REF-914 · Malta et al., 2020 · Sports Medicine, Vol. · Paper · PubMed

The Effects of Regular Cold-Water Immersion Use on Training-Induced Changes in Strength and Endurance Performance: A Systematic Review with Meta-Analysis

A-fairly strong evidenceMeasured on a mixed groupWritten before October 2026, being re-checked

Regular cold-water immersion (CWI) is widely used to speed recovery during training, but earlier work hinted that it might harm resistance-training adaptations and help endurance adaptations. This meta-analysis pooled controlled human studies in which CWI at ≤ 15 °C accompanied a regular training programme, with baseline and post-training tests. Eight articles were included.

Regular CWI with resistance training reduced gains in one-repetition maximum, maximal isometric strength and strength endurance, and in ballistic performance. With endurance training, it had no effect on time-trial mean power or maximal aerobic power in a graded test, nor on time-trial duration.

The authors conclude that regular CWI harms resistance-training adaptations but does not appear to affect aerobic performance.

Participants

Not given in the abstract; eight included articles of controlled human training studies.

Protocol

Search of MEDLINE, Cochrane Central Register of Controlled Trials and SPORTDiscus, ending on November 25, 2019.
Inclusion: (1) controlled investigation; (2) humans; (3) CWI at ≤ 15 °C; (4) associated with a regular training program; (5) baseline and post-training assessments.
Separate pooling for resistance and endurance training outcomes.

Key Results

Resistance training — 1RM, maximum isometric strength, strength endurance: harmful effect of CWI, SMD = -0.60 (95% CI -0.87 to -0.33; p < 0.0001).
Resistance training — ballistic efforts: SMD = -0.61 (95% CI -1.11 to -0.11; p = 0.02).
Endurance training — time-trial mean power and maximal aerobic power in a graded exercise test: SMD = -0.07 (95% CI -0.54, 0.53; p = 0.71) — no effect.
Endurance training — time-trial duration: SMD = 0.00 (95% CI -0.58 to 0.58; p = 1.00) — no effect.

Practical Application

"Will regular ice baths hurt my gains?" For strength, yes: this meta-analysis of eight controlled training studies found that regular cold-water immersion (≤ 15 °C) reduced strength gains (SMD -0.60) and ballistic gains (SMD -0.61) from resistance training, while it had no measurable effect on aerobic performance after endurance training (SMD -0.07 and 0.00).
Keep cold water away from gym sessions whose goal is strength or power; after endurance-only training it does not appear to cost aerobic gains.
The endurance finding is "no effect", not a benefit: the pooled confidence intervals are wide, so small effects either way cannot be excluded.
Not from this paper; the base's own practice: an endurance athlete who lifts keeps cold water for competition, heat, or back-to-back race days, not as a daily habit. The recovery-vs-adaptation reasoning and the session-spacing framework are both in SYNTH-70.

Limitations

Only eight included articles; participant numbers and training status are not in the abstract.
Endurance outcomes have wide confidence intervals; absence of an effect is not proven.
CWI protocols (temperature ≤ 15 °C, duration, frequency) varied across studies.
Written from the abstract and record metadata only (full text not read).
How this entry was checked and changed
Why this level

SR/MA of eight small controlled studies; pooled numbers of participants are not in the abstract

Content correction 2026-09-27
2026-10-01: cross-reference repointed from a merged framework to the one that replaced it (SYNTH-01→31, 05→34, 09→70, 12/15→32, 19→26).
2026-10-01: citation of the superseded pointer SYNTH-09 repointed to SYNTH-70, which carries the cited content.