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III. 1. - Recovery (WBC & Nutrition)

Several studies have tested the efficacy of WBC sessions on functional recovery in a non-disease context. The first of these studies examined exercise-induced muscle damage, later studies were performed in more everyday conditions. Application of WBC during the post-exercise recovery period has now been tested with many sports such as synchronised swimming, tennis, canoeing, and running in rough terrain such as in trail running or rugby (Hausswirth et al. 2011; Kruger et al. 2011). The results of these studies indicate weak effects of WBC on recovery when it is used after exercises performed in a laboratory inducing moderate to severe localised muscle damage. In contrast, a significant improvement in functional recovery compared to a passive recovery situation was observed when WBC was used after exercise performed in real-life conditions. It is interesting to note that the beneficial effects of WBC appear from the first exposure after fatiguing exercise and do not seem to be enhanced by repeated exposures. However, until this year, no study had attempted to introduce a placebo condition. In the vast majority of studies, functional recovery was assessed by measuring physical performance, which is likely to be affected by a placebo effect. In a recent German study, published in January 2015, a placebo condition was introduced for the first time (Kruger et al. 2015). The results of this study indicate that, compared to the placebo condition, WBC is associated with an improvement in early recovery after intermittent high-intensity exercises. It therefore appears that, in this very specific case, WBC presents a significant advantage, confirming the results of other studies applying cold water immersion. In contrast, WBC appears to be only mildly beneficial in functional terms when used during short-term recovery before exercises inducing muscle damage. Persistent use of WBC after exercise inducing mild to moderate muscle damage could actually be counter-productive as it potentially inhibits the anabolic process. Indeed, a recent study of this type of exercise associated with cold water immersion-based methods indicated that chronic exposure to cold limits muscle development and reduces gains in strength production compared to non-cold-based recovery techniques (Roberts et al. 2015). 

In summary, it appears today that there is evidence that WBC can facilitate functional recovery after exercise inducing mild muscle damage (i.e., reduced capacity for immediate force production <20%, rapid functional recovery (<48 h) and [CK]plasma/serum < ∼1000 UI/L), which is of intermittent type at high intensity and is performed in real-life conditions.


Nutritional factors play an essential role. One of the basic rules requires a balance between nutritional needs and diet to be maintained. Biological constants can be restored if there is balance, which must be understood both in terms of calories (quantitative balance) and in terms of macro-and micro-nutrients (qualitative balance).

The aims of nutritional recovery are specific to each athlete and to each training period, and appear thus to be determined by a group of factors:

·        Physiological and homeostatic modifications resulting from training, including:

o   the extent of depletion in energy substrates (mainly glycogen),

o   the extent of dehydration (see previous chapter)

o   the extent of muscle injury or protein catabolism.

·        The goals in terms of performance improvement or adaptation of training sessions, including:

o   the increase in muscle size or strength,

o   the reduction in percent body fat,

o   the increase in enzymes, functional proteins or synthesis of functional cells or tissues (e.g. red blood cells, capillaries etc.),

o   the level of substrates ingested and the hydration status before the next exercise.

·        The duration of the period separating two exercises, including:

o   total recovery time,

o   other obligations or needs during the recovery period (e.g. sleep, travel etc.).

·        The availability of food for ingestion during the recovery period, including:

o   immediate availability of food after training,

o   athletes' appetite and the opportunity to consume food and beverages during the recovery period.


It is remarkable to note that, in regularly trained athletes, consuming excess dietary proteins during recovery has a double result: primarily, to ensure the repair of morphological lesions as a result of exercise; and, to allow the synthesis of structural proteins. However, it is now well established that the anabolic effect of proteins depends strictly on muscle contraction. According to Décombaz (2004) three factors must coincide to activate net muscle protein synthesis: muscle contraction, amino acid availability and insulin circulation.

