Ice Bath – A Guide by CARE

The Ice Bath – Stepping Out of Your Comfort Zone

We want to take you on a quick, imaginative journey: It is a serene winter morning, the air is crisp and invigorating, and the sky is painted with hues of pink and orange as the sun rises. You spot a group of people, undeterred by the frosty chill, making their way toward a frozen lake with a round hole in it. As they stand at the hole’s edge, anticipation and excitement fill the air. In a daring act that defies the norms of comfort, they immerse themselves in the freezing depths, and the cold envelops them. After a while, they step out of the water, feeling healthy, happy, and rejuvenated. Welcome to the world of the ice bath!

Taking an ice bath is a common scene in Northern countries like Finland. The practice of ice bathing, a ritual that has transcended time and cultures, is reemerging as a modern practice sweeping through wellness and health circles.

Ice bath therapy rose to fame thanks to the Dutch extreme athlete Wim Hof. Wim Hof, also known as “The Iceman,” became famous for his extraordinary ability to withstand extreme cold temperatures and his unique method of taking an ice bath combined with breathing techniques. He has gained international recognition for his teachings and his approach to improving physical and mental well-being through controlled cold water therapy and extreme cold.

Wim Hof is not alone in his passion for ice bath therapy and taking a cold water bath. Beyond the surface-level chill, there's a wealth of physiological and psychological benefits to be uncovered in the icy embrace of cold water immersion.

What is an Ice Bath? — Deliberate Cold Exposure at its Best

An ice bath is a practice that involves immersing your body in freezing cold water for a brief period – usually around 5 minutes. The cold water bath or ice bath therapy is often used as a therapeutic and recovery technique by athletes, fitness enthusiasts, and individuals seeking various health benefits.

Exposure to intense cold has been proved to offer a range of physical and mental advantages. [1] There are slight differences between the different types of cold water therapies, which we now want to explain a little further.

Cold water therapy is a broad term encompassing various practices that utilize cold water for therapeutic purposes. Cold water immersion involves immersing the body, partially or entirely, in cold water, which can take the form of cold showers, ice baths, or natural bodies of cold water. The ice bath, which we focus primarily on in this article, entails immersing the body in a tub of cold water and ice up to the neck to harness physical and mental benefits.

Another form of cold water therapy is the so-called cold plunge. The cold plunge resembles an ice bath but typically occurs in natural bodies of cold water like lakes, rivers, or the ocean.

Conversely, Cryotherapy involves exposing the body to icy air or nitrogen gas in a controlled environment. In cryotherapy, fluid water is not involved. This form of deliberate cold exposure is even used as a supportive measure for cancer patients who undergo chemotherapy to reduce the incidence of severe OM (painful mouth sores). [2]

Another form of cold water therapy is contrast water therapy, which alternates between cold and hot water immersion.

Lastly, the Wim Hof Method, created by Wim Hof himself, combines cold exposure, breathing techniques, and meditation to enhance mental and physical well-being.

But now, let’s get back to the traditional form of the ice bath and explore how this practice works precisely.

How Do Ice Baths Work? — A Cascade of Physical Reactions

Ice baths work by subjecting your body to cold water, typically within the range of 50 to 59 degrees Fahrenheit (ca. 10-15 °C). Whether you achieve this by buying an ice bathtub or using a natural body of water during wintertime is up to you.

Exposing your body to these temperatures prompts a cascade of physiological reactions that manifest in both immediate and lasting effects on your body. The physiological mechanisms behind ice baths are multifaceted.

But what exactly happens in our body when we take an ice bath?

Cold water exposure leads to a phenomenon called “vasoconstriction,” where our blood vessels narrow. This response is an attempt by the body to conserve heat and prevent heat loss from your skin's surface. At the same time, vasoconstriction diverts blood away from the skin and extremities towards the body's core to maintain our core temperature. The constriction of blood vessels (vasoconstriction) reduces the influx of immune cells and diminishes inflammation and swelling, particularly in muscles that might be inflamed due to exercise or injury. [3]

Cold water immersion and ice baths aid muscle recovery by flushing out metabolic waste products that accumulate during intense physical activity. This process can help reduce muscle soreness and improve recovery time. [4]

Furthermore, cold exposure triggers the release of endorphins, which are natural pain-relieving and mood-enhancing chemicals. These endorphins can create a sense of euphoria and relaxation, leading to temporary pain relief and improved mood. [5]

After the vasoconstriction, the body enters a phase of vasodilation when it warms up again. This expansion of blood vessels can promote improved circulation and nutrient delivery to muscles and tissues, aiding in recovery and overall health. [6]

Beyond the physical benefits, enduring the discomfort of an ice bath cultivates mental resilience, reinforcing your capacity to manage stress and adversity. Ice baths also prompt your body to burn more calories as it strives to maintain core temperature, offering a modest contribution to energy expenditure and weight management.

