• Both massage and cold water immersion reduced muscle soreness (i.e., DOMS) equally, However, muscle recovery was not improved by massage or cold water immersion despite the athletes having less DOMS. Furthermore, DOMS is not a good indicator that you have recovered from a workout.


Delayed Onset Muscle Soreness (DOMS) is that dreaded feeling in which your muscle feels sore after a workout. Some lifters like to feel sore after a workout to remind them how hard they trained. If you are sore, you stimulated muscle growth, right?

Muscles become resistant to muscle damage, and studies have found no correlation between DOMS and muscle growth.


Elite athletes always seek an edge to enhance the recovery process post-workout.  If you can recuperate faster, you can return to the gym or field to make progress.

Athletes will search the internet for foods that help with muscle soreness.  Protein and whey protein can provide essential amino acids to stimulate muscle protein synthesis. Excellent sources of protein include egg, milk, fish, beef, and chicken.

Some other best supplements for muscle soreness include tart cherry and beetroot juice.  A previous article on Evidence Based Muscle discussed the benefits of EMG for recovery.


Ice baths, icebox cryotherapy, cold showers, and cryotherapy chambers are all gaining popularity.  Cold water immersion benefits include reduced muscle soreness and pain and improved athletic performance. (Ascensão et al., 2011; Klich et al., 2018)

However, the efficacy of cold water immersion as a recovery technique is still a topic of debate in the scientific community. While some studies advocate its benefits, not all researchers are in agreement. For instance, a study by Sellwood et al. (2007) did not find cold water immersion to be particularly beneficial.

On a related note, the use of ice baths for chronic inflammation is an emerging area of research that’s garnering attention. Interestingly, studies have indicated that ice baths can offer several benefits. These include reduced muscle inflammation and an enhanced perception of recovery, as highlighted by research from Dupuy et al. (2018) and Guillot et al. (2017).

Cold water immersion benefits include reduced muscle soreness and pain and improved athletic performance. (Ascensão et al., 2011; Klich et al., 2018) However, not all researchers have found cold water immersion to be beneficial. (Sellwood et al., 2007)

ice bath temperature cold water immersion icebox cryotherapy recovery for athletes athlete recovery cold water immersion benefits ice bath therapy cryotherapy chambers does muscle soreness mean growth do ice baths help sore muscles foods that help wi
Many athletes falsely assume that athletic massage therapy helps reduce lactic acid removal.


Massage benefits for athletes have also been documented for reducing muscle soreness. (Davis et al., 2020; Frey Law et al., 2008) Many athletes falsely assume that athletic massage therapy helps reduce lactic acid removal and improves muscle recovery.

Lactic acid levels return to baseline very quickly after exercise.  Lactic acid has nothing to do with muscle soreness.(Schwane et al., 1983)

Researchers compared cold water immersion, massage, or a combination of massage and cold water therapy on muscle recovery after intense exercise.


The researchers took amateur athletes from various sports and put them thru a muscle-damaging plyometrics protocol. Plyometrics is one of the most muscle-damaging exercises you can do, so the researchers had the subjects perform 20 drop jumps off a 60 cm box.

Plyometrics is one of the most muscle-damaging exercises you can do. Therefore, the researchers had the subjects perform 20 drop jumps off a 60 cm box. Cold water immersion, massage, and a combination of cold water immersion and massage were used in an experiment.

The results showed that these methods recovered participants faster than the control group, meaning there was less muscle soreness.


The subjects immediately after exercise were assigned to four different recovery protocols:

·      Cold Water Immersion: Subjects sat immersed in a cold bath (ice bath temperature was 10 degrees Celsius) for 10 minutes.

·      Massage: 20-minute massage by a sports massage therapist.  A 10-minute massage on each leg was performed with random massage techniques.

·      Cold Water Immersion and Massage: 20-minute massage plus 10 minutes of cold water immersion.

·      Control Group: No recovery intervention.

The researchers measured markers of muscle damage (i.e., creatine kinase), muscle soreness, muscle strength, muscle swelling, and other markers of recovery. Both cold water immersion and massage have been shown to improve muscle recovery following muscle-damaging exercises. (Peake et al., 2017; Zainuddin et al., 2005)


At the end of the study, there was intense soreness, muscle damage, and muscle swelling after the muscle-damaging protocol. The cold water immersion, massage, and combination of cold water immersion and massage recovered faster (i.e., less muscle soreness) than the control group.

Interestingly, muscle strength was impaired in all groups despite the subjects feeling better and having reduced muscle soreness.  However, there were no differences in recovery of strength were noted for any group. (Angelopoulos et al., 2022)

Furthermore, reduced DOMS was not correlated with strength recovery.  The massage and water immersion groups had less soreness, but their strength had not returned to baseline.  This is a false assessment if you use soreness as an indicator of muscle recovery.


