Cooling interventions for athletes: An overview of effectiveness, physiological mechanisms, and practical considerations

Abstract

Exercise-induced increases in core body temperature could negative impact performance and may lead to development of heat-related illnesses. The use of cooling techniques prior (pre-cooling), during (per-cooling) or directly after (post-cooling) exercise may limit the increase in core body temperature and therefore improve exercise performance. The aim of the present review is to provide a comprehensive overview of current scientific knowledge in the field of pre-cooling, per-cooling and post-cooling. Based on existing studies, we will discuss 1) the effectiveness of cooling interventions, 2) the underlying physiological mechanisms and 3) practical considerations regarding the use of different cooling techniques. Furthermore, we tried to identify the optimal cooling technique and compared whether cooling-induced performance benefits are different between cool, moderate and hot ambient conditions. This article provides researchers, physicians, athletes and coaches with important information regarding the implementation of cooling techniques to maintain exercise performance and to successfully compete in thermally stressful conditions.

Keywords: core body temperature; exercise performance; mid-cooling; per-cooling; post-cooling; pre-cooling; thermoregulation.

Figure 1.

An overview of the average performance improvement (%) (A) and effect size (B) of pre-cooling (black bar) and the beneficial effects of different precooling strategies (gray bars). Data are presented as mean ± standard deviation. The figure is adapted from our previous meta-analysis.

Figure 2.

An overview of the average performance improvement (%) (A) and effect size (B) of per-cooling (black bar) and the beneficial effects of different per-cooling strategies (gray bars). Data are presented as mean ± standard deviation.

Figure 3.

Overview of the effects of post-cooling on recovery from prolonged exercise, in which the effects were divided in subjective and objective outcomes. The ‘arrows’ represents a beneficial effects of post-cooling (↑ = higher, ↓ = lower), whereas the ‘ = sign’ represents no impact of post-cooling.

Figure 4.

Infographic of the feasibility and effectivity of pre-, per- and post-cooling strategies. The effectivity of cooling techniques is classified as small (+), moderate (++) or large (+++).