It's essential to remember that ice baths might not be appropriate for everyone, particularly those with specific medical conditions such as cardiovascular problems. Adhering to the recommended timing and duration for ice baths is crucial to prevent excessive cold stress.

What Are the Benefits of Ice Baths?

The effects and potential benefits of an ice bath are numerous and diverse in nature. We’ll now explain the main benefits of ice baths to you so you can make up your mind if cold water therapy in the form of an ice bath might be up your alley.

Ice Baths Boost Your Mood

Ice baths have been associated with mood enhancement due to the release of endorphins and the activation of the body's stress response system. [5]  Endorphins are natural chemicals produced by the body that act as pain relievers and mood enhancers. Cold water immersion, such as an ice bath, triggers the release of endorphins as a response to the body's exposure to the extreme cold.

This release of endorphins contributes to a sense of euphoria and improved mood. A study examined the effects of cold water immersion on endorphin release. The researchers found that exposure to cold water caused a significant increase in circulating levels of endorphins, resulting in reduced pain perception and improved mood. [7]

Deliberate cold exposure, in the form of an ice bath, can stimulate certain brain regions associated with mood regulation and mental well-being. Cold water immersion activates our insular cortex, a part of our brain that plays a role in processing emotions and bodily sensations. This activation can contribute to positive mood changes.

Another study explored the effects of cold exposure/pain on brain activity using functional MRI scans. The researchers, too, found increased connectivity between the insular cortex and other brain regions involved in mood regulation, suggesting a potential mechanism for mood enhancement through cold exposure. [8]

If we look at ice baths psychologically, the intense sensation of cold during ice baths can serve as a powerful distraction from our everyday stressors. Focusing on the immediate physical experience can help you temporarily shift your attention away from worries and negative thoughts, promoting relaxation and mental clarity.

Ice Baths Ease Sores and Aching Muscles

Ice baths can ease sore and aching muscles through a combination of vasoconstriction, reduced inflammation, and modulation of pain perception. When you immerse your body in cold water, the blood vessels constrict in response to the cold temperature.

Reduced inflammation is another crucial factor in relieving muscle soreness. Intense exercise can lead to micro-damage in muscle fibers, triggering an inflammatory response. Cold water immersion can help mitigate this inflammation by limiting the movement of immune cells to the affected areas. The constriction of blood vessels reduces the influx of immune cells and, consequently, diminishes inflammation and swelling, which are often associated with muscle soreness.

A study in 2012 investigated the effects of cold water immersion on markers of inflammation and muscle damage after strenuous exercise. The researchers found that cold water immersion reduced inflammatory markers and muscle damage indicators, indicating a potential role in facilitating recovery. [9] Furthermore, the analgesic (pain-relieving) effect of ice baths contributes to easing muscle soreness. Ice baths also trigger the release of endorphins – natural pain-relieving and mood-enhancing chemicals. These endorphins create a sense of euphoria and relaxation while temporarily alleviating muscle sores and pain.

An Ice Bath Can Help The Central Nervous System

Interestingly enough, ice baths have garnered attention for their potential benefits in influencing the central nervous system (CNS) through various mechanisms, including neurotransmitter modulation, stress response activation, and possible neuroprotective effects. Deliberate cold exposure, such as in ice baths, can impact neurotransmitter levels in the brain.

A study published in “Neuroscience Letters” in 2008 demonstrated that cold exposure led to elevated levels of norepinephrine and dopamine, suggesting an influence on neurotransmitter systems. [10] These neurotransmitters play roles in alertness, attention, and mood regulation.

