Ice-water immersion and delayed-onset muscle soreness: a randomised controlled trial

Br J Sports Med. 2007 Jun;41(6):392-7. doi: 10.1136/bjsm.2006.033985. Epub 2007 Jan 29.


Objective: To determine if ice-water immersion after eccentric quadriceps exercise minimises the symptoms of delayed-onset muscle soreness (DOMS).

Design: A prospective randomised double-blind controlled trial was undertaken. 40 untrained volunteers performed an eccentric loading protocol with their non-dominant leg.

Interventions: Participants were randomised to three 1-min immersions in either ice water (5+/-1 degrees C) or tepid water (24 degrees C).

Main outcome measures: Pain and tenderness (visual analogue scale), swelling (thigh circumference), function (one-legged hop for distance), maximal isometric strength and serum creatine kinase (CK) recorded at baseline, 24, 48 and 72 h after exercise. Changes in outcome measures over time were compared to determine the effect of group allocation using independent t tests or Mann-Whitney U tests.

Results: No significant differences were observed between groups with regard to changes in most pain parameters, tenderness, isometric strength, swelling, hop-for-distance or serum CK over time. There was a significant difference in pain on sit-to-stand at 24 h, with the intervention group demonstrating a greater increase in pain than the control group (median change 8.0 vs 2.0 mm, respectively, p = 0.009).

Conclusions: The protocol of ice-water immersion used in this study was ineffectual in minimising markers of DOMS in untrained individuals. This study challenges the wide use of this intervention as a recovery strategy by athletes.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Biomarkers / blood
  • Clinical Protocols
  • Creatine Kinase / blood
  • Cryotherapy / methods*
  • Double-Blind Method
  • Exercise*
  • Female
  • Humans
  • Hydrotherapy / methods*
  • Ice
  • Leg
  • Male
  • Muscle, Skeletal / physiopathology*
  • Pain / diagnosis
  • Pain Management*
  • Pain Measurement
  • Prospective Studies
  • Time Factors
  • Treatment Outcome


  • Biomarkers
  • Ice
  • Creatine Kinase