The Relationship Between Hot-Cold Compression Therapy and Delayed Onset Muscle Soreness (DOMS) : A Comprehensive Systematic Review
Keywords:
Delayed onset muscle soreness, cryotherapy, compression therapy, contrast therapy, sports recovery, exercise-induced muscle damageAbstract
Introduction: Delayed Onset Muscle Soreness (DOMS) represents a common consequence of unaccustomed or intense exercise, characterized by pain, reduced function, and inflammation. Despite widespread use of thermal and compression therapies in sports recovery, the optimal application parameters and comparative effectiveness remain unclear. This systematic review evaluated the relationship between hot-cold compression therapy and DOMS outcomes.
Methods: A comprehensive systematic review was conducted across multiple databases, screening studies based on predefined criteria including population (healthy individuals or athletes), intervention (thermal and/or compression therapies), outcomes (DOMS-related measures), and study design (RCTs, controlled trials, systematic reviews). Data extraction focused on intervention parameters, population characteristics, DOMS assessment methods, and primary findings.
Results: Eighty studies were included, encompassing diverse interventions including contrast water therapy (CWT), cold water immersion (CWI), compression therapy, and combined approaches. CWI at 10-15°C for 10-15 minutes demonstrated consistent benefits for pain reduction (SMD -0.48 to -0.75) and functional recovery. Compression therapy, particularly pneumatic devices, improved muscle soreness (SMD -0.33) and performance measures. Combined thermal-compression approaches showed synergistic effects in some contexts (d = 0.67-1.12 for strength recovery), though not universally superior.
Discussion: Intervention effectiveness demonstrated systematic variation based on temperature (optimal CWI: 10-15°C), duration (CWT optimal at 6 minutes), timing (immediate post-exercise application critical), and population (trained males show robust responses; females may respond differently). Methodological quality varied substantially, with placebo effects potentially contributing to reported benefits.
Conclusion: Cold water immersion at 10-15°C for 10-15 minutes immediately post-exercise represents the most consistently beneficial single modality for DOMS, particularly in trained male athletes. Compression therapies offer viable alternatives with distinct mechanisms. Personalized approaches considering individual response patterns and resource availability are recommended over universal protocols.
References
E. Hohenauer, J. Taeymans, J. Baeyens, et al (2015) The Effect of Post-Exercise Cryotherapy on Recovery Characteristics: A Systematic Review and Meta-Analysis. PLoS ONE. https://doi.org/10.1371/journal.pone.0139028
Nathan G. Versey, S. Halson, B. Dawson (2012) Effect of contrast water therapy duration on recovery of running performance. International Journal of Sports Physiology and Performance. https://doi.org/10.1123/IJSPP.7.2.130
Trevor R. Higgins, Melainie Cameron, M. Climstein (2013) Acute Response to Hydrotherapy After a Simulated Game of Rugby. Journal of Strength and Conditioning Research. https://doi.org/10.1519/JSC.0b013e31828151b6
Yutan Wang, Hongmei Lu, Sijun Li, et al (2021) EFFECT OF COLD AND HEAT THERAPIES ON PAIN RELIEF IN PATIENTS WITH DELAYED ONSET MUSCLE SORENESS: A NETWORK META-ANALYSIS. Journal of Rehabilitation Medicine. https://doi.org/10.2340/jrm.v53.331
J. Mayer, V. Mooney, L. Matheson, et al (2006) Continuous low-level heat wrap therapy for the prevention and early phase treatment of delayed-onset muscle soreness of the low back: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation. https://doi.org/10.1016/J.APMR.2006.07.259