Furthermore, the stress response activated by cold water immersion can have short-term and potential long-term effects on the Central Nervous System. Cold exposure prompts the release of stress hormones such as adrenaline, which can enhance cardiovascular activity and potentially lead to cognitive benefits. The “European Journal of Applied Physiology” observed increased adrenaline levels following cold water immersion, indicating a stress response that might contribute to improved Central Nervous System functioning. [11]

Another intriguing aspect is the potential for cold-induced hormesis, where the CNS and the body adapt to mild stressors like cold exposure. Hormesis is the concept that mild exposure to stressors, like minimal amounts of toxins, extreme cold, or exhausting exercise, can lead to positive adaptations that enhance overall resilience and health. This adaptation can lead to protection against future stressors, potentially benefiting the CNS.

An Ice Bath Can Reduce Inflammation

Ice baths or a cold tub can reduce inflammation through a combination of vasoconstriction, altered immune response, and the modulation of inflammatory markers. [12] This process involves a series of interconnected physiological reactions that collectively contribute to dampening inflammation.

When our body is exposed to cold water, such as in an ice bath, blood vessels constrict in response to the cold temperature. This constriction is an adaptive mechanism aimed at preserving core body temperature. The vasoconstriction has implications for inflammation. Inflammatory responses often involve the movement of immune cells to affected areas. With reduced blood flow to peripheral tissues, the influx of immune cells is limited, leading to a diminished immune response and decreased inflammation in those areas.

A study published in "Medicine & Science in Sports & Exercise” in 2008 investigated the effects of cold water immersion on markers of inflammation and muscle damage. The researchers found that cold water immersion led to decreases in inflammatory markers, suggesting that the practice has anti-inflammatory effects. [12]

Moreover, ice baths might impact the production of inflammatory markers themselves. Cold exposure could regulate the expression of specific molecules that are involved in the inflammatory cascade, thus limiting the intensity of the overall inflammatory response.

Cold Water Therapy Decreases The Effect of Heat and Humidity

Interestingly enough, an Ice bath or a cold bath can help reduce the effects of heat and humidity on the body through the principle of thermoregulation, which involves the body's efforts to maintain a stable core temperature. While ice baths might not directly counteract heat and humidity, they can influence how the body responds to these environmental factors.

When it is hot and humid, our body can struggle to dissipate heat efficiently, leading to heat stress and discomfort. This is particularly true during physical activity when the body generates additional heat. Anyone who goes running in summer knows what we are talking about. In these conditions, the body relies on mechanisms such as sweating to cool down.

High humidity, especially, can hinder the evaporation of sweat, making it less effective in cooling our bodies. This is where ice baths come into play by providing a significant temperature contrast. Immersing in cold water, even momentarily, can help lower the body's core temperature. This can create a temporary sensation of relief from the heat, especially if we are already experiencing heat stress.

A study published in the “Journal of Science and Medicine in Sport" examined the effects of cold water immersion on recovery from exercise-induced heat stress. [13] The researchers found that cold water immersion after heat stress exposure significantly reduced core body temperature and improved cardiovascular recovery compared to passive cooling methods.

Ice baths can also assist us in the recovery process after being exposed to heat. The cooling effect of the cold water immersion can help counteract the impacts of elevated body temperature and heat stress on our body's systems by cooling it down fast and efficiently.

If you experience heat stress or are feeling unwell, you should take a cool shower. Otherwise, an ice bath could be overwhelming for your circulatory system.

So, how can you get started with taking an ice bath?

How to Get Started With Ice Baths as a Beginner – Ice Bath Therapy for Dummies

Getting started with taking an ice bath or cold bath should be a gradual process that involves building tolerance, managing discomfort, and prioritizing safety.

We have curated some tips to help you begin your ice bath journey:

1. Start with Cold Showers

   Before diving into ice baths, consider starting with cold showers first. Gradually reduce the water temperature over time to acclimate your body to the sensation of cold. This can help you ease into the idea of cold exposure and prepare for more intense experiences.

   Discomfort begins in our mind and can be managed if we practice stepping out of our comfort zone.

2. Water-to-Ice Ratio

   When setting up your ice bath, start with a higher water-to-ice ratio to make the cold more manageable. As you become more accustomed to the cold, you can gradually increase the amount of ice to intensify your experience. This approach allows for a smoother transition and minimizes the shock of extreme cold.

