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Cold and Heat Therapy Recovery for Triathletes

You have probably heard the acronym “RICE” when you turn your ankle or pull a muscle? RICE stands for Rest, Ice, Compress and Elevate. Recent studies have shown that the ice part of this acronym may not be correct in certain situations and the swelling process is in fact natural and beneficial and should not be inhibited with ice treatment.

It has been found that the swelling process also acts as natural stability (rather like a cast used for bones breaks) and the rush of white blood cells to the injured area starts the healing process. But if you do get injured and swelling starts it’s always best to seek medical advice quickly as everyone and situation is different.

In this article we will look at heat and ice therapy in the post training scenario and how it can potentially help with your performance and recovery as a triathlete. We will also explore the general health benefits of both. Ice or cold-water therapy has been popularized by Wim Hof as part of the Wim Hof Method and we will delve in to why.

Heat Therapy for Triathletes

Heat therapy has long been used post injury to help restore and maintain flexibility. You can use a hot water bottle, a heating pad set on low, or a damp, heated towel for example. Do not apply heat to an injury sooner than 48 hours after the injury. To avoid burning your skin, do not use anything that feels too warm.

For us we will be looking at the benefits of heat in training to boost your performance and help with recovery after training sessions.

Does Heat Therapy Work?

Research published in 2010 studied the effects of heat training on performance, examining 20 cyclists who were put through 10 days of training in 40-degree heat. The results found that the heat boosted their VO2 max performance by 6 per cent, even when the testing room was kept at a chilly 12 degrees.

Not surprisingly, when the article was published and eventually did the rounds on various fitness platforms and publications, hot rooms became the go-to option for those seeking altitude training on a budget.

The science suggests that heat training increases the volume of blood plasma required to transport red blood cells to your muscles. Whether that plasma results in improved athletic performance is something researchers still contest.

But it is thought that the resulting dilution of blood might trigger a natural Erythropoietin (EPO) response to produce new red blood cells, a response like altitude training. EPO stimulates the production of red blood cells in bone marrow and regulates the concentration of red blood cells and hemoglobin in the blood.

This is useful for athletes, since red blood cells shuttle oxygen to the cells, including muscle cells, enabling them to operate more effectively.

When and How to Use Heat Therapy for Recovery

Heat therapy after a training session can take the form of a sauna, microwave diathermy water-perfused garments, hot water immersion or steam/heat sheets and heat pads.

For muscle recovery and proactive prehab timing is everything and 10 minutes after a training session is the ideal timeframe for heat therapy. The benefits of heat can be felt in minutes after heat is delivered to the area.

If you are using localized heat therapy, you can use it on multiple areas, but it’s still recommended that sessions on each individual area do not exceed 20 minutes. A growing number of studies indicate that exposure to local heat prior to eccentric exercise may protect against muscle damage and enhance muscle remodeling.

Some studies suggest that heat therapy has the best results for intense eccentric sessions. Eccentric exercises are movements that lengthen muscle under tension, usually creating an adaptation that improves performance. Eccentric exercises include reverse lunges, Romanian deadlifts, and squat with pulse.

Cold Therapy for Triathletes

You may have noticed athletes jumping into ice baths (40°F-50°F) after physical activities and soaking for 5-10 minutes. As uncomfortable as this may look, an ice bath is one of the most effective ways to recover fast and treat muscle soreness and pain sustained during strenuous activities.

Cold water immersion is particularly vital for athletes, especially during intense periods of training. 

How Do Ice Baths Help Triathletes

Cold water immersion is a concept that was developed to treat microtraumas (tiny tears on muscle fibers) after exercise. These micro-tears are good; in fact, they are the reason why athletes exercise so much.

Microscopic muscle damage stimulates muscle cell activity to strengthen and repair the damaged muscles – the “tear and repair” process. However, performing strenuous physical activities can cause delayed onset muscle soreness (DOMS) and pain, which sets in 24-72 hours after exercise and cold therapy can help avoid this being too uncomfortable.

Ice baths help people relax, get rid of stress, and feel alive. One of the most common effects of cold-water immersion is that it helps you move and feel better. Experts have confirmed that practicing cold water immersion on a regular basis can cause long-lasting positive changes to your body’s lymphatic, immune, circulatory, and digestive systems.