P. Wiśniowski, M. Cieśliński, Martyna Jarocka, et al (2022) The Effect of Pressotherapy on Performance and Recovery in the Management of Delayed Onset Muscle Soreness: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. https://doi.org/10.3390/jcm11082077
J. Jakeman, C. Byrne, R. Eston (2010) Lower limb compression garment improves recovery from exercise-induced muscle damage in young, active females. European Journal of Applied Physiology. https://doi.org/10.1007/s00421-010-1464-0
Kate McLellan (2024) Pneumatic Compression Massage Decreases Effects of Delayed Onset Muscle Soreness in Active Females. Journal Of Rehabilitation And Pain Medicine. https://doi.org/10.37191/mapsci-jrpm-1(2)-012
V. Colantuono, R. Oakley, D. Hatfield, et al (2022) Contrast With Compression Therapy Enhances Muscle Function Recovery and Attenuates Glycogen Disruption After Exercise. Sports health. https://doi.org/10.1177/19417381221080172
Shixin Lin, T. Chen, hung-Hao Wang (2025) Cryocompression Therapy for Recovery from Eccentric Exercise-Induced Muscle Damage in Healthy Young Men. Sports. https://doi.org/10.3390/sports13090290
Feiyan Xiao, Jiao Lu, Anastasia V. Kabachkova, et al (2025) Fatigue Recovery and Exercise Performance after Contrast Water Therapy- Meta-analysis. Trends in Physical Education and Sport. https://doi.org/10.31489/3081-0531/2025-1-1/57-83
A. Ascensão, Marco Leite, A. Rebelo, et al (2011) Effects of cold water immersion on the recovery of physical performance and muscle damage following a one-off soccer match. Jurnal sport science. https://doi.org/10.1080/02640414.2010.526132
V. Wellauer, R. Clijsen, G. Bianchi, et al (2025) No acceleration of recovery from exercise-induced muscle damage after cold or hot water immersion in women: A randomised controlled trial. PLoS ONE. https://doi.org/10.1371/journal.pone.0322416
Shabnam Lateef, R. Oakley, Vinny Colantuno, et al (2020) The Effects Of Contrast With Compression Therapy On Muscle Recovery Post Exercise. Medicine & Science in Sports & Exercise. https://doi.org/10.1249/01.mss.0000670296.63184.b6
Barry G. Horgan, Nic West, Nicolin Tee, et al (2021) Acute Inflammatory, Anthropometric, and Perceptual (Muscle Soreness) Effects of Postresistance Exercise Water Immersion in Junior International and Subelite Male Volleyball Athletes. Journal of Strength and Conditioning Research. https://doi.org/10.1519/JSC.0000000000004122
F. Bieuzen, C. Bleakley, J. Costello (2013) Contrast Water Therapy and Exercise Induced Muscle Damage: A Systematic Review and Meta-Analysis. PLoS ONE. https://doi.org/10.1371/journal.pone.0062356
Szczepan Wiecha, I. Cieśliński, Paweł Wiśniowski, et al (2025) Physical Therapies for Delayed-Onset Muscle Soreness: An Umbrella and Mapping Systematic Review with Meta-meta-analysis. Sports Medicine. https://doi.org/10.1007/s40279-025-02187-5
J. Vaile, N. Gill, A. Blazevich (2007) THE EFFECT OF CONTRAST WATER THERAPY ON SYMPTOMS OF DELAYED ONSET MUSCLE SORENESS. Journal of Strength and Conditioning Research. https://doi.org/10.1519/R-19355.1
R. Trybulski, Adrian Kużdżał, A. Vovkanych, et al (2025) Cold Compression and Ischemic Preconditioning With Ice Therapy Enhance Muscle Recovery and Functionality Post-Exercise: A Randomized Study. Annals of Rehabilitation Medicine. https://doi.org/10.5535/arm.250090
R. Trybulski, Sebastian Klich, J. Valera-Calero, et al (2025) Effect of pneumatic and cold compression on muscle performance and recovery in combat sports athletes. Scientific Reports. https://doi.org/10.1038/s41598-025-29014-1
