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Do ice-baths really help exercise recovery?

Nurturing

REST AND RECOVERY Bundee Aki during a gym session at the Yumeria Sports Grounds in Iwata, Shizuoka Prefecture, Japan. How the Irish team recovers in between World Cup matches will be key to their success. Pic: Brendan Moran/Sportsfile

Health

Andrew O'Brien

The Rugby World Cup is upon us. Can this Irish team do what none of their predecessors have managed and progress beyond the quarter-final? To do so, they’ll obviously need to play well, incredibly well considering their quarter-final opponent will be either New Zealand or South Africa. And they’ll need to get over being beaten by Japan.
While South Africa seem to be on an upward curve, New Zealand have been (a little bit) shaky of late, only managing to finish third in the southern hemisphere Rugby Championship on the back of a draw with the Springboks and their biggest ever defeat against the Wallabies.
There is hope then. Beyond the performance aspect though, to go deep into tournament like the Rugby World Cup, a team needs luck. Luck with everything from the bounce of the ball to the referee’s decisions. Most importantly, a team needs luck with injuries and to recover as quickly as possible between matches. What Irish Rugby fan doesn’t remember the elation of beating France in Cardiff during the 2015 edition of the tournament, only to lose Jonathon Sexton, Paul O’Connell and Peter O’Mahony to injury and suffer a trouncing at the hands of Argentina in the quarter-finals?
It is well accepted that injuries are a part of sport, perhaps even more so in elite rugby, and that some of those injuries can neither be prevented or rehabilitated quickly. But what about the standard aches, pains, bumps and bruises that appear after a match and need to be shaken off before the following weekend? How do teams recover?
One recovery technique used by athletes of all levels is the cold-water immersion, the dreaded ice bath. A sort of variation on the ice bath is whole-body cryotherapy, often known as a cryotherapy chamber, where the athlete enters series of freezing rooms with temperatures as low as -100°C. But do they work? Plenty of athletes report benefits, but is there any scientific evidence to back up the anecdotal claims of users? Perhaps it’s best to look at the two variants separately.
Cold water immersion involves people immersing themselves in water at temperatures of less than 15°C to manage muscle soreness after exercise and speed up recovery time. There is some evidence to show that cold-water immersion reduces muscle soreness at 24-72 hours after exercise compared with ‘passive’ treatment, or rest. It is here that the research falls down slightly by not comparing the use of cold-water immersion to an active recovery of light exercise, or perhaps even more pertinently, a combination of the two.
There is less evidence to support the use of cryotherapy chambers, which is not to say that they don’t work, but that not much research has been done. There is some evidence to suggest that whole-body cryotherapy reduces muscle pain at rest from one to 72 hours after exercise. However, the evidence also suggests that it may make no difference, or make the pain worse.
Contrast water therapy, where an athlete alternates between warm and cool water, is another common recovery technique. Again, the evidence suggests that it is better than passive recovery – possibly more so for elite sportspeople - but there is little to show that it is superior to cold-water immersion, warm-water immersion or active recovery and stretching.
An active recovery is the most widely recommended strategy, where light exercise is done for about 20 minutes immediately after a session. For most elite sports teams this is followed up by another recovery session of light exercise the following day, and building intensity through the week based on how well players are recovering.
For the recreational athlete, there are some simple guidelines that can be gleaned from the above. Firstly, almost any recovery strategy is better than complete rest. If you are sore after sport, do something to help you recover. Thus far, there is little evidence to show that cool is better than warm, or that a combination of the two is better again. The evidence does suggest that cool is enough, water at 10-15°C is cold enough and up to 15 minutes is sufficient. It is advisable to include some gentle exercise, focusing on the main muscle groups used; light running and cycling are the two most obvious options for most people.
As for the rugby, if Ireland can prove they deserved their recent number-one ranking by lifting the Webb Ellis Cup, it will be a very different type of recovery we’ll have to worry about!

Andrew O’Brien is a chartered physiotherapist and the owner of Wannarun Physiotherapy and Running Clinic at Westport Leisure Park. He can be contacted on 083 1593200 or at www.wannarun.ie.