BACKGROUND: Cold water immersion (CWI) is commonly used to manage delayed onset muscle soreness (DOMS) resulting from exercise. Scientific evidence for an optimal dose of CWI is lacking and athletes continue to use a range of a treatment protocols and water temperatures. OBJECTIVES: To compare the effectiveness of four different water immersion protocols and a passive control intervention in the management of DOMS. DESIGN: Randomised controlled trial with blinded outcome assessment. SETTING: University research laboratory. PARTICIPANTS: 50 healthy participants with laboratory induced DOMS randomised to one of five groups: short contrast immersion (1 min 38 degrees C/1 min 10 degrees C x 3), short intermittent CWI (1 min x 3 at 10 degrees C); 10 min CWI in 10 degrees C; 10 min CWI in 6 degrees C; or control (seated rest). MAIN OUTCOME MEASURES: Muscle soreness, active range of motion, pain on stretch, muscle strength and serum creatine kinase. RESULTS: 10 min of CWI in 6 degrees C was associated with the lowest levels of muscle soreness and pain on stretch however values were not statistically different to any of the other groups. There were no statistically significant differences between groups for any other outcomes. CONCLUSION: Altering the treatment duration, water temperature or dosage of post exercise water immersion had minimal effect on outcomes relating to DOMS.

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