Contrast Therapy for Athletes | Full Guide

Contrast therapy has been a staple in the athletic community for years, and with incredibly successful users like Kobe Bryant (who was “religious” about using contrast therapy before every game (1)), I wanted to look into the legitimacy of contrast therapy, the benefits of contrast therapy, and the best way to do contrast therapy.

What is Contrast Therapy?

Contrast therapy is a recovery technique where you alternate hot and cold water submersion to loosen up joints and accelerate recovery.

Photo of Bryden Doing Contrast Therapy

I love contrast therapy because I can get some reading in while I’m recovering

The theory behind constantly switching between hot and cold is that the expanding and contracting blood vessels will create a “pump” flushing out toxins and bringing in new blood to the injured or damaged area.

Benefits of Contrast Therapy

Proven benefits of contrast therapy include:

  • Muscular recovery from athletic activities (2)(3)
  • Decreased perceptions of fatigue (2)
  • Reduced muscle soreness post-exercise (3)
  • Improved creatine kinases clearance (4)
  • Improved blood flow (5)
  • Improved tissue oxygenation (5)

Let’s dive a little bit more in-depth into a couple of these benefits.

The most important benefit I see on that list is the muscular recovery from athletic activities. The better your recovery is, the more workouts or practices you can get in, the better you will be.

A meta-analysis of 13 different studies on the effect of contrast therapy on muscle damage from exercise found that contrast therapy “significantly reduced muscle strength loss at [6, 24, 48, 72, and 96 hours after a workout] in comparison to a passive recovery.” (2)

While there aren’t exact percentages on the recovery benefits of contrast therapy it is well established that it is more beneficial than doing nothing particularly in the short term (24-48 hours post-therapy).

Improved blood flow is another benefit that draws my eye.

Improved blood flow is the goal of many popular recovery techniques including massage, foam rolling, and electrical stimulation but why is it important?

Because blood flow is responsible for carrying cells within your blood designed to repair your damaged muscle or injury. By improving your blood flow you can accelerate this delivery of crucial repairing cells, improving your recovery.

Contrast Therapy vs. Cold Water (or Ice) Therapy

Contrast therapy might’ve been a staple in athletic therapy for years but ice or cold water therapy has been the most dominant post-workout recovery technique for decades.

So which is better?

It depends... for simple pain reduction your best choice is ice or cold water as it’s a well-researched pain inhibitor, but that comes with a warning. Pain is a message that your body is sending you and you should listen to it, and not simply remove that pain without fixing what is damaged.

To actually repair what is damaged your best option between the two is likely contrast therapy. Cold water or ice constricts your blood vessels reducing blood flow to the damaged area, the opposite of what we want.

A random control trial of contrast baths and ice baths for recovery using U20 rugby players found that ice baths may actually have a detrimental effect on players' performance recovering from competition and training compared to doing nothing (6). Contrast therapy on the other hand had a significant positive effect on recovery (6).

How To Do Contrast Therapy Properly

Temperature

On the cold end, you want to go as cold as possible. Around 10°C (50°F) is a good metric to shoot for but just stick some ice in a tub of water and you should be good. It should be cold… really cold

On the hot end, you’ll want to aim for around 40°C (104°F). Hot but definitely not hot enough to burn yourself.

Find what you’re comfortable with, and only push beyond these temperatures carefully.

Duration

Two studies in 2012 analyzed the effect of different contrast therapy durations on cycling and running recovery post-workout.

These studies found that a duration between 6 minutes and 12 minutes was the most effective at reducing post-exercise dropoffs in performance. Durations greater than 12 minutes were found to have no additional effect on recovery.

My suggestion would be around a 10-minute duration.

Intervals

The perfect interval for contrast therapy is a severely under-researched topic. As a result, there’s a wide variety of options out there and the best interval is not commonly agreed on. Here’s a couple that I’ve found out there.

Simple Interval (10 Mins)

  • 1 minute hot
  • 1 minute cold
  • 1 minute hot
  • 1 minute cold
  • 1 minute hot
  • 1 minute cold
  • 1 minute hot
  • 1 minute cold
  • 1 minute hot
  • 1 minute cold

Most Popular Interval (12 Mins)

  • 3 minutes hot
  • 1 minute cold
  • 3 minutes hot
  • 1 minute cold
  • 3 minutes hot
  • 1 minute cold

Kobe Bryant Interval (16 Mins)

  • 4 minutes cold
  • 3 minutes hot
  • 3 minutes cold
  • 2 minutes hot
  • 2 minutes cold
  • 1 minute hot
  • 1 minute cold

So which contrast therapy interval is best?

Well, I hate to give this answer... but it’s up to you. Try out each of these intervals and figure out which one you feel the best after. After experimenting myself I found that my body felt the best with the “Sled Dog Interval” below.

Sled Dog Interval (11 Mins)

  • 2 minutes cold
  • 2 minutes hot
  • 1 minute cold
  • 2 minutes hot
  • 1 minute cold
  • 2 minute hot
  • 1 minute cold

Conclusion: Contrast Therapy for Athletes

Contrast therapy is a technique where you alternate between hot and cold water improving recovery, blood flow, and muscle soreness. Contrast therapy is a better option for recovering than cold water therapy as it improves blood flow instead of decreasing it.

To do contrast therapy properly, your cold water temperature should be around 10°C (50°F) with your hot water temperature around 40°C (104°F). Experiment with different intervals but a simple interval of 1 minute cold, 1 minute hot for 10 minutes is a good place to start.

References

  1. Bryant, Kobe Mamba Mentality 2018
  2. Higgins TR, Greene DA, Baker MK. Effects of Cold Water Immersion and Contrast Water Therapy for Recovery From Team Sport: A Systematic Review and Meta-analysis
  3. Bieuzen F, Bleakley CM, Costello JT. Contrast water therapy and exercise induced muscle damage: a systematic review and meta-analysis.
  4. Tavares F, Smith TB, Driller M. Fatigue and Recovery in Rugby: A Review. Sports Med
  5. Shadgan B, Pakravan AH, Hoens A, Reid WD. Contrast Baths, Intramuscular Hemodynamics, and Oxygenation as Monitored by Near-Infrared Spectroscopy.
  6. Higgins TR, Heazlewood IT, Climstein M. A random control trial of contrast baths and ice baths for recovery during competition in U/20 rugby union
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