Good morning. I hope you’re warm. My roommate (who probably won’t read this) and I refuse to turn on the heater until absolutely necessary, so it’s probably 58 degrees in my apartment at the time you’re reading this. 🥶 

But I’m less strict than he is. Hopefully I’ve snuck the heat on while he’s away hehe. 🤭

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🧊 Ice, Ice, Baby

With single digit temps and wind chills in the negatives across the US this week, I thought this would be a great time to write about immersing yourself in ice cold water!!

There is much to be said about cold therapy. I couldn’t possibly cover it all in one little newsletter. But I’ll do my best to give a comprehensive overview that touches on most aspects of cold therapy, including benefits, use cases, potential drawbacks, and protocols to follow.

What is cold therapy?

Cold therapy, sometimes also referred to as cold immersion therapy, is when one immerses oneself in a cold substance or environment for a relatively brief period of time. It can take several different forms, including ice baths, cold showers, “winter swimming” (a not-uncommon practice in some nordic countries), cryotherapy (very cold pods/chambers/rooms, typically cooled by liquid nitrogen), etc. 

Long story short, immersion in water—think baths or swimming—is the most common, potent, and effective cold therapy stimulus, particularly when it’s up to the neck or includes the full head. 

Cold therapy provides a quick, strong, shocking stimulus to the body. It’s certainly a stressor, but in the appropriate dose, can act as a eustress (good stress). 

When cold therapy can be beneficial

It seems based on current literature like the primary benefits of cold immersion revolve around mental health and cognition. I would say the close seconds are its energizing effects and its stimulation of brown fat. Lastly, it can have some effects on pain reduction.

Let’s start from the top.

If you feel sluggish, unenergized, brain fog, etc., I dare you to jump into an ice bath and not change your mental state. While many of the benefits of cold immersion remain speculative, it’s pretty clear that it can have a significant boost on mental sharpness, alertness, and energy. Whether the remaining purported benefits are true or not, there is much to be said about the discipline and resilience that regular cold immersion provides. It will never not be cold or difficult. This is a practice of getting outside one’s comfort zone on a regular basis and challenging oneself, which can pour over into other aspects of life.

• Many people use cold showers or baths as a mental jumpstart to their day.

Brown fat is rare. Most of the adipose tissue on our bodies is white adipose tissue (WAT). In excess, it’s associated with many negative effects throughout the body. Brown adipose tissue (BAT), however, exists in small quantities around vital organs, like near the clavicles and upper spine. This is a very metabolically active form of fat tissue that actually generates heat and burns calories. Cold exposure (even sleeping in a cold room or being outdoors in the cold, but particularly immersion) has been shown to increase BAT in the body. This could perhaps have positive health effects and metabolism-boosting effects.

Cold therapy can also act as a pain modulator. Cold is anti-inflammatory. When the body is hot or inflamed, which is often associated with pain, cold can reduce this effect. Some athletes use cold to help quickly recover from intense bouts of damaging, soreness-inducing activity so they can quickly turn around and perform again. 

When cold therapy may not be helpful

Beware of jumping straight into the cold plunge right after every workout, however. While it can mitigate soreness and inflammation short-term, cold can actually impede long-term gains that result from exercise stimuli. 

That’s right—we actually need a degree of acute inflammation and damage that exercise produces to act as a stimulus for our bodies to rebuild and repair. Evidence shows that cold therapy post-exercise can reduce gains.

It’s also important to note that the age-old recommendation of “RICE” for an injury has gone by the wayside and is no longer recommended. While chronic over-inflammation is a bad thing, our bodies respond to the stimulus of acute inflammation to kickstart a healing process. See this article I wrote last year for more info on that. So while ice and anti-inflammatory medicines can temporarily reduce pain, they can also impede and slow healing from injuries. It’s more recommended to utilize compression, elevation, and non-anti-inflammatory medicines like acetaminophen if necessary for pain management.

And of course, it should also be stated that if you’re already highly stressed or have a medical condition that precludes you from engaging in cold therapy, you should use caution, as it could do more harm than good. 

What cold therapy protocol should I follow?

Based on the research, I’ve heard one expert recommend accumulating a total of ~11 minutes per week in cold therapy for the most-bang-for-your-buck benefits. 

Of course, one can work up to this level.

• Even starting with 30 seconds at a time a few times a week can be a great stimulus to start off with as you accommodate.

• You should gradually build your tolerance to last longer, but it’s generally not recommended to immerse in very cold water for more than a few minutes at a time. Benefits seem to top out there. 

As far as the temperature:

• Anything below 40 degrees F is certainly going to do the trick, and you shouldn’t expect to last too long.

• Between 40 to 50 or 55 degrees F is still cold enough to produce many of the same effects.

• The further you get above 60 degrees or so, the less potent the stimulus.

• Basically, the colder the water, the less time you need. Would you rather endure extreme cold for shorter time or not-as-cold for longer time? Up to you!

Are cold showers as effective? Likely not, for some of the brown fat-stimulating benefits. But the research is also more sparse because these are harder to study and standardize. However, many people still find a cold shower can have many of the mood and alertness-boosting effects, particularly early in the day or during a slump! 

Speaking of timing, I’d advise against cold therapy shortly after a bout of exercise, unless for some reason you drastically need to reduce soreness or bounce back quickly, and can accept that some adaptations may be blunted.

• Generally, cold in the morning and heat therapy at night are what most people find works for them. The shocking, sympathetic nervous system-inducing effects of cold probably aren’t what you want close to bed time.

One last tip: Breath control is vital when it comes to controlling cold water immersion. The body is going to want to kick into a panic response and hyperventilate. You can practice control and calm your nervous system by focusing on slow and controlled breathing.

Cold therapy certainly has some interesting proposed benefits that may be right for you. But remember, it’s more of a supplemental therapy than a staple like proper nutrition and exercise are. You can get along just fine without it, but you may just find it gives you the jolt you’re looking for! ⚡️ 

✅ Take Action

Every newsletter's Take Action section will invite you to take small steps to improve your health. Recognizing that we all have different capabilities, I'll offer three different levels of action you can choose to take.

Level 1: Want to dip your toes into cold water immersion (pun intended)? Try shifting your shower to cold water for the last 10—30 seconds.

Level 2: Run some cold water in the tub and take a dip. How long can you last? Thirty to 60 seconds would be a great goal. Try it every other day and build up tolerance.

Level 3: Dive right in! It’s the perfect time of year to find a cold body of water and go for a dip or swim for a couple minutes. (Just don’t warm up too quickly, that can be dangerous) 🤿 

This newsletter is brought to you by… me!

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✍️ Drew's Picks:

• Listen: This episode of Life Kit by NPR is a guide to get started cold plunging.

• Listen x2: This episode of The Doctor’s Farmacy covers the science behind both cold and heat therapy with a leading expert!

Stay warm, friends. Unless you spend a couple minutes in extreme cold this week. Regardless, enjoy! ☃️ 

Keep moving,

Drew

The content in Move to Improve is meant to be informative in nature, but it should not be taken as medical advice. It is always a good idea to consult with a trusted health professional before making any major lifestyle changes that could have a significant impact on your health. This is not a medical resource, and any opinions and articles are not intended for use as diagnosis, prevention, and/or treatment of health problems. They are not substitutes for consulting a qualified medical professional. Please think critically and take what I say with a grain of salt (aka don’t sue me).