Yutan Wang, Sijun Li, Yuanyuan Zhang, et al (2021) Heat and cold therapy reduce pain in patients with delayed onset muscle soreness: A systematic review and meta-analysis of 32 randomized controlled trials. Physical Therapy in Sport. https://doi.org/10.1016/j.ptsp.2021.01.004
J. Vaile, S. Halson, N. Gill, B. Dawson (2008) Effect of hydrotherapy on the signs and symptoms of delayed onset muscle soreness. European Journal of Applied Physiology. https://doi.org/10.1007/s00421-007-0605-6
D. French, K. Thompson, S. Garland, et al (2008) The effects of contrast bathing and compression therapy on muscular performance. Medicine & Science in Sports & Exercise. https://doi.org/10.1249/MSS.0b013e31816b10d5
M. P. Schwellnus (2010) SportsMedUpdate. British Journal of Sports Medicine. https://doi.org/10.1136/bjsm.2010.076182
William H. DuPont, B. Meuris, Vincent H. Hardesty, et al (2017) The Effects Combining Cryocompression Therapy following an Acute Bout of Resistance Exercise on Performance and Recovery. Journal of Sports Science and Medicine
J. Jakeman, C. Byrne, R. Eston (2010) Efficacy of Lower Limb Compression and Combined Treatment of Manual Massage and Lower Limb Compression on Symptoms of Exercise-Induced Muscle Damage in Women. Journal of Strength and Conditioning Research. https://doi.org/10.1519/JSC.0b013e3181e4f80c
Sheila Alicea, R. Braithwaite, Vanessa Lentillon‐Kaestner (2015) Peer-Reviewed Abstracts. Research Quarterly for Exercise and Sport. https://doi.org/10.1080/02701367.2015.1049504
Ruohan Chen, Xiaopeng Ma, Xiaoman Ma, Chenmin Cui (2024) The effects of hydrotherapy and cryotherapy on recovery from acute post-exercise induced muscle damage—a network meta-analysis. BMC Musculoskeletal Disorders. https://doi.org/10.1186/s12891-024-07315-2
Trevor R. Higgins, M. Climstein, Melainie Cameron (2013) Evaluation of Hydrotherapy, Using Passive Tests and Power Tests, for Recovery Across a Cyclic Week of Competitive Rugby Union. Journal of Strength and Conditioning Research. https://doi.org/10.1519/JSC.0b013e318260ed9b
R. Trybulski, J. Muracki, M. Aldhahi, et al (2025) Effect of cold compression and ice therapy on muscle recovery after plyometric exercise: A randomized crossover trial. Journal of Bodywork & Movement Therapies. https://doi.org/10.1016/j.jbmt.2025.10.021
R. Trybulski, A. Żebrowska, Marta Bichowska-Pawęska, et al (2024) The Effects of Combined Contrast Heat Cold Pressure Therapy on Post-Exercise Muscle Recovery in MMA Fighters: A Randomized Controlled Trial. Journal of Human Kinetics. https://doi.org/10.5114/jhk/190220
G. Bogdanis, Dalila Scaturro, G. Millour, et al (2025) Effects of combining cold exposure and compression on muscle recovery: a randomized crossover study. Frontiers in Physiology. https://doi.org/10.3389/fphys.2025.1598075
Adrian Kużdżał, Filipe M Clemente, Adam Kawczyński, et al (2024) Comparing The Effects of Compression Contrast Therapy and Dry Needling on Muscle Functionality, Pressure Pain Threshold, and Perfusion after Isometric Fatigue in Forearm Muscles of Combat Sports Athletes: A Single-Blind Randomized Controlled Trial. Journal of Sports Science and Medicine. https://doi.org/10.52082/jssm.2024.548
K. Jones, B. Skinner, Saul Cuttell (2024) An investigation into the effects of cryo-compression versus TECAR therapy on symptoms of exercise-induced muscle damage. Graduate Journal of Sports Science, Coaching, Management, & Rehabilitation. https://doi.org/10.19164/gjsscmr.v1i3.1488
Tatsuhiro Maruyama, Sahiro Mizuno, K. Goto (2019) Effects of cold water immersion and compression garment use after eccentric exercise on recovery. The Journal of Exercise Nutrition and Biochemistry. https://doi.org/10.20463/jenb.2019.0007