Overall, all these benefits contribute to giving you a better quality of life. Ice baths have been found to reduce inflammation, boost your mood, improve circulation, and heart health and give you better sleep.

Types of Heat Therapy Options

Here we will look at various ways to experience the benefits of heat therapy to suit every pocket.

Personal Sauna

If you have ever had a sauna, you will know how good this feels! I have mainly used the ones at the gym so there is no additional outlay over and above my gym membership. But if you do want experience a sauna every day then a home sauna may be an option.

The Signature 1 Person Sauna

The Signature 1 person sauna is a great product and is just over $4,000.

It is lightweight and compact, but also durable and sustainable.

The benefits of frequent sauna use, such as decreasing the risk of developing cardiovascular diseases, have been studied extensively in the Finnish population where saunas are customary.

In other countries, saunas and other hot bath options may be expensive, and so are more cost-effective when used occasionally for intense muscle spasms or severe pain.

Pros: A proper wooden sauna with all the benefits of a gym sauna. It is lightweight and compact, but also durable and sustainable.

Cons: Expensive and you need room to install it permanently.

SereneLife Portable Personal Sauna – $213.19

SereneLife SLISAU35BK Full Size Portable Steam Sauna –Personal Home Spa, with Remote Control, Foldable Chair, Timer

SereneLife portable personal sauna is a lower cost alternative to a wooden sauna.

The personal sauna portable steam sauna spa features easy access ‘sit-in’ sauna design and convenient hand access zippers so you can use your phone or read a book.

This single person sauna kit indoor steam sauna has a compact assembled size and conveniently folds away so you can have a mobile spa and easily move your it from one room to another.

SereneLife portable sauna steamer box tent has a 1600-watt high power heating element and can reach a max temp of 122°F/50°C quickly making it highly power efficient. Comes with a wired controller for timer and auto heat setting.

The heat that radiates from the sauna and soothes achy muscles, helps prevent fatigue and helps detox your system. It comes with a foldable sauna chair that can be easily assembled and disassembled.

Pros: Low cost, portable, collapsible, energy efficient and incudes a chair.

Cons: It’s not as robust as a wooden sauna and the remote control does not work when in the sauna.

iReliev Far Infrared Heating Pad with Natural Jade & Tourmaline – $149.95

iReliev Far Infrared Heating Pad with Natural Jade & Tourmaline (24” x 16”) - Penetrating Heat Soothes Sore Muscles, Stiff Joints, Cramps, Arthritis, and Back Pain - Travel Bag Included

Infrared heat therapy provides natural therapeutic relief that penetrates up to three inches deep into the muscle and soft tissues. The flexible pad wraps gently around the targeted area. Jade and tourmaline distribute heat evenly to the body as the far infrared waves pass through the stones.

When heated the stones emit 1500+ negative ions per square inch. Negative ions act as antioxidants in the air and are believed to promote healing, positive energy, and overall wellbeing.

Adjustable temperature settings allow you to choose your desired heat from 55 -160° F. It comes with a handy bag for portability and storage.

Combining all-natural jade and tourmaline, the iReliev Far Infrared Heating Pad helps to reduce aching, inflamed muscles, and to relieve pain through infrared wavelengths.

These wavelengths permeate deep into your body to help increase blood flow, so your muscles and joints get the nutrients that they need. This flexible and durable heating pad also has a new and improved controller to make using this pad easier than ever.

Pros: It has adjustable temperature and is large enough to cover your back or other areas like your knees, thighs, calf’s etc

Cons: The stones may be uncomfortable for some people.

Knee Massager with Heat for Joint Pain Relief – $68.99

Knee Massager with Heat for Joint Pain Relief, Goldmill Vibration Knee Brace Wrap Rechargeable Warm Therapy for Arthritis, Cramps, Meniscus Pain, Ideal for Parents & Grandparents( 1 Pair)

The are many heating products that work on a specific part of your body. This device heats and massages your knees. It applies deep-penetrating thermal treatment onto your painful knees and muscles, and it helps improve blood circulation and to accelerate healing.

