Leeder, J., van Someren, K., Gisane, C., Gregson, W., & Howatsons, G. (2011). The effect of cold water immersion on recovery from exercise-induced fatigue: A meta-analysis. Medicine and Science in Sports and Exercise, 43(5). Supplement abstract 3036.

"When an exercise stress incorporates a novel eccentric component or the exercise is of considerable intensity or duration, athletes will likely experience myriad signs and symptoms of fatigue and cellular disturbance, termed exercise-induced fatigue. Cold-water immersion is a commonly used modality to enhance recovery from exercise-induced fatigue in athletic populations; however its efficacy is equivocal."

A meta-analysis of the current literature evaluated the efficacy of cold-water immersion in promoting recovery from exercise-induced fatigue. Exercise-induced fatigue was classified as either metabolic or mechanical in nature. Outcome variables of dynamic muscle function, isometric muscle function, delayed-onset muscle soreness (DOMS), and creatine kinase at 24, 48, 72, and 96 hours post-exercise were assessed. A systematic literature search was performed to identify relevant randomized control trials. Standardized mean differences and 95% confidence intervals were calculated for all outcome variables across all time points and a meta-analysis was conducted using a random-effects model.

Fourteen studies meeting the inclusion criteria were used for the meta-analysis. Cold-water immersion was effective in reducing DOMS at 48 and 96 hours following exercise-induced fatigue. Cold-water immersion had no effect on recovery of isometric muscle function or creatine kinase at any time. Following metabolic exercise-induced fatigue only, cold-water immersion improved recovery of dynamic muscle function at 24 and 48 hours and DOMS at 24 hours.

Implication. Cold-water immersion is effective in reducing DOMS following all modes of exercise-induced fatigue. Muscle function shows greater recovery following metabolic, but not mechanical exercise fatigue. Despite mechanical and metabolic exercise stresses both causing exercise-induced fatigue, cold-water immersion appears to be of greatest benefit following metabolic exercise types.

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