E. Robey, B. Dawson, C. Goodman, J. Beilby (2009) Effect of Postexercise Recovery Procedures Following Strenuous Stair-climb Running. Research in Sports Medicine: An International Journal. https://doi.org/10.1080/15438620902901276
Fiona Crowther, R. Sealey, M. Crowe, et al (2017) Effects of Various Recovery Strategies on Repeated Bouts of Simulated Intermittent Activity. Journal of Strength and Conditioning Research. https://doi.org/10.1519/JSC.0000000000002396
E. Hohenauer, P. Clarys, J. Baeyens, R. Clijsen (2017) Non-invasive Assessments of Subjective and Objective Recovery Characteristics Following an Exhaustive Jump Protocol. Journal of Visualized Experiments. https://doi.org/10.3791/55612
J. Farmer, Jennifer Kirk-Sorrow, C. M. Lee, et al (2017) Effects of Compression Socks on Muscle Recovery in Competitive Masters Endurance Athletes: 3738 Board #185 June 3 9. https://doi.org/10.1249/01.MSS.0000519953.64239.A4
William H. DuPont, Vincent H. Hardesty, Emily C. Barnhart, et al (2017) The Effects Of Cryo-compression Therapy On Recovery From An Acute Bout Of Resistance Exercise.: 2433 Board #6 June 2 9. https://doi.org/10.1249/01.mss.0000518801.59947.9c
D. French, K. Thompson, Christopher A Barnes, et al (2007) Influence of Contrast Bathing and Compression Therapy on Recovery Following Acute Exercise-Induced Muscle Damage: 2571. https://doi.org/10.1249/01.mss.0000274930.54110.cb
Maruyama Tatsuhiro, Sahiro Mizuno, K. Goto (2017) Combined Effects of Cold Water Immersion and Compression Garment after Exercise on Muscle Damage Markers: 3742 Board #189 June 3 9. https://doi.org/10.1249/01.mss.0000519957.09981.af
E. Hiruma (2005) Effects Of Massage And Compression Treatment On Delayed Onset Muscle Soreness Following Maximum Calf-raise Exercise: 1356 Board #211 3:30 PM - 5:00 PM. https://doi.org/10.1097/00005768-200505001-01353
Molly R Winke, S. Williamson (2018) Comparison of a Pneumatic Compression Device to a Compression Garment During Recovery from DOMS. International Journal of Exercise Science. https://doi.org/10.70252/yxdx1767
O. Dupuy, W. Douzi, D. Theurot, et al (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. Frontiers in Physiology. https://doi.org/10.3389/fphys.2018.00403
R. Trybulski, Adrian Kużdżał, A. Stanula, et al (2024) Acute effects of cold, heat and contrast pressure therapy on forearm muscles regeneration in combat sports athletes: a randomized clinical trial. Scientific Reports. https://doi.org/10.1038/s41598-024-72412-0
Natanael P. Batista, Flávia A. de Carvalho, A. F. Machado, et al (2022) What Parameters Influence the Effect of Cold-Water Immersion on Muscle Soreness? An Updated Systematic Review and Meta-Analysis. Clinical Journal of Sports Medicine. https://doi.org/10.1097/JSM.0000000000001081
J. Alexander, J. Jeffery, D. Rhodes (2021) Recovery profiles of eccentric hamstring strength in response to cooling and compression. Journal of Bodywork & Movement Therapies. https://doi.org/10.1016/J.JBMT.2021.03.010
Kyoungrae Kim, Christopher K Kargl, Bohyun Ro, et al (2021) Neither Peristaltic Pulse Dynamic Compressions nor Heat Therapy Accelerate Glycogen Resynthesis after Intermittent Running. Medicine & Science in Sports & Exercise. https://doi.org/10.1249/MSS.0000000000002713
E. Ahokas, H. Kyröläinen, A. Mero, et al (2020) Water immersion methods do not alter muscle damage and inflammation biomarkers after high-intensity sprinting and jumping exercise. European Journal of Applied Physiology. https://doi.org/10.1007/s00421-020-04481-8
Nihel Ghoul, M. Tabben, K. Chamari, C. Tourny (2017) Effect of Cooling on Postmatch Recovery in Elite Volleyball Players in Warm Conditions: 3740 Board #187 June 3 9. https://doi.org/10.1249/01.mss.0000519955.71863.22