The massager can be adjusted between 113℉, 131℉, 150℉ and improves joint flexibility and circulation plus helps increase range of motion and reduces stiffness in painful joints.

Pros: The device heats and massages. It can be used for both pain and after training.

Cons: Can only heat one specific area of your body.

Hot water bottles – $12.36

Attmu Rubber Hot Water Bottle with Cover Knitted, Transparent Hot Water Bag 2 Liter- Blue

Hot water bottles can seem a bit old fashioned but if you’re on a budget they could be an option. Very simple – just fill will hot water but be careful if you are filing from the kettle and cover with a towel. To cover more areas of your body you could buy a few and apply at the same time?

Pros: Low cost and portable.

Cons: Small so can only cover a small area. Cannot regulate the temperature.

DIY: Hot or steamed towel and Hot Baths

You can of course opt for a DIY option such as a hot towel or a hot bath.

To prepare a hot towel, it is best to immerse the hand towel in water, by running the towel under hot water in a faucet or by placing the towel in a pot of warm water around 105 degrees Fahrenheit, for 2 to 3 minutes.

Squeezing the towel will remove excess water before applying to the back. Hot towels typically stay warm for 5 to 10 minutes and will then need to be reheated.

This form of heat therapy is short-lived, making it suitable for quick relief of muscle tension or pain, such as before physical activity or during work breaks.

A hot bath quickly heats the body above its core temperature and can be used for about 30 minutes, or 10 minutes if the temperature of the water exceeds 100 degrees Fahrenheit.

Types of Cold Therapy Options

The Plunge – $4990

The plunge is a cold bath that requires no plumbing so can be used inside or outside your house. It cools down to 39f or 4C degrees and has an insulated cover.

Cold plunge benefits extend beyond the mental and chemical aspects of your body too. Sports medicine has utilized cold water therapy for years, to help the active recovery of your muscles.

Being immersed in cold water stimulates leukocytes, the white blood cells that help fight off sicknesses. It also causes the lymphatic system to contract, forcing fluid through the lymph nodes. This process aids in detoxing the body and strengthening your immune system. A study has shown to substantially lower upper respiratory tract infections.

Cold plunging has shown the ability increase your baseline dopamine. Dopamine is the molecule in our brain and body that is linked to motivation. According to Dr. Andrew Huberman dopamine can enhance our depth of focus and lower our threshold for taking action towards our specific goals.

Researchers have known for a while that it connects to our daily energy. In particular, there is lots of evidence that a lack of norepinephrine can contribute to depression, meaning that a cold plunge might help to reduce depression and improve overall mood! Don’t take our word for it though, just ask anyone who has ever plunged!

The boost in norepinephrine you’ll get from consistent ice baths has been shown to be up to 5x. This neurotransmitter can dramatically reduce inflammation and help with chronic pain.

Cold water therapy has been shown to be an effective supplemental treatment for stress relief by decreasing the stress hormone cortisol. A study found that regular cold showers and ice baths helped reduce anxiety and improve the mood of participants.

When you dip into the Plunge, your body triggers the autonomic nervous system. This system is a network of vessels and nerves, split into two parts that control your response to stress. When you begin to control your response to stress, you’ll likely find that you begin to control your relaxation and sleep.

Pros: It is specifically designed for cold water therapy and will keep your temperature at the one you desire. No plumbing is needed so can be used inside and outside.

Cons: Costly.

Alaskey Lower body Ice Bath – Inflatable Recovery Tub for Athletes – $119.99

Alaskey Lower body Ice Bath - Inflatable Recovery Tub for Athletes - Portable Ice Bathtub

This unique Ice Bath for athletes has been designed to enable flexibility inside to heal muscle pain and relief effectively. It allows a comfortable and pleasant experience suitable for both adults and Athletes. It can be used indoors or outdoors with its portable and user-friendly properties.

The portable bathtub adult has been efficiently ergonomically designed to provide a unique ice bath experience with top-quality materials that maintain water temperature so you can get the most out of your inflatable tub for longer.

