Much like foam rolling and putting coconut oil on f**cking everything, during the last decade or so the use of ice baths has become a mainstay of rugby strength and conditioning.
To explain the popular rationale for using ice baths, let’s remind ourself of the body’s 3 step response to injury. Because when we perform strenuous exercise like strength and power training, that is essentially what we are creating: microscopic injury to muscle tissue
1. Acute inflammation
The body attempts to inhibit and immobilise itself to prevent any further damage by flooding the area with fluid. Damaged cells are destroyed and broken down, and chemical signals for growth and repair are released at the site of the injury.
The waste products of the previous phase are transported away from the injury site, and the raw materials for repair are laid down in their place. However the formation of new tissue is haphazard and unordered.
The final stage in which new tissue is re-ordered to better tolerate the demands placed upon it. Increases in performance will be apparent during this stage.
Fully aware of this standard response to injuries, coaches and athletes looked to ice baths as a tool to accelerate gains in strength, power and lean muscle mass. The rationale goes like this:
- The inflammation we create after heavy training is associated with soreness and a decline in performance.
- All of the positive adaptations associated with training (strength, hypertrophy, power etc.) occur during recovery.
- Ice baths- due to their constrictive effect on blood vessels- limit inflammation and reduce the decline in performance we experience after strenuous exercise.
- This may also create a pumping effect, clearing tissue of by products like lactic acid when the cold is eventually removed, the blood vessels re-open and new blood floods the muscles again.
- By reducing inflammation and creating less mess in the first place, ice baths also speed up recovery, allowing us to train harder, more frequently, substantially increasing gains in strength and power.
Here’s the problem though: ice baths may actually slow recovery down, and reduce longer term increases in strength and power. In fact, much of the evidence suggests that the only real benefits to ice baths are psychological. Here’s why:
Delayed inflammation and white blood cell accumulation
Many of the studies which demonstrate the effectiveness of ice baths in reducing inflammation and accumulation of white blood cells (the guys responsible for destroying damaged tissue and creating signals for re-growth) measure this response over a very short time frame- for hours or a couple of days at best.
Opposing studies have shown that once the ice bath has stopped, this inflammation and white blood cell response still happens. The ice bath just delays this effect. Whether we like it or not, it is going to happen! If this response is responsible for creating soreness and impaired performance, why not get it over and done with rather than delay the inevitable?
By working against the body’s natural response to tissue damage, we may actually be slowing recovery down rather than speeding it up as we intend to.
Inflammation is the signal for adaptation
Training is all about stress. Without stress there is no adaptation, there is no improvement in strength, speed or power. Internally, inflammation is the body’s stress response to heavy training. Within reason the more inflammation we create, the bigger a signal for adaptation we create. Why would we work against this and turn the signal down by using ice baths?
A number of studies have now shown that long term ice bath use results in less strength, power and muscle gains than when no ice baths are used. Yes soreness, inflammation and temporarily impaired performance are unpleasant things to deal with, but that is the price of improvement.
It’s a placebo effect
Much of the evidence suggests that the biggest benefit of ice baths is psychological. Athletes may experience a small reduction in soreness and benefit to performance in the short window of time following intense exercise, but there is no significant physical change taking place within the body. In short, the ice bath acts a placebo.
After intense contact training and matches, being in pain is never a good thing. It can affect motor learning and execution of skills in future sessions, with negative consequences. But getting some rugby players into an ice bath after a training session is like getting a cat in the shower.
A lot of players absolutely HATE ice baths. For these guys there is nothing relaxing or beneficial about standing in a dustbin full of ice whilst their balls jump into their torso. My guess is that for these players ice has no beneficial effect whatsoever, and their time would be better spent on other activities.
What to do instead?
My preference is that athletes get out of the body’s way as much as possible! To steal a quote from my colleague Carl Valle, recovery is pretty much just sleep, time and nutrition so I would rather my athletes invest energy in these three activities.
Once the acute stage of inflammation is ending or over, I prefer any low impact, movement based activity which is able to accelerate the flushing out the muscles (or Normatec if you have the money!). Massage and self massage activities like foam rolling can also replicate the pain reducing effects of ice, but without the drawbacks.
When ice baths may work?
Despite my misgivings I think there may be a few occasions when ice baths may be merited. The most obvious situation is a very short turn around between games. When the team only has a few days to prepare for a game, no significant strength or power training will take place, so reduced adaptation does not matter. The goal here is freshness, and ice may help.
Whilst ice baths are probably a bad idea following non contact gym or speed training, I think there is still a place for ice baths following high contact training if players have sustained impact injuries like dead legs or sore shoulders. To my knowledge there is no performance benefit to be derived from being stamped on the leg, so what is the harm in reducing inflammation and pain?!
A final scenario in which I think ice baths may help is, if despite all the appropriate education and provision of other options, some players still decide that ice baths are their favourite way to recover. If for some reason they feel better and perform better when ice baths are part of their preparation than not.
As much as this upsets my inner scientist, perception is reality and it is extremely important to make sure that athletes believe in what they are doing. Optimal performance is an unlikely outcome if a player hates his or her programme, regardless of how scientific it is! But for everyone else labouring under the assumption that ice baths are helping their performance… nope.