What is essential in the relationship between recovery and endocrinology, is that the very nature of nutrients influences growth hormone release. In man, it has been show that the absorption of 500 calories as carbohydrates (maltodextrin) or 500 calories as proteins (commercially available supplement made up of a complex of several amino acids) was followed by a reduction in growth hormone release (Matzen et al. 1990). After this initial drop, protein-based nutrition has the particularity of inducing a peak of growth hormone secretion. This starts 90 minutes after absorption of the supplement, and extends into the fourth hour. These results show that the composition of the daily diet plays an important role in the control of growth hormone release. It casted a significant shadow of doubt over the advantages of consuming very large quantities of proteins – i.e. above the needs induced by exercise – for the development of muscle mass during recovery.

The importance of an anabolic environment was indicated by a recent study in which immediate intake – 5 minutes after muscle reinforcement training – of a dietary supplement including 19 g of milk proteins (rich in essential amino acids), over twelve weeks, produced muscular hypertrophy and strength gain at increased levels compared to when intake was delayed for two hours. This was observed in a population of master athletes (Esmarck et al. 2001). In parallel to this study, the authors investigated the relevance of food intake just before exercise, and its incidence on athletes' recovery. In this case, Tipton et al. (2001) suggest that taking essential amino acids (EAA) before exercise mainly based on resistance, has a more marked effect on later protein synthesis than if they are taken after exercise. These authors compared situations before and after exercise, and showed higher protein synthesis when athletes were given a solution of 6 g EAA and 35 g glucose before performing resistance exercises.


Reductions in muscle glycogen as a result of prolonged exercise stimulate the metabolic pathways leading to glycogen synthesis during recovery. Ingesting sugar-containing foods during this recovery phase leads to two phenomena: on the one hand, an increased rate of resynthesis, and on the other, an increased level of glycogen, above those present prior to exercise. Glycogen resynthesis capacities differ depending on the nature of the sugars available. Intake of CHO and its precise "timing" during the recovery phase largely influence the quality of glycogen resynthesis. These strategies are very important during unique restrictive situations (such as triathlon or marathon), but also during events where competitive legs are repeated throughout the day (such as swimming, middle-distance racing or repeated judo combats). The sooner carbohydrates are consumed after completing exercise, the higher the amount of muscle glycogen resynthesised. Thus, when some CHO is ingested immediately after exercise, the quantity of muscle glycogen measured 6 hours later is higher than when the intake of CHO is delayed for 2 hours after the end of exercise (Ivy et al. 1988). It is now accepted that exercise increases both sensitivity to insulin (Richter et al. 1989) and permeability of the muscle cell membrane to glucose, and that the highest rates of muscle glycogen resynthesis are recorded during the first hour (Ivy et al. 1988a, Fig. 8.8). This is mainly due to the fact that the enzyme glycogen synthase is activated by glycogen depletion (Wojtaszewski et al. 2001). Sugar-based nutrition immediately after exercise takes advantage of these effects, as reflected by the higher rates of glycogen storage (7.7 mmol.kg−1.h−1) over the first two hours of recovery. The usual rates of glycogen storage (4.3 mmol.kg−1.h−1), are judged insufficient in this context (Ivy et al. 1988). This study showed the basis for recovery with regards to glycogen: ingestion of too little CHO immediately after exercise induces very low rates of glycogen resynthesis, rates which are not inclined to promote repeated performances (training or competition).

The quantity of carbohydrates to be consumed during recovery after exercise is often questioned. Thus, different energy drinks have been marketed to maintain athletes' plasma and blood volumes. As part of this, Criswell et al. (1991) tested the influence of a drink at 7% glucose (and containing electrolytes) on the levels of haematocrit and haemoglobin after a football match in comparison with a drink containing no glucose. The data obtained from 44 football players showed that the energy drink allowed plasma volumes to be stabilised during recovery, while the non-glucose drink with electrolytes did not allow maintenance of blood volume (i.e. a 5% reduction in plasma volume). However, the energy drink did not influence the drop in anaerobic performance.

