Hot Water Immersion and Post-Workout Recovery

Gyakuto

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Ice was seen as the primary way to recover for decades because of its ability to reduce inflammation. But, as time has gone on, scientists have discovered that some inflammation can be good and can support recovery. More importantly, they’ve discovered that heat has potential benefits too.​
In this study, participants immersed themselves in warm water, and those who maintained a core body temperature of 38.5 to 39 degrees Celsius (about 101 degrees Fahrenheit) for 25 minutes experienced less muscle fatigue and muscle damage. The key was not remaining too warm for too long or allowing body temperature to rise too high, which could have the opposite impact.​
And, if you’re trying to build muscle, heat could be a more effective post-workout routine because research suggests that cold exposure after a workout can reduce muscle growth.
If you want to step up your recovery, there are plenty of ways to heat your core body temperature. You could do a hot tub, a warm bath, the sauna, heat packs, or even a quick heated yoga session. Give it a try, and see how it makes you feel.​

 
What I recall learning in college on this was that the RICE method was the best, but my own PT mentioned that he was learning that heat was better, and to save ice for major recovery needs - basically heat for every day workouts, ice for things like following a marathon or a major/long tournament.
 
What I recall learning in college on this was that the RICE method was the best, but my own PT mentioned that he was learning that heat was better, and to save ice for major recovery needs - basically heat for every day workouts, ice for things like following a marathon or a major/long tournament.
Isn’t ‘RICE’ more for localised blunt force trauma and strained muscles/torn stuff rather than over all body post-workout? Having said that I can see how ice baths have become de rigueur if training soreness is viewed as micro tears to muscle fibres and/or as is becoming a more popular idea, associated connective tissue.

I’ve been reading a lot about how post-workout inflammation of muscles may be the mechanism via which growth and increasing strength occurs, so taking NSAID post-workout may reduce gains. But research is ongoing.

I suffer so badly from post-workout fatigue and soreness that I might try a hot bath despite generally disliking them due to boredom!
 
Isn’t ‘RICE’ more for localised blunt force trauma and strained muscles/torn stuff rather than over all body post-workout? Having said that I can see how ice baths have become de rigueur if training soreness is viewed as micro tears to muscle fibres and/or as is becoming a more popular idea, associated connective tissue.

I’ve been reading a lot about how post-workout inflammation of muscles may be the mechanism via which growth and increasing strength occurs, so taking NSAID post-workout may reduce gains. But research is ongoing.

I suffer so badly from post-workout fatigue and soreness that I might try a hot bath despite generally disliking them due to boredom!
The mainstream recommendation when I was in college (likely was different both before and after) was for it to be for acute issues like you said, but also for general post-workout issues, at least for competitive athletes. Like you mentioned, ice baths. Mostly the RIC; you would rest and not do anything physical outside of workouts/training, take an icebath and put ice on anywhere that you notice significant soreness, and compression on any nagging/ongoing issues. The R and C still make sense, but my PT had doubts about the I part of it specifically. He would actually rotate me between ice and heat for my own injuries; I forget the logic of why he chose each.
 
Our resident physio who trains with us ice baths.

But I haven't looked in to the science of it.
 
Our resident physio who trains with us ice baths.

But I haven't looked in to the science of it.
There is very little science to support ice bathing as a post-workout recovery aid but some people seem to like it. Of the two, I prefer a hot bath, thank you very much!

 
RICE is for local injuries; joint sprains and such. Off hand, I can think of one study that tried to quantify the differences between heat/cold/nothing following workouts. As I recall, although both showed some benefit compared to doing nothing, it was a small difference. The difference between hear and cold was insignificant. The study group was small, and I suspect the difference between the two comes down to individual differences and a larger sample group would show even less statistical difference.
I tell patients to use whichever feels better.
I am heat intolerant, so I prefer ice packs. When we're diving someplace like Cozumel, and the overnight low is 80F, my wife wears a sweater when we go out to dinner, so it's no surprise she doesn't like ice packs.

