Cold Plunges And Your Health: What You Need to Know

Cold plunging is one aspect of cold water therapy or cold water immersion, which is a practice that involves immersing oneself in cold water temperatures, usually for some type of health benefit. “People of all activity levels are experimenting with cold plunging as a non-pharmacologic means of [relieving] joint pain and inflammation,” says Troy Russell, M.D., regional medical director of Primary360 at Teladoc Health.

“Traditionally, cold therapy has been performed by athletes in an effort to enhance post-workout recovery,” notes Craig Van Dien, M.D., a physical medicine and rehabilitation specialist at Hackensack Meridian Health’s JFK Johnson Rehabilitation Institute in Edison, New Jersey. “There has been growing interest amongst the general population, possibly as a consequence of the purported health benefits and wellness trends,” he adds.

Cold water immersion can be performed in various locations, such as indoor or outdoor tubs, specially designed tanks or plunge barrels, local spas and even cold bodies of water, according to Dr. Van Dien and Dr. Russell. Though immersing yourself in a cold body of water may provide a dynamic plunge experience, Dr. Van Dien notes there’s limited evidence to suggest whether one location is more beneficial than another.

Some studies suggest 50 to 59 degrees Fahrenheit (10 to 15 degrees Celsius) to be an optimal temperature range for cold plunges focused on reducing muscle soreness, notes Dr. Van Dien^[1][2]. However, there aren’t standard temperatures for cold plunges and temperatures vary depending on the user’s preference, says Dr. Russell, adding that most participants report using water temperatures ranging from 38 to 60 degrees Fahrenheit.

For individuals cold plunging for the first time, experts recommend gradually easing into the practice to build a tolerance to frigid temperatures. Beginners should aim for no more than 10 to 15 minutes of cold exposure, says Dr. Russell. As one builds a tolerance to the temperature, the length of the cold plunge can be extended, though Dr. Van Dien notes that research typically focuses on the frequency of cold plunges when considering its health benefits, rather than the duration of each plunge.

“Oftentimes, the duration that one may spend immersed depends on several factors including the water temperature, and how habituated one is to the process. Moreover, the duration may change based on an individual’s intent,” says Dr. Van Dien.

The evidence around the benefits of cold plunging is largely inconclusive, according to Dr. Van Dien. “Athletes looking to reduce post-workout muscle soreness, or individuals looking for an experience may find cold immersion appealing,” he says. The practice also serves as a treatment for long-distance endurance athletes who are prone to heat stroke.

Cold plunges may have a positive effect on stress management as well. One recent study in EXPLORE notes the association of winter sea bathing with lower levels of stress and higher overall well-being. The study also suggests that participants who take part in winter sea bathing feel a heightened sense of understanding their health versus those who don’t ^[3]. Another small 2020 study saw small reductions in negative mood, heightened sense of well-being and increases in positive mood in a group of novice open water swimmers^[4].

An ongoing clinical trial on Sea Swimming for Treatment of Depression and Anxiety further highlights the potential benefits of regular open water bathing on mental well-being, specifically, the impact that cold water swimming may pose for depression and anxiety. The trial suggests that cold water could have an impact on depression, possibly linked to the inflammatory system. Other factors such as the physical activity component and being present in nature are among additional developing evidence^[5].

However, even with these small and ongoing studies, “there is low-quality evidence to suggest that cold water immersion offers benefits in major depressive disorders or enhances relaxation,” says Dr. Van Dien. “This is similar for other purported benefits, including enhanced immune function and improved post-exercise recovery. There is more evidence to support use in muscle soreness,” he adds.

While Dr. Russell also agrees that additional research is needed, it’s possible that cold plunging may also contribute to weight loss, increased libido and improved glycemic control, he notes.

Risks of cold plunging can include hypothermia, cardiovascular events or dysfunction and drowning, says Dr. Van Dien. Additional risks to consider include the following, according to the National Weather Service:

• Cold shock: Sudden cold water immersion in temperatures less than 50 to 60 degrees Fahrenheit can cause the body to enter into a state of “shock,” which can lead to involuntary gasping, rapid breathing, heart rate and blood pressure spikes and impaired cognitive function, such as clouded thinking and decision-making.
• Physical incapacitation: Another risk is the loss of muscular control, which can worsen the longer someone is immersed in cold water, and potentially lead to drowning. Symptoms include feeling weak or exhausted and being unable to control the fingers, hands, arms or legs.
• Hypothermia: After one to three minutes of immersion in water with temperatures below 70 degrees Fahrenheit, body temperature continues to drop, increasing the risk of hypothermia, which can begin at a core body temperature of 95 degrees Fahrenheit.

“Understanding your medical comorbidities and what risk they pose is extremely important before cold plunging,” says Dr. Van Dien. “At a minimum, individuals with known cardiac or pulmonary disease should steer clear of cold water immersion, given the immense burden placed on these body systems,” he adds. Older adults should use caution when cold plunging as well, adds Dr. Russell.

Individuals with diabetes may want to consider avoiding cold plunging as diabetes can impact one’s ability to sense tissue damage.

Additionally, experts recommend never cold plunging alone. “Cold water swims should always be done with others with access to medical personnel,” states Dr. Russell. As with any wellness practice, speak to your doctor to determine if cold plunging is a safe option for you.

If you’re ready to experience a cold plunge and have cleared it with your doctor, try to go into it with an informed mindset and an open mind, knowing that your body’s response could be different from someone else’s. Immersing yourself in cold water can be an invigorating experience when practiced in the company of others and in a safe environment.

 By Carley Prendergast