S. Elsayed, N. A. Abdel Raoof, N. Abdallah (2015) Efficacy of cryoflow therapy in induced muscle soreness: a randomized trial. https://doi.org/10.4103/1110-6611.174692
Kazuki Kino, Mitsuo Neya, Yuya Watanabe, Noriyuki Kida (2026) Effects of Contrast Water Therapy on Physiological and Perceptual Recovery Following High-Intensity Interval Swimming in Collegiate Swimmers. Sports. https://doi.org/10.3390/sports14010026
E. S. Hassan (2011) Thermal therapy and delayed onset muscle soreness. Journal of Sports Medicine and Physical Fitness
William J. Kraemer, Jill A. Bush, R. Wickham, et al (2001) Influence of compression therapy on symptoms following soft tissue injury from maximal eccentric exercise. Journal of Orthopaedic and Sports Physical Therapy. https://doi.org/10.2519/JOSPT.2001.31.6.282
R. O'Connor, D. Hurley (2003) The Effectiveness of Physiotherapeutic Interventions in the Management of Delayed Onset Muscle Soreness: a Systematic Review. https://doi.org/10.1179/108331903225003181
R. Nahon, Jaqueline Santos Silva Lopes, A. Monteiro de Magalhães Neto (2021) Physical therapy interventions for the treatment of delayed onset muscle soreness (DOMS): Systematic review and meta-analysis. Physical Therapy in Sport. https://doi.org/10.1016/j.ptsp.2021.07.005
P. Angelopoulos, Anastasios Diakoronas, Dimitrios P. Panagiotopoulos, et al (2022) Cold-Water Immersion and Sports Massage Can Improve Pain Sensation but Not Functionality in Athletes with Delayed Onset Muscle Soreness. Healthcare. https://doi.org/10.3390/healthcare10122449
J. Petrofsky, I. Khowailed, Haneul Lee, et al (2015) Cold Vs. Heat After Exercise—Is There a Clear Winner for Muscle Soreness. Journal of Strength and Conditioning Research. https://doi.org/10.1519/JSC.0000000000001127
P. Glasgow, Roisin Ferris, C. Bleakley (2014) Cold water immersion in the management of delayed-onset muscle soreness: is dose important? A randomised controlled trial. Physical Therapy in Sport. https://doi.org/10.1016/j.ptsp.2014.01.002
J. Adamczyk, Ilona Krasowska, D. Boguszewski, P. Reaburn (2016) The use of thermal imaging to assess the effectiveness of ice massage and cold-water immersion as methods for supporting post-exercise recovery. Journal of Thermal Biology. https://doi.org/10.1016/j.jtherbio.2016.05.006
Nayro Isaac Domínguez-Gavia, Ramón Candia-Luján, Lidia Guillermina De León Fierro, et al (2022) La hidroterapia y sus efectos sobre el dolor muscular tardío en deportistas: una revisión sistemática (Hydroterapy and its effects on delayed onset muscle soreness in athletes: a systematic review). Retos. https://doi.org/10.47197/retos.v46.93960
Cristina N Getto, Grace M. Golden (2013) Comparison of Active Recovery in Water and Cold-Water Immersion After Exhaustive Exercise. https://doi.org/10.3928/19425864-20130702-03
Mohd Hafiz Muhd Ghoth, N. H. Amir, J. Radzi, et al (2019) Comparison between two recovery methods: Cold water immersion versus progressive muscle relaxation in reducing DOMS among young athletes. https://doi.org/10.15282/MOHE.V8I2.256
Greg J. Rowsell, A. Coutts, P. Reaburn, Stephen V. Hill-Haas (2011) Effect of post-match cold-water immersion on subsequent match running performance in junior soccer players during tournament play. Jurnal sport science. https://doi.org/10.1080/02640414.2010.512640
D. Sartika (2021) COMBINATION OF STRETCHING WITH IMMERSION SYSTEM (COLD AND CONTRAST) ON DOMS PAIN TOLERANCE. Sport and Fitness Journal. https://doi.org/10.24843/SPJ.2021.V09.I02.P04
