Benefits and risks of cold water therapy

If you follow any serious workout buffs on social media, you may have noticed that ice baths or cold water therapies are becoming a common form of post-workout therapy. An ice bath involves sitting in a tab of icy water for a short period of time for purposes of healing muscles torn or fatigued during a workout.  

This therapy is favoured by marathon runners, walkers, footballers and mountain climbers, among others.

Every so often, you will see pictures on social media of a fitness enthusiast immersed in a tab filled with ice cubes and water followed by an explanation that they are helping their sore muscles heal faster. 

I once witnessed Joseph Beyanga, a walking enthusiast and fitness buff, immerse himself in a tab of icy water at Sheraton Hotel Kampala. He had been walking that afternoon and said dipping himself in the ice would help prevent soreness in muscles and ready himself for more walking excursions. He spent 32 minutes in the tab.

To understand why this is an impossible fit for regular people, four other people that tried it that evening did not even last a minute in the ice. The coldness bites hard to the born, causing such extreme discomfort that most people simply cannot stand it. They jump out almost immediately. 

Types of cold water therapy

There are two types of cold water therapy, ice bath and cold showers. 

Ice bath

Ice baths and cold water plunges are closely related. They both involve submerging your body from the neck down in water that is between 10-15 degrees Celsius for five to 15 minutes.

Cold showers

Cold showers involve standing under the shower in your bathroom, set to the coldest temperature possible for five to 15 minutes. This technique achieves the same results as immersing oneself in icy water. Cold showers are effective early in the morning or on very cold days as the water in the bathroom is not that cold on hot days. 

The question that must be explored is if this is based on science. As it turns out, yes.

May aid muscle recovery

According to a 2016 study in the Open Access Journal of Medicine, participants who immersed themselves in cold water after a workout (no warmer than 15 degrees Celsius) reported experiencing less muscle soreness later, compared to those who did not.

The study explained that this was due to the fact that the body regulates temperature through the same nerve pathways that carry pain signals, explaining why putting ice on injuries helps moderate pain. Cold water immersion helps constrict blood vessels, thereby reducing blood flow to the nearby body parts. Research suggests that this blood flow redistribution improves oxygenation of muscles and may enhance exercise performance.

Other studies have showed that this therapy may help regulate the nervous system as exposure to cold water stimulates the vagus nerve. The vagus nerve extends from the brainstem through the neck and chest, down to the belly. It is responsible for regulating breathing and heart rate. Studies have showed that regular ice baths helps one to learn how to regulate intense emotion and be able to function during high stress.

Side effects and risks

Sports doctor Ntege Ssengendo says while cold water therapy has many benefits as recorded above, there are risks that come with it. Different bodies react to an ice bath differently. He says it depends on your health, time spent in the water, and water temperature. Ntege lists the following as potential side effects:

Cold panniculitis: This is a cold-induced rash which can be itchy and painful. This may develop if the extreme coldness of the ice bath injures the skin's fatty tissue layer. It may appear as scaly patches, hard bumps, or deep lumps.

Cold shock response: This is the shock that happens due to sudden immersion in extremely cold water. This may lead to fast breathing, rapid heart rate, and high blood pressure. This can cause a strain on the heart and it may lead to higher chances of drowning.

Hypothermia: This simply means low body temperature. Ice baths can make you too cold and cause your body temperature to drop dangerously low. This can eventually lead to organ failure.

Ice burn: Direct contact with ice for long periods of time may burn your skin, causing painful blisters and discoloured red, white, or gray skin. You can also develop frostbite, skin damage and tissue death caused by freezing skin and underlying tissues.

Nerve damage: Prolonged cold exposure can reduce blood flow enough to kill tissue and cause permanent neuropathy (nerve damage). Nerve damage can lead to pain, numbness, and loss of muscle strength.