Ice bath
Encyclopedia
In sports therapy, an ice bath or sometimes a cold-water immersion or cold therapy is a training regimen usually following a period of intense exercise in which a substantial part of a human body
Human body
The human body is the entire structure of a human organism, and consists of a head, neck, torso, two arms and two legs.By the time the human reaches adulthood, the body consists of close to 100 trillion cells, the basic unit of life...

 is immersed in a bath
Bathing
Bathing is the washing or cleansing of the body in a fluid, usually water or an aqueous solution. It may be practised for personal hygiene, religious ritual or therapeutic purposes or as a recreational activity....

 of ice or ice-water for a limited duration. While it is becoming increasingly popular and accepted among athletes in a variety of sports, the method is controversial and potentially dangerous with little solid scientific evidence to support or refute its usefulness or to understand its method of operation within the body, although there is speculation about processes within the body regarding vasoconstriction
Vasoconstriction
Vasoconstriction is the narrowing of the blood vessels resulting from contraction of the muscular wall of the vessels, particularly the large arteries, small arterioles and veins. The process is the opposite of vasodilation, the widening of blood vessels. The process is particularly important in...

. In medicine, the practice would be classified as cryotherapy
Cryotherapy
Cryotherapy is the local or general use of low temperatures in medical therapy or the removal of heat from a body part. The term "cryotherapy" comes from the Greek cryo meaning cold and the word therapy meaning cure...

 which uses low temperatures as medical therapy.

History

There have been traditions of people ice swimming in the middle of winter on a lake for short stretches, sometimes as part of a Polar Bear Club
Polar Bear Club
Polar Bear Club is an American post-hardcore/indie rock band from Rochester and Syracuse, upstate New York. Formed in 2005, the band currently consists of vocalist Jimmy Stadt, lead guitarist Chris Browne, rhythm guitarist Nate Morris, bass guitarist Erik Michael "Goose" Henning and drummer Tyler...

. Sometimes people taking short swims for thirty seconds or so have felt invigorated afterwards. The Coney Island Polar Bear Club
Coney Island Polar Bear Club
The Coney Island Polar Bear Club is the oldest winter bathing organization in the United States. The club was founded by famed health advocate Bernarr McFadden in 1903...

 was founded in 1903. A Polar Bear member explained:
In the 1890s, Russian immigrant Professor Louis Sugarman of Little Falls, NY brought his practice of ice bathing to the United States. He attracted worldwide attention for his daily plunge in the Mohawk River, even when the thermostat hit 23 below zero, earning him the nickname "the human polar bear".

In 1899, an Iowa
Iowa
Iowa is a state located in the Midwestern United States, an area often referred to as the "American Heartland". It derives its name from the Ioway people, one of the many American Indian tribes that occupied the state at the time of European exploration. Iowa was a part of the French colony of New...

 woman filed for divorce
Divorce
Divorce is the final termination of a marital union, canceling the legal duties and responsibilities of marriage and dissolving the bonds of matrimony between the parties...

 from her husband because he had forced her to undergo ice baths. There has been a tradition in American football
American football
American football is a sport played between two teams of eleven with the objective of scoring points by advancing the ball into the opposing team's end zone. Known in the United States simply as football, it may also be referred to informally as gridiron football. The ball can be advanced by...

 of pouring a large bucket of ice water on the winning coach as a victory celebration. And physical therapists have applied ice packs to selected areas of the body to prevent swelling.
Until recently, however, bathing in ice was seen as unusual. One account suggested that ice bath therapy did not become popular until 2002, when marathon runner
Running
Running is a means of terrestrial locomotion allowing humans and other animals to move rapidly on foot. It is simply defined in athletics terms as a gait in which at regular points during the running cycle both feet are off the ground...

