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.

Ethics & registration: Approved by the UCLA Institutional Review Board [IRB #pending]; all participants provided informed consent. Registered on ClinicalTrials.gov as NCT06565468.
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

Authors & Research Team

Jeremy Swisher, MD
First Author · Presenting Author AMSSM 2025
UCLA · Primary Care Sports Medicine
Brian Donohoe, MD
Co-Author
UCLA · David Geffen School of Medicine
Jeremy Vail, PT, SCS, OCS
Co-Author
UCLA Athletics
Jeonguen Kim, MBI
Co-Author
UCLA · Biomedical Informatics
Calvin Duffaut, MD
Co-Author
UCLA · David Geffen School of Medicine
Nicolas Hatamiya, DO
Co-Author · Collaborating Investigator
UCSF · Department of Orthopaedic Surgery
Nelson Boland, MD
Co-Author
UCLA Health
Kristen Holmes, PhD
Co-Author
WHOOP · Performance Science
Joshua Goldman, MD, MBA
Senior Author · Principal Investigator
UCLA · David Geffen School of Medicine

View on ClinicalTrials.gov

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

NCT06565468

Want to get involved?

UCLA varsity athletes can join an active study, and researchers or partners can collaborate with the HERO Lab.

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