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Physioworks Health Group

by Andrew Dalwood, Specialist Musculoskeletal Physiotherapist (FACP)*

January 2018

Common after sporting activity of high level intensity, or after a change in activity type, your muscles the following day (and for up to two days) can be sore and you feel minor discomfort. It has been shown that this is a combination of build-up of lactate within the muscles, a normal by-product of muscle action, minor swelling and inflammation after the muscle overload, all a very normal response.

In an attempt to reduce this side effect of increased activity, a variety of recovery strategies have been proposed over the years. These strategies include:

  • light stretching
  • cold water immersion,
  • hot-cold water therapy
  • low grade active therapy
  • stretching

All these recovery strategies are attempting to increase the blood flow to the region and increase oxygen to the area promoting clearance of the lactate and improve the body’s mechanism of clearing the inflammation and swelling.

A recent study published in the BMC Sports Science, Medicine and Rehabilitation 2017, has attempted to compare which of these recovery strategies is most effective.

The study used 34 recreational athletes and put them through a series of exercise, then implemented either active recovery, cold water immersion, cold therapy or combination of active and cold, and then just to rest.

Interestingly the study found that the athlete’s greatest perceived improvement was with the cold water therapy in the first hour post exercise. Cold water recovery people reported less pain than active recovery in the first hours, thus less need for rest in the next few days. All other ratings were equal over the next 48 hours. However, of interest is that some athletes reported increased cramping with the cold water therapy or more pain, which is of interest.

Image Source: The big chill ©

 What this study shows is that the cold water therapy most likely provides a “pain relieving effect” which is why it is perceived to be better. It may also show that as an individual you may prefer one method over another, e.g. you don’t tolerate the cold water, thus you prefer the active program.

More studies are needed to determine and further refine which technique is best.

It may be interesting to see if a person’s tolerance to cold has an impact on the successful use of cold water therapy, and whether different bodies respond to different methods of recovery, or if different exercise type responds to a different recovery strategy.


About the Author and Physioworks Health Group: Physioworks Health Group has a team of dedicated physiotherapists and health professionals providing a range of physiotherapy and specialist health services at five clinics across Melbourne. Andrew Dalwood (FACP) is a Specialist Musculoskeletal Physiotherapist (as awarded by the Australian College of Physiotherapy in 2009). He is the Director of Physioworks Camberwell and Waverley Park Physiotherapy Centre (Physioworks Mulgrave), providing consultation at both clinics.