 Paula Radcliffe
Paula Radcliffe
Paula Jane Radcliffe, MBE is an English long-distance runner. She is the current women's world record holder in the marathon with her time of 2:15:25 hours...

 won the championship in Europe
Europe
Europe is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally 'divided' from Asia to its east by the watershed divides of the Ural and Caucasus Mountains, the Ural River, the Caspian and Black Seas, and the waterways connecting...

 and attributed her victory to its use. She reportedly said "It's absolute agony, and I dread it, but it allows my body to recover so much more quickly." She reported taking ice baths before racing and preferred her pre-race bath temperature to be "very cold." After the Radcliffe comment, the technique has grown in popularity. It is gaining in popularity among athletes, such that some athletes "swear by it" but other accounts suggest it may be a fad. It has been used by athletes such as A. J. Soares
A. J. Soares
A. J. Soares is an American soccer player, currently playing for New England Revolution in Major League Soccer.-College and Amateur:...

 as well as other celebrity endorsers and is getting to become "common practice" among athletes from different sports, including association football (soccer), long distance running
Running
Running is a means of terrestrial locomotion allowing humans and other animals to move rapidly on foot. It is simply defined in athletics terms as a gait in which at regular points during the running cycle both feet are off the ground...

, rugby
Rugby football
Rugby football is a style of football named after Rugby School in the United Kingdom. It is seen most prominently in two current sports, rugby league and rugby union.-History:...

, tennis
Tennis
Tennis is a sport usually played between two players or between two teams of two players each . Each player uses a racket that is strung to strike a hollow rubber ball covered with felt over a net into the opponent's court. Tennis is an Olympic sport and is played at all levels of society at all...

, volleyball
Volleyball
Volleyball is a team sport in which two teams of six players are separated by a net. Each team tries to score points by grounding a ball on the other team's court under organized rules.The complete rules are extensive...

, and other sports.

There are indications that ice baths may be gaining popularity with groups outside sports, such as dance. The Pittsburgh Post-Gazette
Pittsburgh Post-Gazette
The Pittsburgh Post-Gazette, also known simply as the "PG," is the largest daily newspaper serving metropolitan Pittsburgh, Pennsylvania, USA.-Early history:...

reported that some Radio City Rockettes
The Rockettes
The Rockettes are a precision dance company performing out of the Radio City Music Hall in Manhattan, New York City. During the Christmas season, the Rockettes have performed five shows a day, seven days a week, for 77 years...

, a precision dance company performing in New York City, use ice baths after a long day of performing as a way to "unwind" and cope with "aches and pains." And there are indications that use of ice baths is spreading to amateur sports, such as high school football.

Ice baths are a part of a broader phenomenon known as cryotherapy
Cryotherapy
Cryotherapy is the local or general use of low temperatures in medical therapy or the removal of heat from a body part. The term "cryotherapy" comes from the Greek cryo meaning cold and the word therapy meaning cure...

––the Greek
Greek language
Greek is an independent branch of the Indo-European family of languages. Native to the southern Balkans, it has the longest documented history of any Indo-European language, spanning 34 centuries of written records. Its writing system has been the Greek alphabet for the majority of its history;...

 word cryo (κρυο) means cold––which describes a variety of treatments when cold temperatures are used therapeutically. Cyrotherapy includes procedures where a person is placed in a room with "cold, dry air at temperatures as low as -135°C" for short periods of time, and which has been used in hospitals in Poland
Poland
Poland , officially the Republic of Poland , is a country in Central Europe bordered by Germany to the west; the Czech Republic and Slovakia to the south; Ukraine, Belarus and Lithuania to the east; and the Baltic Sea and Kaliningrad Oblast, a Russian exclave, to the north...

 as well as a center in London to treat not only muscular ailments, but psychological problems such as depression
Depression (mood)
Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behaviour, feelings and physical well-being. Depressed people may feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, or restless...

. Occasionally ice baths have been an ill-advised treatment of fever
Fever
Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...

 in young children, but that doctors were counseled not to use this technique because of the risk of hypothermia
Hypothermia
Hypothermia is a condition in which core temperature drops below the required temperature for normal metabolism and body functions which is defined as . Body temperature is usually maintained near a constant level of through biologic homeostasis or thermoregulation...

. Ice baths have been suggested as a way to prevent muscle soreness after shoveling snow.
In addition, there have been instances of ice bathing as an extreme bodily test by persons vying for an endurance record, such as Dutch Iceman Wim Hof
Wim Hof
Wim Hof is a Dutch world record holder, adventurer and daredevil, commonly nicknamed the Iceman for his ability to withstand extreme coldness. He holds eighteen world records including a world record for longest ice bath. In 2007, he attempted, but failed , to climb Mount Everest wearing nothing...

