Deliberate Cold Exposure, DCE, Explained

Among the most straightforward and ancient methods of treating ailments is Deliberate Cold Exposure, often termed ice treatment or cold water immersion. Due to its efficacy, accessibility, inexpensiveness, and ease of shipping, it has become widely used worldwide.

To this day, such techniques are among the very fundamental and tried-and-true procedures for decreasing inflammation and soreness. Cold treatment has been used in numerous civilizations for ages.

When a sprained ankle or a swollen knee undergoes deliberate cold exposure, you utilize a modern kind of ice therapy to alleviate your pain. Ice baths, coolant mists, ice massages, and whirlpools are all kinds of cold treatments.

Ice is thought to relieve pain by inducing local anaesthesia. During a session of deliberate cold exposure, the nerve conduction velocities, metabolic activity and regional blood flow all are reduced. The effectiveness of Deliberate Cold Exposure is determined by the procedure, duration, subcutaneous fat depth, and temperature.

Deliberate Cold Exposure technique is becoming more popular as a potential therapeutic target. It has been demonstrated to improve subjective recovery evaluations. However, its effects on objective criteria are less noticeable.

Despite having the potential to improve recovery, the psycho-physiological mechanisms that promote this type of healing are still unknown. While additional research is needed, the lowering of inflammatory markers, as well as the osmotic repercussions of water immersion, give fascinating possibilities for the positive benefits of cold water therapy. Finally, according to the latest report, the ideal immersion time is around eleven and fifteen minutes.

What is Deliberate Cold Exposure?

Deliberate Cold Exposure, DCE for short, also known as cold water immersion or CWI, is a rehabilitation technique that involves intentional exposure to extreme cold, usually in ice water. The temperature of the water is around ≤15˚C/59˚F in some studies. But usually the water can be as cold as zero degrees.

It is done shortly after training to improve recovery. Despite having only a minor influence on recuperation, DCE has been demonstrated as an efficient strategy for improving recovery.

Deliberate Cold Exposure Recovery

Recovery is an essential element of training because it helps to reduce the danger of overexertion and injury while also improving physical and mental fitness. This is especially necessary during rigorous practice or competition phases to maintain a high standard of achievement.

Many rehabilitation procedures have been developed as a result of this concept. To name a few:

  • Massage therapy
  • Foam rollers
  • Electrotherapy
  • Whole-body stimulation
  • Compression gear
  • Hyperbaric oxygen treatment
  • Aquatic immersion therapy
  • Coldwater, warm water and contrast bathing

Due to their capability to enhance the recovery period and reduce delayed onset muscle soreness DOMS, water immersion treatments have become a renowned recovery method amongst scientists.

As mentioned earlier, warm water, cold water, and contrast immersion are all types of water-based healing treatments referred to as water immersion treatment. The therapy is thought to be able to cause:

  • Edema reduction
  • Reduction in pain perception related to muscle soreness
  • Reduction in fatigue perception
  • Alteration of localized circulation
  • Core temperature alteration
  • Alteration of heart rate
  • Muscle spasm reduction
  • Tissue inflammation reduction
  • Muscle damage reduction
  • Improvement in range of motion ROM

Lewis Hunting Response & Deliberate Cold Exposure

In deliberate cold exposure, the Lewis hunting mechanism, often known as the hunting response, is a phenomenon involving repeated vasoconstriction and vasodilation. It is termed after Thomas Lewis, who originally described it in 1930.

As soon as the injured area comes in contact with ice, the initial reaction to the extreme cold would be vasoconstriction. This will cause a restricted blood flow. After a short period, the vessels would automatically vasodilate to avoid damage due to excessive cold exposure.

This vasodilation would cause increased blood flow leading to the removal of noxious stimulus from the pain site. Following this vasodilation period, vasoconstriction would occur again. This continuous cycle of vasoconstriction followed by vasodilation and so on would help alleviate the pain symptoms from the injury site.

Rest Ice Compression Elevation

The ‘I’ element of the R.I.C.E. physiotherapy regimen is ice exposure. Rest, ice, compression, and elevation are abbreviated as R.I.C.E.

It is widely recommended for self-treatment of a variety of injuries, particularly athletic injuries. To achieve therapeutic benefits, integrate deliberate cold exposure with the other aspects of the R.I.C.E. regimen as directed below.

  • Rest: put an end to any activity that can make the pain worse.
  • Compression can help with discomfort and edema by exerting firm and medium pressure to the injured region. It will also assist the damaged area in remaining stable, preventing further damage.
  • Elevate the injured body part if possible.

Depending upon the nature of the injury, rehab practices should be carried out. To assist in recovering, stabilize the region, you may wish to strengthen and perform stretching activities recommended by your physiotherapist. Over-the-counter drugs can also aid with pain-related discomfort.

Does Deliberate Cold Exposure Aid the Healing Process?

