Ice Water Immersion And Delayed Onset Muscle Soreness

Abstract

Delayed onset muscle soreness (DOMS) is common in athletes following unaccustomed eccentric exercise. DOMS and its associated strength and functional deficits may render an athlete unable to perform or train to full potential in subsequent days. The cause of DOMS remains poorly understood, thus there is no universally accepted treatment strategy. Ice water immersion is a commonly used intervention believed to diminish DOMS. PURPOSE To determine if ice water immersion after eccentric quadriceps exercise minimises soreness, swelling, muscle damage and reduced function. METHODS An RCT was performed. Eleven males (mean age 23.3 yrs) and 29 females (mean age 20.4 yrs) participated. Following baseline assessment, participants underwent eccentric exercise of the non-dominant quadriceps (50 contractions at 120% of the 1-RM on a leg extension machine). Immediately following exercise, participants randomly allocated to the treatment group were immersed in ice water (5+/−1 °C) to the ASIS's for one minute, followed by one minute out of the bath. This cycle was repeated for a total of three immersions. The control group underwent the same protocol in tepid water at 24°C. Outcome measures included pain (hopping, running, stretch, isometric and eccentric contraction using visual analogue scales), thigh circumference, one-legged hop for distance and serum CK. Outcome assessments were performed blinded at baseline, and 24, 48 and 72 hours post-exercise. Change in outcomes from baseline were analysed using two-way ANOVA with repeated measures and post hoc tests. RESULTS A significant effect of time was evident for CK (p<0.01), with the greatest elevation at 24 hours (p<0.05). Group allocation did not influence serum CK. A significant time effect was evident for all pain scores (p<0.001), with pain greater at 24 and 48 hours post-exercise (p<0.05). Between-group differences were evident for pain on eccentric and isometric contraction and stretch (p<0.05). Compared to controls, the ice water group reported more pain on eccentric contraction (mean (SD) 5 (8) vs 15 (15) mm respectively, p=0.012) and stretch (mean (SD) 5 (14) vs 21 (21) mm respectively, p=0.007) at 24 hours. Pain on isometric contraction at 48 hours approached statistical significance (p=0.052), with the ice water group reporting more pain. No effects were evident for thigh circumference, muscle tenderness or hop for distance. CONCLUSION Ice water immersion following eccentric exercise results in significantly greater pain 24–48 hours later compared to tepid water immersion. Ice water immersion has no effect on other markers of DOMS. The use of ice water immersion in athletic populations must be questioned.