3. Control Your Breath

   Breathing techniques play a crucial role in managing the initial shock of cold water immersion. Focus on slow, controlled breathing to help reduce the body's stress response. Deep, deliberate breaths can also aid in relaxing your body and mind as you adapt to the cold.

   The Dutch extreme athlete Wim Hof has several techniques and methods on how to breathe through the cold to seize all the potential health benefits from your cold water therapy.

4. Immerse Into The Water Gradually

   When entering your ice bath, start by immersing your feet and lower legs first. Gradually work your way up instead of just plunging in fully, allowing your body to adjust to the temperature changes. As you become more comfortable, you can fully immerse yourself up to your neck.

5. Hydrate & Nourish

   Make sure you're well-hydrated and have had a balanced meal before your ice bath. Cold exposure can place stress on the body, and being properly fuelled and hydrated can support your overall well-being during the experience.

   Please note that you should not eat immediately before taking an ice bath since this can put stress on your digestive system, which is still working to digest your food. After a meal, wait at least one hour before taking an ice bath.

6. Post Ice Bath Care

   After your ice bath, focus on gradually warming up your body. Avoid hot showers immediately after the ice bath, as this can cause a sudden temperature change and is counterproductive to the positive effects of cold water therapy.

   Instead, opt for lukewarm water to help your body slowly return to a comfortable temperature.

Insider tip: You might want to look out for your pet to warm up with some extra cuddles. If your pet refuses, which is very likely if we are talking about a cat, you can try some hot tea.

What is the Recommended Temperature For an Ice Bath?

The recommended temperature for an ice bath typically falls within the range of 10 to 15 degrees Celsius. This temperature range is considered optimal for reaping the benefits of cold water immersion while minimizing the risks associated with extreme cold exposure.

The ideal temperature for an ice bath is influenced by various biological aspects and physiological responses of our body to cold water immersion.

The recommended temperature range of 10 to 15 degrees Celsius strikes a balance between activating thermoregulatory responses and avoiding prolonged or extreme cold stress that could lead to hypothermia. Staying within the 10 to 15 degrees Celsius range helps ensure safety and avoids the risk of frostbite or hypothermia, which can occur with prolonged exposure to colder temperatures.

How Long Should You Stay in an Ice Bath?

Generally, the ideal amount of time you should stay in your ice bath is up to 10 minutes.

Please note that the specific duration you can and should stay in an ice bath can vary based on factors such as your tolerance, experience level, and the purpose of the ice bath.

As a general guideline, starting with 5–10 minutes and gradually increasing the time as you become more accustomed to the cold is recommended. It's essential to listen to your body and prioritize your comfort and safety. If you're new to ice baths, you might want to begin with shorter durations, like 2 – 3 minutes, and gradually extend them over time.

The professional ice bather, Wim Hof has set a record of 3 hours and 28 seconds, which showcases the remarkable capabilities of our human body to sustain even extreme stressors. Please note that this amount of time is not recommended at all for health purposes.

How Often Should You Take Ice Baths?

For beginners, it's recommended to start gradually with 1-2 ice baths per week. This allows your body to adapt to the cold stress and minimize the risk of overexposure.

You should approach the frequency of your ice baths with consideration for your individual limits, goals, and your body's response to cold exposure. While there is no one-size-fits-all answer, paying close attention to your body's signals is essential. If you find yourself feeling excessively cold, fatigued, stressed or experiencing adverse effects, it might be an indication to adjust the frequency or duration of your ice baths. Always remember that you take ice baths for health benefits and not as a competition or to stress you out.

If you are an athlete or regularly exercise, ice baths can be particularly valuable for muscle recovery after intense workouts or physically demanding activities. Many athletes incorporate ice baths into their post-training routines, often engaging in 2–3 sessions per week for this purpose.

Your personal goals play a role in determining the frequency of your ice bath practice. If you're seeking mental resilience and mood enhancement, you might opt for more frequent ice baths. If your focus is primarily on muscle recovery after doing sports, a few times a week might be sufficient.

What Are the Potential Risks When Taking an Ice Bath?

Engaging in ice baths can offer many benefits, but there are also potential risks to be aware of. Ice bathing is not suitable for everybody, and certain groups of people should avoid them consciously. Understanding potential risks is crucial to practising ice baths safely and responsibly.