Exercise can fatigue the musculoskeletal, neurological, and metabolic systems to varying degrees depending on the extent. Activity creates minute breaks in muscle tissue, known as exercise-induced muscle damage (EIMD), resulting in DOMS.

Several metrics have determined the effectiveness of Deliberate Cold Exposure. Subjective and objective metrics are the two main types.

The subjective measures consist of DOMS and ratings of perceived exertion RPE. At the same time, the objective measures include blood lactate level, interleukins, creatine kinase and C-reactive protein.

Deliberate Cold Exposure has been proven to reliably minimize the impact of DOMS and RPE in a broad stream of work. Deliberate Cold Exposure is an efficacious regimen for reducing the effects of DOMS 24 hours, 48 hours, and 96 hours after exercise, according to a recent study and discourse. Furthermore, it was demonstrated to lessen RPE symptoms 24 hours after exercise.

The Basic Deliberate Cold Exposure Practice Guide 

It is vital to realize some principles when using Deliberate Cold Exposure:

  • Whenever it comes to water temperatures, it is preferable to be vigilant.
  • Acknowledge that everyone’s cold tolerance is varied, and moving water is colder than motionless water.
  • Overexposure and rewarming immediately after the therapy are also not recommended.
  • Also, remember that assuming the colder the liquid, the better is not a good technique. Lesser temperatures may cause tissue damage.

Practical Use

1. Temperature

Even though there is no universally accepted degree for optimal outcomes, temperatures in studies often vary from 8-15˚C (46-59˚F), with an average of 11˚C (52˚F). As a result, professionals are encouraged to employ temperatures of around 11˚C (52˚F) in order to capitalize on any impact generated by lesser (8˚C/46˚F) or greater (15˚C/59˚F) degrees used throughout Deliberate Cold Exposure.

2. Duration

According to current studies, the ideal immersion time is anywhere between eleven and fifteen minutes, as mentioned above. Furthermore, to maximize the effects of rehabilitation, patients should stay immersed for a minimum of ten minutes to assure blood plasma fractioning. It is the migration of interstitial-intravascular fluid.

Nevertheless, it is known that immersion for such a long period is unrealistic, especially when dealing with big groups. Deliberate Cold Exposure has been shown to have favorable effects with durations ranging from one to fifteen minutes. Therefore, practitioners may choose shorter periods regardless of the unknown benefits or drawbacks.

3. Immersion Depth

Hydrostatic pressure is thought to play a role in recuperation. The deeper the individual is submerged, the greater the possibility for healing. Furthermore, deliberate cold exposure aims to transport fluids from the peripheral to the thoracic region while also exerting an inward and upward compression on the body, as discussed earlier.

Owing to this, it is generally recommended that athletes stay upright throughout immersion. This, though, may differ based on the form of activity. For example, upper-limb dominated activities may advantage from being soaked in the supine posture.

What Effect Does It Have on Recovery?

For the efficient measures of its ability to enhance recuperation, the following hypotheses have been suggested:

1. Vasoconstriction:

Based on one study, immersing oneself in ice water causes vasoconstriction, leading to reduced localized blood circulation. The cold temperature is thought to activate thermal nerve endings (nociceptors), causing changes in sympathetic activation.

As a result, a reduction in blood flow occurs. The temperature-induced drop in blood flow near wounded tissues caused by strenuous exercise reduces edema and inflammatory response.

2. Analgesia

Pertaining to one research, the analgesic effect of cold water is accountable for the reduced pain sensation. With sympathetic activation, deliberate cold exposure slows nerve conduction and irritation, decreasing nociceptor transmission. Finally, this will result in a reduction in pain perception.

3. Inflammatory markers’ reduction

Lowered inflammatory markers, like nociceptor oversensitivity, exercise-induced edema, and leukocyte accessibility have been hypothesized to cause decreased pain sensitivity. Consequently, this concept is a combination of outcomes, and it is frequently mentioned as the primary physiological reason for the report’s superior results.

4. Placebo Effect

It is critical to do a psychological examination of Deliberate Cold Exposure effectiveness in reducing post-exercise soreness and exhaustion. This indicates that the individual is more “awake” during and after the DCE, which decreases pain sensitivity.

5. Hydrostatic Pressure

When immersed in water, a person is subjected to the effects of hydrostatic pressure. The pressure gradient rises by 74mm Hg for every meter of sinking. This is nearly the same as a standard diastolic bp reading (80mm Hg).

The hydrostatic pressure will generate inward and upward compression on the individual’s body, increasing the pressure gradient with depth. This implies that the greater the depth, the greater the pressure imposed.

This mechanism causes the benefits of buoyancy. Since buoyancy lowers the gravitational pressure, the human body also weighs less when immersed in water.

The osmotic pressure will cause fluid to be displaced from lower limbs to the thoracic area following immersion at the pelvis level. According to some specialists, migrating these fluids to the thoracic region may be the most crucial factor in improved healing.

