Ice Bath Therapy
Can cryotherapy really relieve pain and heal muscles faster?
Long distance running can really stress your muscles. Like any intense exercise, it causes micro-trauma or tiny tears in the muscle fibers. Those tears can take 2 or 3 days before they mend. The longer you have to wait for your body to heal, the longer it is before you can get another workout in. That's why athletes are always looking for ways to speed up the recovery process.
Quicker recovery + more workouts = more muscles faster.
One of the tricks long distance runners use for quicker recovery is an ice bath. It was believed you could speed healing by dropping your legs into freezing cold water.
Ice baths (or cryotherapy as it's technically called) were believed to help in three ways. The ice was thought to reduce inflammation, swelling and tissue breakdown. The theory was that as the blood vessels constricted from the cold, they would push waste products like lactic acid out. When you get out and start warming your legs up again, the body rushes warm blood back into the affected areas, which then were supposed to heal faster. REMEMBER: That was the theory. The reality is, it didn't work.
UPDATE: Ice therapy may not be as effective as once believed. Click here to learn more about P.R.I.C.E. after an injury.
UPDATE: Researchers find Ice therapy doesn't work.
In a study published in the February 1, 2017 issue of the Journal of Physiology, researchers “...compared the effects of cold water immersion versus active recovery on inflammatory cells, pro-inflammatory cytokines, neurotrophins and heat shock proteins (HSPs) in skeletal muscle after intense resistance exercise.” (They tested the differences between using active recovery and cold water therapy.)
After muscle biopsies were analyzed, they found that “...cold water immersion is no more effective than active recovery for reducing inflammation or cellular stress in muscle after a bout of resistance exercise.” In other words, there's no benefit from submerging parts of your body in cold or ice water over simple active recovery. Ditch the ice bath.
Here's how ice baths were supposed to be taken.
- You started by filling a tub with cool water until it would reach just slightly below your waist.
- Then you put on a sweatshirt or warm jacket, hat and neoprene booties. Only your legs were to be chilled, so you wanted to keep the rest of your body warm.
- Many people liked to have some music playing or a good book to take their minds off the cold.
- Once you're ready, you would climb into the tub and pour 1 or 2 bags of ice in the water with you. It got cold quick!
The water temperature range people wanted was between 50 and 59 degrees Fahrenheit (5 and 10 degrees Celsius). If it was much hotter than 60 degrees Fahrenheit, it wasn't thought it could reduce the muscle inflammation. You wouldn't want to sit in a tub of solid ice either. That would be too cold and very uncomfortable.
The exact length of time you were supposed to chill was never established. Runners websites and magazines usually said 15-20 minutes, but in tests, the subjects only stayed for 5-15 minutes. Since no time limit has been shown to have beneficial effects, the time doesn't matter.
Taking an ice bath was believed to give the most benefit when it was done as soon as the event is over. That was a problem if you're in a race or far away from your home when you finish. What many people did was look for a cold body of water, a river or lake at the end of the race and they used that in place of an ice bath. Of course, that won't work very well in the warm waters of my home Key West, but in northern states, it was a reasonable alternative.
Ice therapy also doesn't help Delayed Onset Muscle Soreness (DOMS). DOMS results from the way your muscles repair themselves. Your body rushes immune cells in to repair torn muscle tissue. Those immune cells make pain receptors in your body more sensitive and mediate the inflammatory response. In two separate studies, an ice bath did nothing to lessen the pain. In fact, in an experiment reported in the 2007 British Journal of Sports Medicine, pain levels were higher for subjects who went through cryotherapy than for those who didn't.
If you're a runner, skip the ice bath therapy. Don't waste your time on something that has been clinically shown to have no real benefit over the much simpler active recovery.
Reference Links:
Ice-water immersion and delayed-onset muscle soreness: a randomised controlled trial
Kylie Louise Sellwood, Peter Brukner, David Williams, Alastair Nicol, Rana Hinman
British Journal of Sports Medicine, Published Online First 29 January 2007
Click Here for the Study: https://bjsm.bmj.com/content/41/6/392
The effects of cold water immersion and active recovery on inflammation and cell stress responses in human skeletal muscle after resistance exercise
Jonathan M. Peake, Llion A. Roberts, Vandre C. Figueiredo, Ingrid Egner, Simone Krog, Sigve N. Aas, Katsuhiko Suzuki, James F. Markworth, Jeff S. Coombes, David Cameron-Smith, Truls Raastad
The Journal of Physiology, Published 04 October 2016
Click Here for the Study: https://doi.org/10.1113/JP272881
Throwing cold water on muscle growth: A systematic review with meta-analysis of the effects of postexercise cold water immersion on resistance training-induced hypertrophy
Alec Piñero, Ryan Burke, Francesca Augustin, Adam E. Mohan, Kareen DeJesus, Max Sapuppo, Max Weisenthal, Max Coleman, Patroklos Androulakis-Korakakis, Jozo Grgic, Paul A. Swinton, Brad J. Schoenfeld
European Journal of Sport Science, Published 05 February 2024 https://doi.org/10.1002/ejsc.12074
Click Here for the Study: https://onlinelibrary.wiley.com/doi/10.1002/ejsc.12074
UPDATE: 8/23/2025 - New Research on Muscle Building
While our conclusion about ice baths and recovery remains accurate, important new research has emerged about their effects on muscle growth. A 2024 meta-analysis published in the European Journal of Sport Science found that ice baths taken immediately after resistance training can reduce muscle growth by 40-60 percent compared to training without ice baths.
The study analyzed eight research trials and found that cold water immersion interferes with the body's natural muscle-building processes, including muscle protein synthesis and satellite cell activity. This means that while ice baths don't help with recovery (as we've known since 2018), they may actually hinder progress for people trying to build muscle and strength.
The bottom line for runners remains the same: skip the ice bath for recovery. But now we know there's an additional reason to avoid them if you're doing any strength training to support your running performance.
Click Here for the Full Article: Ice Baths May Be Killing Your Muscle Gains
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5/24/2009
Updated 4/19/2014
Updated 7/20/2018
Updated 8/23/2025
