Cold water immersion for forearm recovery

(you don't actually need Antarctic sea ice)

Note: The Rock Climbing Training Manual advocates for CWI for both treatment of finger/forearm injuries, and for everyday therapy for climbing induced micro trauma (Anderson and Anderson, 2014: 179). This is very helpful advice. This post follows up on that work by summarizing insights taken from freely available research online.

CWI for forearm recovery:   Cold water immersion (CWI) involves submerging a body part in cold water for a period of time in order to cause elevated blood flow after the cold is removed.  CWI can help athletes recover after intense training.  Use CWI after you are done for the day, and not in the the middle of your workout, which can reduce max performance (see Crowe, O’Conner and Rudd 2007).

Why they think it benefits muscles:  cold water immersion reduces blood flow rates while that region is cooled.  Subsequent to that restriction, the body elevates blood flow to the cooled region.  This elevated blood flow is shown to increase the removal of metabolic waste and theorized to aid repair of micro trauma. One study on climbing recovery strategies (Heyman, et al 2009) also found that low intensity exercise can increase blood flow and recovery rates (see recommendations below).

A range of sports medicine studies(Heyman, et al 2009; Ingram et al 2007; Bailey et al 2007; Meeusen and Lievens 1986) have shown that CWI can:

• increase muscular recovery rates and removal of metabolic waste
• increase recovery of maximum muscular capacity 24 and 48 hours after initial exercise
• reduce feeling of muscle soreness during recovery period
• reduce aches and pains during and immediately after CWI

Why it might work for tendons, etc:  Sports medicine studies tend to focus on things that are easier to measure, and focus on shorter term impacts, therefore there are few (if any?) studies of the efficacy of CWI for aiding recovery from normal wear and tear of tendon and connective tissue. However, CWI, might also

• increase recovery and repair of micro trauma to connective tissue, tendons, etc.
• reduce finger aches and stiffness (anecdotally observed)
• may aid recovery from injuries (research on this?)

Potentially, the benefits of CWI for tendons, joints and connective tissue would be caused by the same increased blood flow mechanism attribute above. This might be especially true because baseline rate of blood flow to connective tissue is much lower than for muscle.  

Now, here is what you should do:

Cool down and stretch first:  Build cool-down climbs and “active rest” into the end of your climbing day.  Ideally these cool downs will work the same muscle fibers recruited in your hard workout but at a much lower intensity.  At the very least do some range of motion exercises that get your hand and finger grip muscles working at a low intensity but active enough to increase blood flow. Always do your finger, hand, forearm stretches at the end of your workout, on your way home, or while smack talking at Miguel’s.  Rest completely for 30 min (as you eat your pizza).  

Ice, Ice, Baby!

• Get a suitable container (window planter, long tupperware or wide PVC pipe).  
• Partly fill with F 50-64 [c10-18] degree water (not too cold)
• Completely submerge your forearm (fingertips to above elbow).
• Keep arm submerged for 10 to 15 minutes.   
• Remove and allow your arm to warm up on it’s own.  
• Repeat for other arm.

Things to avoid:  Don't make the water too cold.  Don't give yourself frostbite.  Don't stretch or exercise your forearms after you ice.  Don’t do anything to restrict blood flow to the region during the warming period. Don't elevate your arm afterwards, see (Hughson et al 1996) who find that elevating the hand/forearm above the heart reduces blood flow rates (study tested during exercise).  Don't hop into a hot shower until your arms have warmed up on their own.  

Do:   Be consistent, being consistent is the hardest part.  Keep notes on timing, temperature, and results both short term and long term.  The suggestions above are based on research studies drawn from a variety of sports, and should be fine tuned to what seems to work best for you.   

Abstracts for all the papers cited are online at pubmed, if you want to look them up. There is plenty of room for further studies. Get on it! Here they are:

(Bailey et al 2007)
Bailey DM, Erith SJ, Griffin PJ, Dowson A, Brewer DS, Gant N, Williams C “Influence of cold-water immersion on indices of muscle damage following prolonged intermittent shuttle running.”  Journal of Sports Sciences [2007, 25(11):1163-1170]  http://europepmc.org/abstract/MED/17654228
(Crowe, O'Conner & Rudd 2007)
Crowe MJ, O'Connor D, Rudd D “Cold water recovery reduces anaerobic performance.”   International Journal of Sports Medicine [2007, 28(12):994-998]
http://www.ncbi.nlm.nih.gov/pubmed/17534786
(Heyman, et al 2009)
Heyman E, DE Geus B, Mertens I, Meeusen R. 2009.  Effects of four recovery methods on repeated maximal rock climbing performance. Medicine and Science in Sports and Exercise [2009, 41(6):1303-1310]
http://www.ncbi.nlm.nih.gov/pubmed/19461534
(Hughson et al 1985)
Hughson RL, Shoemaker JK, Tschakovsky ME, Kowalchuk JM.”Dependence of muscle VO2 on blood flow dynamics at onset of forearm exercise.” Journal of Applied Physiology (1985). 1996 Oct;81(4):1619-26.
http://www.ncbi.nlm.nih.gov/pubmed/8904578

(Meeusen and Lievens 1986)

Meeusen R, Lievens P. The use of cryotherapy in sports injuries. Sports Med. 1986 Nov-Dec;3(6):398-414.

http://www.ncbi.nlm.nih.gov/pubmed/3538270
(Ingram et al 2007)
Jeremy Ingram, Brian Dawson, Carmel Goodman, Karen Wallman, John Beilby, 2007. “Effect of water immersion methods on post-exercise recovery from simulated team sport exercise” Journal of Science and Medicine in Sport.  http://www.jsams.org/article/S1440-2440%2808%2900038-8/abstract