The effect of different water immersion strategies on delayed onset muscle soreness and inflammation in elite race walker

Background: This study aimed to investigate the effects of cold water immersion (CWI) and contrast water therapy (CWT) on serum interleukin 6 and prostaglandin 2 levels in self-perceived exertion, and muscle soreness of elite race walkers over a 15-day high-intensity training period. Methods: Thirty elite male race walkers were randomly divided into three groups: control group (C, n = 10), cold-water immersion (CWI, n = 10) group, contrast water therapy (CWT, n = 10) group. After daily training, elite race walkers were exposed to either CWI (10 minutes at 10 ◦C) or CWT (4 cycles of 2.5 minutes, alternately at 12 ◦C and 38 ◦C). Elite race walkers in the control group only performed simple stretching without any additional treatment. The serum interleukin 6, prostaglandin 2, self-perceived exertion, and muscle soreness were tested at 6 training points at baseline (B), light load-1 (L1), heavy load-1 (H1), medium load (M), heavy load-2 (H2), light load-2 (L2), respectively. Results: When compared with the CWT group, the interleukin 6 level, prostaglandin 2 level, self-perceived exertion, and muscle soreness of the C group were not significantly different. When compared with the CWT group, the interleukin 6 level in the CWI group was significantly lower at the time point of L1 and H2. Similarly, CWI significantly reduced the prostaglandin 2 levels at M and L2, except for H2. Self-perceived exertion and muscle soreness were not significantly different in both groups. Conclusions: The results from this study demonstrate that CWI may be more effective than CWT for reducing inflammatory markers at certain points in a training cycle, but it does appear that this effect can be induced in a predictable fashion.

water immersion; interleukin 6; prostaglandin 2; elite race

[1] Cheung K, Hume PA, Maxwell L. Delayed Onset Muscle Soreness. Sports Medicine. 2003; 33: 145–164.

[2] Lewis PB, Ruby D, Bush-Joseph CA. Muscle Soreness and Delayed-Onset Muscle Soreness. Clinics in Sports Medicine. 2012; 31: 255–262.

[3] Pumpa KL, Fallon KE, Bensoussan A, Papalia S. The effects of Lyprinol® on delayed onset muscle soreness and muscle damage in well trained athletes: A double-blind randomized controlled trial. Complementary Therapies in Medicine. 2011; 19: 311–318.

[4] Zainuddin Z, Newton M, Sacco P, Nosaka K. Effects of mas-sage on delayed-onset muscle soreness, swelling, and recovery of muscle function. Journal of Athletic Training. 2005; 40: 174–180.

[5] Kawamura T, Gando Y, Takahashi M, Hara R, Suzuki K, Mu-raoka I. Effects of hydrogen bathing on exercise-induced oxida-tive stress and delayed-onset muscle soreness. Japanese Journal of Physical Fitness and Sports Medicine. 2016; 65: 297–305.

[6] Philippe M, Krüsmann PJ, Mersa L, Eder EM, Gatterer H, Melmer A, et al. Acute effects of concentric and eccentric ex-ercise on glucose metabolism and interleukin-6 concentration in healthy males. Biology of Sport. 2016; 33: 153–158.

[7] Chia YY, Liu CC, Feng GM, Tseng CA, Hung KC, Chen CC, et al. The Antinociceptive Effect of Light-Emitting Diode Irradia-tion on Incised Wounds Is Correlated with Changes in Cyclooxy-genase 2 Activity, Prostaglandin E2, and Proinflammatory Cy-tokines. Pain Research & Management. 2017; 2017: 4792489.

[8] Hoseinzadeh K, Daryanoosh F, Baghdasar PJ, Alizadeh H. Acute effects of ginger extract on biochemical and functional symptoms of delayed onset muscle soreness. Medical Journal of the Islamic Republic of Iran. 2015; 29: 261.

[9] Simmons G, Cooper S, Muse D. Enhancing methods for the de-layed onset muscle soreness (DOMS) pain model. The Journal of Pain. 2018; 19: S81.

[10] Pearcey GEP, Bradbury-Squires DJ, Kawamoto J, Drinkwater EJ, Behm DG, Button DC. Foam rolling for delayed-onset mus-cle soreness and recovery of dynamic performance measures. Journal of Athletic Training. 2015; 50: 5–13.

[11] Guo J, Li L, Gong Y, Zhu R, Xu J, Zou J, et al. Massage al-leviates delayed onset muscle soreness after strenuous exercise: A systematic review and meta-analysis. Frontiers in physiology. 2017; 8: 747.

[12] Shoultz JA, Snyder KR, Evans TA, Lund RJ. Effect of Soft Tis-sue Oscillation Therapy on the Relief of Pain Associated with Delayed Onset Muscle Soreness. Athletic Training & Sports Health Care. 2017; 9: 17–23.