A recent study (Berardi et al. 2006) studied the effect of one hour of against-the-clock cycling in six experienced cyclists. The study subjects then ingested different meals and solutions, immediately, 1 or 2 hours after exercise. The nutritional composition was as follows: (C + P: carbohydrate + proteins; CHO: carbohydrate; placebo: solid food placebo). After 6 hours' recovery, a second one-hour against-the-clock trial was performed. Various muscle biopsies were taken pre- and post-exercise to quantify glycogen resynthesis. Although cycling performances were similar over the two trials (P = 0.02), the rate of resynthesis of muscle glycogen was greater (+ 23 %) in the "C + P" condition than in the "CHO alone" condition. This final result has an undeniable impact: when post-exercise nutrition must be spaced out and when two exercise periods are to be performed with only a small recovery period, the combination of carbohydrates and proteins probably has great advantages with regards to increasing the speed of glycogen resynthesis.


Practical applications in nutrition:


  • ·        For the stimulation of glycogen storage in muscles after exertion, all the data underline the importance of early food intake (from the end of exercise) and somewhat reduce the role of increased insulin, as well as the relevance of ingesting insulogenic proteins and amino acids ;
  • ·        Intake of substituted amino acids – mainly leucine (0.1 g.kg−1.h−1) – associated with carbohydrates (0.3 g.kg−1.h−1) and proteins (0.2 g.kg−1.h−1), is recommended in order to stimulate post-exercise protein synthesis, and thus recovery;
  • ·        The importance of an anabolic environment was shown by an immediate intake, after muscle reinforcement exercise, of 19 g of milk proteins (rich in essential amino acids) over 12 weeks: the strength gain was increased compared to when intake was delayed for 2 hours;
  • ·        Dietary composition plays an important role in the control of growth hormone release. Stimulation of this, observed one hour after the ingestion of dietary protein, favours anabolism of contractile and structural proteins in skeletal muscle. There is a threshold for protein synthesis; above it, amino acids from excess dietary proteins are oxidised rather than stored (above 1.5 g.kg-1.d-1).



III. 2. - Muscle soreness

Intense training and competition particularly with underrecovery time could induce muscle damage indicated by muscle soreness, swelling, prolonged loss of muscle function and the leakage of muscle proteins, such as C-Reactive Protein (CRP) in the circulation (Hirose et al. 2004). The essential component of the physical stress theory is that high intensity physical exercise creates muscle damage and inflammation leading to disturbance in cellular homeostasis and discomfort, a phenomenon that is referred to as delayed onset muscle soreness (DOMS) (Stacey et al. 2010).

Even though cold is very frequently suggested to limit muscle damage in the scientific literature, few studies using WBC have investigated this aspect. On the whole, the studies that have, showed that the benefits of WBC were low compared to a control condition, whether applied after exercises inducing significant muscle damage (repeated eccentric contractions) or mild muscle damage (repeated tennis training or mountaineering races). These results were recently confirmed in a Cochrane meta-analysis indicating that, after exercise inducing muscle damage or after exercise in real-life conditions, plasma creatine kinase, lactate dehydrogenase or aspartate aminotransferase levels were only mildly affected by one or more WBC sessions compared to a control condition (Costello et al. 2013). An increase in serum creatine kinase (CK) is the most typical indicator of exertional rhabdomyolysis, and assay of this marker could be used to determine physical workload, recovery and possible overtraining. The benefits of cold-based recovery have been described in top-level rugby players after training, where immersion of the legs in cold water resulted in a decrease in total serum CK concentrations compared to passive recovery (Banfi et al. 2007). This confirmed the results of Gill et al. (2006) who also measured CK levels in the interstitial fluid surrounding the muscles in rugby players. WBC induced a clear and significant decrease in the mean values of CK and lactate dehydrogenase (LDH) after 1 week of treatment in professional rugby players. It seems that short-lived exposure to cold air enhances muscle fibre repair, limiting the breakdown of the cell membrane or reducing its increased permeability. These effects are generally caused by oxidising agents produced during physical exercise. Since the athletes did not change their training scheme or load during the period of WBC treatment, the significant decrease in total serum CK and LDH concentrations led to effective and rapid recovery from muscle damage. In a recent study, Hausswirth et al. (2011) demonstrated that a unique session of WBC (3 min at -110°C) performed immediately after eccentric dynamic exercise enhanced muscular recovery by decreasing the DOMS process. These findings suggest that multiple interactions between cytokines are likely involved in the physiological response to exertional fatigue and cold may serve to limit the severity of the host inflammatory response. In this case, accordingly with the hypothesis of the authors, multiple WBC exposures can enhance recovery, by decreasing the acute phase inflammatory response after a running trail exercise, thus contributing to its beneficial role in organ protection after muscle damage.