, and Chinese
China
Chinese civilization may refer to:* China for more general discussion of the country.* Chinese culture* Greater China, the transnational community of ethnic Chinese.* History of China* Sinosphere, the area historically affected by Chinese culture...

 record-holders Chen Kecai and Jin Songhao. These people have spent more than an hour and a half submerged in an ice bath, and survived.

Bath

It is done by standing or sitting in a bucket or bath of icy water. One writer advised: "don't overdo it." Wearing rubberized "dive booties" on the feet (to protect toes) as well as rubber briefs to warm the midsection have been recommended. While there are different types of ice baths, a writer described one arrangement:
Champion weightlifter Karyn Marshall
Karyn Marshall
Dr. Karyn Marshall, DC, is an American Olympic weightlifter of Norwegian descent who was notable for being world champion in 1987. She set 60 American and world records in women's weightlifting and is the first woman in history to clean and jerk over . She became a doctor of chiropractic and runs...

, who won the world women's weightlifting championship in 1987, described what it was like to take an ice bath after a day of competition at the CrossFit Games in 2011 in Los Angeles:
One report suggested that if ice water is circulating, it's even colder such that the water will be colder than measured by a thermometer, and that athletes should avoid overexposure. Physical therapist Nikki Kimball explained a way to make the bath more endurable:

Ice bath only versus contrast bath therapy

Accounts differ whether it is best to follow the ice bath with a hot shower; two accounts suggested that a hot shower followed by a massage would be helpful, but other reports counsel against such a practice. There are reports that some athletes use this technique, sometimes known as contrast water therapy or contrast bath therapy
Contrast bath therapy
Contrast bath therapy, also known as "hot/cold immersion therapy", is a form of treatment where a limb or the entire body is immersed in ice water followed by the immediate immersion of the limb or body in warm water....

, in which cold water and warmer water are alternated. One method of doing this was to have two tubs––one cold (10-15 degrees Celsius) and another hot (37-40 degrees Celsius)––and to do one minute in the cold tub followed by two minutes in a hot tub, and to repeat this procedure three times.

Temperature and timing

The temperature can vary, but is usually in the range of 50–59 degrees Fahrenheit or between 12 and 15 degrees Celsius. Some athletes wear booties to keep their toes warm or rubberized coverings around their midsection while immersed. Some drink a warm beverage such as tea
Tea
Tea is an aromatic beverage prepared by adding cured leaves of the Camellia sinensis plant to hot water. The term also refers to the plant itself. After water, tea is the most widely consumed beverage in the world...

. One report suggested that "ten minutes immersed in 15 degree Celsius water" was sufficient.

Accounts vary about how long to be immersed and how often to do them. One adviser suggested that an athlete should take ten two-minute ice bath treatments over a two-week period. One account suggested immersion times should be between ten and twenty minutes. Another suggested that immersion run from five to ten minutes, and sometimes to twenty minutes. There were no sources advocating being immersed for longer than twenty minutes.

Ice baths versus cold baths

Several sources suggest that cold baths (60–75 degrees Fahrenheit) were preferable to ice baths. Physiotherapist Tony Wilson of the University of Southampton
University of Southampton
The University of Southampton is a British public university located in the city of Southampton, England, a member of the Russell Group. The origins of the university can be dated back to the founding of the Hartley Institution in 1862 by Henry Robertson Hartley. In 1902, the Institution developed...

 said that extremely cold temperatures were unnecessary and a "cold bath" would be just as effective as an ice bath. Another agreed that a mere cold bath is preferable to ice baths which are "unnecessary." A third report suggested that cool water (60-75 degrees Fahrenheit) was just as good as cold water (54-60 degrees Fahrenheit) and that eight to ten minutes should be sufficient time, and warned against exceeding ten minutes.

