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True or False: Ice baths are good for recovery
Beth Skwarecki

Last month I tackled the question of whether ice helps you recover from injuries. This time, we're back in the freezer: what about the painfully beloved (behated?) practice of taking ice baths?

Similar to throwing an ice pack on an injury, dunking your muscles in frigid water should reduce inflammation. Inflammation is a complex reaction our body has to injury--including the microscopic muscle damage that occurs as a routine part of exercise--and includes pain and swelling. Just like an ice pack on a sprained ankle reduces swelling and pain, applying ice to your muscles should reduce the pain from next-day muscle soreness, plus, the thinking goes, help you recover faster for your next workout or competition.

But the same arguments against icing injuries (which, as we learned last month, is beginning to fall out of fashion) also apply here: if our bodies react to damage with inflammation, doesn't that mean inflammation is a necessary part of healing, and we should save the ice for delicious post-workout drinks while our muscles get to work repairing themselves in the usual way?

The staff at the Olympic Training Center seems to think so. While the center has the equipment for ice baths, athletes don't use them for everyday training. One trainer told Outside magazine that he recommends cool baths (a mere 50 degrees Fahrenheit), but they are reserved for competitions and "hell week" scenarios.

When opinions are flying, we turn to the science. Is there an evidence-based reason to either ditch or embrace ice baths?

In 2012, a Cochrane review concluded that, based on 14 trials (which the reviewers described as "small" and "low quality") there is weak evidence that ice baths reduce delayed onset muscle soreness, compared with doing nothing. They didn't find enough evidence to come to any conclusions about other outcomes, for example measures of recovery.

But plenty of studies find no effect to ice baths. One recent study, published last year, sent 20 "recreationally active males" on a 40-minute downhill run, a protocol notorious for making your quads sore. Half the men got ice baths, and they ended up just as sore as their buddies who didn't.

Here's a key problem all the studies have: participants can't be blinded. Say you want to know if Coke or Pepsi tastes better. People have their favorites, so you'd hide the bottles and ask them to taste mysterious liquids labeled "A" and "B" without telling them which is which. Drugs are tested in a similar way: each subject gets a pill, which might be the new wonder drug or might be a dud with no medicine at all. (The trial is considered "double blinded" if the hospital staff giving you the pill is also in the dark.) With ice baths, there's no way to hide the fact that you're dunking someone in miserably cold water. And the lack of mystery may be a big part of the baths' positive effect.

Think about it: if you're in a study, and the investigator asks you to do a workout, then sit in a chair for 15 minutes, then report back later for another workout? You'll probably just feel like he's wasting your time. But if you spend that time in an ice bath, and in between winces of pain remember that Usain Bolt uses them, and your trainer recommends them, and something that hurts this much has to be good for you, maybe you'll gain a mental benefit instead of (or in addition to) a physical one, maybe similar to psyching yourself up with music.

I know, you're thinking you wouldn't be that dumb. But check out this study on how a special "recovery oil" compares to ice baths. After an intense cycling interval session, subjects who took an ice bath regained their strength faster than those who took a plain warm-water bath. But there was a third condition tested, a warm bath with recovery oil. It turned out to be just as good as the ice baths by almost every metric. Is this a new miracle soreness cure? Nope. The recovery oil was just an ordinary body wash. So the effect of ice baths, in this study, was equal to the effect of a placebo. That hints (but does not prove) that the benefits of ice baths may be a mind-over-matter phenomenon in the first place.

But does that really mean ice baths are useless? If you believe they work, and as a result they help you (remember, there were real effects in some of the studies), I'd say keep on keepin' on. But if you hate the ice baths, try something you hope will work better, like a massage. Or a beer. Or some recovery oil.


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