The effects of contrast water therapy on recovery of muscle function post exercise

Background: Recovery from training is one of the most important aspects of improving athletic performance (Bishop el al., 2008). Contrast Water Therapy (CWT) has been reported to accelerate recovery of muscle function after intense exercise (Vaile el al., 2007). CWT involves repeated alternate immersion in hot and cold water. This research consists of two studies; the first study aimed to evaluate the effects of CWT treatment on the effects of muscle function following prolonged intermittent exercise and the second study aimed to evaluate the effects of CWT on the recovery of muscle function following high intensity resistance training. The Loughborough Intermittent Shuttle run Test (LIST) is a field test specifically designed to replicate the demands associated with intermittent activity such as soccer (Thompson el al., 1999). The LIST has been reported to result in muscle damage, severe muscle soreness and an associated period of muscular dysfunction. Novel predominantly eccentric resistance exercise has also been reported to result in temporary repairable damage to human muscle. The aim of this research was to evaluate whether a typical CWT protocol was effective in reducing symptoms of exercise induced muscle damage in two studies. Methods Study 1: Sixteen active human volunteers, 14 males and 2 females, (mean ± S.D; height 176.8 ± 6.9 centimetres, body mass 75.6 ± 10.9 kilograms, age 22.4 ± 3 years) participated in this study. The volunteers were randomly assigned to either a CWT group (n = 8) or a tepid water immersion control group (n = 8). Each volunteer performed a familiarisation session, a pre-test session to record baseline measures, the LIST, a post exercise treatment , and four post-testing sessions at 24 ± 3, 48 ± 3, 72 ± 3 and 96 ± 3 hours after exercise. Measures were: knee extensor isometric Maximum Voluntary Contraction (MVC) force measured at an internal knee angle of 100 degrees, concentric and eccentric torque measured during knee extension at 1.04 and 2.08 rad.s-1, Ultrasound imaging to measure muscle swelling by muscle size and muscle soreness measured by questionnaire. The CWT group completed 5 cycles of 2 minutes immersion at 9 ± 1oC alternating with 4 minutes of immersion at 39 ± 1 oC. The control group completed 30 minutes immersed in water at a temperature of 29 ± 1oC. Volunteers were seated in the tanks, immersed to the level of the anterior superior iliac spine. The treatment was administered immediately after the LIST. Results Study 1: A Mixed Model Analysis of Variance was used to compare results of the two treatment groups over five time points. Study 1 showed changes overtime occurred for the following measures; MVC (p < 0.01, F value = 5.12, Observed power = 0.95), Isokinetic dynamometry at 2.08rad.s-1 (p = 0.02, p < 0.05, F value = 3.78, observed power = 0.79) and at 1.04rad.s-1 (p = 0.049, p < 0.05, F value = 2.55, observed power = 0.68) concentric contraction of the Quadriceps, Soreness rating using arbitrary scale (p < 0.01, F value = 7.61, Observed power = 0.93), Flight time (p = 0.03, p < 0.05, F value = 2.96, observed power = 0.71) and Peak force (p = 0.046, p= 0.05, F value = 2.88, observed power = 0.65) during performance of a Squat jump. Differences between groups showed no significance for all measures (p > 0.05). Methods study 2: Thirty-five active human volunteers (mean ± S.D.; height 173.9 ± 7.4 centimetres, body mass 72 ± 9.6 kilograms, age 22 ± 2.6 years) participated in this study. The volunteers were randomly assigned to either a CWT group (n=18) or tepid water immersion control group (n=17). Each volunteer performed a familiarisation session, a pre-test session to record baseline measures, a 45 minute resistance training protocol, and four post-testing sessions at 24 ± 3, 48 ± 3, 72 ± 3 and 96 ± 3 hours after exercise. Measures were the same as in study 1 mentioned above with the exception of; concentric and eccentric torque measured during knee extension at 0.87 and 1.75rad.s-1, no Ultrasound Imaging was completed, and Electrically Stimulated Muscle Force (ESMF) of the knee extensors was included as a measure. The CWT group completed 4 cycles of 1 minute immersion at 9 ± 1oC alternating with 4 minutes of immersion at 39 ± 1 oC. The control group completed 20 minutes immersed in water at a temperature of 29 ± 1oC. Volunteers were seated in the tanks, immersed to the level of the anterior superior iliac spine. Treatments were administered immediately after resistance training and 24 ± 3, 48 ± 3 and 72 ± 3 hours later, after post tests were completed. Results study 2: Study 2 showed that; Isometric MVC, Electrical Stimulation, Soreness rating, Isokinetic Dynamometry at 1.75 rad.s-1 eccentric, were statistically significant (p < 0.05) with a strong Observed Power (0.95 ± 0.05) for changes overtime. All measures were non significant for differences within the groups, and differences between groups (p > 0.05). Results are as follows; for MVC changes overtime (p = 0, p < 0.01, F value = 4.92, Observed power = 0.9), Electrical Stimulation (p = 0, p < 0.01, F value = 6.7, Observed power = 0.98), Soreness Rating (p = 0, p < 0.05, F value = 45.6, Observed power = 1), and Isokinetic Dynamometry at 1.75 rad.s-1 eccentric contraction of the quadriceps (p = 0, p < 0.01, F value = 5.49, observed power = 0.97). Isokinetic Dynamometry at 0.87rad.s-1 concentric contraction of the quadriceps came close to significance (p = 0.06, F value = 1.09, Observed power = 0.30). There was no significance recorded between treatment groups. Conclusion: The LIST was effective in inducing decrements in muscle function. Muscle soreness and reduction in muscle force suggest that the resistance training protocol also induced delayed onset muscle soreness and damage. Contrast water therapy had no significant effect on the recovery of markers of muscle function in the days following high intensity exercise. This research does not show evidence that CWT is an effective treatment in aiding the recovery of a healthy active population.