The effects of tow protocol cold water immersion on the post match recovery and physical performance in well-trained handball players

The aim of the present study was to identify neuromuscular, biochemical, and endocrine markers of fatigue after Rugby League match play. Seventeen elite Rugby League players were monitored for a single match. Peak rate of force development (PRFD), peak power (PP), and peak force (PF) were measured during a countermovement jump (CMJ) on a force plate pre and postmatch play. Saliva and blood samples were collected 24 hours prematch, 30 minutes prematch, 30 minutes postmatch, and then at 24-hour intervals for a period of 120 hours to determine plasma creatine kinase concentration ([CK]) and salivary cortisol concentration ([sCort]). There were significant (p < 0.05) decreases in PRFD and PP up to 24 hours postmatch with PF significantly (p < 0.05) decreased immediately postmatch. The [sCort] significantly (p < 0.05) increased from 24 hours prematch to 30 minutes prematch and up to 24 hours postmatch compared with 24 hours prematch. Plasma [CK] significantly (p < 0.05) increased 30 minutes postmatch with a peak occurring 24 hours postmatch and remained elevated above 24 hours prematch for at least 120 hours postmatch. There were significant (p < 0.05) correlations between the increase in [CK] and reduction in PRFD 30 minutes postmatch and 24 hours postmatch. The [sCort] was significantly (p < 0.05) correlated with the reduction in PF 30 minutes postmatch. Results demonstrate that neuromuscular function is compromised for up to 48 hours after match play. Elevated [CK] despite 120-hour recovery indicate that damage to muscle tissue after Rugby League match play may persist for at least 5 days postmatch. Despite the prolonged presence of elevated [CK] postmatch, strength training 48 hours postmatch may have resulted in a compensatory increase in PRFD supporting the inclusion of strength training during the short-term postmatch recovery period.

Objective Exercise induced muscle damage (EIMD) is one common physiological phenomenon in competitive sports and mass sports. Water immersion recovery and whole body cryotherapy (cryostimulation) (WBC) has become one of the fast recovery methods adopted by high level athletes in the world. The aim of this study was to compare the water immersion recovery and WBC from timing sequential recovery on EIMD, subjective scales, biochemical indicators, exercise performance indicators.&#x0D; Methods Twelve middle and long distance runners from Beijing Sport University were recruited in this study (exercise performance is secondary level in China). All participants performed four models in four weeks which included rest control (CON), cold water immersion(CWI), contrast water therapy (CWT) and whole body cryotherapy (cryostimulation) (WBC) separated by one week. The subjects needed to complete the EIMD exercise program, includes two parts: the treadmill running and the jump step. The individual speed of treadmill running was based on the individual VO2max. running including 5 sets and total time is about 90 min. Every set consist of 6 min flat running, 6 min uphill running and 6 min downhill running. The speed of the treadmill was stable in different stages. The slope of the uphill running is（＋6,＋5,＋4,＋3,＋2）, and the slope of downhill running is (-8, -7, -6, -5, -4). The jump was performed 20 times separated by 30 s via special step ( height is 40 cm) . After the EIMD exercise program, the subjects were treated with different recovery methods immediately after exercise, 24 h, 48 h, 72 h after exercise, while CON group received no intervention. The CWI group was immerged in 15 °C cold water for 12min, and the CWT groups was immerged in 15°C cold water for 1min and 38°C hot water for 1min with 6 cycles. The whole body cryotherapy (cryostimulation) group was immerged in special chamber (-110—-140℃）for 3 min. The three interventions were immerged body to the position of shoulders. The indexes including subjective scales (VAS scale, RPE scale, Borg scale, WHO deep sleep scale, PQSI scale), biochemical indicators (creatine kinase, lactate dehydrogenase, myoglobin, interleukin-6, C reactive protein, SICAM-1), exercise performance indicators ( vertical jump height, grip, running distance). The indexes was collected in different periods (i.e. Before exercise, immediately after exercise,Post1h, Post 24h, Post 48h, Post 72h, Post 96h after exercise etc.).&#x0D; Results (1) Subjective scales. From results of VAS scale, RPE scale, and Borg scale, the WBC had best recovery effects than the other three interventions (P&lt;0.05). The recovery effect of the CWI group was similar with the CON group. From results of WHO deep sleep scale and PQSI scale, the WBC group had better recovery effects than CON group (P&lt;0.05). (2) Biochemical indicators. From results of CK, Mb and SICAM-1, the WBC group had better recovery effect than the other three groups (P&lt;0.05). In the LDH, the WBC group had similar effects with the CWT group (P&gt;0.05). From results of CRP and IL-6, the WBC group had better recovery effects than the other three groups (P&lt;0.05).（3）Exercise performance indicators. From results of vertical jump, WBC had lower decrease than the other three groups (P&lt;0.05). From results of the grip, of the WBC and CWT groups have significant retentive effects than CON group (P&lt;0.05), but there was no significant difference between CON and CWI groups (P&gt;0.05).&#x0D; Conclusions (1)Through combine the treadmill running and the jump step exercise program,Can effectively lead to human body appear the EIMD. (2)WBC has positive effects on the subjective scale, biochemical indicators, exercise performance indicators associated with EIMD.For middle and long distance runners EIMD,compared with CWI CWT,WBC effect is better.(3) CWI and CWT has a positive effect on some subjective scales, biochemical indicators, and exercise performance indicators related to EIMD. However, the positive effect of CWI and CWT is lower than WBC in the extent of action and timing sequence. (4)For the middle and long distance runners EIMD timing sequence recovery effects,WBC have better effects,Followed by CWT , CWI effect is not significant.

