Perception of Cold Water Immersion among Elite Athlete’s
Noorah Alshoweir, Peter Goodwin, Jamie McFee and Gill Yeowell
Manchester Metropolitan University, Faculty of Health, Psychological & Social Care, Manchester, U.K.
Keywords: Cold Water Immersion, Pain, Performance, Soreness.
Abstract: Background Delayed onset muscle soreness is a common symptom after over-load training. It typically
begins 12-24 hours post exercise and lasts up to 72 hours, resulting in muscle pain and reduced function.
Cold-water immersion (CWI) has emerged as an effective method of recovery, reducing pain and enhancing
function. However, limited literature exists regarding the psychology of its perceived effectiveness.
Therefore, athletes’ pain, perceptions of performance and expectations post-CWI were investigated.
Methods Eight male rugby players participated in a 2 weeks cross-over trial comprising of 15 minutes of
CWI (12-13ºC) vs passive recovery after 20 minute step-up exercises. Three questionnaires were self-
completed, two investigating the experience of CWI and perceived performance, immediately post CWI and
the third investigating expectations, 48 hours later. A focus group was held 48-hour post-CWI. Results were
analyzed using a mixed methods approach. Results All players found this CWI protocol acceptable. For
most in this cohort, there was a perception that CWI would enhance performance and expect it to reduce
pain more than passive recovery. The focus group confirmed the questionnaire findings. Conclusion Player
perceptions of CWI might have a significant psychological impact on recovery outcomes.
1 BACKGROUND
Delayed onset muscle soreness is a common
symptom after over-load training. It typically begins
12-24 hours post exercise and lasts up to 72 hours,
resulting in muscle pain and reduced function (Crow
et al, 2007).
Cold-water immersion (CWI) has emerged as an
effective method of recovery, reducing pain and
enhancing function (Ingram et al, 2009). It suggests
that the diminish of the nerve impulse associated
with greater tissue cooling may reduce muscle
spasm and pain perception (Analgesia effect)
(Wilcock et al, 2006). Moreover, psychological
factors, such as expectancy, have been suggested to
significantly contribute to both positive and negative
sporting performance (Cook and Beaven, 2012).
However, limited literature exists regarding the
psychology of its perceived effectiveness. Therefore,
athletes’ pain, perceptions of performance and
expectations post-CWI were investigated.
2 METHODS
Eight male rugby players participated in a 2 weeks
cross-over trial comprising of 15 minutes of CWI
(12-13ºC) to the waist level vs passive recovery after
20 minute step-up exercises. Psychological effect
was determined by three questionnaires. It were self-
completed, two investigating the experience of CWI,
pain level and perceived performance, immediately
post CWI and the third investigating expectations,
48 hours later. A focus group was held 48-hour post-
CWI. Pain level was measured using VAS tool.
Results from the questionnaires were analysed using
mixed methods approach. Thematic analysis of the
transcript for focus groups identified four themes:
Awareness, Motivation, Response and Preferences
of using CW.
3 RESULTS
All players found this CWI protocol acceptable. For
most in this cohort, there was a perception that CWI
would enhance performance and expect it to reduce
pain more than passive recovery. The focus group
confirmed the questionnaire findings. CWI was
better than passive recovery by 95%,
p< 0.005.
Alshoweir N., Goodwin P., McFee J. and Yeowell G..
Perception of Cold Water Immersion among Elite Athlete’s.
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 2014 SCITEPRESS (Science and Technology Publications, Lda.)

4 CONCLUSIONS
Previous experience and expectation can play an
essential role for improving the performance The
application of the CW of a short period of time was
preferable to the players. Understanding of the CWI
benefits among the players has improved their
body’s response. Hence, player perceptions of CWI
might have a significant psychological impact on
recovery outcomes.
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Cook, C.J., Beaven, C.M. (2012), Individual perception of
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Crowe, M.J., O’Connor, D., and Rudd, D. (2007), Cold
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Ingram, J., Dawson, B., Goodman, C., Wallman, K. and
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Wilcock, I., Cronin, J. and Hing, W. (2006) Physiological
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