In the following chapter, we have summarized the main potential risks of taking an ice bath.

Hyperventilation

The shock of cold water can lead to hyperventilation, where rapid and shallow breathing occurs. This response is the body's attempt to manage the cold, but it can lead to reduced carbon dioxide levels in the blood.

This imbalance can result in dizziness, lightheadedness, and even fainting.

Gasp Reflex

When entering cold water, an involuntary gasp reflex can occur due to the body's sudden shock. This reflex can cause water to be aspirated into the lungs, increasing the risk of drowning or other respiratory complications.

Be aware of your body's reaction at all times, and immerse into the water gradually and cautiously.

Drowning

Cold water immersion can impact coordination and muscle control, making it challenging to swim or stay afloat. Inexperienced individuals or those unprepared for the physiological response to cold water might face an increased risk of drowning.

If you are a beginner at taking an ice bath, practice your cold water therapy with another person close by or another ice bather who can watch over you.

Reduction of Muscle Hypertrophy

Ice baths, when used excessively, can potentially interfere with muscle hypertrophy, the process of muscle growth. Cold exposure might reduce blood flow to muscles, impacting nutrient and oxygen delivery necessary for muscle repair and growth.

This is why you should gradually practice ice bathing and give your body time to adapt to the cold water shock

Who Shouldn't Take Ice Baths?

While ice baths can offer various benefits, they might not be suitable for everyone. Certain individuals should exercise caution or avoid ice baths altogether due to specific health conditions or circumstances.

People with certain health conditions, such as heart problems, respiratory issues, or Raynaud's disease, should avoid or consult a healthcare professional before attempting ice baths. Cold water therapy could exacerbate these health conditions or be a potential risk to their health.

People With Cardiovascular Issues & Heart Disease

Especially people with heart conditions such as heart disease, hypertension, or arrhythmias, should avoid ice baths or consult a healthcare professional before attempting them. Cold exposure can place additional strain on the cardiovascular system.

If You Have Respiratory Conditions

People with respiratory issues like asthma or chronic obstructive pulmonary disease (COPD) might find cold water immersion challenging, as it can trigger breathing difficulties or bronchospasms. Cold air can also constrict airways and worsen their respiratory conditions symptoms.

People With Raynaud's Disease

Raynaud’s disease involves extreme sensitivity to cold temperatures, causing blood vessels to constrict significantly, leading to pain and discoloration in the extremities. Since Ice baths constrict our blood vessels even further, they can exacerbate the symptoms and cause considerable discomfort for individuals with Raynaud's disease.

Someone Who Has Open Wounds or Skin Conditions

Ice baths can potentially irritate open wounds or exacerbate skin conditions like eczema. Direct exposure to cold water might delay wound healing or cause skin discomfort, so be cautious in such cases.

Pregnant Women

Furthermore, pregnant women should avoid ice baths, especially during the later stages of pregnancy. Exposure to cold water could potentially affect fetal circulation and increase the risk of complications.

After your postpartum journey and consulting your lactation specialist, ice baths can be a great support to cure your body after giving birth or after stopping breastfeeding.

People With A Low Cold Intolerance

Some people naturally have a lower tolerance for cold temperatures. If you are one of those people, engaging in ice baths might lead to extreme discomfort and stress or even contribute to hypothermia. It's essential to listen to your body and prioritize your well-being.

Young Children

Children have a less developed ability to regulate body temperature compared to adults. Ice baths could lead to rapid heat loss and discomfort in young children, which is why young children should generally not take ice baths.

Elderly People

Older adults might have reduced thermoregulatory capabilities and a higher susceptibility to cold stress. Exposure to the cold for longer periods of time can lead to hypothermia or other complications for elderly people, and should therefore be practiced with caution.

There are many older people who successfully take a cold water bath and are happy with the positive effect on their bodies. As with everything in life, this is an individual case that depends on the person's overall well-being, mindset, experience, and fitness.

People With Individual Health Conditions

If you have a medical condition that is not mentioned above, such as autoimmune disorders, diabetes, or neurological conditions, you should consult your healthcare provider before attempting ice baths.

Seeking medical advice from a trusted practitioner can help determine whether cold exposure aligns with your personal situation and health goals.