[Edit]
I suspect there is a large placebo effect here. Much like the weird tape patterns people are wearing, or those "high altitude masks". There's zero science to support either, and in the case of the masks, lots of science showing why they would do zero good and possibly have negative effects. But people still use them. I would actively discourage anyone from using the masks, because those are actually potentially dangerous. The tape stuff is nonsense, but it isn't going to hurt anything.
 
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What I recall learning in college on this was that the RICE method was the best, but my own PT mentioned that he was learning that heat was better, and to save ice for major recovery needs - basically heat for every day workouts, ice for things like following a marathon or a major/long tournament.
I've read that the creator of RICE retracted his original research and claimed he made a huge mistake publishing it. I can't recall where I read this, but have you heard of anything like this?
 
I've read that the creator of RICE retracted his original research and claimed he made a huge mistake publishing it. I can't recall where I read this, but have you heard of anything like this?
You’re absolutely right, Ivan! Well remembered.


From the conclusions of the paper-

‘These findings, along with the public recant from Dr. Gabe Mirkin in 2015 (31), support the premise that the RICE protocol, which is a generally preferred method of immediate treatment for acute musculoskeletal injuries, is a myth.’

Based on the available literature, a rehabilitation protocol for an acute athletic injury should prioritize pain free movement through a full range of motion as early as possible and gradually progress to higher intensities and more complex movements.’

‘….. However, there should be little to no utilization of ice or NSAIDs, unless the only desired outcome is pain reduction.’
 
I tried the warm bath protocol after my workout on Friday. I set the bath temperature at 40 Celsius (assuming inefficient heat transfer), measuring the temperature with one of those cooking thermometers with a spike at the end for plunging into cooking chickens etc. I’d’ve liked to have measured my own core temperature during the procedure, but the thermometer’s vicious-looking spike put me off somewhat considering where I’d have to stick it 😳 I ensured I rotated in the bath from time to time (thermal roll) to ensure even heating.

It wasn’t as hot as I thought it would be and, other than the tortuous 25 minutes of boredom, very tolerable. Perhaps playing some music might be a good option in future.

I have to say, I felt far less sore for the rest of the day and didn’t required any analgesic at all! I did feel weaker and more lethargic than usual, however. My shoulders and upper trapezius were a little sore, perhaps because they weren’t fully submerged in the warm water for long enough compare to say my legs. I might use a snorkel next time so I can lie more submerged! 🤿
 
Who knew that testicles float? 😳
 
Ice was seen as the primary way to recover for decades because of its ability to reduce inflammation. But, as time has gone on, scientists have discovered that some inflammation can be good and can support recovery. More importantly, they’ve discovered that heat has potential benefits too.​
In this study, participants immersed themselves in warm water, and those who maintained a core body temperature of 38.5 to 39 degrees Celsius (about 101 degrees Fahrenheit) for 25 minutes experienced less muscle fatigue and muscle damage. The key was not remaining too warm for too long or allowing body temperature to rise too high, which could have the opposite impact.​
And, if you’re trying to build muscle, heat could be a more effective post-workout routine because research suggests that cold exposure after a workout can reduce muscle growth.
If you want to step up your recovery, there are plenty of ways to heat your core body temperature. You could do a hot tub, a warm bath, the sauna, heat packs, or even a quick heated yoga session. Give it a try, and see how it makes you feel.​


Then is better cold or hot water?

Let me guess... it depends? I hate this answer
 
Some more research in favour of cold water immersion for post workout muscle recovery.

Scientists examined 28 studies and assessed cold water immersion, warm water immersion, active recovery (like walking or stretching), and massage.​
Cold water immersion was as good or better than other methods at improving recovery and helping your muscles bounce back faster. Spending time in cold water reduced soreness, inflammation, and muscle damage.
Water around 10 degrees Celsius (about 50 degrees Fahrenheit) for 10 to 30 minutes within 48 hours after exercise appears to be the best approach.​


It appears to contradict the hot bath method of muscle recovery until you see it says ’…cold water immersion was AS GOOD OR BETTER [than other methods].

Also, research suggests that it is the inflammation itself that releases factors that promote healing recovery and muscle growth (even though it is also painful). Thus reducing the inflammation with cold water immersion might be counterproductive to muscle growth.