III. 3. - Inflammation process

Classical immunological markers such as immunoglobulins (Ig) and C-reactive protein (CRP) were measured in athletes before and after a treatment cycle. These markers are both regularly and easily measured in the general population and in athletes as markers of acute or chronic infection and/or inflammation. In rugby players who underwent WBC treatment, immunoglobulins were slightly, but not significantly, increased, and CRP showed a slight, but also not significant, decrease. The lymphocyte and monocyte counts were unchanged: 44.7% (standard deviation (SD) 8.2) for lymphocytes before WBC and 37.8% (SD 10.6) after (p-value not significant), and 9.6% for monocytes in both blood samples (SD 1.7 before, 3.5 after; p-value not significant) [23]. Thus, WBC is not associated with alterations to immunological markers, and it does not appear to have a detrimental effect on the immune system. Other data suggest that WBC does not impact immunological parameters, although the period of observation in this study was too short to assess modifications to lymphocyte involvement and function. In fact, subjecting healthy males to prolonged cold water immersion resulted in slight increases in plasma tumour necrosis factor-a levels, and lymphocyte and monocyte counts.

There is thus limited evidence that short- or long-lived exposure to cold causes immunosuppression. Rather, cold exposure has an immunostimulating effect possibly related to the enhanced noradrenaline (norepinephrine) response triggered by cold. Therefore, a stimulating effect of cold exposure could be argued. This effect is regulated by the relationship between the decrease in core temperature and the duration of exposure.

Although exposure to cold is very extensively used to limit inflammation triggered by physical exercise, or in the context of inflammatory diseases, its physiological effects on the processes involved remain poorly known. A few studies showed a significant effect of WBC on the inflammatory process after exercises inducing mild muscle damage. Thus, an increase in IL-1ra associated with a reduction in IL-1β and in CRP was observed after a WBC session following simulated trail running lasting less than 2 h (Pournot et al. 2011). Similarly, a reduction in IL-6, and IL-1β levels was observed when a WBC session was scheduled before 40 min exercise (Mila-Kierzenkowska et al. 2013). These recent results reinforce observations by Banfi et al. (2013) although their study did not include a control group) indicating that 5 WBC sessions in athletes reduced the level of soluble intracellular adhesion molecules (sICAM-1), the pro-inflammatory response, as attested by PGE2, IL-2, IL-8 levels, and increased levels of the anti-inflammatory cytokine IL-10. More recently, Ziemann et al. (2013) showed that 10 sessions of whole body cryostimulation significantly reduced the inflammatory response induced by eccentric exercise. Interestingly, they noted that after the second eccentric exercise session, CK activity declined in both groups, with the reduction seen in the WBC group being more pronounced. They strongly suggest that this effect was mediated by IL-10. This was the first time that whole body cryostimulation has been shown to have sustained an increased level of IL-10 after exercise with an eccentric component. A way to prevent injuries?


III. 4. - Sleep quality

Physical exercise is a source of significant physiological and psychological stress for the body; be it muscular, energetic, cognitive or other. Almost all athletes attempt to apply regular training and competitive stimuli to overload their physiological and cognitive systems in order to promote adaptation and improve performance (Issurin 2010). The demands of such training and competitive stimuli are normally large, and the importance of recovery to ensure adequate adaptation is deemed critical to both short (Barnett 2006) and long-term success (Issurin 2010). As highlighted previously, engagement in sleep is a regular and important aspect of human physiological functioning and is viewed as important to both recovery and athletic success (Halson 2008). Accordingly, it is recommended that the post-exercise recovery phase provide conditions allowing for high quality sleep to ensure sufficient and adequate recovery and maintenance of exercise performance. 

