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Throwing cold water on muscle growth

A systematic review with meta-analysis of the effects of post-exercise cold water immersion on resistance training-induced hypertrophy


  • Alec Piñero
  • Ryan Burke
  • Francesca Augustin
  • Adam Mohan
  • Kareen Dejesus
  • Max Sapuppo
  • Max Weisenthal
  • Max Coleman
  • Patroklos Androulakis-Korakakis
  • Jozo Grgic
  • Paul Swinton
  • Brad Schoenfeld Lehman College



recovery strategies, cold application, cooling, cross-sectional area, fat-free mass, lean mass


The purpose of this paper was to systematically review the literature and perform a meta-analysis of the existing data on the effects of post-exercise cooling coupled with resistance training (RT) on gains in measures of muscle growth. To locate relevant studies for the topic, we comprehensively searched the PubMed/MEDLINE, Scopus, and Web of Science databases. A total of 8 studies met inclusion criteria; all employed cold water immersion (CWI) as the means of cold application. Preliminary analyses conducted on non-controlled effect sizes provided strong evidence of hypertrophic adaptations with RT that were likely to be at least small in magnitude (SMD0.5 = 0.36 [95%CrI: 0.10 to 0.61]; p(>0) = 0.995, p(>0.1) = 0.977). In contrast, non-controlled effect sizes provided some evidence of hypertrophic adaptations with CWI + RT that were likely to be between small and zero in magnitude (SMD0.5 = 0.14 [95%CrI: -0.08 to 0.36]; p(>0) = 0.906, p(>0.1) = 0.68). The primary analysis conducted on comparative effect sizes provided some evidence of greater relative hypertrophic adaptations with RT compared to CWI + RT (cSMD0.5 = -0.22 [95%CrI: -0.47 to 0.04]), with differences likely to be greater than zero (p(<0) = 0.957) and of at least a small magnitude of effect (p(< -0.1) = 0.834). Meta-regression did not indicate a potential moderation effect of training status (= -0.10 [95%CrI: -0.65 to 0.43] =0.653). In conclusion, the current data suggest that the application of CWI immediately following bouts of RT may attenuate hypertrophic changes.


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