Medical efficacy

There is theoretical
Theory
The English word theory was derived from a technical term in Ancient Greek philosophy. The word theoria, , meant "a looking at, viewing, beholding", and referring to contemplation or speculation, as opposed to action...

 speculation, although unproved, about how the ice bath technique might operate, as well as differing accounts about how the technique is supposed to help the human body. A common theme is that the cold prompts the body to recover faster from an intense period of activity. According to several accounts, the cold in the ice bath signals temperature receptors to alert the brain to "withdraw blood to the body's core". According to another account, after five to ten minutes, the "icy cold water causes your blood vessels to tighten and drains the blood out of your legs." Another report suggested that it causes metabolic activity
Metabolism
Metabolism is the set of chemical reactions that happen in the cells of living organisms to sustain life. These processes allow organisms to grow and reproduce, maintain their structures, and respond to their environments. Metabolism is usually divided into two categories...

 to slow. After getting out of the ice bath, the blood is pumped "vigorously" back to tissues "stimulating oxygen and nutrient supply to areas that need revitalising," according to one assessment, and another suggests that blood flow is speeded up, sometimes described as a "blood rush." A report along these same lines suggested that the benefit came from after the ice bath with "increased blood flow" bringing fresh nutrients to an "inflamed, injured area" which helps the tissues heal. A slightly different explanation was that cold causes the diameters of blood vessels to contract during the period of immersion in the ice water, meaning that more toxins were pumped out of the area, similar to a massage
Massage
Massage is the manipulation of superficial and deeper layers of muscle and connective tissue to enhance function, aid in the healing process, and promote relaxation and well-being. The word comes from the French massage "friction of kneading", or from Arabic massa meaning "to touch, feel or handle"...

. And blood is a way to bring oxygen
Oxygen
Oxygen is the element with atomic number 8 and represented by the symbol O. Its name derives from the Greek roots ὀξύς and -γενής , because at the time of naming, it was mistakenly thought that all acids required oxygen in their composition...

 to the cells as well as remove waste products from muscular exertion, particularly lactic acid
Lactic acid
Lactic acid, also known as milk acid, is a chemical compound that plays a role in various biochemical processes and was first isolated in 1780 by the Swedish chemist Carl Wilhelm Scheele. Lactic acid is a carboxylic acid with the chemical formula C3H6O3...

. Here is one description of how it is believed to work:
Ice baths are generally believed to be a way to help the body recover from a vigorous workout, with one account suggesting helpful effects not only for muscles, but for tendons, bones, nerves, and other tissues as well. An advantage cited is that cold-water immersion is a more "efficient means of cooling large groups of muscles simultaneously" and helps lead to "longer lasting changes in deep tissues." A second report echoed this view and suggested that "immersion allows controlled, even constriction around all muscles."

Ice baths have been a source of medical treatment when a person is suffering from heat illness
Heat illness
Heat illness or heat-related illness is a spectrum of disorders due to environmental heat exposure. It includes minor conditions such as heat cramps, heat syncope, and heat exhaustion as well as the more severe condition known as heat stroke....

, and when this happens, sufferers are urged to get into an air conditioned room quickly or get into an ice bath.

Benefits

Benefits are speculative but include the following:
  • Prevents injury.

  • Speeds recovery. According to one report, it is believed to decrease the amount of time needed by the muscles of athletes to return to top condition between training sessions.

  • Keeps muscles limber. One account suggested it would reduce muscle soreness after heavy exertion, such as after snow shoveling.

  • Repairs muscles.

  • Reduces inflammation. But one account disputes there is any benefit in fighting inflammation. However, according to Greg Whyte of the English Institute of Sport, inflammation may be good for the body and act as an "important and beneficial part of the muscle's response to training."

  • Feels good afterwards.

  • Less muscle soreness.

  • Induces sleep. A report in the Huffington Post suggested that a ten minute ice bath about an hour prior to bedtime acted like an "elephant tranquilizer."

  • Less muscle pain.

  • Less muscle stiffness.

Drawbacks

  • Painful. One account suggested "Don't expect it to be pleasant at first."

  • Cold. The "discomfort associated with sitting in a tub full of ice water" can cause many to avoid it.

  • Possibly medically dangerous. Doctor Lisa Silver of Oxfordshire
    Oxfordshire
    Oxfordshire is a county in the South East region of England, bordering on Warwickshire and Northamptonshire , Buckinghamshire , Berkshire , Wiltshire and Gloucestershire ....

     explained that "exposing yourself to prolonged cold" may result in hypothermia
    Hypothermia
    Hypothermia is a condition in which core temperature drops below the required temperature for normal metabolism and body functions which is defined as . Body temperature is usually maintained near a constant level of through biologic homeostasis or thermoregulation...

     or frostbite
    Frostbite
    Frostbite is the medical condition where localized damage is caused to skin and other tissues due to extreme cold. Frostbite is most likely to happen in body parts farthest from the heart and those with large exposed areas...

     and that sudden exposure to extreme cold could harm patients with heart problems or asthma and possibly lead to sudden death
    Sudden Cardiac Death
    Sudden cardiac death is natural death from cardiac causes, heralded by abrupt loss of consciousness within one hour of the onset of acute symptoms. Other forms of sudden death may be noncardiac in origin...