During intense training periods, deterioration in sleep is commonly reported (with sleep latency, reduced duration and efficacy of sleep); these effects were not observed when athletes were exposed to very intense cold on a daily basis. Exposure to cold could thus help athletes to better support the training workload, consequently limiting the symptoms associated with overreaching such as reduced sleep, increased fatigue or diminished physical capacities.

In a recent study, Schaal et al. (2014) showed that the periods of intense training performed over the months preceding the major swimming competitions led to the appearance of early symptoms of functional overreaching, including impaired autonomic and metabolic responses to exercise, increased perceived fatigue and deteriorated sleep quantity and quality. This study used a longitudinal design to investigate the effectiveness of WBC at -110 °C as a daily recovery strategy during intensified training. The results suggested that several of the physiological indicators of fatigue accumulation observed in the control condition could be reduced by daily WBC sessions. Thus, WBC improved the quality of recovery for swimmers by preserving sleep quantity, preventing an increase in perceived fatigue, and by mitigating the decrease in performance and associated physiological changes during exercise, all of which were observed in the control population. It is possible that the strong influence of WBC on post-exercise parasympathetic reactivation may have played a role in preserving these sleep parameters. Schaal et al. (2013) demonstrated that WBC elicited a prompt parasympathetic reactivation at the cardiac level following a maximal exercise bout in elite synchronized swimmer, bringing vagal-related HRV indices two to four-fold higher than pre-exercise values. Furthermore, Al Haddad et al. (2012) reported that male swimmers using cold water immersion daily during a week of normal training displayed higher indices of parasympathetic activity in the morning and expressed improved sleep quality. WBC aiding the reduction of sympathetic activity before sleep may promote relaxation and the onset of sleepiness; this could explain the preserved sleep latency and actual sleep duration, in turn preventing fatigue levels from rising over the course of intense training. This is the first time that the influence of WBC on sleep is investigated in a sports training context, and future studies are needed to describe the mechanisms by which cryostimulation may help preserve sleep quantity during training and/or competition. 


III. 5. - Overreaching

Elite athletes in many sports follow rigorous, carefully planned training regimen designed to optimize peak performance during the most important competitions of the season. Periods of intensified training (IT) are inherent to these athletes’ training programs, and are intended to impose a large enough training stress to further stimulate the physiological adaptations that are necessary to improve performance.

To date, only one study evaluate the impact of typical lT periods on physiological and psychological indicators of recovery, fatigue and performance in elite swimmers (Schaal et al. 2014).  The authors showed that the periods of intense training performed over the months preceding the swimmers’ major competitions led to the appearance of early signs of the Functionnal Overreaching (F-OR) state, including an impaired autonomic and metabolic response to exercise, increased perceived fatigue and deteriorations in sleep quantity and quality.  This study is also the first to use a longitudinal design to investigate the effectiveness of WBC at -110 °C as a daily recovery strategy during intensified training. The results suggest that several of the physiological signs of fatigue accumulation observed during intense training with no WBC (ITCON) during recovery could be reduced by daily WBC sessions. The latter improved the quality of the swimmers’ recovery by preserving sleep quantity, preventing levels of perceived fatigue from increasing, and by mitigating the decrease in performance and associated physiological changes during exercise that were observed during ITCON.  

The daily WBC sessions may have improved the swimmers’ tolerance to the training load in part by helping to preserve sleep quantity during this period of increased physical and psychological stress. WBC use at -110 °C significantly improved the quality of the swimmers’ recovery by preserving sleep quantity, perceived fatigue and limiting the appearance of physiological signs associated with F-OR during exercise. WBC is known to alleviate depressive symptoms, and it could also be apply during high job strain in order to prevent burn-out and/or overreaching.


