Delayed onset of muscle soreness (DOMS) is a well-documented phenomenon, often occurring as a result of:

a) Unaccustomed or high intensity exercise or

b) Poor recovery strategies.

DOMS is generally exacerbated following repetitive high intensity muscle contractions. (e.g. after a weight training session)

Associated symptoms may include: localized muscle soreness, swelling, inflammation, decreases in strength, mobility and power and the inability to sit down on a toilet.

Can be useful when suffering a bout of DOMS

Research suggests symptoms may appear up to 24 hours post exercise and tend to diminish 3-4 days later (depended on training status and recovery strategies). Evidently, the natural recovery process can be relatively slow which may prohibit training at an optimal intensity in the days following which can hinder progress, depending on your training goals

As a result, current literature has placed great emphasis on establishing valid and efficient methods to improve recovery rates. Numerous physical, psychological and nutritional methods have been used to accelerate the recovery process.

Today we will just focus on the physical aspect and I encourage you to re-visit our previous blog post: “Exercise Recovery and Post-Workout Nutrition” which targets how to manage recovery through nutrition.

There are a range of modalities associated with physical recovery. This can include: massage & foam rolling, hyperbaric oxygenation therapy, dry needling, acupuncture and contrast therapy (ice baths and hot and cold water immersion).

Contrast therapy is a popular method currently implemented among elite athletes to enhance recovery and reduce severity of injuries.

showerOne’s circulation can be given a significant boost by taking a shower and alternating the flow from hot and cold water, back and forth.

This technique is proposed to create a “vaso-pumping” action by alternating the diameter of the blood vessels due to temperature change. The cold water helps relieve inflammation and stimulates the removal of toxins (lactate and hydrogen ions) whilst hot water is relaxing.

Specifically, the recovery process is sped up by enhancing the peripheral (vascular) circulation, slowing down the metabolic rate, removing metabolic wastes and stimulating the central nervous system. Thus, there is said to be an overall reduction in DOMS.

Physiology of Contrast Therapy

Now we will look more in-depth at how the body speeds up recovery post contrast therapy (sorry if I lose you with some of the science talk!). Thermotherapy (applying heat) causes the vasodilation (expanding the diameter) of blood vessels by decreasing the sympathetic nerve drive, thus enabling enhanced local blood flow.

As a result, there is an increase supply of oxygen and antibodies to the target muscles. The rate of toxin clearance within the muscles (lactate and hydrogen ions) is therefore multiplied, which is ideal

While we are on the topic, it is important to note that it is NOT the lactate or ‘lactic acid’ causing muscle soreness during and post exercise. This is a common misconception. Our bodies use lactate as a fuel source. It is actually hydrogen ions within lactate that builds up over time during exercise, reducing the muscles efficiency at buffering and/ or removing hydrogen, and essentially reducing the muscles ability to contract and produce force. This is what causes the fatigue and pain we feel in the muscles when we exercise.

So in summary, the key function of thermotherapy (applying heat) is to increase metabolite production and flush away toxins.

Following the thermotherapy (applying heat), the application of cold or ice water is performed (Cryotherapy). This process decreases the tissue temperature, which is believed to stimulate the cutaneous receptors (pain and temperature receptors under the skin) resulting in the vasoconstriction of vessels (reduction in vessel diameter).

Blood vessells
Vasodilation and Vasoconstriction of blood vessels.


The key functions of Cryotherapy includes; the decrease of swelling and inflammation (in turn reducing muscle soreness) by slowing the metabolism and production of metabolites. This thereby limits the degree of training effects or injury.

In summary, the key purpose of contrast therapy is to gain physiological effects including:

· Vasodilation and vasoconstriction of blood vessels
· Alternations in blood flow
· Reduction in swelling, inflammation, pain and muscle spasm
· Overall reduced DOMS

What is contrast therapy particularly good for?

Enhanced recovery rates is the primary goal of contrast therapy.

Recovery is defined as “the return of the muscle to its pre exercise state following exercise “(Tomlin and Wenger, 2001).

Post exercise, the aerobic metabolism remains elevated resulting from what is known as excess post-exercise oxygen consumption” (EPOC). EPOC contains two components, the fast and the slow.

The fast component restores up to 70% of energy stores (ATP and PCr, amongst other things), within 30 seconds. (This is what’s happening during your rest breaks at the gym.)

In contrast the slow component may take up to 24 hours due to elevated bodily functions such as the respiratory and cardiac systems and core temperature. These functions are important for the removal of metabolic waste (lactate). However, exercise intensity is a key determinant of the slow component. It will take longer to return to baseline (if you did a strenuous workout and metabolic waste is high). This is due to the amount of lactate produced. The ability for the slow component to clear this lactate relies on the efficiency of the working muscles removal rates and/or buffering of the hydrogen ions.

Hot and cold water immersion recovery can therefore assist in enhancing the EPOC process by speeding up the removal of metabolic wastes and replenishing fuel stores which in turn enhances the natural recovery rate process to reduce DOMS

Another interesting benefit of this form of therapy is neural recovery. Neurological recovery of the peripheral nervous system may be augmented by contrast therapy by reducing the load of sympathetic activity. During exercise the sympathetic NS is triggered, releasing adrenaline and noradrenaline which accelerates bodily functions such as heart rate.


Post exercise the sympathetic activity remains quite high. Administering recovery strategy’s, such as contrast therapy post exercises has shown to be beneficial as it has been shown to return the body back to resting levels. As a result, athletes tend to report feeling lighter, having reduced muscle pain, improved mobility and have an overall feeling of mental freshness.

On a more practical level, contrast therapy may also benefit people who have musculoskeletal injuries and more specifically repetitive strain injuries. These include:

– plantar fasciitis
– shin splints
– carpal tunnel syndrome
– tennis elbow
– Achilles tendinitis
– Iliotibial band syndrome
– Patellofemeral syndrome

How to administer hot and cold water immersion therapy

Studies have suggested that in order to gain optimal effects, the fluctuations in muscle temperature must be significantly different. Ideally, contrasting should follow the following basic pattern: three to six alternations between hot and cold. More is probably getting to be a waste of time. Less than three is probably not worth bothering with either.

Shower taps

about 2 minutes of heating: comfortably hot
about 1 minute of cooling: cool, not cold (unless you’re tough)
about 2 minutes of heating: hotter!
about 1 minute of cooling: colder!
about 2 minutes of heating: hot as you can handle
about 1 minute of cooling: cold as you can handle

Finish with cold. You should finish a contrast session with cold, especially if you suspect that you might be a little inflamed.
I hope this information helps assist with your recovery!

Thanks for reading 🙂

Katrina Laczoffy,
Fit Stop Personal Trainer

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