Cold Water Immersion

Cryotherapy (meaning ‘cold treatment’) is the most commonly used strategy for the treatment of acute soft tissue sports injuries, due to its ability to reduce the inflammatory response and to alleviate spasm and pain.

Cold water immersion is particularly effective at reducing the symptoms associated with DOMS, repetitive high intensity exercise, and muscle injury.

Hot Water Immersion (Spa)

Hot water immersion can assist the rehabilitation of soft tissue injuries (but not within the first 24-48 hours after the injury is sustained) and recovery and is usually performed in water greater than 37°C, resulting in a rise in muscle and core body temperature. A 20 minute immersion is typical.

Contrast Water Therapy (Hot/Cold)

“Hot/Cold” therapy is perhaps the most common, whether done in the shower (alternating hot and cold) or going from a cold bath/pool into a warmer one.

Temperatures for contrast water therapy generally range from 10-15°C for cold water and 35-38°C for warm water.

Pool Recovery

Pool recovery sessions are commonly used by team sport athletes to recover from competition, generally as a form of “active recovery”.

These sessions are typically used to reduce muscle soreness and stiffness, and often include walking and stretching in the pool as well as some swimming. This is an example of active recovery.

Hydrotherapy Recommendations

  • Where possible, full body immersion (excluding head and neck) should be implemented.
  • Recovery interventions should aim to be practical and time efficient. Hydrotherapy interventions of 10-15 min duration appear to be effective.
  • Current knowledge suggests water temperatures of 10-15°C (cold) and 38-42°C (hot) are effective. If athletes are performing a continuous cold water immersion protocol it is recommended to use a slightly warmer temperature (e.g. 15°C). This is more comfortable (enhancing compliance), and has been shown to enhance the recovery of performance. However, if an athlete is performing an intermittent cold water immersion protocol, a cooler temperature (e.g. 10-12°C) may be more effective given the shorter exposure time.
  • It is currently recommended that during “hot/cold” therapy, athletes should avoid having more hot water exposure than cold water exposure.
  • Individual responses to recovery will vary and not every athlete will find them beneficial.