Interestingly, in the midst of a growing number of individuals praising the benefits of cold water immersion, its effects were found to be no different from a massage in certain contexts. However, it’s worth noting a distinction: unlike massage, consistent use of cold water therapy over an extended period has been linked to a reduction in muscle hypertrophy.

Evidence Based Muscle Conclusions

In conclusion from Evidence Based Muscle, drawing from the massage vs. ice baths study, the researchers concluded the study by stating, “An organized cooling down following high-volume plyometric exercise may partially lead to a reduced feeling of pain and DOMS when combined with CWI and sports massage. While the cold-water immersion, massage, combined massage, and cold-water immersion treatment interventions used in this research did succeed in minimizing pain, they didn’t make a significant impact on other crucial parameters of athletes’ functional capacities. Given these observations, the current study raises questions about the efficacy of these methods when used by athletes as functional rehabilitation strategies.”

Evidence Based Muscle REFERENCES

Angelopoulos, P., Diakoronas, A., Panagiotopoulos, D., Tsekoura, M., Xaplanteri, P., Koumoundourou, D., Saki, F., Billis, E., Tsepis, E., & Fousekis, K. (2022). Cold-Water Immersion and Sports Massage Can Improve Pain Sensation but Not Functionality in Athletes with Delayed Onset Muscle Soreness. Healthcare (Basel), 10(12). https://doi.org/10.3390/healthcare10122449

Ascensão, A., Leite, M., Rebelo, A. N., Magalhäes, S., & Magalhäes, J. (2011). Effects of cold water immersion on the recovery of physical performance and muscle damage following a one-off soccer match. Journal of Sports Sciences, 29(3), 217-225. https://doi.org/10.1080/02640414.2010.526132

Davis, H. L., Alabed, S., & Chico, T. J. A. (2020). Effect of sports massage on performance and recovery: a systematic review and meta-analysis. BMJ Open Sport Exerc Med, 6(1), e000614. https://doi.org/10.1136/bmjsem-2019-000614

Dupuy, O., Douzi, W., Theurot, D., Bosquet, L., & Dugué, B. (2018). An Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review With Meta-Analysis. Front Physiol, 9, 403. https://doi.org/10.3389/fphys.2018.00403

Evidence Based Muscle  REFERENCES

Frey Law, L. A., Evans, S., Knudtson, J., Nus, S., Scholl, K., & Sluka, K. A. (2008). Massage Reduces Pain Perception and Hyperalgesia in Experimental Muscle Pain: A Randomized, Controlled Trial. The Journal of Pain, 9(8), 714-721. https://doi.org/https://doi.org/10.1016/j.jpain.2008.03.009

Guillot, X., Martin, H., Seguin-Py, S., Maguin-Gaté, K., Moretto, J., Totoson, P., Wendling, D., Demougeot, C., & Tordi, N. (2017). Local cryotherapy improves adjuvant-induced arthritis through down-regulation of IL-6 / IL-17 pathway but independently of TNFα. PLoS One, 12(7), e0178668. https://doi.org/10.1371/journal.pone.0178668

Klich, S., Krymski, I., Michalik, K., & Kawczyński, A. (2018). Effect of short-term cold-water immersion on muscle pain sensitivity in elite track cyclists. Physical Therapy in Sport, 32, 42-47. https://doi.org/https://doi.org/10.1016/j.ptsp.2018.04.022

Peake, J. M., Roberts, L. A., Figueiredo, V. C., Egner, I., Krog, S., Aas, S. N., Suzuki, K., Markworth, J. F., Coombes, J. S., Cameron-Smith, D., & Raastad, T. (2017). The effects of cold water immersion and active recovery on inflammation and cell stress responses in human skeletal muscle after resistance exercise. J Physiol, 595(3), 695-711. https://doi.org/10.1113/jp272881

Schwane, J. A., Watrous, B. G., Johnson, S. R., & Armstrong, R. B. (1983). Is Lactic Acid Related to Delayed-Onset Muscle Soreness? Phys Sportsmed, 11(3), 124-131. https://doi.org/10.1080/00913847.1983.11708485

Sellwood, K. L., Brukner, P., Williams, D., Nicol, A., & Hinman, R. (2007). Ice-water immersion and delayed-onset muscle soreness: a randomised controlled trial. British Journal of Sports Medicine, 41(6), 392-397. https://doi.org/10.1136/bjsm.2006.033985

Zainuddin, Z., Newton, M., Sacco, P., & Nosaka, K. (2005). Effects of massage on delayed-onset muscle soreness, swelling, and recovery of muscle function. J Athl Train, 40(3), 174-180.

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