The physiological response to cold-water immersion following a mixed martial arts training session

Appl Physiol Nutr Metab. 2017 May;42(5):529-536. doi: 10.1139/apnm-2016-0582. Epub 2017 Jan 17.


Combative sport is one of the most physically intense forms of exercise, yet the effect of recovery interventions has been largely unexplored. We investigated the effect of cold-water immersion on structural, inflammatory, and physiological stress biomarkers following a mixed martial arts (MMA) contest preparation training session in comparison with passive recovery. Semiprofessional MMA competitors (n = 15) were randomly assigned to a cold-water immersion (15 min at 10 °C) or passive recovery protocol (ambient air) completed immediately following a contest preparation training session. Markers of muscle damage (urinary myoglobin), inflammation/oxidative stress (urinary neopterin + total neopterin (neopterin + 7,8-dihydroneopterin)), and hypothalamic-pituitary axis (HPA) activation (saliva cortisol) were determined before, immediately after, and 1, 2, and 24 h postsession. Ratings of perceived soreness and fatigue, counter movement jump, and gastrointestinal temperature were also measured. Concentrations of all biomarkers increased significantly (p < 0.05) postsession. Cold water immersion attenuated increases in urinary neopterin (p < 0.05, d = 0.58), total neopterin (p < 0.05, d = 0.89), and saliva cortisol after 2 h (p < 0.05, d = 0.68) and urinary neopterin again at 24 h (p < 0.01, d = 0.57) in comparison with passive recovery. Perceived soreness, fatigue, and gastrointestinal temperatures were also lower for the cold-water immersion group at several time points postsession whilst counter movement jump did not differ. Combative sport athletes who are subjected to impact-induced stress may benefit from immediate cold-water immersion as a simple recovery intervention that reduces delayed onset muscle soreness as well as macrophage and HPA activation whilst not impairing functional performance.

Keywords: cold-water immersion; cryotherapy; cryothérapie; endocrine hormones; exercice physique; exercise; hormones; immersion en eau froide; inflammation.

MeSH terms

  • Adult
  • Cold Temperature*
  • Exercise*
  • Fatigue / physiopathology
  • Humans
  • Hydrocortisone / chemistry
  • Hydrocortisone / urine
  • Immersion*
  • Male
  • Martial Arts*
  • Muscle, Skeletal / physiology
  • Myalgia / physiopathology
  • Myoglobin / metabolism
  • Myoglobinuria
  • Neopterin / urine
  • Saliva / chemistry
  • Young Adult


  • Myoglobin
  • Neopterin
  • Hydrocortisone