Cold water therapy is the use of water to promote health or manage disease, according to research. While it has a long history, it’s primarily used to speed healing after an injury, ease joint and muscle pain, and quicken recovery from exercise, among other possible health benefits. Research on the topic has generally focused on pain, muscular injury prevention and recovery, and mood, and cold water therapy is considered a complementary therapy given that it’s an evolving field. Read on to learn about potential health benefits and the possible risks of cold water approaches for health and medical uses, and to evaluate if this therapy is worth discussing with your doctor. Per the same review, physician Edgar A. Hines came out with research in the early 20th century that helped us understand some of how cold water immersion works in the body — in particular, the effects of cold water immersion on blood pressure and the autonomic nervous system, which controls automatic physiological processes like heart rate. In the early 2000s, researchers turned their attention to cold water and exercise recovery. “A lot of the research that we see now shows how cold water influences circulation and how that plays into muscle damage that occurs as a result of exercise, and also some of the cellular processes that go into muscle soreness,” says Mathew Welch, CSCS, an exercise physiologist at the Hospital for Special Surgery in New York City. As a result, many professional and everyday athletes turn to cold water therapy to help recover from exercise. Recent interest in cold water therapy is thanks in part to Wim Hof. Hof, also known as “The Iceman,” is a Dutch extreme athlete who earned his nickname by breaking world records related to cold exposure. His feats include swimming underneath ice for approximately 217 feet and standing in a container while covered in ice cubes for more than 112 minutes, according to his website. He took what he learned from his cold experiences and created the Wim Hof Method, a combination of breath work, cold therapy, and commitment practices. Proponents claim that this method increases energy, boosts the immune system, improves sleep, and helps the body heal faster. Plus, water exerts pressure (known as hydrostatic pressure) on the body, which promotes blood flow to major organs like the heart, brain, and lungs, according to research. When more blood moves toward your major organs, it’s able to gather more oxygen and nutrients. As soon as you emerge from the cold water, those same blood vessels expand (known as vasodilation), Dr. Leary says. When that happens, the oxygen- and nutrient-rich blood gets pumped back to your tissues, helping remove waste products, such as lactic acid, and lower inflammation, per research. “You can’t have pain or disease without inflammation,” Leary says. As such, methods that lower inflammation, like cold water therapy, may be helpful for many health complaints. Using cold water therapy on a regular basis may also have long-term benefits for your heart and blood vessels. Around every blood vessel is a muscle, so just like doing a bicep curl strengthens your biceps, cold water therapy strengthens your blood vessels, Leary explains. Over time, this may boost circulation by improving your blood vessels’ ability to circulate blood through your body. Cold water therapy can be done at home, in a natural body of water, or at a fitness club, physical therapy clinic, or specialty wellness studio. However, it’s best to do cold water therapy under the guidance of a physical therapist, chiropractor, or other healthcare professional if you’re using it to recover from an injury, for sports performance, or to help with chronic pain.
Cold Water Immersion
Like the name suggests, cold water immersion involves immersing yourself in cold water up to your neck or immersing a specific joint or area of the body. Ice baths are a popular option for cold water immersion because you can control the temperature. You can take them at home, in a physical therapy clinic, or in a specialty recovery studio. If you live in a colder climate, you can wade into an icy body of water such as a lake. How long you spend in the cold water varies depending on the temperature and your tolerance level. If you stick to the temperature range of 50 to 59 degrees F that some research has used, be sure to limit your exposure to a maximum of 15 minutes, says John Gallucci, Jr., DPT, a medical coordinator for Major League Soccer who is based in Bridgewater, New Jersey.
Contrast Water Therapy
This method is similar to cold water immersion, except that it alternates exposure to cold water with exposure to hot water. The approach varies, but studies typically follow this protocol: Begin by immersing the affected limb in hot water (100.4 to 104 degrees F) for 10 minutes, then alternate between a one-minute immersion in cold water (46.4 to 50 degrees F) and a four-minute immersion in hot water until you reach a total duration of 30 minutes, according to research published in August 2018 in the Journal of Athletic Training. Contrast water therapy is often used in sports and physical therapy settings to promote recovery and reduce muscle damage, per this study.
Cold Showers
Taking a frigid shower offers a way to ease into cold water therapy, though the benefits may not be the same as those seen with cold water immersion, says Scott J. Biehl, DO, an orthopedics and sports medicine physician at Rochester Regional Health in New York. You may feel more alert in the short term, but research hasn’t shown that cold showers can help heal exercise-induced stress on the body, per Rochester Regional Health. However, cold showers can be an entry point into cold water immersion therapy, Dr. Biehl notes.
