The Case For and Against Cold Therapy by Team RunRun Coach Scott Fauble
Everyone who is training seriously, or even not so seriously, seems to be obsessed with recovery. Every time I open my phone, I’m bombarded with TikToks, Instagram reels and targeted ads featuring people touting all sorts of hacks or tools to help you recover faster and live longer. One of the most popular ones is cold therapy. From cold plunges and cryotherapy, to something called a RecoveryTherm Cube, there is no shortage of options to freeze fatigue away, hoping to get you ready for your next workout faster. Here’s the thing though, none of it really works, certainly not to the extent all these influencers advertising the latest ice pack or vibrating gizmo want you to believe. In fact, there is basically no situation where an amateur runner should be freezing themselves!
This piece is going to focus on ice baths which at best do nothing, and at worst may inhibit adaptations. But before attempting to debunk the “magic” of ice baths, know that I am not a doctor. And, if a doctor does prescribe ice therapy for an acute injury, their 8+ years of schooling should supersede anything that I, or anyone for that matter, write in a blog on the old interwebs.
Ok, onto the part you all came to read.
Icing and ice baths came into vogue as a recovery technique decades ago. Seemingly harmless, they’re touted as benign ways to reduce soreness and pain, especially after high intensity exercise. When you expose your body to cold, the blood vessels narrow and blood supply decreases. The result of this is less inflammation, which provides relief.
We all know inflammation is bad… right?
Recently, particularly in the health and wellness arenas, inflammation has become the bogey man and cause of all ills. Hence the rise in popularity of ways to reduce inflammation, a la cold therapy. Ironically, this is the exact opposite thing that we want if we are trying to get fitter. Inflammation is your body’s natural response to exercise, and only with inflammation do we get adaptation. Exercise damages your muscles and your body uses this as information to adapt to the workout that caused it. This inflammation-adaptation cycle runs true whether you have sore quads after a long run with a lot of downhill, calves that feel like they’re being gripped by boa constrictors following being spiked up for a speed workout, or even the day after you try to do push-ups for the first time in 6 months and it feels like your pecs just went through a cheese grater. Your body responds to the stimulus you provide it, better preparing you for the next time you do that activity. Put simply, you improve and adapt from the exercise-induced inflammation.
Breaking down the science (briefly!)
I’ll save you from all the super science-y details because I too glazed over in organic chemistry class. But study after study finds that ice baths blunt adaptations to training. Research reports ice exposure leading to decreased protein synthesis–how your body repairs muscle damage, as well as decreases in anabolic signaling–your body’s message to get stronger. The results are decreases in long term gains in muscle mass and strength. Relatedly, adjacent studies have found that taking anti-inflammatory drugs have similar effects. All of this evidence tells us that, despite it being uncomfortable, we want the inflammation. We want DOMS (delayed onset muscle soreness). This is where the gains come from!
An exception to every rule
Now pay attention, because I am going to do a little writer trick where I tell you about an exception to my thesis but then flip it at the bottom to actually make the exception support my argument. The time when research supports ice bathing as a useful tool is when athletes are competing, or exercising, at a high intensity repeatedly over a short timespan. Examples include athletes’ running multiple events at NCAA conference or national meets, or preliminary and final races hours apart. In these cases, taking an ice bath may provide some relief and get you ready to race again sooner. (A note for fellow running sickos: that does not mean that it is a good idea to cram sessions close together just because you CAN get through them with the help from a cold tub!)
As highlighted above, I don’t imagine this being a situation that many of you reading this will find yourselves in. Therefore I refer you back to my original point: there’s really no reason for the average runner to ice bathe!
Pleading the case for ice baths
The one benefit of ice baths that I will ride for is the psychological (*read placebo*) boost it can convey. It feels good to be doing something for recovery, especially if you’re doing it with others. I think back to the ice baths I took with my college teammates in the training room and I do think that we all benefited from those sessions, even though I don’t think that benefit came from sitting balls deep in 50-degree water. Rather, I think the benefit we got was from hanging out together and joking and thinking we were doing something good for ourselves. Not to mention, if you are taking an ice bath, you’re likely sitting down for a period of time. How often do you take time to do that each day?
TL:DR on ice baths
If you’re one of those recovery inclined individuals who gets confidence from feeling like they are doing a little extra to make sure they’re ready to go for the next session, or if you and your running buddies enjoy love hopping in a lake or river after a long run, I hear you, I see you. I don’t want to yuck your yum, but consider grabbing a burrito together and 30 minutes of extra sleep instead!
References
Fröhlich, M., Faude, O., Klein, M., Pieter, A., Emrich, E., & Meyer, T. (2014). Strength training adaptations after cold-water immersion. Journal of Strength and Conditioning Research, 28(9), 2628–2633. https://doi.org/10.1519/JSC.0000000000000434
Lateef F. (2010). Post exercise ice water immersion: Is it a form of active recovery? Journal of Emergencies, Trauma, and Shock, 3(3), 302. https://doi.org/10.4103/0974-2700.66570
Roberts, L. A., Raastad, T., Markworth, J. F., Figueiredo, V. C., Egner, I. M., Shield, A., Cameron-Smith, D., Coombes, J. S., & Peake, J. M. (2015). Post-exercise cold water immersion attenuates acute anabolic signalling and long-term adaptations in muscle to strength training. The Journal of Physiology, 593(18), 4285–4301. https://doi.org/10.1113/JP270570
Professional runner (with a 2:08 marathon PR) Scott Fauble has joined the Team RunRun coaching roster! Scott has multiple top 10 finishes in marathon majors such as Boston and NYC, along with 3 Olympic Marathon Trial races. He is ready to help athletes take their training to the next level.