III. 6. - Cooling strategies 1

High internal body temperatures resulting from differences in the production and loss of heat during exercise is demanding on physiological functioning and can lead to the reduction in exercise performance and an increased risk of heat illness (Armstrong et al. 2007). Accordingly, pre- and post-exercise cooling interventions have a developing research profile and are commonly used interventions in the field to assist the reduction of thermoregulatory load before and following exercise to assist performance and recovery (Duffield et al. 2009). The use of cooling procedures generally entails the use of a range of interventions designed to reduce skin, muscle and/or core body temperature and associated physiological functioning (Marino 2002). Cooling procedures can be classified as either full-body (cold water immersion, showers, cold-rooms) or part-body (ice-vests, cold towels, ice packs) based interventions (Hausswirth et al. 2013; Duffield 2008). While full-body cooling is proposed to be of greatest physiological benefit, it is often logistically the most difficult and hence mixed-method designs have been suggested as more practically beneficial (Duffield et al. 2009). Pre-exercise cooling is generally only utilized during warm to hot environmental conditions and is reported to be ergogenic when the thermoregulatory load of exercise is pronounced (Marino 2002; Duffield 2008). Alternatively, post-exercise cooling has proven to be a popular recovery strategy for many sports and is employed in a range of environmental conditions, regardless of thermoregulatory or environmental load (King and Duffield 2009). 

Pre-cooling as a performance aid

The benefits of pre-cooling for performance seem to depend on the type and duration of exercise performed. In general, short duration, maximal intensity exercise is not improved following pre-cooling, while prolonged continuous and intermittent exercise may be improved (Duffield 2008). If a sufficient initial pre-cooling exposure is provided, the cold-induced physiological responses tend to be present for up to 30 min (Duffield et al. 2010); accordingly, research involving prolonged exercise longer than 5-min in duration in warm conditions generally reports improved performances (Marino 2002). Whether the exercise mode be constant-intensity or free-paced (Kay et al. 1999), time-to-exhaustion, set distance or distance covered, the act of pre-cooling has generally been shown to be ergogenic in the heat.  

Initial results of research using intermittent-sprint protocols did not report performance improvements following upper-body pre-cooling (Cheung and Robinson 2004). However, more recent evidence indicates pre-cooling with ice-vest may also benefit team sport type exercise (Duffield and Marino 2007). These differences may result in the use of fixed versus free paced intensities and the amount and duration of repeated sprint efforts. Castle et al. (2006) have reported an improved maintenance of repeated 5-sec sprint efforts with various cooling methods while the control condition exhibited a greater decline over a 40-min protocol. Moreover, Duffield and Marino (2007) demonstrated improved sub-maximal, free-paced running between sprint efforts following cold immersion, similar to previous studies using continuous endurance protocols. Therefore, while the body of research literature for simulated team-sport exercise is much smaller than that reporting continuous exercise, recent evidence indicates similarities in performance benefits following pre-cooling in the heat.  


Post-exercise cooling as a recovery aid

Post-exercise cooling, particularly via cold water immersion is a popular and common recovery intervention with many athletes and scientists (Barnett 2006). While the research evidence remains somewhat equivocal, enough evidence exists to suggest the ergogenic benefits of this intervention. Previously, Peiffer et al. (2009) reported the suppression of peak isometric force recovery following post-exercise cold water immersion. Accordingly, these data suggest that cooling may have negative effects on maximal force development during the acute recovery phase. However, King and Duffield (2009) reported that post-exercise cooling resulted in only moderate effects for a smaller percent decrement during repeated vertical jump and sprint efforts on the second day of simulated team-sport exercise. Similarly, Dawson et al. (2005) reported minimal differences in vertical jump or peak power during a 48 h post-game recovery with cold water immersion compared to a control condition. However, Vaile et al. (2008) reported that active recovery resulted in a 4% reduction in ensuing performance of a second 30-min cycling bout, while cold water immersion maintained performance following recovery in the heat (34oC). The small improvement was in contrast to the significant reductions noted when passive recovery was employed following the first cycling bout.  As such, while somewhat sporadic, to date mixed evidence exists over the effectiveness of post-exercise cooling to speed the recovery of performance.

