Cold Therapy for Performance: What the Science Says About When and How To Use It
ritten by: Susie Reiner, PhD, CSCS, ACSM-EP, TheoryEx
Reviewed by Therabody Scientists: Tim Roberts, MSc; Rachelle Reed, PhD, MS, ACSM-EP
Cold therapy isn’t one-size-fits-all. Discover what research says about using cold to manage soreness and support performance.
Cold therapy has become a staple in modern recovery culture: cold plunges and ice baths are accessible in studios and available for at-home use, and cryotherapy chambers promise faster recovery, better performance, and even improved well-being.
The reality is more nuanced. When matched appropriately to your intended goal, cold therapy can meaningfully support recovery, pain management, and even performance. When used improperly, it can blunt training adaptations or introduce unnecessary risk.
This article breaks down the evidence on cold therapy for performance and recovery and translates research into practical guidance you can apply to your training routine.
What “cold therapy” really means Cold therapy is a tool to extract heat and trigger downstream changes in pain, circulation, and nervous system activity. [1]
When scientists and practitioners discuss cold therapy, they use an umbrella term that encompasses a wide range of methods, falling into two broad categories: localized cold therapy and whole-body cooling.
Localized cold therapy applies cooling to a specific area, typically using ice packs, cold wraps, palm cooling, or cold-compression devices such as the RecoveryTherm® Cube, placed over a joint or muscle after injury or intense use. The primary goal is to support thermoregulation, or relieve a specific symptom, like pain or swelling, by reducing tissue temperature and sensory input. [1, 2]
Whole-body cooling refers to strategies such as cold-water immersion (CWI) or cryotherapy chambers that lower skin and tissue temperature across large portions of the body. This can trigger cardiovascular, neural, and perceptual responses simultaneously. [1]
While frequently grouped together, localized cold therapy devices and whole-body cooling treatments operate through different physiological mechanisms and are best used in different contexts. More on that later.
The physiology of cold: How does cold therapy work in the body?
Cold exposure influences recovery and performance through three primary pathways:
Cold lowers nerve conduction velocity, meaning pain signals travel more slowly from the periphery to the brain. [2] This mechanism explains why cold can reduce soreness or discomfort even when underlying tissue damage (think: a rolled ankle) remains unchanged. It’s important to note that different cooling methods like ice packs, ice massage, and cold-water immersion affect motor and sensory nerves differently. [4]
Cold exposure immediately triggers a sympathetic nervous system response — rapid breathing, heightened alertness, and increased heart rate and blood pressure. [3] As the body adapts to cold exposure (within seconds to minutes), the nervous system transitions to a parasympathetic response, which is associated with reductions in heart rate and a subjective sense of calm. [5]
Whether the effects of cold therapy support or hinder training outcomes depends on how cold therapy is applied and your goal. [1]
That's because these three primary pathways trigger broader metabolic and inflammatory changes. Cold effectively lowers tissue temperature and reduces blood flow, which can dampen local inflammation and metabolic activity, affecting muscle protein synthesis. This explains why cold reduces swelling and soreness — and why when you apply it matters. The mechanisms that manage acute inflammation can also interfere with the signaling needed for muscle growth. [6, 7]
Localized cold therapy: When and how to use it
Localized cold therapy remains among the most common interventions for soft-tissue irritation or post-exercise soreness because it reliably reduces pain by altering pain sensations. [2] That’s why ice is a staple in the classic RICE (rest, ice, compression, elevation) formula for treating soft-tissue injuries. However, modern sports medicine no longer treats ice as a universal solution. Frameworks such as PEACE (Protection, Elevation, Avoid anti-inflammatories, Compression, Education) and LOVE (Load, Optimism, Vascularisation, Exercise) emphasize education, progressive loading, and functional movement over routine inflammation suppression. [8] Within these models, cold is a supportive tool rather than the primary method for tissue healing.