Cryotherapy and phototherapy have been suggested as recovery methods due to their anti-inflammatory effects. They may also induce mitochondrial biogenesis, thus favoring endurance training adaptation. The aim of this study was to evaluate the anti-inflammatory and ergogenic effects of phototherapy or cold water immersion (CWI) applied daily after exercise in rats. Thirty-five rats were divided into five groups: control (CO), non-exercised (CE), passive recovery (PR), cold water immersion (CWI), and LED therapy (LED). The CO and CE groups were not submitted to training; however, the CE were submitted to an exhaustion test after the training period. Low-intensity swimming training (21 sessions, 45min) was performed followed by passive recovery (PR), CWI (10°C, 5min), or infrared irradiation (940nm, 4J/cm2). Forty-eight hours after the final training session, the CE, PR, CWI, and LED animals were submitted to an exhaustion test. The animals were euthanized 24h later and submitted to hematological, creatine kinase (CK), and C-reactive protein (PCR) analysis. Gastrocnemius and soleus muscles were submitted to histological analysis. No differences in blood cell counts, CK, and PCR were detected between groups. The CE group presented an increased number of areas with necrosis in the gastrocnemius and soleus muscles. The PR group presented the highest frequency of areas with edema and inflammation followed by CWI and LED groups. None of the recovery methods improved the performance in the exhaustion test. Successive applications of recovery methods do not improve exercise performance, but downmodulate the inflammation and prevent muscle necrosis.

Despite lacking clear scientific evidence, hydrotherapies (water treatments) are accepted techniques to help team sport athletes recover from the physical effects of games. The purpose of this study was to assess the comparative effectiveness of cold water immersions (CWIs) and hot-and-cold contrast baths on athletes' recovery after a simulated game of rugby union. Twenty-four experienced, well-trained, male rugby union players were divided into 3 groups to receive recovery interventions: CWI for 1 group, contrast baths for a second group, and passive recovery for a third (control) group. Pregame and postgame measurements included a countermovement jump (normalized as a ratio to body weight), a sit-and-stretch flexibility test (centimeters), thigh circumference (to detect swelling; centimeters), and participants' perception of delayed-onset muscular soreness (DOMS, 100-mm visual analog scale). Statistical analysis included analysis of variance, and the calculation of omnibus effect sizes for each group ((Equation is included in full-text article.)) and the magnitudes of change within and between groups (Cohen's d). The participants in the contrast bath group reported statistically significantly greater measures of DOMS than participants in the control group did at 1 hour postintervention (p = 0.05, control group: d = 1.80; contrast bath: d = 4.75), and than participants in the CWI group did at 48 hours postintervention (p = 0.02, CWI: d = 1.17; contrast bath: d = 1.97). These findings provide modest evidence that contrast baths are a less effective strategy for recovery from rugby union than are CWI or passive recovery. Specifically, 2 × 5-minute CWI is superior to both contrasts baths and passive recovery in alleviating DOMS after exercise-induced muscle damage. Our recommendation for rugby union players aiming to attenuate the effects of DOMS postgames is to take 2 × 5-minute CWIs baths immediately after the game.