It has easy assembly allowing you to rapidly inflate the ice bathtub in 2 minutes to enjoy a hassle-free, comfortable ice bath. The foldaway bathtub has been made with thick, light, and transportable PVC for maximum sturdiness and portability. Suitable for personal healthcare, Alaskey ice bath has extra wide room simply and perfect for adults under 6.5 feet.

The ice bath is made with premium quality, eco-friendly PVC, ensures a waterproof interior and exterior layer with leakproof qualities for durability and reusability (2x times thicker than most other ice tub). The Alaskey ice bath is easy to store once deflated.

Pros: Low-cost ice bath specifically designed for athletes. Can be packed away when not is use.

Cons: Needed to be filled with cold water and has no temperature regulation.

Cold Water Therapy System Kit by Polar Vortex – $211.99

Cold Water Therapy System Kit by Polar Vortex - Ice Circulation Machine with 3-Strap Knee/Elbow/Shoulder Wrap and 4 Cold Cubes - Cryotherapy Kit

The AIS Clear cool therapy machine provides relief from soreness, aches, pain, and discomfort. With a comfortable and breathable therapy pad, it effectively targets the ankle, knee, hip, shoulder, arms, and more to alleviate swelling and inflammation following surgery or injury.

The ice therapy system is also effective at relieving joint pain due to arthritis or overuse.  The Versatile Joint Wrap is designed to be utilized with the Universal Pads for cryotherapy machines for a variety of body areas including the knee, shoulder, elbow, and more.

Pros: Portable and easy to use.

Cons: Relies on cubes from the freezer so the temperature cannot be regulated. Can only be used on parts of your body not your whole body.

Coldest Extra-Large Ice Pack for Back and Full Body – $79.99

Coldest Extra Large Ice Pack for Back and Full Body - Cold Compress for Pain Relief, Ice Blanket for Sleeping or Ice Pad Physical Therapy - Folds Compact (53' x 13' - Full Body)

This is an extra-large ice pack that you put into your freezer to cool and use. It’s a very simple ice pack with no temperature regulation.

Pros: Extra large so can cool more of your body in one go.

Cons: No temperature regulation.

Contraindications

When using heat (thermal therapy) and cold (cryotherapy) you should use caution if you have certain conditions.

If you suffer from a vascular condition or disruption to your blood flow like Raynaud’s disease you need to be very cautious when applying cold or heat.

Neurological conditions like diabetes where feedback from distal areas isn’t as good as it could be then going to hot, cold or long can cause damage.

Check with a professional for guidance on what temperatures are suitable for you.

Using heat or cold therapies is personal choice but generally people tend to prefer heat on their upper limbs and lower limbs cold therapy. As with all treatments see what works for you.

References

https://www.frontiersin.org/articles/10.3389/fspor.2021.707503/full

Attenuation of muscle damage by preconditioning with muscle hyperthermia 1-day prior to eccentric exercise – PubMed (nih.gov)

Is it time to put traditional cold therapy in rehabilitation of soft-tissue injuries out to pasture? – PMC (nih.gov)

https://blog.sidekicktool.com/the-role-of-heat-in-muscle-recovery/

https://www.gq.com.au/fitness/workout/heat-therapy-could-be-the-answer-to-better-athletic-performance/news-story/e527505965611940af068edb6fc5b957

https://icebarrel.com/blog/cold-water-immersion-for-athletes/#:~:text=You%20may%20have%20noticed%20athletes,pain%20sustained%20during%20strenuous%20activities.

Scientific Evidence-Based Effects of Hydrotherapy on Various Systems of the Body – PMC (nih.gov)

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Karen Parnell
Karen Parnellhttps://chilitri.com/one-to-one-coaching
Karen Parnell is British Triathlon Federation (BTF) Level 3 High Performing Coach and Tutor and ASA Open Water Swimming Coach. She is also a qualified NASM Personal Trainer, Nivel 3 Técnicos Federados FATRI España and IRONMAN® Certified Coach as well as being a Stryd running with power coach. Karen is based near Malaga in Southern Spain where she runs ChiliTri coaching and camps. You can find training plans for swimming, cycling, running and triathlon on Training TiltTrainingPeaks and FinalSurge.
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