Palm cooling, which uses specialized heat exchange through the hands, is an emerging performance tool. The palms contain vascular structures ideal for rapid heat transfer. Early evidence suggests that palm cooling can effectively extract heat through the palms and lower rating of perceived exertion, which may improve endurance by reducing heat-related strain. [9]
Palm cooling offers a portable, simple way to alter the perception of heat strain without the logistical challenge of an ice bath or cryo chamber. It’s one of several localized cold therapy strategies worth watching as evidence builds. [10]
Practically, localized cold makes the most sense when pain or swelling is interfering with movement or sleep. Applying ice to the area in pain for 10–20 minutes can make movement more comfortable and improve sleep in the short term. [1]
When discomfort is low and mobility is intact, other recovery inputs, including sleep, nutrition, and load management, are likely to have a greater long-term impact. [8]
While study design and findings are mixed, these benefits are most apparent when exercise is strenuous, and recovery time between sessions is limited. [13, 14]
If you’re training hard multiple days in a row, a cold plunge or ice bath can help you feel more ready for the next session. [12, 13]
That said, if your primary goal is muscle growth, repeated and immediate cooling post-workout can interfere with how your body adapts and responds to resistance training. More on that below. [15]
Protocols in the literature vary, but many use water temperatures between 10 and 15°C (50-59 °F) for 2 to 15 minutes. Actual practice should always be adjusted to your tolerance and safety considerations, and the “dose” (time × temperature) likely matters for outcomes like soreness. [5, 11, 12]
Whole-body cryotherapy: Popular, but evidence is limited
Whole-body cryotherapy exposes the body to extremely cold air for a short time. It’s popular in elite sport and wellness spaces, but the research supporting its benefits is much more limited than for cold water immersion.
A large review found that there isn’t enough high-quality research to show that whole-body cryotherapy reliably reduces muscle soreness or improves recovery compared with no treatment. The review also pointed out that safety issues are not consistently reported, which is important because extreme cold is a strong physical stressor. [16]
Other research reviews suggest that some people may feel more recovered after whole-body cryotherapy, possibly due to nervous system effects. However, results vary widely depending on the protocol, with little long-term data. [17]
Research also explores the benefits of whole-body cryotherapy on sleep quality when used for five consecutive days. The data shows that whole-body cryotherapy improves slow-wave sleep (a sleep phase associated with the body’s physical recovery) and perceived sleep quality. [18]
Based on current evidence, cold water immersion remains the more evidence-supported whole-body cold option.
Does cold therapy stunt muscle building?
If your primary goal is muscle growth (hypertrophy) rather than short-term recovery, using cold therapy right after a workout may not be appropriate. Studies examining post-exercise cooling show that cold water immersion immediately after lifting reduces muscle protein synthesis during recovery, which can limit muscle building. [19]
After a workout, inflammation levels rise as part of the body's natural repair response. Post-exercise inflammation plays a role in muscle adaptation (though chronic inflammation can be harmful). Cold reduces inflammation, but it also suppresses the anabolic signaling pathways and muscle protein synthesis, which drive muscle growth. If your primary goal is muscle growth, this interference with the body's natural adaptation response makes immediate post-workout cold unsuitable. [6, 7, 15]
This does not mean cold should be avoided entirely. It means timing matters. During muscle growth blocks, avoid immediate post-lift cold; if you use cold, do it on rest days or several hours later. When rapid recovery between performances is critical, cold may still be appropriate. This balanced strategy lets you keep the short-term recovery benefits when you need them without undermining your long-term adaptation goals. [1]
Cold therapy for relaxation
Cold also affects recovery by altering how you feel. Acute cold exposure produces a strong sympathetic response, followed by parasympathetic rebound that leads to relaxation and balance, especially after repeated exposures. [3]
Heart rate variability (HRV) studies show that acute cold exposure can increase indices associated with parasympathetic activity, suggesting a shift toward a recovery-ready autonomic state as the body adapts. While HRV is just one marker and not a standalone indicator of “better recovery,” these shifts align with many people’s subjective reports of better mood, reduced stress, better sleep, and improved readiness after a cold session. [5]
These perceived effects of cold exposure can be particularly useful when fatigue is driving how you’re feeling (rather than local muscle failure). Cold can help you feel more recovered, which often translates into moving better and training again sooner. [3, 4]
Cold exposure for performance in the heat
Cold therapy goes beyond just recovery after exercise; it can also support performance when training in the heat. Targeted cooling of the head, face, and neck has been shown in a systematic review and meta-analysis to improve performance measures in hot conditions by altering the perception of heat and physical exertion. When your brain feels cooler, your pace and power output often stay higher for longer. [9]
If you compete or train in warm environments, consider incorporating pre-cooling (before activity) and per-cooling (during) strategies that target high-yield areas like the neck, face, or palms. These are easier to implement than whole-body cold and can directly support performance by reducing fatigue. [10]
Safety and smart practices
Cold exposure is powerful, and it can carry risks. Prolonged or extreme exposure can lower core body temperature dangerously, and direct application of extreme cold to bare skin can cause cold burns or tissue damage. [1]
To mitigate these risks, start with short, tolerable exposures and work your way up gradually. Have supervision or a partner when doing full immersion in cold water. Be cautious with known cardiovascular, pulmonary, or metabolic conditions and check with a healthcare professional before starting intensive cold routines.