This effect is expected to minimize exercise-induced edemas, promote extracellular fluid transport into the circulation, and boost cardiac output. An enhancement in heart rate means more blood circulation and a faster breakdown of waste materials that build up during exercise.

The buoyant impact of water soaking may potentially relieve tiredness by enhancing energy preservation and reducing neuromuscular signaling. Surprisingly, bathing athletes in excessively cold water may reverse some of the beneficial effects of the osmotic pressure.

Vasoconstriction is induced by cold water, which lowers pulse rate and consequently cardiac output. As a consequence of this mechanism, the body reduces peripheral blood circulation to sustain its internal temperature, which causes core metabolism to rise for maintaining this core temperature.

The increased central metabolic activity increases waste generation and depletes energy storage. Both are regarded as hostile and undesirable effects after a workout and improving the recovery period.

Consequently, it is recommended that until muscles strain or sprains have arisen, immersion in cool-to-neutral water temperatures might be the best choice for healing. In that situation, soaking in colder temperatures might be a little more advantageous.

What are the Benefits of Deliberate Cold Exposure?

A couple of the perks of cold therapy were described earlier in the essay; nevertheless, here are some additional specifics. Let’s have a look at them.

1. Immunity and the Lymphatic System are Boosted

In general, the lymphatic system cleanses the body. It is a mechanism that works throughout your system and aids in removing toxins, germs, and pathogens from bodily cells. The lymphatic system uses muscular contractions to move the lymphatic fluid through channels.

This means that if you do not exercise, your lymphatic system will become inefficient and cumbersome. Due to a clogged lymphatic system, lymphatic fluid stagnates, producing toxin accumulation in the body, culminating in common cold, joint soreness, infections, and diseases.

During submergence in ice water, lymphatic vessels contract, forcing the lymphatic system to transport the fluid across your systems. The lymphatic fluid will be pumped out of your body, flushing the toxins out.

Our leukocytes would then become activated, attacking and destroying any unwanted elements. To summarize, deliberate cold exposure activates the lymphatic system, which in turn activates the immune response. The two systems hence function together to keep you strong and healthy.

2. Circulatory Improvements

Better cardiovascular flow is amongst the most critical factors of overall health. Poor circulation not just impedes blood supply but also puts a load on the heart. This might lead to weariness, headaches, muscle cramps, and increased blood pressure. A heart attack or stroke could occur in the worst situation.

On the other hand, improved blood circulation would benefit our metabolism and our circulatory, neurological, and immune systems. Deliberate cold exposure, in addition to training and dieting, is a way to improve circulation.

When you expose yourself to ice water, your core body temperature drops dramatically. As a result, the blood circulation will become more centralized as a defensive strategy. This indicates that blood will flow to your body’s essential organs.

The heart would be forced to beat faster and pump more blood to all veins, supplying oxygen and nourishment to all of your physical components. Regularly practicing this would result in a better circulatory system and physique.

3. Reduction in Muscle Inflammation

After a strenuous workout, many people become pretty uncomfortable. DOMS is the name given to this syndrome.

For some people, it can be pretty unpleasant, demanding the usage of anti-inflammatory drugs. Tiny tears in fibres are caused by activities that strain your muscles further than their natural inclinations, resulting in tissue injury.

Clinical studies have shown that ice baths can help relieve these complaints. Coldwater, as previously stated, lowers tissue temperature and constricts veins and arteries. The decrease in temperature anaesthetizes the nerve receptors, making the soreness go away.

4.     Increased Weight Loss

Deliberate cold exposure has been shown to improve the body’s metabolism by about sixteen percent when done daily. The body will respond to this purposeful deviation from its ideal temperature to sustain the temperature.

A rise in metabolism is one of these outcomes. As a result, weight loss would be aided by an improved metabolic rate.

Since the benefits are adaptable, a few solitary cold showers are unlikely to offer them. They are directly linked to a person’s desired temperature and absolute temperature.

It is important to remember that cold treatment is not a magical formula for weight loss. However, it can help when accompanied by proper nutrition and regular exercise.

5.     Your Core Temperature Regulation is Reset

Deliberate cold exposure can assist you in recalibrating the body’s natural temperature control if you’re always chilly. In the modern environment, most of us lost our innate desire to be warm.

We maintain a constant temperature by using central heating and wearing warm clothing. Our bodies have become dependent upon external heaters rather than their heat-generating capacities over time.

Bathing in ice water may aid in the re-heating of your body. Regular cold treatment has numerous advantages, one of which is that you will always stay warm. This could be quite beneficial for someone who struggles with a chronic cold.


While Deliberate Cold Exposure is routinely utilized in clinical settings, significantly less is understood about the optimal procedures to follow to maximize recovery. In contrast to constantly increasing knowledge about cold exposure, there is always controversy about the appropriate temperature to cause maximum recovery effects. In conclusion, for eleven to fifteen minutes, vertical full-body exposure to cold post-exercise seemed to improve recovery.



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