Influence of cold water immersion on limb and cutaneous blood flow at rest

Am J Sports Med. 2011 Jun;39(6):1316-23. doi: 10.1177/0363546510395497. Epub 2011 Feb 18.


Background: Cold water immersion reduces exercise-induced muscle damage. Benefits may partly arise from a decline in limb blood flow; however, no study has comprehensively investigated the influence of different degrees of cooling undertaken via cold water immersion on limb blood flow responses.

Purpose: To determine the influence of cold (8°C) and cool (22°C) water immersion on lower limb and cutaneous blood flow.

Study design: Controlled laboratory study.

Methods: Nine men were placed in a semireclined position and lowered into 8°C or 22°C water to the iliac crest for two 5-minute periods interspersed with 2 minutes of nonimmersion. Rectal and thigh skin temperature, deep and superficial muscle temperature, heart rate, mean arterial pressure, thigh cutaneous blood velocity (laser Doppler), and superficial femoral artery blood flow (duplex ultrasound) were measured during immersion and for 30 minutes after immersion. Indices of vascular conductance were calculated (flux and blood flow/mean arterial pressure).

Results: Reductions in rectal temperature (8°C, 0.2° ± 0.1°C; 22°C, 0.1° ± 0.1°C) and thigh skin temperature (8°C, 6.2° ± 0.5°C; 22°C, 3.2° ± 0.2°C) were greater in 8°C water than in 22°C (P < .01). Femoral artery conductance was reduced to a similar extent immediately after immersion (~30%) and 30 minutes after immersion (~40%) under both conditions (P < .01). In contrast, there was less thigh cutaneous vasoconstriction during and after immersion in 8°C water compared with 22°C (P = .01).

Conclusion: These data suggest that immersion at both temperatures resulted in similar whole limb blood flow but, paradoxically, more blood was distributed to the skin in the colder water. This suggests that colder temperatures may be associated with reduced muscle blood flow, which could provide an explanation for the benefits of cold water immersion in alleviating exercise-induced muscle damage in sports and athletic contexts.

Clinical relevance: Colder water temperatures may be more effective in the treatment of exercise-induced muscle damage and injury rehabilitation because of greater reductions in muscle blood flow.

MeSH terms

  • Adult
  • Athletic Injuries / therapy
  • Blood Pressure
  • Body Temperature Regulation
  • Cold Temperature
  • Cryotherapy*
  • Femoral Artery / physiology*
  • Heart Rate
  • Humans
  • Immersion
  • Laser-Doppler Flowmetry
  • Leg / blood supply
  • Male
  • Muscle, Skeletal / blood supply*
  • Regional Blood Flow*
  • Skin / blood supply*
  • Young Adult