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!

*Runner in an ice barrel debating whether the pain of icing is worth it.*

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!)

*Runners ice bathing between two races on the same day.*

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

Scott Fauble, author of this piece on ice baths.

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.

As runners, there’s nothing more frustrating than an injury that stops you from doing what you love every day. Injuries can come in all shapes and sizes, but they generally fall into two categories. The first—and by far the most common—are overuse injuries, which happen when we push too hard, too soon. The second type is acute injuries, like sprained ankles. Today, we’re focusing on overuse injuries. Rather than diving into rehab specifics, we’ll talk about how to tune into your body’s signals, so you can get back to running smarter and stronger, overcoming the all too common overuse injury cycle!

Runner dealing with an overuse injury — Runner dealing with a typical overuse injury.

Case Study: The chronic twinge and the pain-weakness-injury cycle

Picture this: You’re out for a run, and that tiny twinge in your calf you’ve been ignoring suddenly forces you to stop. You rest for three days, and when it feels better, you lace up again. Everything seems fine, but then the pain creeps back. You take a full week off this time, and when you return to running, you feel great—for a while. But then, the pain comes back worse than before. Sound familiar?

This is the classic pain-weakness-injury cycle that so many runners find themselves stuck in when dealing with overuse injuries. You run until something hurts, so you rest. When you finally feel better, you go back to running. But even though the pain’s gone, the tissue is now weaker than it was before, and eventually, the pain returns. Resting doesn’t mean you’re ready to run again—it just means you’ve hit pause on the problem. Breaking this cycle is the goal, and the secret lies in gradually reintroducing movement without overdoing it. The challenge is finding that sweet spot, and let’s be honest—no one knows your body better than you.

What to do next?

Let’s take a look at this “Goldilocks” dilemma with three different runs.

Runner crossing a finish line healthy and happy. PC: Ryan Thrower

In Scenario A, you head out for a one-hour run. Your calf feels a bit tight for the first ten minutes, but then it loosens up and you finish pain-free. A few hours later, though, it stiffens up, and the next day the pain is worse than ever. That’s a clear sign you pushed too hard.

In Scenario B, you keep it super safe and only run for 20 minutes. You feel fine both during the run and the next day. But while this cautious approach keeps you pain-free, it doesn’t do much to help you move forward.

In Scenario C, you run for 45 minutes. You feel a little soreness afterward, but it’s nothing major, and you’re not limping. The next day, you wake up feeling back to normal.

Scenario A was definitely too much, and you’re now facing more downtime to recover. Conversely, Scenario B kept you safe, but it’s not helping you make any real progress. Scenario C, though, is the sweet spot for breaking the injury cycle. You gave your calf just enough of a challenge to help it adapt, without causing more harm.

Keys to managing overuse injuries effectively

The trick here is to introduce a little stress to the injured area. Your body needs to know that a bit of discomfort is okay—it doesn’t mean you’re about to get hurt again. After an injury, your pain response can get overly sensitive. This doesn’t mean the pain is “all in your head.” It means your body is trying to protect you, so it sends pain signals before you’ve done any actual damage. If you can learn to navigate those warning signals without triggering a full-blown injury, your body will start to trust the process again. However, if you stop running at the first sign of pain, you teach your body that’s what it’s supposed to do. By interpreting those signals correctly and easing back into running the right way, you’ll find that your pain-free running time starts getting longer and longer.

When to seek professional help

That said, if your calf is still acting up after every run, it’s a sign that something’s not quite right. Instead of just hoping the pain will go away, or resting endlessly, it’s time to add something new to help your calf handle running better. This is where a coach can be a huge help. They can suggest simple exercises that target those problem areas—muscles and tendons that need a little extra support. It doesn’t take much—just a few minutes of specific work each day can make a huge difference in how well your body handles the demands of running.

And if you’ve tried all this and the pain just won’t go away, it’s time to see a professional. A physical therapist or chiropractor who specializes in working with runners can help you get to the bottom of the issue and give you a plan that’s tailored to your body’s needs.

Don’t let overuse injuries steal your joy for running—listen to your body, trust the process, and you’ll get back on track.

Guy Love is a coach with Team RunRun based in Boulder, CO. He is a long time ultramarathon runner and physical therapist assistant here to coach the whole athlete on the roads and trails.

Ice Baths and Inflammation