The aim of this study was to determine the effect of 3 post-match recovery modalities on physical performance, physiological measures, and players' perceptions of recovery after 90-minute soccer match play. On separate days, 28 young (age: 14.3 +/- 0.7 years) soccer players played 3 soccer matches each randomly followed by 1 of 3 recovery modalities: (a) CONT-cold (12 degrees C) water immersion and hot (38 degrees C) shower, (b) COMB-cold water immersion and active recovery using a cycle ergometer, and (c) PASS-a passive post-match routine (stretching and leg raise). Performance (vertical jump height), physiological (heart rate and tympanic temperature), and perceptual measures (perceived quality of recovery) were determined before each match, 10 minutes after each match, after each recovery method, and after 24 hours. There was a 0.6 +/- 6.7% drop in immediately after a match, but there was no difference in vertical jump height after 24 hours (p = 0.997). Perceived quality of recovery immediately after COMB was substantially higher than CONT and PASS, but the effect did not last more than 24 hours. The players perceived lighter legs after COMB, compared with the PASS, at post-24 hours. In conclusion, a combined recovery modality (cold water immersion and active recovery) after a soccer match did not have a substantial effect on vertical jump height performance when compared with contrast water immersion and passive recovery alone. However, the observed positive effects on perceived recovery (higher quality of recovery and lighter legs) after the combined modality (cold water immersion and active recovery) suggest that this approach may be effective for young players after intense soccer match play.

A relatively novel recovery modality is whole-body cryotherapy (WBC), which refers to brief exposure (2 to 3 min) to extremely cold air (−110 to −195 °C) in a temperature-controlled chamber or cryocabin. In sports medicine, WBC and cold-water immersion (CWI) have been used recently as an approach to accelerate recovery from muscle damage. However, comparisons between WBC and CWI on the time course of strength recovery and delayed-onset muscle soreness (DOMS) after exercise-induced muscle damage (EIMD) are still controversial. PURPOSE: To compare the effects of two different recovery modalities (WBC vs. CWI) performed immediately after a muscle damaging protocol on recovery. METHODS: Twenty six untrained men (21 ± 3 years, 174.1 ± 5.5 cm, 72.0 ± 10.6 kg) completed five sets of 20 drop jumps with 2 min rest between sets. After EIMD, participants were randomly assigned to two groups: 1) 3 min of WBC at −110 °C (n=13); or 2) 20 min of CWI at 5 °C (n=13). Isometric knee extensor torque (KT) and DOMS were measured at baseline, immediately, 24, 48, 72 and 96 h post exercise. RESULTS: There was a significant interaction between recovery modalities and time on KT. The CWI group did not recover KT after 96 h. However, the WBC group recovered KT 96 h after EIMD (Table 1). Furthermore, the WBC group recovered from DOMS at 72 h, while the CWI group recovered 96 h after EIMD (Table 1). There was no difference in KT and DOMS between groups pre EIMD (p>0.05).Table: No title available.CONCLUSION: Our data suggest that WBC and CWI applied immediately after an EIMD protocol present dissimilar time course responses in strength and DOMS recovery. For WBC, strength and DOMS recovered at three and four days respectively. However, for CWI, strength was still depressed at four days, and pain was still present at three days, following EIMD. Thus, it appears that WBC enhances recovery from muscle damage more quickly than CWI.

BACKGROUND:Recovery is an important aspect of every physical activity.Many athletes train hard without giving their body time to recover which can lead to overreaching, burnout or poor performance.Currently cold-water immersion recovery and active recovery have emerged as some of the most popular interventions enabling faster recovery.OBJECTIVE: To assess the eff ect of three kinds of recovery (active recovery, cold water immersion, passive recovery) on medium-term knee strength in the extension and fl exion.METHODS: Fourteen athletes at the age of 26.6 ± 4.4 years performed, in a random cross-over design, 3 sessions with 3 repeated medium-term isokinetic tests.The eff ect of active recovery, passive rest and cold water immersion were assessed by 3 × 3 (time × recovery) repeated-measure ANOVA, respectively.The dependent variables were -peak torque, total work and average power.RESULTS: We found signifi cantly lower absolute diff erences between the fi rst and third trial in knee extension for peak torque after the active recovery (↑ 0.9 N × m) than after the cold water immersion (↓ 14.6 N × m) or the passive recovery (↓ 13.9 N × m).The decrease of the average power was signifi cantly lower diff erences after the active recovery (↓ 5 W) than after the cold water immersion (↓ 23.7 W) or passive recovery (↓ 25.9 W).The changes in total work were not signifi cant.We did not found any changes in the isokinetic strength for the knee fl exors after diff erent kinds of recovery.Maximal heart rate (HR max ) was signifi cantly higher during the active recovery than during the cold water immersion and the passive recovery (173 ± 14, 166 ± 14 and 167 ± 14 rpm).We have found signifi cant diff erences in the average heart rates (HR avg ) during active recovery, cold water immersion and passive recovery (124 ± 8, 97 ± 9 and 107 ± 12 rpm).CONCLUSION: We found the positive eff ect of the active recovery on the subsequent medium-term performance for knee extension.That was the only method which showed lower decrease of knee strength in extension in comparison with passive recovery and cold water immersion.We have found the signifi cant diff erences of heart rate which was recovery dependent.