[13] Kwiecien SY, Mchugh MP. The cold truth: the role of cryother-apy in the treatment of injury and recovery from exercise. Euro-pean Journal of Applied Physiology. 2021; 121: 2125–2142.

[14] Ihsan M, Watson G, Abbiss CR. What are the Physiological Mechanisms for Post-Exercise Cold Water Immersion in the Re-covery from Prolonged Endurance and Intermittent Exercise?Sports Medicine. 2016; 46: 1095–1109.

[15] de Freitas VH, Ramos SP, Bara-Filho MG, Freitas DGS, Coim-bra DR, Cecchini R, et al. Effect of Cold Water Immersion Per-formed on Successive Days on Physical Performance, Muscle Damage, and Inflammatory, Hormonal, and Oxidative Stress Markers in Volleyball Players. Journal of Strength and Condi-tioning Research. 2019; 33: 502–513.

[16] Leeder J, Gissane C, van Someren K, Gregson W, Howatson G. Cold water immersion and recovery from strenuous exercise: a meta-analysis. British Journal of Sports Medicine. 2012; 46: 233–240.

[17] Wilcock IM, Cronin JB, Hing WA. Physiological Response to Water Immersion. Sports Medicine. 2006; 36: 747–765.

[18] Tipton MJ, Collier N, Massey H, Corbett J, Harper M. Cold wa-ter immersion: kill or cure? Experimental Physiology. 2017; 102: 1335–1355.

[19] Hyldahl RD, Peake JM. Combining cooling or heating applica-tions with exercise training to enhance performance and muscle adaptations. Journal of Applied Physiology. 2020; 129: 353–365.

[20] Halson SL, Bartram J, West N, Stephens J, Argus CK, Driller MW, et al. Does hydrotherapy help or hinder adaptation to train-ing in competitive cyclists? Medicine and Science in Sports and Exercise. 2014; 46: 1631–1639.

[21] Jakeman JR, Macrae R, Eston R. A single 10-min bout of cold-water immersion therapy after strenuous plyometric exercise has no beneficial effect on recovery from the symptoms of exercise-induced muscle damage. Ergonomics. 2009; 52: 456–460.

[22] Bieuzen F, Bleakley CM, Costello JT. Contrast water therapy and exercise induced muscle damage: a systematic review and meta-analysis. PLoS ONE. 2013; 8: e62356.

[23] Tavares F, Beaven M, Teles J, Baker D, Healey P, Smith TB, et al. Effects of Chronic Cold-Water Immersion in Elite Rugby Players. International Journal of Sports Physiology and Perfor-mance. 2019; 14: 156–162.

[24] St Clair Gibson A, Lambert EV, Rauch LHG, Tucker R, Baden DA, Foster C, et al. The Role of Information Processing between the Brain and Peripheral Physiological Systems in Pacing and Perception of Effort. Sports Medicine. 2006; 36: 705–722.

[25] Crystal NJ, Townson DH, Cook SB, LaRoche DP. Effect of cryotherapy on muscle recovery and inflammation following a bout of damaging exercise. European Journal of Applied Physi-ology. 2013; 113: 2577–2586.

[26] Ascensão A, Leite M, Rebelo AN, Magalhäes S, Magalhäes J. Effects of cold water immersion on the recovery of physical per-formance and muscle damage following a one-off soccer match. Journal of Sports Sciences. 2011; 29: 217–225.

[27] Torre MF, Martinez-Ferran M, Vallecillo N, Jiménez SL, Romero-Morales C, Pareja-Galeano H. Supplementation with Vitamins C and E and Exercise-Induced Delayed-Onset Muscle Soreness: A Systematic Review. Antioxidants. 2021; 10: 279.

[28] Kennedy RH, Silver R. Neuroimmune Signaling: Cytokines and the Central Nervous System. Neuroscience in the 21st Century. 2016; 37: 1–41.

[29] Banfi G, Melegati G, Barassi A, Dogliotti G, Melzi d’Eril G, Dugué B, et al. Effects of whole-body cryotherapy on serum me-diators of inflammation and serum muscle enzymes in athletes. Journal of Thermal Biology. 2009; 34: 55–59.

[30] Lattermann C, McIlwraith C. Intra-articular Corticosteroids for Knee Pain-What Have We Learned from the Equine Athlete and Current Best Practice. The Journal of Knee Surgery. 2019; 32: 009–025.

[31] Fonseca LB, Brito CJ, Silva RJS, Silva-Grigoletto ME, da Silva WM, Franchini E. Use of Cold-Water Immersion to Reduce Muscle Damage and Delayed-Onset Muscle Soreness and Pre-serve Muscle Power in Jiu-Jitsu Athletes. Journal of Athletic Training. 2016; 51: 540–549.

[32] Ahokas EK, Ihalainen JK, Kyröläinen H, Mero AA. Effects of Water Immersion Methods on Postexercise Recovery of Physi-cal and Mental Performance. Journal of Strength and Condition-ing Research. 2019; 33: 1488–1495.