Junjie Ma, Changfei Guo, Long Luo, et al (2025) Comparison of the Effects of Cold-Water Immersion Applied Alone and Combined Therapy on the Recovery of Muscle Fatigue After Exercise: A Systematic Review and Meta-Analysis. Life. https://doi.org/10.3390/life15081205
G. Howatson, K. A. Someren (2003) Ice massage. Effects on exercise-induced muscle damage. Journal of Sports Medicine and Physical Fitness
A. Gurovich, Luis Peñailillo, A. Reyes, Paula Plaza (2006) What is the Best Treatment to Control Delayed Onset Muscle Soreness: Ultrasound, Cryotherapy or Both on a Combined Therapy? https://doi.org/10.1249/00005768-200605001-01001
Fernanda Bortolo Pesenti, R. A. Silva, D. Monteiro, et al (2020) THE EFFECT OF COLD WATER IMMERSION ON PAIN, MUSCLE RECRUITMENT AND POSTURAL CONTROL IN ATHLETES. Revista Brasileira de Medicina do Esporte. https://doi.org/10.1590/1517-869220202604214839
Adam W. Cranston, M. Driller (2020) Investigating the Use of an Intermittent Sequential Pneumatic Compression Arm Sleeve for Recovery After Upper-Body Exercise. Journal of Strength and Conditioning Research. https://doi.org/10.1519/JSC.0000000000003680
R. Trybulski, A. Stanula, A. Vovkanych, et al (2024) Optimal Duration of Cold and Heat Compression for Forearm Muscle Biomechanics in Mixed Martial Arts Athletes: A Comparative Study. Medical Science Monitor. https://doi.org/10.12659/MSM.944149
George P. Elias, V. Wyckelsma, M. Varley, et al (2013) Effectiveness of water immersion on postmatch recovery in elite professional footballers. International Journal of Sports Physiology and Performance. https://doi.org/10.1123/IJSPP.8.3.243
Cheng Guo, Yongzhao Fan, Xiaoyang Kong, Chenyang Zhao (2022) The effect of different water immersion strategies on delayed onset muscle soreness and inflammation in elite race walker. Journal of Men's Health. https://doi.org/10.31083/j.jomh1803064
Luis Peñailillo, Paula Plaza, Tanya Husak, et al (2006) Cryotherapy as Control Delayed Onset Muscle Soreness Treatment: 688. https://doi.org/10.1249/00005768-200605001-01000
Chaoyi Qu, Zhaozhao Wu, Minxiao Xu, et al (2020) Cryotherapy Models and Timing-Sequence Recovery of Exercise-Induced Muscle Damage in Middle- and Long-Distance Runners. Journal of athletic training. https://doi.org/10.4085/1062-6050-529-18
Caio Bueno de Moraes, Lucas Chumei Cavalaro, Vinícius Marcílio, et al (2024) COMPARISON OF THE EFFECTIVENESS OF INTERMITTENT PNEUMATIC COMPRESSION, COLD WATER IMMERSION, AND A PASSIVE PROTOCOL IN THE RECOVERY OF MUSCLE DAMAGE INDUCED BY PLYOMETRIC EXERCISE. Revista contemporânea. https://doi.org/10.56083/rcv4n6-073
Tom Clifford, Will Abbott, S. Kwiecien, et al (2017) Cryotherapy Reinvented: Application of Phase Change Material for Recovery in Elite Soccer. International Journal of Sports Physiology and Performance. https://doi.org/10.1123/ijspp.2017-0334
J. Alexander, Jane E Keegan, A. Reedy, D. Rhodes (2021) Effects of contemporary cryo-compression on post-training performance in elite academy footballers. Biology of Sport. https://doi.org/10.5114/biolsport.2022.102866
Mark G. L. Sayers, A. Calder, J. Sanders (2011) Effect of whole-body contrast-water therapy on recovery from intense exercise of short duration. https://doi.org/10.1080/17461391.2010.512365
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Dendy Edyana, Wianne Carima (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors publishing here keep copyright but grant the journal first publication rights, under a Creative Commons Attribution-NonCommercial 4.0 License. They can distribute their work non-exclusively elsewhere with an acknowledgment of its first publication in this journal. Posting the work online before and during submission for earlier and greater citation is encouraged, reflecting Open Access benefits.
