How to Do an Ice Bath, and Is It Worth It?

I finished Week 7 of my 18-week marathon training plan, and with it I completed my longest run ever of 12 miles. Suffice it to say, I felt some soreness by the time I made it home.

I expected this and have already been doing homework about how to take care of myself and recover properly from longer runs. Post-run stretches, massage and nutrition are all well and good, but there's one recovery tool I've always put off: the ice bath.

My running friends swear by it, as do most online running bloggers. Jump in a tub full of ice and water, sit for 15 minutes and your legs will feel like a million bucks. I have a low tolerance for cold water, so I haven't been anxious to hop on this bandwagon, but now that I'm running past the 10-mile mark I figured it was time to get serious.

Yep, I did my first ice bath.

How to Do an Ice Bath

There's a lot of info online about ice baths, but I'll give kudos to the Running for Bling blog for what I found to be the simplest and best instructions, especially for beginners. Unfortunately, I didn't find them until after my chilled experience... and they would have been useful:

1. Buy Three 10-Pound Bags of Ice. Yes, three. The first will melt quickly.
2. Start with LUKEWARM Water. I learned this the hard way. Starting with cold water makes it very painful to get into the tub. Don't add the ice yet!
3. Wear Clothes if You Need Them. Most people seem to keep their running clothes on for their ice baths. Some have a better tolerance for cold, but if you're like me then a winter coat with the running shorts is required to stay in the tub. Remember, only your legs need to be submerged. Some people even recommend neoprene booties for your feet. 
4. Fill Up the Water to Hit Just Above Mid Leg. No worries about covering your legs completely with water because the ice will add volume.
5. Get in the Tub, THEN Add One Bag of Ice. Add it near your feet. The first bag will melt quickly in the lukewarm water, but the temperature change will be more tolerable than jumping into ice cold water.
6. Slowly Add the Next Two Bags of Ice. No rush, do it at your own pace. These bags will melt much more slowly.
7. Sit for 15-20 Minutes

That's about it, although adding music, a warm cup of coffee or tea and having a magazine handy can also help pass the time (and keep your mind off the cold). I'm sure there are plenty of hardcore runners out there who do ice baths regularly enough that they can just jump into a tub of freezing water without the adjustment period, but I'm not one of them. If you can do that and start by filling the tub with cold water then you may be able to get by with only one bag of ice.

Why Do an Ice Bath?

Why bother with all this coldness in the first place? The theory behind the process, known as cryotherapy, is fairly simple: cold temps restrict blood vessels resulting in decreased blood flow and metabolic activity. This helps reduce inflammation that can add to swelling and tissue breakdown, which would lead to impaired recovery of damaged muscles. When you warm up again (i.e., step out of the bath) your blood vessels open up, allowing blood to run faster and do a better job flushing out metabolic debris and harmful byproducts. This is believed to help muscles heal and recover faster.

Basically, it's the same idea as holding an ice pack on a sore muscle, except it's a really big ice pack that covers every muscle in your legs. Opinions vary regarding the temperature of the water and the length of time you should stay submerged, but the consensus seems to be that 10-15°C (50-60°F) for 10-20 minutes is ideal. Some studies suggest that less than 10 minutes doesn't do much and more than 20 minutes doesn't add anything.

Do Ice Baths Really Work?

This one isn't so easy to answer. Runners swear by them. I rarely meet a distance runner who doesn't insist that a nice frigid bath works wonders for recovery. Their testimonials mean a lot to me, but what does the science say?

A study published last year in the Journal of Science and Medicine in Sport attempted to tackle this question. Nine endurance athletes (all men) performed various training bouts running to the point of failure. Between the workouts, the men sat in either hip-level water at 8°C (46°F), 15°C (49°F) or un-immersed (no ice bath). In the end, the results suggested that participants in ice baths of both temperatures showed better recovery times, with the colder ice baths being slightly better (95% likely beneficial effect as opposed to 89%). The official conclusion: "These data indicate that a 15min period of cold water immersion applied between repeated exhaustive exercise bouts significantly reduces intestinal temperature and enhances post-immersion running performance in normothermic conditions."

That sounds very promising, although it was a small sampling pool. A more recent study, brought to attention by a Runners World article last July, suggests otherwise. Published in the European Journal of Applied Physiology, this study compared the recovery of 10 runners taking 5°C ice baths for 20 minutes with 10 runners skipping the baths. After analyzing blood samples, muscle soreness and CCL2 levels, they found no noticeable difference in recovery time between the two groups (CCL2 levels did show a slight difference, but this was deemed "highly variable"). Their conclusion: "20 min of cryotherapy was ineffective in attenuating the strength decrement and soreness seen after muscle-damaging exercise... These results do not support the use of cryotherapy during recovery."

In the end, here's what all the official studies tell us: ice baths may or may not work.

Anti-climactic, to say the least.

Ultimately, I go with the theory that if you think ice baths help you then you should do them, especially if it's already part of a routine that seems to be working. I know studies of barefoot running and minimalist shoes are still inconclusive and under heated debate, but I swear by the benefits myself. I'm not about to argue with an experienced runner who has been using ice baths for a long time and feels benefited by them. And if you don't want to do them, that's fine, too.

World champion runner Mo Farah does ice baths. I wouldn't debate it with him.

My First Ice Bath

So how did my first ice bath go? Not so great. I filled a tub with cold water, dumped in a 10-pound bag of ice, put on my heaviest winter coat, set a timer for 15 minutes and turned up the iPod. Everything seemed well and good so I jumped in.

Suffice it to say, I didn't last the whole 15 minutes. Not even close. The shock to my system was a little too overwhelming. I didn't have a thermometer, but if I had to guess the temperature of the water then I'd say it was about DAMN COLD degrees Farenheit (-32 x 5/9 to convert to Celsius).

I'm not anxious to make ice baths part of my regular routine, although I would be curious to try the more gradual approach outlined above. We'll see if I'm feeling brave after my next long run...

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