Podium Presentation

Cold Water Immersion on Recovery and Performance

A Prospective Crossover Trial in NCAA Division I Athletes Using Continuous WHOOP Biometrics

AMSSM 35th Annual Meeting · 2025

Study Overview

Cold water immersion (CWI) is widely used by athletes for post-exercise recovery, but meta-analyses of the general population show variable effects. This study asked a more targeted question: which athletes actually respond to CWI, and can wearable biometrics identify them? Using a prospective crossover design with continuous WHOOP monitoring, we tracked heart rate variability (HRV), resting heart rate (RHR), subjective recovery, and muscle soreness in 37 NCAA Division I athletes across CWI and control conditions.

Design
Prospective Crossover
Enrollment
37 NCAA D1 Athletes
Duration
4-Week Crossover
Monitoring
Continuous WHOOP

Key Findings

Results from 37 NCAA Division I athletes, with a pre-specified responder analysis.

Pooled ↓ DOMS
Significant Reduction in Muscle Soreness Across All Athletes
Pooled cohort analysis · p = 0.013
Responder Subgroup
+9.6 ms
Heart Rate Variability (HRV)
p = 0.017
Responder Subgroup
−1.2 bpm
Resting Heart Rate
p = 0.016
Responder Subgroup
+3.5%
Subjective Recovery Score
p = 0.008
Responder Subgroup
−6.9%
Muscle Soreness (DOMS)
p = 0.0004
Performance
No Change
Countermovement Jump Height & Power
No negative impact observed
Individualization
Wearable-ID'd
Responder Identification via WHOOP
Supports personalized recovery protocols

Takeaway

Cold water immersion produced a significant reduction in muscle soreness across the full cohort and meaningful improvements in HRV, RHR, and subjective recovery in a wearable-identified responder subgroup — without impairing jump performance. These findings support an individualized approach to recovery: using wearable biometrics to identify which athletes actually benefit from CWI, rather than applying a one-size-fits-all protocol.

Intervention Protocol

  • Modality: Cold water immersion (CWI), performed post-training
  • Temperature: Approximately 53°F (11.7°C)
  • Duration: 10 minutes per session
  • Frequency: 5 sessions per week
  • Total Intervention: 4-week crossover period
  • Monitoring: Continuous WHOOP biometric tracking throughout

Outcome Measures

  • Heart Rate Variability (HRV): Nightly via WHOOP, weekly averages
  • Resting Heart Rate (RHR): Nightly via WHOOP
  • Subjective Recovery: Daily WHOOP recovery score (0–100%)
  • Muscle Soreness (DOMS): Daily Likert-scale self-report
  • Countermovement Jump: Baseline and post-intervention, force plate

Investigators

Jeremy Swisher, MD
Presenting Author · AMSSM 2025
UCLA · David Geffen School of Medicine
Joshua Goldman, MD, MBA
Principal Investigator
UCLA · David Geffen School of Medicine
Jeremy Vail, PT, SCS, OCS
Co-Investigator
UCLA Athletics
Nicolas Hatamiya, DO
Collaborating Investigator
UCSF · Department of Orthopaedic Surgery

View on ClinicalTrials.gov

Access the full study record, protocol details, and enrollment status.

NCT06565468
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