Effect of water immersion on recovery from fatigue: a meta-analysis


  • Kristy Barrantes-Brais
  • Pedro Ureña-Bonilla
  • Julio Calleja-González
  • Sergej Ostojic


The aim of this meta-analysis was to study the effect of cold water immersions and the contrast immersions of cold/hot water. METHODOLOGY: We analyzed studies including search terms in the: title, keywords and abstract. From the analysis overall and corrected (Hedges’s g) effect sizes, 95% confidence intervals, meta-analysis Z, Cochran’s Q and I2 for heterogeneity were obtained. RESULTS: We analyzed 11 studies published from 1998 to 2013, for a total of 48 effect sizes. The global effect size for the cold water immersion was significant (0.38, IC [0.18, 0.58]), Q = 61.77 and I2 = 88.67. For the contrast immersion cold/hot water the global effect size was not significant (0.17, IC [0.00, 0.33]) CONCLUSION: The evidence in this meta-analysis confirms the existence of a positive moderate effect of cold water immersion on the recovery process, but not with contrast immersion, which did not present effect on this process.


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Al Haddad, H., Laursen, P., Chollet, D., Lemaitre, F., Ahnire, S., Buchheit, M., et al.(2010). Effect of cold or thermo neutral water immersion on post-exercise heart rate recovery and heart rate variability indices. Autonomic Neuroscience: Basic and Clinical 156:111–116. Doi:10.1016/j.autneu.2010.03.017.

Bieuzen. F., Bleakley, C.M., & Costello, J.T. (2013). Contrast water therapy and exercise induced muscle damage: A systematic review and meta-analysis. PLoS ONE 8(4): 1-15. Doi: 10.1371/journal.pone.0062356.

Bieuzen, Francois. (2013). Water Immersion Teherapy. In Hausswirts, C., & Mujika I. (Ed). Recovery for performance in sport (191 - 197).Human Kinetics, Champaing, IL.

Borenstein, M., Hedges, L.V., Higgins, J.P.T., & Rothstein, H.R. (2009). Introduction to Meta-Analysis. Wiltshire: Wiley.

Bleakley, Ch., & Davison, G. (2010). What is the biochemical and physiological rationale for using cold-water immersion in sports recovery? A systematic review. British Journal Sports Medicine 44:179–187. Doi:10.1136/bjsm.2009.065565.

Brukner. P., Williams, D., Nicol, A., & Hinman, R. (2007). Ice-water immersion and delayed-onset muscle soreness: a randomised controlled trial. British Journal Sports Medicine 41: 392–397. Doi: 10.1136/bjsm.2006.033985.

Burgess. T., & Lambert, M. (2010). The efficacy of cryotherapy on recovery following exercise-induced muscle damage. International Sport Medicine Journal 11(2): 258-277.

Cochrane, D.J. (2004). Alternating hot and cold water immersion for athlete recovery: a review. Phys Therapy Sport 5:26–32. Doi:10.1016/j.ptsp.2003.10.002.

Cooper, H., Hedges, L., & Valentine, J. (2009). The handbook of research synthesis and meta-analysis. New York. Russell Sage Foundation.

Delaxtrat, A., Calleja-González, J., Hippocrate, A., & Clarke, N.D. (2012).

Effects of sports massage and intermittent cold-water immersion on recovery from matches by basketball players. Journal of Sports Sciences, 31(1), 11-19. Doi: 10.1080/02640414.2012.719241.

Dolan, M.G., Thornton, R.M., Fish, D.R., et al. (1997). Effects of cold water immersion on edema formation after blunt injury to the hind limbs of rats. Journal Athletic Training 32:233–7.

Elias, G.P., Wyckelsma, V.L., Varley, M., McKenna, M., & Aughey, R. (2013). Effectiveness of water immersion on postmatch recovery in elite professional footballers. International Journal of Sports Physiology and Performance 8: 243-253.

Eston, R., & Peters, D. (1999). Effects of cold water immersion on the symptoms of exercise induced muscle damage. Journal Sports Science 17(3): 231-238. Doi: 10.1080/026404199366136.

French., D., Thomson., K., Garland., S., Barnes., C., Portas., M, Hood., P., et al. (2008). The effects of contrast bathing and compression therapy on muscular performance. Medicine and Science in Sports Exercise 40(7):1297–1306. Doi: 10.1249/MSS.0b013e31816b10d5.

Fridén, J., & Lieber., R.L. (2001). Eccentric exercise-induced injuries to contractile and cytoskeletal muscle fibre components. Acta Physiol Scand 171:321–6. Doi: 10.1046/j.1365-201x.2001.00834.x.

Gill, N.D., Beaven., C.M, & Cook., C. (2006). Effectiveness of postmatch recovery strategies in rugby players. British Journal of Sports Medicine 40(3):260–263. Doi: 10.1136/bjsm.2005.022483.

Goodall S and Howatson G (2008).The effects of multiple cold water immersions on indices of muscle damage. Journal of Sports Science and Medicine 7:235-241.

Gregson, W., Black, M.A., Jones, H., Milson, J., Morton, J., Dawson, B. et al (2011). Influence of cold water immersion on limb and cutaneous blood flow at rest. American Journal Sports Medicine 39:1316–23. Doi: 10.1177/0363546510395497.

Hing, W., White, S., Bouaaphone, A., & Lee, P. (2008). Contrast therapy -A systematic review. Physical Therapy in Sport 9: 148–161. Doi:10.1016/j.ptsp.2008.06.001.

