power. A 2021 paper in Front Sports Act Living concludes "Lastly, a periodized approach to recovery is proposed, where the use of CWI may be incorporated during competition or intensified training, whilst strategically avoiding periods following training focused on improving muscle strength or hypertrophy."

It is suggested that you would want to practice your CWI before a lifting session where you are focusing on muscle hypertrophy.

A 2019 study in the Journal of Applied Physiology stated "This study adds to existing evidence that post-exercise cold water immersion attenuates muscle fiber growth with resistance training, which is potentially mediated by attenuated post-exercise increases in markers of skeletal muscle anabolism coupled with increased catabolism and suggests that blunted muscle fiber growth with cold water immersion does not necessarily translate to impaired strength development." Basically CWI worsens post exercise skeletal muscle growth but does not necessarily impact strength development. Which as a female I kind of like this! Most studies I found on this subject matter where on men (shocking- not!)

Okay, one more study- is that ok? This one is interesting. The Effects of Cold Water Immersion and Active Recovery on Molecular Factors That Regulate Growth and Remodeling of Skeletal Muscle After Resistance Exercise- found in a study completed on 9 men who did leg strengthening exercises, then got a muscle biospy (yikes!) Myostatin mRNA and ubiquitin protein expression did not change with CWI. "The present findings suggest that regular cold water immersion attenuates muscle hypertrophy independently of changes in factors that regulate myogenesis, proteolysis and extracellular matrix remodeling in muscle after exercise."

So where does all of this leave my cold plunging? It depends. For me, a business owner, wife, mother of four who doesn't have a nanny or days off I will do what fits best into my schedule! I will try to cold plunge before a strength work out but it won't be a game changer. I think if my job was to be a body builder or compete in shows where hypertrophy is important, I would not cold plunge or use CWI after a strength work out. I am excited to see what other studies come out in the next few years as CWI get more and more popular!

What about you? Have you tried CWI? If so, will this change when you plunge?

In health,

Dr. Jen


Earp JE, Hatfield DL, Sherman A, Lee EC, Kraemer WJ. Cold-water immersion blunts and delays increases in circulating testosterone and cytokines post-resistance exercise. Eur J Appl Physiol. 2019 Aug;119(8):1901-1907. doi: 10.1007/s00421-019-04178-7. Epub 2019 Jun 20. PMID: 31222379.

White GE, Rhind SG, Wells GD. The effect of various cold-water immersion protocols on exercise-induced inflammatory response and functional recovery from high-intensity sprint exercise. Eur J Appl Physiol. 2014 Nov;114(11):2353-67. doi: 10.1007/s00421-014-2954-2. Epub 2014 Jul 30. PMID: 25074283.

Ihsan M, Abbiss CR, Allan R. Adaptations to Post-exercise Cold Water Immersion: Friend, Foe, or Futile? Front Sports Act Living. 2021 Jul 16;3:714148. doi: 10.3389/fspor.2021.714148. PMID: 34337408; PMCID: PMC8322530.

Fyfe JJ, Broatch JR, Trewin AJ, Hanson ED, Argus CK, Garnham AP, Halson SL, Polman RC, Bishop DJ, Petersen AC. Cold water immersion attenuates anabolic signaling and skeletal muscle fiber hypertrophy, but not strength gain, following whole-body resistance training. J Appl Physiol (1985). 2019 Nov 1;127(5):1403-1418. doi: 10.1152/japplphysiol.00127.2019. Epub 2019 Sep 12. PMID: 31513450.

Peake JM, Markworth JF, Cumming KT, Aas SN, Roberts LA, Raastad T, Cameron-Smith D, Figueiredo VC. The Effects of Cold Water Immersion and Active Recovery on Molecular Factors That Regulate Growth and Remodeling of Skeletal Muscle After Resistance Exercise. Front Physiol. 2020 Jun 30;11:737. doi: 10.3389/fphys.2020.00737. PMID: 32695024; PMCID: PMC7339943.

Petersen AC, Fyfe JJ. Post-exercise Cold Water Immersion Effects on Physiological Adaptations to Resistance Training and the Underlying Mechanisms in Skeletal Muscle: A Narrative Review. Front Sports Act Living. 2021 Apr 8;3:660291. doi: 10.3389/fspor.2021.660291. PMID: 33898988; PMCID: PMC8060572.

PMID: 26735552

PMID: 24799686

PMID: 31222379

1 Comment

Jul 13, 2023

Yes! I have started CWI and do it about an hour after I workout. So I should do it prior??

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