What to Know About Cold Water Therapy

From social media influencers posting pictures of themselves taking ice baths to a documentary about Wim Hof, a cold water therapy retreat host and guide, cold water therapy is emerging as a popular health trend. A growing body of research suggests cold water therapy may have various health benefits, including mood enhancement, stress reduction and metabolic and heart health support.

Read on to discover what experts say about cold water therapy, including the types of treatments available, science-supported health benefits of the practice and whether incorporating an icy plunge into one’s wellness routine may be beneficial [3].

What Is Cold Water Therapy?

“Cold water therapy, also known as cold hydrotherapy, is the practice of using water around 59 degrees Fahrenheit (15°C) to treat health conditions or stimulate health benefits,” says Wan Na Chun, an Indianapolis-based registered dietitian and personal trainer who recommends cold water therapy in her practice. “Studies show that cold water immersion can lead to decreased stress levels after a one-hour session and induce significant physiological and biochemical changes in the body, such as improved blood pressure, metabolism and peripheral blood flow,” she adds [2].

These changes may have secondary effects on metabolism and heart disease by reducing body fat and improving insulin resistance, two factors associated with chronic conditions like diabetes and cardiovascular disease.

Cold water therapy is performed in a variety of ways, from topical skin exposure to full-body ice baths [3].

Types of Cold Water Therapy

The origins of using cold water therapy for health and muscle recovery may date back to ancient Greece, according to research. Types of cold water therapy range from a quick spray or rinse to full-body immersion in icy water.

Cold water therapy is a form of cryotherapy, a broad field that encompasses using cold therapies to attain health and wellness benefits. Examples of cryotherapy include cold water immersion, applying ice/cold to the skin and other general uses of cold for therapeutic needs. “Cold water immersion and cryotherapy chambers are generally considered the most effective forms of cold therapy, as they provide the most significant benefits,” says Chun [3].

Below are the most common types of cold water therapy:

• 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 (10-15°C) 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 [1].

  
  
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• 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 (100.4-104 degrees F / 38-40°C) for 10 minutes, then alternate between a one-minute immersion in cold water (46.4-50 degrees F/ 8-10°C) 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 [1].

  
  
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• 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 [1].

  
  
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• 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].

  
  
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Potential Benefits of Cold Water Therapy

While more research is needed to make conclusive claims about cold water therapy, preliminary studies demonstrate compelling potential mental and physical health benefits [3].

• May Aid Muscle Recovery and Decrease Pain

  In a 2016 study in Medicine, participants who performed a set amount of exercise and then immersed themselves in a cold water pool (no warmer than 59 degrees Fahrenheit / 15°C) afterward reported experiencing less muscle soreness compared to those who didn’t undergo hydrotherapy.
  
  The body regulates temperature through the same nerve pathways that signal pain, which is why icing injuries helps moderate pain, says Joseph Bunn, a personal trainer and physical therapist assistant in Warrenton, Virginia. Alternatively, using cold showers or cold water immersion techniques may decrease pain and improve muscle recovery.
  
  Cold water therapy works to alleviate pain by constricting blood vessels and reducing blood flow to peripheral body parts. Research suggests this blood flow redistribution improves oxygenation of muscles and may enhance exercise performance [3].

• May Help Regulate the Nervous System

  Exposure to cold water—including splashing it on your face or plunging into a cold lake—stimulates the vagus nerve. The vagus nerve is the main nerve of the autonomic nervous system responsible for regulating breathing and heart rate. For example, an ice bath helps one learn how to regulate intense emotion and essentially breathe through it, says Renee Solomon, Ph.D., a licensed psychologist and CEO and clinical director of Forward Recovery, a counseling practice focusing on the treatment of anxiety, depression, addiction and more. Dr. Solomon uses cold water therapy in her practice [3].

• May Decrease Stress and Improve Mood

  “While no randomized controlled trials exist, case reports and anecdotal evidence suggest cold water therapy can be beneficial for mood, treat depression, increase libido, reduce stress and improve stress regulation,” says Sid Khurana, M.D., a board-certified adult, child and adolescent psychiatrist and medical director of outpatient services at Nevada Mental Health.
  
  According to research, immersing oneself in cold water is linked to reduced cortisol levels, indicating it may offer stress relief, says Chun. Research of cold water therapy’s effect on mood is in its preliminary stages, but there’s compelling evidence that people may experience a mood boost within days of trying cold water exposure.
  
  Similarly, adults in a small 2023 study in Biology noted feeling more alert, inspired and attentive after a single five-minute session in a 68-degree F bath (20°C). In the study, brain scans taken before and after cold water therapy revealed an increased connection between the regions of the brain controlling attention, emotion and self-regulation after cold water immersion.
  
  “Cold exposure is thought to increase the production of the hormone and neurotransmitter norepinephrine,“ says Dr. Solomon. “Norepinephrine is associated with focus, attention, natural high feelings and improved mood. Cold water therapy may produce feelings of calmness and happiness and generally may improve well-being,” she adds. However, additional research suggests that high levels of norepinephrine can also be associated with depression, anxiety, panic attacks and hyperactivity (in spite of a brief period of potential euphoria).
  
  More research is needed regarding the long-term effects cold water therapy may have on mood and focus [3].

• May Have a Metabolism-Boosting Effect

  Researchers at the Arctic University of Norway observe a metabolic increase in individuals after they experience cold water immersion. However, this type of research is often carried out among small sample sizes, and further studies are needed to understand cold water therapy’s effect on metabolism, including body fat percentages and weight loss.
  
  The potential metabolism-boosting effect is credited to brown adipose tissue, a type of fat in the body that can produce heat when exposed to cold, burning more calories. This metabolism increase appears to be small, and research is inconclusive regarding whether cold water therapy supports long-term, significant weight loss [3].

Is Cold Water Therapy Safe?

Before attempting cold water therapy of any kind, it’s best to speak with a health care provider about any unique individual risks that may arise.

Cold water therapy is safe, although the American Heart Association cautions that the most dangerous time is within the first 60 seconds until breathing regulates. Speak with a trusted health care provider prior to practicing cold water therapy to ensure it’s a safe and beneficial option for your unique goals [3].

Who to Speak With About Cold Water Therapy

Physical therapists often use topical ice application and cold water immersion for muscle recovery and pain reduction, and many other types of health care providers, such as dietitians, personal trainers, athletic trainers and mental health professionals, also utilize cryotherapy and cold water exposure as part of their treatment plans [3].

To speak with a trusted provider for reliable guidance on how to incorporate this modality into a daily wellness routine, click on the button below ⬇⬇⬇

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