As always, listen to your body. A loss of sensation, numbness beyond the exposure period, or prolonged shivering are signals to watch out for. [1]
How to incorporate cold therapy in your routine
1. Weekly training with limited recovery time: Use CWI 2–15 minutes at ~10–15°C (50-59 °F) after your hardest sessions to reduce soreness and support perceived recovery. Avoid it after sessions where building muscle is the top priority.
2. Strength and muscle-building blocks: Separate cold exposure from resistance sessions by at least several hours. Use localized cold when pain occurs. Avoid immediate post-lift cold therapy.
3. Hot environment performance: Apply head, face, neck, and palm cooling before and during efforts when exercising in the heat. This can lower perceived heat strain and support performance.
4. Local pain or acute discomfort: Targeted, short cold applications can modulate pain and allow better movement, especially on non-training days or when sleep is disrupted by soreness.
While cold therapy has well-established benefits, it’s not recommended in all recovery scenarios. Cold therapy is best used as a targeted tool, and the method should match the goal. Used thoughtfully, it can reduce soreness, support perceived recovery, and enhance performance under specific conditions while complementing strong training, smart nutrition, and adequate sleep.
References
- Cold for Centuries: A Brief History of Cryotherapies to Improve Health, Injury and Post-Exercise Recovery
- The effect of cryotherapy on nerve conduction velocity, pain threshold and pain tolerance
- Autonomic nervous function during whole-body cold exposure before and after cold acclimation
- Motor and sensory nerve conduction are affected differently by ice pack, ice massage, and cold water immersion
- Effects of Cold-Water Immersion on Health and Wellbeing
- Cold water immersion attenuates anabolic signaling and skeletal muscle fiber hypertrophy
- Postexercise cold water immersion attenuates training adaptations
- Soft-tissue injuries simply need PEACE and LOVE
- Head, Face, and Neck Cooling for Performance
- Heat extraction through the palm of one hand improves aerobic exercise endurance in a hot environment
- Effects of Cold-Water Immersion Compared with Other Recovery Modalities on Athletic Performance Following Acute Strenuous Exercise
- Impact of Cold-Water Immersion Compared with Passive Strategies on Recovery of Athletic Performance, Perceptual Measures and Creatine Kinase
- Effects of cold water immersion after exercise on fatigue recovery and exercise performance: a meta-analysis
- Can Water Temperature and Immersion Time Influence the Effect of Cold Water Immersion on Muscle Soreness?
- Throwing cold water on muscle growth: A systematic review with meta‐analysis of the effects of postexercise cold water immersion on resistance training‐induced hypertrophy
- Whole-body cryotherapy (extreme cold air exposure) for preventing and treating muscle soreness after exercise in adults
- Whole-Body Cryotherapy in Athletes: From Therapy to Stimulation
- Effects of repeated cryostimulation exposures on sleep and wellness in healthy young adults
- Postexercise cooling impairs muscle protein synthesis rates in recreational athletes
