Research findings and tips for practice_Water immersion-2
25 February 2021 / 0 comments

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ProCcare continuously extracts the newly published research studies on water immersion and whole-body cryotherapy. These studies are the basis of our literature database and form the foundation of our ProCare method, which is implemented in our software solution. Our software solution assists athletic trainers, cryo-operators, and business owners who look for optimal support for their athletes and clients by limiting liability, increasing customer value, and elevating customer experience instead of the current one-size-fits-all approach.

Study: Wang, Y. et al. Heat and cold therapy reduce pain in patients with delayed onset muscle soreness: A systematic review and meta-analysis of 32 randomized controlled trials. Phys Ther Sport 48,177–187 (2021).

Method: Meta-analysis including 32 randomized controlled trials that looked into the effect of cold and heat therapy on the treatment of delayed onset of muscle soreness.

Primary findings by the authors:

  1. Both heat and cold therapy reduce pain in patients with delayed onset muscle soreness.
  2. The difference between cold and heat therapy is not significantly different.
  3. From the applied cold therapies, cold water immersion is the most effective.
  4. From the applied heat therapies, hot pack application is the most effective.
  5. Cold-water immersion should be applied within the first 24 hours after exercise to become effective.

ProCcare's take-home message:

Exercise is associated with microscopic tears in muscle tissue, commonly known as exercise-induced muscle damage (abbreviated by EIMD), leading to delayed onset of muscle soreness (DOMS). DOMS usually peaks between 24 and 48 hours (in some reports up to 72 hours) after exercise and is characterized by muscle shortening, increased passive stiffness, swelling, decreases in strength and power, localized soreness, and altered proprioception. The results are in line with previously published studies from Bleakly and colleagues (2012), Leederand colleagues (2012), and Hohenauer and colleagues (2015); Cold-water immersion had a moderate effect in alleviating DOMS post-exercise at all time points up to 96 hours post-exercise while being more effective at 24 and 48hours. Studies on hot water immersion and recovery benefits are rare. The study from Wang, in line with others, shows that the timing for applying water immersion is essential as your athlete should perform the immersion as close as possible after the end of the activity and necessarily within 24 hours after. To improve effectiveness in reducing DOMS when applying water immersion, you should consider two other clinical questions: What type of activity is it? What's, is the core temperature status? An athlete immersing with an elevated core temperature following a high intermittent activity requires a more intense protocol than an athlete with a regular core temperature status following an endurance-type activity. Secondly, you should consider gender, age, body composition. An older female athlete with a low-fat percentage requires a less intense protocol than a young, muscular male athlete. Third, consideration should be given to the phase in the season when applying water immersion. In case your athlete is in the recover-to-adapt phase, the use of cold water immersion should be discouraged, and your athlete should accept the perceived pain fromDOMS.

How to apply these findings in practice (by ProCcare):

There is considerable evidence that applying cold-water immersion for treating perceived pain following DOMS is sufficient, while not enough is known regarding hot-water immersion. Consideration should be given to the when, why, and how. Cold-water immersion should be applied as close as possible to the end of the activity and within 24 hours. The protocol should be customized to the athlete, considering gender, age, cold susceptibility, and body composition. And the phase of the season should determine whether or not to apply cold-water immersion. The CustoRec® software solution for water immersion takes all this into account and provides an ultimately safe and customized protocol. Interested in how our software works? Please reach out to us and request a demonstration.

Published studies on water immersion in January- 2021

  1. ésar,E. P., Júnior, C. S. R. & Francisco, R. N. Effects of 2 IntersectionStrategies for Physical Recovery in Jiu-Jitsu Athletes. Int J Sports PhysiolPerform 1–6 (2021) doi:10.1123/ijspp.2019-0701.
  2. Bartley, J. M. et al. Effects of cold water immersion on circulating inflammatory markers at the Kona Ironman World Championship. Appl Physiol Nutr Metab (2021) doi:10.1139/apnm-2020-0602.
  3. Wang,Y. et al. Heat and cold therapy reduce pain in patients with delayed onset muscle soreness: A systematic review and meta-analysis of 32 randomized controlled trials. Phys Ther Sport 48, 177–187 (2021).
  4. Smith,M. S., Casa, D., Stearns, R., Filep, E. & Endres, B. Heat Illness in football. in Football Injuries: A Clinical Guide to In-Season Management (ed.Farmer, K. W.) 267–283 (Springer International Publishing, 2021).doi:10.1007/978-3-030-54875-9_14.
  5. Javorac,D. et al. Hydrotherapy with hydrogen-rich water compared with RICE protocol following acute ankle sprain in professional athletes: a randomized non-inferiority pilot trial. Res Sports Med 1–9 (2020)doi:10.1080/15438627.2020.1868468.
  6. Mansfield,R., Hoekstra, S., Bill, J. & Leicht, C. Local cooling during hot water immersion improves perceptions without inhibiting the acute interleukin-6response. (2021).
  7. Malta, E. S., Dutra, Y. M., Broatch, J. R.,Bishop, D. J. & Zagatto, A. M. The Effects of Regular Cold-Water ImmersionUse on Training-Induced Changes in Strength and Endurance Performance: ASystematic Review with Meta-Analysis. Sports Med 51, 161–174 (2021).
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