Intense training results in numerous physiological perturbations such as muscle damage, hyperthermia, dehydration and glycogen depletion. Insufficient/untimely restoration of these physiological alterations might result in sub-optimal performance during subsequent training sessions, while chronic imbalance between training stress and recovery might lead to overreaching or overtraining syndrome. The use of post-exercise cold water immersion (CWI) is gaining considerable popularity among athletes to minimize fatigue and accelerate post-exercise recovery. CWI, through its primary ability to decrease tissue temperature and blood flow, is purported to facilitate recovery by ameliorating hyperthermia and subsequent alterations to the central nervous system (CNS), reducing cardiovascular strain, removing accumulated muscle metabolic by-products, attenuating exercise-induced muscle damage (EIMD) and improving autonomic nervous system function. The current review aims to provide a comprehensive and detailed examination of the mechanisms underpinning acute and longer term recovery of exercise performance following post-exercise CWI. Understanding the mechanisms will aid practitioners in the application and optimisation of CWI strategies to suit specific recovery needs and consequently improve athletic performance. Much of the literature indicates that the dominant mechanism by which CWI facilitates short term recovery is via ameliorating hyperthermia and consequently CNS mediated fatigue and by reducing cardiovascular strain. In contrast, there is limited evidence to support that CWI might improve acute recovery by facilitating the removal of muscle metabolites. CWI has been shown to augment parasympathetic reactivation following exercise. While CWI-mediated parasympathetic reactivation seems detrimental to high-intensity exercise performance when performed shortly after, it has been shown to be associated with improved longer term physiological recovery and day to day training performances. The efficacy of CWI for attenuating the secondary effects of EIMD seems dependent on the mode of exercise utilised. For instance, CWI application seems to demonstrate limited recovery benefits when EIMD was induced by single-joint eccentrically biased contractions. In contrast, CWI seems more effective in ameliorating effects of EIMD induced by whole body prolonged endurance/intermittent based exercise modalities.

The aim of this study was to examine the relationship between the physiological data from subjects and their reported sensory experiences during two types of recovery methods following a handball training session. Female handball players (average age: 21.4 ± 1.3 years; weight: 59.2 ± 3.3 kg; height: 158 ± 3 cm; body mass index, 23.4 ± 2.0 kg.m−2) carried out an athletic training session (rating of perceived exertion RPE: 14.70 ± 0.89) with either a passive recovery (PR) period or cold water immersion (CWI) for 14 min) (cross-over design). Physiological data were collected during the recovery period: CWI had a greater effect than PR on heart rate (HR; bpm), the higher frequencies (HF) of heart rate variability (HRV: 46.44 ± 21.50 vs. 24.12 ± 17.62), delayed onset muscle soreness (DOMS: 1.37 ± 0.51 vs. 2.12 ± 1.25), and various reported emotional sensations. Spectrum HRV analysis showed a significant increase in HF during CWI. Sensorial experiences during the recovery periods were gathered from verbatim reports 24 h later. Players' comments about CWI revealed a congruence between the physiological data and sensorial reports. They used words such as: “thermal shock,” “regeneration,” “resourcefulness,” “dynamism,” and “disappearance of pain” to describe their sensations. In conclusion, this study demonstrated the link between physiological and experiential data during CWI and we propose that action of the parasympathetic system on the autonomic nervous system can, at least in part, explain the observed correlations between the corporeal data measured and the sensorial experiences reported.