As with any cooling procedure, commonly proposed mechanisms relate to an increase in circulatory volume and therefore an improved muscle blood flow (Marino 2002, Vaile et al. 2008). The resultant peripheral vasoconstriction following changes in skin temperature from cooling and closing of local vasculature promote a larger central circulatory reserve that may be beneficial to reduce cardiac stress due to the increased venous return and stroke volume (Maw et al. 2000). However, of the limited studies that investigated post-exercise cooling, few report differences in heart rates that are not explained by the passive nature of cold water immersion or differences in any cardiovascular measure during ensuing bouts of exercise (Vaile et al. 2008). Further, given the absence of notable differences in cardiovascular, metabolite or hormonal measures due to cooling interventions in the recent research (Vaile et al. 2008), it is possible that centrally-mediated mechanisms regulate the recovery of exercise performance following exercise-induced stress. However, to date this is speculative as there is currently no published research to support or refute this notion.    

Another area of practical importance is the assistance to perceptual recovery following exercise. Post-exercise cooling has been reported to be beneficial to the perception of a recovered state (Duffield et al. 2009).  Perception of exertion (RPE) and muscle soreness ratings have been reported to be reduced following post-exercise cooling or recovery in cooler environments (Duffield et al. 2009; King and Duffield 2009). Further, Rowsell et al. (2008) reported that over a 4 day simulated soccer tournament, cold water immersion following each game did not improve any physical measure, but rather improved the perceived state of recovery and rating of muscle soreness following consecutive days play. While difficult to discount a placebo effect, the perceptual benefits to post-exercise cooling may also be an important recovery tool for athletes in field-based environments. Additionally, post-exercise cooling may also reduce the sensations of pain and inflammatory response to any induced muscle damage or injury (Meeusen et al. 1986). Further, recent evidence has reported that the use of ice-packs following repeated 250-m maximal running efforts suppressed both anti and pro- inflammatory blood markers (Nemet et al. 2009). While these factors have not been directly attributed to improved exercise performance, it is likely that singularly or as an additive effect they act to assist both the acute or prolonged recovery of performance following exercise-induced stress. In another context, as further evidence of the effectiveness of pre-cooling to improve endurance performance, Hasegawa et al. (2005) reported that wearing a cooling vest improved cycle ergometer performance of 60 min at 60% V ̇O2max, followed immediately by a time to exhaustion effort at 80% V ̇O2max in hot conditions (32 °C and 80% relative humidity). The results indicated that wearing a cooling vest during exercise combined with drinking water significantly improves performance to a greater extent than either water intake alone or wearing the cooling vest without concomitant water intake. According to these authors, the improvement in exercise time at 80% of V ̇O2max was related to the greater physiological margin before critical limiting temperatures were reached, thus allowing continuation of exercise performance. Such findings concur with the results of Cotter et al. (2011) in suggesting that the reduced thermoregulatory and physiological loads result in longer time to exhaustion or more work performed within set duration efforts in hot ambient conditions.


In summary, evidence on the effectiveness of post-exercise cooling as a recovery strategy is somewhat mixed; however, enough evidence exists to suggest benefits in the use of this practice. Although some evidence highlights an acute improvement in muscle performance following post-exercise cooling, the longer term benefits seem to be minimal. Consequently, despite mixed findings for the use of post-exercise cooling, in particular environments (heat, injury), post-exercise cooling seems an effective recovery strategy. 

Practical Applications:

  • Pre-cooling can improve prolonged exercise in the heat, while reducing the physiological and perceptual load of the exercise bout.  WBC at -110 °C has a positive impact on power, performance and especially endurance.
  • Intermediate cooling can be used to optimize training, by shortening the break between one and the other training unit, allowing to train more in the end of the day.
  • Post-exercise cooling can be of benefit to speed the recovery of some physiological systems, and may be of benefit for the faster recovery of performance, especially in the heat or from excessive physiological load.
  • The extent of cooling depends on the specific logistics of the situation, but try to cool as much surface area as possible, says WBC at -110 °C is an ideal cooling method.  
  • Caution, if the aim is to build up musculature and strength. In this case WBC shall not be used as intermediate cooling and post cooling shall only be applied