    .

Scientific investigation

There is little solid scientific research to support a case that ice baths are either beneficial or detrimental for athletes. Professor Kenneth L. Knight of Brigham Young University
Brigham Young University
Brigham Young University is a private university located in Provo, Utah. It is owned and operated by The Church of Jesus Christ of Latter-day Saints , and is the United States' largest religious university and third-largest private university.Approximately 98% of the university's 34,000 students...

 said there is no evidence to either support or refute the claim that ice-bath treatments, or cryotherapy
Cryotherapy
Cryotherapy is the local or general use of low temperatures in medical therapy or the removal of heat from a body part. The term "cryotherapy" comes from the Greek cryo meaning cold and the word therapy meaning cure...

 methods in general, reduces inflammation. Runner's World.com executive editor Mark Remy believes that ice-bath treatments are "bunk" opining that it is an "elaborate practical joke being played on runners." Physiotherapist Chris Bleakley of the University of Ulster
University of Ulster
The University of Ulster is a multi-campus, co-educational university located in Northern Ireland. It is the largest single university in Ireland, discounting the federal National University of Ireland...

 reported that there are "no high-level scientific studies that say this is good for the body" although he admitted that athletes had been reporting positive results, and that there is considerable anecdotal evidence
Anecdotal evidence
The expression anecdotal evidence refers to evidence from anecdotes. Because of the small sample, there is a larger chance that it may be true but unreliable due to cherry-picked or otherwise unrepresentative of typical cases....

 from athletes that it makes them "feel better." In contrast, one report suggested that there was scientific research showing that ice baths promote recovery, but no specific studies were cited. There have been smaller-scale studies which either indicate no benefit or a detrimental effect, or that offer "inconclusive or contradictory findings."

Australian study

A study by Australian
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...

 researchers, publishing in the British Journal of Sports Medicine on a small sample size, suggested that ice bath therapy may "do more harm than good." The team asked 40 volunteers to undergo leg exercises and gave half ice baths and the other half a dip in tepid water. Researchers measured pain levels, swelling, performance in a "hopping test" and blood chemicals which might indicate damage to muscles, and found no statistically important differences between the two groups, except that the ice therapy treated volunteers experienced more muscular pain, specifically in the legs. The study found that:

Study of Cyclists

One study in 2008 in the International Journal of Sports Medicine suggested that cold water immersion and contrast water therapy
Contrast bath therapy
Contrast bath therapy, also known as "hot/cold immersion therapy", is a form of treatment where a limb or the entire body is immersed in ice water followed by the immediate immersion of the limb or body in warm water....

 might help in situations where athletes engaged in "high intensity efforts on successive days", such as weightlifters in a multi-day competition. Researchers studied cyclists during a week of intense training and found that they performed better with these methods than complete rest or hot water baths.

Benchpress study

A study in 2007 reported in the Journal of Strength and Conditioning Research found that contrast water therapy delayed the onset of muscle soreness after "intense leg press exercise" and found "faster restoration of strength and power in athletes" who used this therapy instead of a merely "passive recovery."

English Institute of Sport study

This study suggested that ice baths could help top athletes recover faster during a peak competition but that such methods should not be used during training since it limits the "growth and strengthening of muscle fibers." The authors of the study, including physiologist Jonathan Leeder, counseled against ice bath treatments during training.

See also

Note: the term ice bath has different meanings for chemistry, food preparation, and in medicine

  • Contrast bath therapy
    Contrast bath therapy
    Contrast bath therapy, also known as "hot/cold immersion therapy", is a form of treatment where a limb or the entire body is immersed in ice water followed by the immediate immersion of the limb or body in warm water....

  • Cryotherapy
    Cryotherapy
    Cryotherapy is the local or general use of low temperatures in medical therapy or the removal of heat from a body part. The term "cryotherapy" comes from the Greek cryo meaning cold and the word therapy meaning cure...

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