Effects of cold water immersion vs body cryotherapy on delayed onset muscle soreness and jump performance following acute strenuous exercise in physically active participants: A systematic review and meta-analysis.

BACKGROUND

Delayed onset muscle soreness (DOMS) and reduced athletic performance are common consequences of high-intensity exercise. Cold-water immersion (CWI) and body cryotherapy (BC) are widely used recovery methods, but their relative effectiveness remains unclear. To systematically compare the effects of CWI and BC on alleviating DOMS and restoring jump performance, with implications for optimizing post-exercise recovery and reducing muscle damage.

METHODS

This systematic review and meta-analysis included 13 randomized controlled trials with a total of 214 participants aged 20-47.2 years. Databases searched included PubMed, Excerpta Medica Database (EMBASE), Cochrane Central Register of Controlled Trials, Web of Science, covering the period from January 1, 2002 to December 10, 2024. The primary outcomes were the alleviation of DOMS and the recovery of jump performance. Data were analyzed using Review Manager 5.3, with standardized mean difference or mean difference used as effect size metrics.

RESULTS

The analysis showed that CWI was significantly more effective than BC in alleviating DOMS, particularly within 24 hours (mean difference = 1.07; 95% confidence interval [CI]: 0.70-1.43; P < .00001). However, this difference was not statistically significant at 48 hours (mean difference = 0.47; 95% CI: -0.04 to 0.98; P = .07). In terms of jump performance recovery, BC showed a small and fragile effect on 24-hour jump performance (standardized mean difference = 0.52; 95% CI: 0.03-1.02; P = .04), while no significant differences were observed between CWI and BC at 48 hours (standardized mean difference = 0.26; 95% CI: -0.82 to 1.33; P = .64). The analysis of DOMS showed low heterogeneity, whereas the jump performance recovery analysis exhibited high heterogeneity.

CONCLUSION

CWI appears more effective than BC for short-term DOMS relief. BC may offer a modest, short-term advantage in jump performance recovery, though this finding is limited by heterogeneity and a marginal effect size. Both methods support post-exercise recovery by accelerating the restoration of muscle function and reducing soreness, which can benefit athletes and physically active individuals globally.