Although cold water immersion (CWI) is one of the most widely used post-exercise strategies to accelerate recovery processes, the benefits of CWI may be associated with placebo effects. This study aimed to compare the effects of CWI and placebo interventions on time course of recovery after the Loughborough Intermittent Shuttle Test (LIST). In a randomized, counterbalanced, crossover study, twelve semi-professional soccer players (age 21.1 ± 2.2 years, body mass 72.4 ± 5.9 kg, height 174.9 ± 4.6 cm, O2max 56.1 ± 2.3 mL/min/kg) completed the LIST followed by CWI (15 min at 11°C), placebo (recovery Pla beverage), and passive recovery (Rest) over three different weeks. Creatine kinase (CK), C-reactive protein (CRP), uric acid (UA), delayed onset muscle soreness (DOMS), squat jump (SJ), countermovement jump (CMJ), 10-m sprint (10 mS), 20-m sprint (20 mS) and repeated sprint ability (RSA) were assessed at baseline and 24 and 48 h after the LIST. Compared to baseline, CK concentration was higher at 24 h in all conditions (p < 0.01), while CRP was higher at 24 h only in CWI and Rest conditions (p < 0.01). UA was higher for Rest condition at 24 and 48 h compared to Pla and CWI conditions (p < 0.001). DOMS score was higher for Rest condition at 24 h compared to CWI and Pla conditions (p = 0.001), and only to Pla condition at 48 h (p = 0.017). SJ and CMJ performances decreased significantly after the LIST in Rest condition (24 h: −7.24%, p = 0.001 and −5.45%, p = 0.003 respectively; 48 h: −9.19%, p < 0.001 and −5.70% p = 0.002 respectively) but not in CWI and Pla conditions. 10 mS and RSA performance were lower for Pla at 24 h compared to CWI and Rest conditions (p < 0.05), while no significant change was observed for 20 mS time. These data suggests that CWI and Pla intervention were more effective than the Rest conditions in recovery kinetics of muscle damage markers and physical performance. Furthermore, the effectiveness of CWI would be explained, at least in part, by the placebo effect.

Background: Cryotherapy has been widely used for post-exercise recovery for decades. Whole-body cryotherapy (WBC) is a technique that involves brief exposure to extremely cold temperatures to produce therapeutic effects. Its effectiveness in treating exercise-induced impairments is currently under investigation. Purpose: This systematic review aims to assess whether WBC is more, less, or equally effective compared to other recovery interventions in reducing perceived muscle soreness and restoring muscle function after exercise-induced muscle damage (EIMD) in runners. Methods: A systematic literature review was conducted using the following MeSH terms: cryotherapy, whole-body cryotherapy, exercise-induced muscle damage, muscle soreness, muscle recovery, and running. The databases searched included PubMed, CINAHL, EBSCO Host, and Google Scholar. Articles were included if they were published in the last 10 years, had a level of evidence of IIb or higher according to the Centre for Evidence-Based Medicine (CEBM), a PEDro scale score of at least 5, focused on runners, and assessed both perceived muscle soreness and muscle function recovery. Studies were excluded if they did not involve runners, used partial-body cryotherapy (PBC) instead of WBC, or failed to measure both muscle performance and perceived soreness. Results: Among the four studies analyzed: Two studies found WBC significantly more effective than other interventions, such as far-infrared radiation and passive recovery, in reducing muscle soreness and restoring muscle power and endurance following simulated trail runs and high-intensity interval running. One study reported no significant difference between WBC and passive recovery in reducing muscle soreness and restoring muscle power after sprint intervals. One study indicated that WBC had a negative impact compared to cold water immersion (CWI) and passive recovery, worsening both muscle soreness and muscle strength recovery after a marathon. Conclusion: The findings were inconclusive regarding WBC’s effectiveness in treating exercise-induced muscle damage in runners compared to other recovery methods. However, WBC appears to have a time-dependent positive effect on muscle recovery, particularly after high-intensity interval and endurance running—though this benefit does not extend to marathon recovery. Further research is necessary to establish optimal WBC treatment protocols, including temperature, timing, duration, and frequency.