Wim Hof Method
The Wim Hof Method combines cold water therapy, breath work, and commitment practices, with the aim of reconnecting with yourself and the environment, according to its website. The potential benefits include greater energy, reduced stress, lower inflammation, better sleep, and faster recovery, per the website. However, most of the research supporting the Wim Hof Method consists of case studies on Hof himself. A more extensive study that tracks the outcomes of a randomized cohort of individuals following the Wim Hof Method, people who practice general meditation and breathing exercises, and people who don’t practice any of these methods would offer better support for these claims, says Biehl.
1. May Aid Muscle Recovery
Stepping into an ice bath may help speed up recovery after exercise. In fact, the majority of research on the potential health benefits of cold water therapy involve muscle recovery. There has been some evidence that cold water immersion reduces delayed onset muscle soreness after exercise, compared with passive interventions involving rest or no intervention at all, according to both a review and a meta-analysis. Separately, one study evaluated the effectiveness of different types of cold therapy, either with chilled water or cold air. In this study, 10 men hopped into water at 50 degrees F for 10 minutes after performing a set of leg exercises. On another day, after the same leg exercises, they received whole-body cryotherapy, a therapy that involves sitting or standing in a chamber in which the air is up to minus 200 degrees F (the air was minus 166 degrees F in this study) for about three minutes. Researchers found that cold water immersion was more effective than whole-body cryotherapy in lowering muscle soreness and perceptions of recovery 24 to 48 hours after exercise. But because this study and others like it have small participant groups, more robust research is needed to fully understand the relationship between cold water immersion versus whole-body cryotherapy for post-workout healing.
2. May Help Relieve Pain
Cold water therapy is often used in physical therapy settings to lower inflammation and pain in people with long-lasting (chronic) and short-term (acute) pain, Dr. Gallucci says. Contrast water therapy has been reported to be used for treating pain from rheumatoid arthritis, carpal tunnel syndrome, foot and ankle sprains, and diabetes, according to the study in the Journal of Athletic Training. Switching between the two extremes causes blood vessels to repeatedly constrict and open, leading to a pumping effect that increases blood flow and delivers more oxygen and nutrients to the tissues. It’s thought that this may reduce swelling, improve muscle function, and promote healing, per that study.
3. May Boost Your Mood
A cold water plunge may temporarily put you in a better mood. For example, research shows that cold water immersion led to a 250 percent increase in dopamine. Dopamine is a neurotransmitter and hormone that plays a key role in mood. In fact, it’s known as the feel-good hormone, according to the Cleveland Clinic. Plus, a small study found that taking a 20-minute ice bath four days a week improved quality of life in people with gout. Participants also reported less stress, anxiety, and depression. Submerging your body in cold water also increases your risk of hypothermia, a potentially life-threatening condition that develops when your body temperature drops too low, according to the Mayo Clinic. Hypothermia can occur much more quickly in the water because water pulls heat away from the body 25 times faster than air, warns the National Institute for Occupational Safety and Health (NIOSH). What’s more, hypothermia can happen anytime the water temperature dips below 70 degrees F, per the NIOSH. Cold water immersion therapies generally use water temperatures between 50 and 59 degrees F, so take extra caution and foster awareness of hypothermia symptoms. It’s best to try cold water therapy with a healthcare provider’s guidance to avoid hypothermia and other risks given your health status. And while the temperatures typically used in cold water therapies may not be cold enough to cause frostbite, you may get skin redness and irritation, Biehl says. Water therapy (hydrotherapy) in general may help people with chronic pain and those healing from injury, per the Cleveland Clinic. However, given how stressful cold water therapy can be for the heart and blood vessels, people with heart, blood pressure, and circulatory issues shouldn’t attempt cold water therapy without talking to their doctor first. People with nerve disorders such as diabetic neuropathy (a type of nerve damage that can occur in people with diabetes, per the Mayo Clinic) should also check with their doctor before trying cold water therapy. According to Rochester Regional Health, the cold can affect the body’s sensory nerves and potentially place you in a state of paralysis if you have nerve issues. You can also do most forms of cold water therapy on your own at home, after you’ve spoken with your doctor or a healthcare provider to determine if cold water therapy is safe for you. Taking a cold shower may be the easiest method for beginners who aren’t used to cold water exposure, but you can do ice baths if you have a bathtub or basin. If you prefer, you can perform cold water immersion outdoors if you have access to natural bodies of water. Just check the water temperature before you wade in. Studies of cold water therapy tend to use temperatures between 50 and 59 degrees F, but there are no universal guidelines, so talk to your doctor about what’s best for you. Some specialty recovery studios also offer cold water therapy. For example, Remedy Place has an ice bath class that begins with breathing exercises to help participants prepare for the frigid temperatures. If you’re interested in learning the Wim Hof Method, start with the free mini class and then practice with the mobile app. To go deeper, take an online video course or attend an