Updated: Oct 22
So we've all seen the ice bath challenges and many of us as athletes have spent many an hour in the training room suffering through an ice bath. But is the suffering worth it?
We thought it might be good to take a look at what the science and pro's say about ice baths.
Soak Therapy has been around for some time...
So I can remember as a middle school track athlete, complaining about a tough practice, and my Mom saying "you need to soak!" So soaking in the tub has long been a tried and true remedy for soreness, etc. History tells of the Ancient Romans using soak therapy. These were often in the form of public bath houses and even had heating systems.
In a review of scientific evidence on hydrotherapy, Mooventhan and L Nivethitha1 found that it has long been used for benefit across various body systems including cardiovascular, respiratory, nervous system, and musculo skeletal system, and immunology, the actual physiologic impact on these systems varies according to temperature and a number of factors and there is still not enough scientific evidence to understand the actual mechanisms of action at play. 
Is it more beneficial for specific athletes?
Many athletes have long used water immersion as a form of recovery. And it seems to becoming even more popular as athletes increasingly understand the importance of self care along with pursuing more intense and cross-functional training regimens.
In Post exercise ice water immersion: Is it a form of active recovery?, Fatimah Lateef concluded that post performance and training recovery are indeed important, however emphasized a more holistic approach including rest, massage and adequate nutrition.
Athletes might also be advised to be thoughtful about when to incorporate ice baths into their progression and allow for enough to time to "recover from the recovery". M J Crowe1, D O'Connor and D Rudd studied the effects of cold water immersion on recovery from anaerobic cycling and concluded that it caused a significant decrease in sprint cycling performance. Peak power, total work and post- exercise blood lactate were all lower in a test one hour after the immersion.
What about cold temperature therapy? Cold therapy has been studied in many different ways, from cold immersion to more recent cryo chambers. In a literature review by of scientific studies on whole body cryotherapy, Lombardi, Ziemann and Banfi found concluded that there was much evidence supporting whole body cryotherapy providing relief for certain inflammatory and improvement in post-exercise recovery, however there were many studies that showed no effect and also noted that there are certain contraindications and risks that should be taken into consideration. 
Soaking & Cryo?
There have been several studies specifically looking at soaking
In Effects of Cold Water Immersion and Contrast Water Therapy for Recovery From Team Sport: A Systematic Review and Meta-analysis, Higgins, Greene and Baker reviewed several published studies and recommended that specific protocol should be followed to obtain benefits from cold water immersion including 2 to 5 minute immersions in water at approximately 50 degrees Fahrenheit with 2 minute rest intervals in-between. They also recommend contrast therapy, which is, alternating between cold and "hot" water immersion (approximately 100 degrees Fahrenheit) with a total immersion time no longer than 10 minutes.  Lateef as noted above, also found that Contrast therapy indeed had specific physiologic effects and indeed may promote reduction in lactate levels.
Can pre-soaking help?
In Pre-cooling for endurance exercise performance in the heat: a systematic review, Jones, Morrisey, Maffulli and Hemmings concluded that cold water immersion could improve endurance performance in hot environment conditions however noted the practical limitations of access to water sources etc. and that studies hint it could possibly be due to delaying the time it takes for an athletes core temperature of approximately 102 degrees Fahrenheit at which time athletes are more likely to experience a reduction in cardiac output and muscle blood flow
Overall athletes have expressed that they get many benefits from soaking as well as ice immersion. Some of the benefits may be physiologic, others might be psychological.
As in all things, the key is to assess your own needs along with your professional providers, e.g. PT's, trainers, coach and Doctor and determine what is best to meet your needs and how it fits into your overall training regimen.
1. "Roman Baths", Mark Cartwright, www.ancient.eu
2.Scientific Evidence-Based Effects of Hydrotherapy on Various Systems of the Body,
3. Whole-Body Cryotherapy in Athletes: From Therapy to Stimulation. An Updated Review of the Literature, Lombardi, Ziemann, Banfi, Frontiers in Physiology, 2017
4. Effects of Cold Water Immersion and Contrast Water Therapy for Recovery From Team Sport: A Systematic Review and Meta-analysis, Journal of Strength and Conditioning Research, 2017
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