We investigated whether cold water immersion (CWI) after intensive training sessions can enhance recovery in elite Olympic weightlifters, taking into account each athlete's individual response pattern. The entire German male Olympic weightlifting national team participated in the study (n = 7), ensuring collection of data from elite athletes only. Using a randomized cross-over design, the athletes went through 2 high-intensity training microcycles consisting of 5 training sessions that were either followed by a CWI or passive recovery. Barbell speed in a snatch pull movement, blood parameters, and subjective ratings of general fatigue and recovery were assessed throughout the study. Physical performance at 2 snatch pull intensities (85% one repetition maximum [1RM]: -0.15% vs. -0.22%, p = 0.94; 90% 1RM: -0.7% vs. +1.23%, p = 0.25) did not differ significantly (condition × time). Although questionnaires revealed a significant decline in the ratings of overall recovery (p < 0.001) and a significantly higher rating of overall stress (p = 0.03) over time, no significant differences between conditions (p = 0.14; p = 0.98) could be revealed. Similarly, neither of the analyzed blood parameters changed significantly between conditions over time (creatine kinase: p = 0.53; urea: p = 0.43; cortisol: p = 0.59; testosterone: p = 0.53; testosterone:cortisol ratio: p = 0.69). In general, CWI did not prove to be an effective tool to enhance recovery in elite Olympic weightlifters over a 3-day intensive training period. However, even though the group was rather homogeneous with regard to performance, there were considerable intersubject differences in their response to CWI. It seems that athletes are best advised on a case-by-case basis.

The accumulated stresses of training and competition may temporarily cause impairments in an athlete’s physiological and muscular function, leading to suboptimal performance levels. Cold-water immersion (CWI) has become a widely used post-exercise recovery method to accelerate the recovery process by purportedly reducing the symptoms associated with exercise-induced muscle damage (EIMD). However, the underlying physiological mechanisms, which mediate the effects of CWI, are not well understood. Therefore, the aim of this thesis was to investigate the influence of cold-water immersion (CWI) on limb blood flow and thermoregulatory responses following different modes of exercise. In study 1 (Chapter 4), the reliability of Doppler ultrasound in the assessment of superficial femoral artery blood flow (FABF) was examined under resting conditions. A Doppler ultrasound scan of the superficial femoral artery was measured on eight recreationally active male participants; twice on the same day separated by 5-min (within-day), and on a separate day (between-days). The coefficient of variation (CV) for mean blood flow (MBF) was ~16 % and ~20 % for within and between-days, respectively. A relatively small standard error of measurement (SEM) was found both within day, 13.30 mL·min-1 (95% CI, -14.79 to 38.40 mL·min-1) and between-day, 17.75 mL·min-1 (95% CI, -40.12 to 30.88 mL·min-1) for MBF differences. These findings suggest duplex Doppler ultrasound is a reliable method to collect measurements of FABF under resting conditions. The purpose of study 2 and 3 was to determine the influence of different degrees of water immersion cooling on FABF and cutaneous blood flow (CBF) and thermoregulatory responses after endurance (Chapter 5) and resistance (Chapter 6) exercise, respectively. Participants completed a prescribed endurance of resistance exercise protocol prior to immersion into 8 oC (cold) or 22 oC (cool) water to the iliac crest or rested non-immersion (CON) in a randomized order. Limb blood flow and thermoregulatory responses were measured before and up to 30-min after immersion. In both studies, thigh skin temperature (Tskthigh) (P < 0.001) and muscle temperature (Tmuscle) (P < 0.01) were lowest in the 8 oC trial compared with 22 oC and control trials. However, femoral artery conductance (FVC) was similar after immersion in both cooling conditions and was reduced (~50-55 %) compared with the CON condition 30-min after immersion (P < 0.01). Similarly, there was a greater thigh (P < 0.01) and calf (P < 0.05) cutaneous vasoconstriction during and after immersion in both cooling conditions relative to CON with no differences noted between 8 and 22 oC immersion. Together, these findings suggest that colder water temperatures may be more effective in the treatment of EIMD and injury after both endurance and resistance exercise, respectively, due to greater reductions in Tmuscle and not limb blood flow per se. The aim of study 4 (Chapter 7) was to compare the influence of CWI and whole body cryotherapy (WBC) on FABF and CBF and thermoregulatory responses after endurance exercise. On separate days, participants completed a continuous cycle ergometer protocol before being immersed semi-reclined into 8 oC water to the iliac crest for 10 min (CWI), or exposed to 2.5 min (30 s -60 oC, 2 min -110 oC) WBC in a specialized cryotherapy chamber, in a randomized order. Limb blood flow and thermoregulatory responses were measured before and up to 40-min after immersion Reductions in Tskthigh (P < 0.001) and Tmuscle (P < 0.001) were larger in CWI during recovery. Similarly, decreases in FVC were greater (~45-50 %) in the CWI condition throughout the recovery period (P < 0.05). There was also a greater skin vasoconstriction observed in CWI at the thigh (P < 0.001) and calf (P < 0.001) throughout the post-cooling recovery period. These results demonstrate that CWI may be a better recovery strategy compared with WBC due greater reductions in both Tmuscle and limb blood flow. This thesis provides a novel insight into the influence of different degrees of water immersion cooling, as well as WBC, on limb blood flow and thermoregulatory responses after different modes of exercise. These findings provide practical application for athletes and an important insight into the possible mechanisms responsible for CWI in alleviating inflammation in sport and athletic contexts.