Personally I’d go for what is most pleasant even if it’s slightly less effective than cold water immersion (which I find very unpleasant). After all, I’ve just caused myself great discomfort in the gym getting those sore muscles!
 
Some more research in favour of cold water immersion for post workout muscle recovery.

Scientists examined 28 studies and assessed cold water immersion, warm water immersion, active recovery (like walking or stretching), and massage.​
Cold water immersion was as good or better than other methods at improving recovery and helping your muscles bounce back faster. Spending time in cold water reduced soreness, inflammation, and muscle damage.
Water around 10 degrees Celsius (about 50 degrees Fahrenheit) for 10 to 30 minutes within 48 hours after exercise appears to be the best approach.​



It appears to contradict the hot bath method of muscle recovery until you see it says ’…cold water immersion was AS GOOD OR BETTER [than other methods].

Also, research suggests that it is the inflammation itself that releases factors that promote healing recovery and muscle growth (even though it is also painful). Thus reducing the inflammation with cold water immersion might be counterproductive to muscle growth.

Personally I’d go for what is most pleasant even if it’s slightly less effective than cold water immersion (which I find very unpleasant). After all, I’ve just caused myself great discomfort in the gym getting those sore muscles.
I will preface my comment by saying I am an electrical and mechanical engineer and very much see things in the natural/physical sense. Inflammation is akin to interference in an assembly or mating application. Interference in a dynamic assembly like a joint in the body, causes friction, which causes heat, and both cause wear and damage. It may be subtle over time and no, very few mechanical components can repair themselves, but I believe the premise holds.
I do agree, that is it 'old knowledge' that inflammation is a part of the healing and muscle building process. But as we age, we naturally lose muscle mass. This subsequently puts more load directly on our joints resulting in friction and interference which can cause joint damage. Plus, personal genetics are very much at play as well as a person's lifestyle and history.

I have had 2-1/2 knee replacements on my left leg. 1-1/2 due to severe injury of the leg (long story) and one because I simply wore it out. My right knee has also been replaced, largely due to being chronically overloaded from carrying my left leg.

I can't remember hearing a recommendation of just one or the other (hot/cold). I Always did a combination of both, via my trainer (in my competition days) or on my own. Cold (full immersion) for 30-45 minutes first for healing, then heat for recovery. I am not doctor so this is purely my personal experience and 'common sense' approach to inflammation. But I do know when a certain part of my body is inflamed. I kinda Sucks.
 
I will preface my comment by saying I am an electrical and mechanical engineer and very much see things in the natural/physical sense. Inflammation is akin to interference in an assembly or mating application. Interference in a dynamic assembly like a joint in the body, causes friction, which causes heat, and both cause wear and damage. It may be subtle over time and no, very few mechanical components can repair themselves, but I believe the premise holds.
It is very similar to the biological system except that local factors (that means biochemicals) are produced to attract various repair cells which come via the blood and so the area swells and becomes sore and stiff due to this influx.
I do agree, that is it 'old knowledge' that inflammation is a part of the healing and muscle building process. But as we age, we naturally lose muscle mass.
And this ‘sarcopenia’ causes great problems and accounts for doddery old people who move slowly and thus cannot correct unbalancing and falls (type II, fast twitch muscle fibres are particularly lost by ageing). This can be totally avoided and reversed by heavy weight lifting.
I have had 2-1/2 knee replacements on my left leg. 1-1/2 due to severe injury of the leg (long story) and one because I simply wore it out. My right knee has also been replaced, largely due to being chronically overloaded from carrying my left leg.
I’m convinced road running is the major cause of cartilage damage. It’s so bad for ones knees where the pressure on an area about that of a matchbox (in each knees) is huge. We’re meant to be dead by 35-40yrs old so it’s n wonder we develop bad knees.
I can't remember hearing a recommendation of just one or the other (hot/cold). I Always did a combination of both, via my trainer (in my competition days) or on my own. Cold (full immersion) for 30-45 minutes first for healing, then heat for recovery.
I’m not sure either: the data is often conflicting.
I am not doctor so this is purely my personal experience and 'common sense' approach to inflammation.
Common sense often not very sensical.
 

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