Cryotherapy is commonly utilized by physically active individuals through cold-water immersion (CWI) and ice packs to decrease muscle soreness and improve functional performance outcomes. 1 Exercise can induce microscopic tears in a muscle, leading to delayed-onset muscle soreness (DOMS). Characterized by inflammation, muscle soreness, decreased strength, and decreased power seen 24-72 hours following exercise, DOMS impairs performance, so it is imperative to address its symptoms. 2 Cryotherapy has been shown to induce local vasoconstriction, which reduces the overall metabolic demand for oxygen in damaged tissue leading to an overall reduction in hypoxic secondary injury. Cryotherapy may also decrease nerve conduction velocity and increase pain receptor threshold, decreasing exercise-associated pain. 3 Cryotherapy is also commonly used before athletic events to improve specific physical performance outcomes such as endurance and prevention of DOMS, as well as after events to decrease inflammation and soreness. 4 Many studies have evaluated the effect of post-exercise CWI on pain/fatigue associated with DOMS. [2][3][4][5][6][7][8][9][10][11] Generally, improvements in pain/fatigue have been noted in subjects 24, 48, 72, and even up to 96 hours following CWI, which includes the timeframe in which DOMS occurs. 2,4 Numerous studies have evaluated the psychological and physiological effects of CWI on exercise performance, but there has not been a comprehensive approach to address multiple factors that impact physical performance such as flexibility, strength, speed, agility, power, and pain. 5,7,[9][10][11][12][13][14][15][16][17][18][19] In recent years, several studies 17,19 have found CWI
AbstractAthletes in recent years are to prophylactically use cold-water immersion (CWI) 24 hours before a game, in hopes of improving performance and reduction of soreness. To assess the effects of pre-and post-exercise CWI on muscle performance or pain perception. Twenty subjects enrolled in the study. Muscle performance measures included flexibility, strength, power, agility, and speed for the lower extremity. The subjects were pseudo-randomly assigned to a CWI or control group. The independent variables were group (ice immersion vs control) and time (Baseline, 24 hours, and 48 hours). The dependent variables were muscle performance measurements and pain/soreness visual analog scale (VAS). A 2 × 3 mixed design ANOVA with repeated factors revealed a significant interaction for group × time for strength (P = .024), agility (P = .04), and VAS (P = .019). A post-hoc independent sample t test revealed significant differences at 24 hours for strength (P = .001), 48 hours for agility (P = .03), and 48 hours for VAS (P = .001). There were no significant differences in flexibility, power, and speed between the CWI and control groups. The use of CWI 24 hours pre-exercise improved strength, but improved agility 24 hours post-exercise, and less muscle soreness when compared to the control group.
K E Y W O R D SCWI, pain perception, post-wo...