The aim of the present study was to investigate the potential benefits of cold water immersion (CWI) and active recovery (AR) on blood lactate concentration ([Lac]) and heart rate variability (HRV) indices following high-intensity exercise. 20 male subjects were recruited. On the first visit, an incremental test was performed to determine maximal oxygen consumption and the associated speed (MAS). The remaining 3 visits for the performance of constant velocity exhaustive tests at MAS and different recovery methods (6 min) were separated by 7-day intervals [randomized: CWI, AR or passive recovery (PR)]. The CWI and AR lowered [Lac] (p<0.05) at 11, 13 and 15 min after exercise cessation in comparison to PR. There was a 'time' and 'recovery mode' interaction for 2 HRV indices: standard deviation of normal R-R intervals (SDNN) (partial eta squared=0.114) and natural log of low-frequency power density (lnLF) (partial eta squared=0.090). CWI presented significantly higher SDNN compared to PR at 15 min of recovery (p<0.05). In addition, greater SDNN values were found in CWI vs. AR during the application of recovery interventions, and at 30 and 75 min post-exercise (p<0.05 for all differences). The lnLF during the recovery interventions and at 75 min post-exercise was greater using CWI compared with AR (p<0.05). For square root of the mean of the sum of the squares of differences between adjacent R-R intervals (RMSSD) and natural log of high-frequency power density (lnHF), a moderate effect size was found between CWI and PR during the recovery interventions and at 15 min post-exercise. Our findings show that AR and CWI offer benefits regarding the removal of [Lac] following high-intensity exercise. While limited, CWI results in some improvement in post-exercise cardiac autonomic regulation compared to AR and PR. Further, AR is not recommended if the aim is to accelerate the parasympathetic reactivation.

What is the central question of this study? Acute and repetitive cryotherapy are routinely used to accelerate postexercise recovery, although the effect on resident immune cells and repetitive exposure has largely been unexplored and neglected. What is the main finding and its importance? Using blood-derived mononuclear cells and semi-professional mixed martial artists, we show that acute and repetitive cryotherapy reduces the in vitro and in vivo T-cell and monocyte activation response whilst remaining independent of the physical performance of elite athletes. We investigated the effect of repetitive cryotherapy on the in vitro (cold exposure) and in vivo (cold water immersion) activation of blood-derived mononuclear cells following high-intensity exercise. Single and repeated cold exposure (5°C) of a mixed cell culture (Tcells and monocytes) was investigated using in vitro tissue culture experimentation for total neopterin production (neopterin plus 7,8-dihydroneopterin). Fourteen elite mixed martial art fighters were also randomly assigned to either a cold water immersion (15min at 10°C) or passive recovery protocol, which they completed three times per week during a 6week training camp. Urine was collected and analysed for neopterin and total neopterin three times per week, and perceived soreness, fatigue, physical performance (broad jump, push-ups and pull-ups) and training performance were also assessed. Single and repetitive cold exposure significantly (P<0.001) reduced total neopterin production from the mixed cell culture, whereas cold water immersion significantly (P<0.05) attenuated urinary neopterin and total neopterin during the training camp without having any effect on physical performance parameters. Soreness and fatigue showed little variation between the groups, whereas training session performance was significantly (P<0.05) elevated in the cold water immersion group. The data suggest that acute and repetitive cryotherapy attenuates in vitro T-cell and monocyte activation. This may explain the disparity in in vivo neopterin and total neopterin between cold water immersion and passive recovery following repetitive exposure during a high-intensity physical impact sport that remains independent of physical performance.