in-person retreat. It’s always best to work with a physical therapist, chiropractor, or other healthcare professional to create a cold water therapy routine that fits your wellness needs, especially if you’re interested in using cold water therapy to improve sports performance or help with chronic pain or injury recovery. “We recommend our athletes and patients start with a cold shower or an outdoor pool that’s around 65 degrees F,” Gallucci says. You can use repeated showers over time (days or even weeks) to build up your tolerance. Once you’re ready to submerge, simply fill your tub with the coldest water you can get from your tap. This will most likely fill your tub within the range of 50 to 60 degrees F, Biehl says. Double-check by dipping a thermometer in the water. If your water isn’t cold enough to reach 60 degrees, that’s okay; you can add ice after your tolerance to cold exposure has increased. If you prefer to plunge into a natural body of water, look online to find information about options in your area. The Centers for Disease Control and Prevention provides water quality information by state, so you can avoid bodies of water that pose health and safety risks. In addition, the National Weather Service offers daily water temperature data. Look for water between 50 to 60 degrees F and bring a buddy for support. Don’t try it alone. Once you’re ready for a dip, step carefully into the tub, barrel, or natural body of water and slowly lower yourself until you’re submerged from the neck down. You can also target a specific region of the body. For example, only sit in water high enough to cover the legs to boost recovery following an intense lower-body strength routine or cycling session, Biehl suggests. “Try to sit for two or five minutes and work your way up to 10 minutes,” he says. Leary recommends getting out once you start to shake or shiver. “That’s your body telling you that you’ve reached your max time for the day,” he says. Expect to submerge your body (or parts of your body) in water at least 59 degrees F. You can sit in a bathtub filled with cold water and ice, wade into a chilly lake, take a cool shower, or alternate cold water immersion with hot water immersion. If you’re doing cold water therapy at home, you may choose to go without clothes. In other places, you can wear a swimsuit or shorts and a light top or sports bra. Entering cold water may take your breath away at first, “and you can feel your heart race,” Biehl says. It may shock you into a heightened state of awareness, giving you an instant pick-me-up. As you sit there longer, your body adapts, and your heart and breathing rates slow, Biehl says. You may even feel relaxed. In the beginning, you might spend only a few minutes in the cold water. You’ll have to gauge how your body responds and tailor your practice accordingly. “There’s a very fine line between what each person can tolerate,” Welch says. Just because your friend can sit for five minutes doesn’t mean you can. Get out once you start to shake or shiver, Leary says. Once you get out of the water, let your body warm up naturally. “You will shiver,” Leary says. And it may take a while for your body to return to its normal temperature, “but allowing your body to get there on its own intensifies the effects of [cold water therapy],” he notes. You may notice that you have greater mobility or less pain once you warm up, which is the circulation-boosting power of cold water therapy at work. In Leary’s opinion, there’s no better feeling than stepping out of a cold water therapy tub. Learn more about the Wim Hof Method by visiting the official website. Here, you’ll find a blog, a newsletter, online courses, an app, and books.
Book
What Doesn’t Kill Us Written by investigative journalist and anthropologist Scott Carney, What Doesn’t Kill Us explores how extreme environments such as freezing water and high altitude may make people stronger. While the book covers many topics, it includes cold water therapy and the Wim Hof Method.
Television
National Geographic’s Limitless With Chris Hemsworth In National Geographic’s show Limitless With Chris Hemswoth, the actor interviews scientific experts and takes on a variety of physical and mental challenges in search of answers on what may help humans live healthier and longer. In “Shock,” the second episode in the series, Hemsworth works with cold exposure as he goes for a freezing swim in open water. (His exposure was much more extreme, and under medical guidance, so don’t try this at home.) It’s chock-full of visuals on the effects of cold and hot temperatures on the body, and may be useful if you’re interested in learning more.
Products, Blogs, and Guided Videos
Note: Everyday Health does not endorse these products. There are no universal guidelines for how cold the water should be or how long to stay in cold water. After you’ve talked with your doctor or worked with a licensed therapist, if you’re interested in practicing at home, some of these links may be helpful. Polar Monkeys While you can take ice baths in your bathtub, companies like Polar Monkeys are designing tanks to use indoors or outdoors. This Hallandale Beach, Florida–based company offers steel tanks, inflatable tanks, and cedar wood tubs with chillers that drop the water below 40 degrees F (water temperatures of 50 to 59 degrees F are recommended by most experts). The Cold Plunge Based in Lincoln, California, The Cold Plunge creates tubs built specifically for cold water immersion therapy. You can set the water temp (down to 39 degrees F), and the indoor or outdoor tubs are generally safe for most healthy people. If you want to know more before you plunge, check out the company’s blog, watch guided plunge videos, and review the potential benefits. Ice Barrel For some people, barrels offer a more accessible way to do cold water therapy. Ice Barrel offers lightweight barrels (55 pounds when empty) that feature an easy-to-use drainage system and enable you to sit in an upright position. Need more info? Explore its blog.