Ingram, J., Dawson, B., Goodman, C., Wallman, K., & Beilby., J. (2009). Effect of water immersion methods on post-exercise recovery from simulated team sport exercise. Journal of Science and Medicine in Sport 12: 417–421. Doi: 10.1016/j.jsams.2007.12.011.

Kuligowski, L., Lephart., S, Giannantonio, K., & Blanc., R. (1998). Effect of whirlpool therapy on the signs and symptoms of delayed-onset muscle soreness. Journal of Athletic Training 33(3): 222-228.

Leal, E., De Godoi, V., Mancalossi., J.L., Rossi, R., De Marchi, T., et al. (2011). Comparison between cold water immersion therapy (CWIT) and light emitting diode therapy (LEDT) in short-term skeletal muscle recovery after high-intensity exercise in athletes - preliminary results. Lasers Medecine Science 26:493–501. Doi: 10.1007/s10103-010-0866-x.

Leeder, J., Gissane, C., Van Someren, K., Gregson, W., & Howatson, G. (2012). Cold water immersion and recovery from strenuous exercise: A meta-analysis. British J Sports Medicine 46: 233–240. Doi:10.1136/bjsports-2011-090061.

Montgomery, P., Pine, D., Hopkins, W., Dorman, J., Cook, K., & Minaham, C. (2008). The effect of recovery strategies on physical performance and cumulative fatigue in competitive basketball. Journal of Sports Sciences 26(11): 1135–1145. Doi: 10.1080/02640410802104912.

Morton, R.H. (2007). Contrast water immersion hastens plasma lactate decrease after intense anaerobic exercise. Journal of Science and Medicine in Sport, 10, 467-470.

Peiffer, J., Abbiss, C., Watson, G., Nosaka, K., & Laursen, P. (2009). Effect of cold-water immersion duration on body temperature and muscle function. Journal of Sports Sciences, 27(10): 987–993. Doi: 10.1080/02640410903207424.

Pointon, M., Duffield, R., Cannon, J., & Marino., F. (2012a). Cold water immersion recovery following intermittent-sprint exercise in the heat. European Journal Applied Physiology, 112: 2483–2494. Doi: 10.1007/s00421-011-2218-3.

Pointon, M., & Duffield, R. (2012b). Cold Water immersion recovery after simulated collision sport exercise. Medicine Science Sports Exercise, 44(2):206–216. Doi: 10.1249/MSS.0b013e31822b0977.

Pournot, H., Bieuzen, F., DuYeld, R., Lepretre, P., Cozzolino., C, & Hausswirth, C. (2011). Short term effects of various water immersions on recovery from exhaustive intermittent exercise. European Journal Applied Physiology, 111: 1287–1295. Doi: 10.1007/s00421-010-1754-6.

Robey, E., Dawson, B., Goodman, C., & Beilby, J. (2009). Effect of post exercise recovery procedures following strenuous stair-climb running. Research in Sports Medicine, 17:245–259. Doi: 10.1080/15438620902901276.

Rowsell, G., Coutts, A., Reaburn, P., & Hill-Haas, S. (2009). Effects of cold water immersion on physical performance between successive matches in high-performance junior male soccer players. Journal Sports Science, 27, 565–573. Doi: 10.1080/02640414.2010.526132.

Stanley, J., Peake, J., & Buchhet, M., (2012). Consecutive days of cold water immersion: effects on cycling performance and heart rate variability. European Journal Applied Physiology, 113(2): 371-84. Doi: 10.1007/s00421-012-2445-2.

Tipton, M.J., Golden, F.S., Higenbottam, C., Mekjavic, I.B., & Eglin, C.M. (1998).Temperature dependence of habituation of the initial responses to cold-water immersion. European Journal Appl Physiol Occup Physiol, 78: 253–7.

Tipton, M.J., Mekjavic, I.B., & Eglin, C.M. (2000). Permanence of the habituation of the initial responses to cold-water immersion in humans. European Journal Appl Physiol, 83: 17–21.

Tipton, M.J., Stubbs, D.A., and Elliott, D.H. (1990). The effect of clothing on the initial responses to cold water immersion in man. J R Nav Med Serv, 76:89–95.

Thomas, J., & French., K. (1986). The use of meta-analysis in exercise and sport: A tutorial. Research Quarterly for Exercise and Sport, 57(3): 196-204.

Vaile, J., Gill, N., & Blazevich, A. (2007). The effect of contrast water therapy on symptoms of delayed onset muscle soreness. Journal Strength Cond Research 21: 697–702.

Vaile, J., Halson, S., Gill, N., & Dawson, B. (2008a). Effect of cold water immersion on repeat cycling performance and thermoregulation in the heat. Journal of Sports Sciences, March 26(5): 431 – 440. Doi: 10.1080/02640410701567425.

Vaile, J., Halson, S., Gill, N., & Dawson, B. (2008b). Effect of hydrotherapy on recovery from fatigue. International Journal Sports Medicine, 29: 539–544. Doi: 10.1007/s00421-007-0605-6.

Vaile, J., Halson, S., Gill, N., & Dawson, B. (2008c). Effect of hydrotherapy on the signs and symptoms of delayed onset muscle soreness. European Journal Applied Physiology, 102: 447–455.

Wilcock, I., Cronin, J., & Hing, W. (2006). Physiological response to water immersion. A method for sport recovery? Sports Medicine 36(9): 747-765.






Original Research