The cold truth about NBA players and their ice baths

Dorian Finney-Smith decided the bucket was too small, so he took the trash can.

It was late at night at the end of January, and it was 4 degrees below zero, cold even for Detroit.. The Dallas Mavericks touched down just hours after beating the New York Knicks, and were mere hours away from facing the Pistons to complete the back-to-back set. After playing 24 minutes in the win, Finney-Smith didn’t have time for his usual cold bath before his team had to depart Madison Square Garden.

So, with trash can in hand, the 25-year-old, 6-foot-8 forward walked down the hall, filled the receptacle with ice from the hotel ice machine, walked back to his room, dumped the ice into the tub, and went back for more. Fill. Dump. Repeat. After a few trips, he ran cold water over the ice and took the plunge. Ten minutes later, the all-important cold therapy was complete.

“I’m not that dedicated,” said teammate Courtney Lee, who soaks in an ice bath after every home game and practice, but admitted it can be tougher to access on the road.

The ice bath — or the cold tub — has long been a staple for recovery for NBA players. As Lee pointed out, some players are more dedicated to it than others. Some limit the ice to their feet or knees. Some avoid it entirely. But for those players who brave the icy water, the benefits are worthwhile. Or so they think. The truth is, the idea that ice baths aid in post-game recovery is not scientifically proven.

The ice bath is a form of cryotherapy that requires athletes to submerge themselves in cold water for 10 to 15 minutes. Theoretically, it helps reduce inflammation and improve recovery by changing the way blood flows through the body. When you sit in the ice bath, your blood vessels constrict and blood flow to the muscles is decreased, limiting the inflammatory response to stress, which equals less muscle damage and faster recovery, according to Casey Batten, MD, director of primary care sports medicine at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles. “More theoretical than proven,” Batten adds.

The water should be 59 degrees or below, but sometimes it can be colder and, to some players, unbearable.

“It’s that shock, you know, it takes your breath away,” Batten said. “It hurts.”

“That’s how I used to feel in college, that it was too cold,” Finney-Smith said. “But then you wonder where your bounce go at and then you start taking care of your body, and you get through the season a lot more healthy.”

The hurt, however, is what drives players to keep doing it. In her book, Good to Go: What the Athlete in All of Us Can Learn from the Strange Science of Recovery, health journalist Christie Aschwanden asserts that ice baths are a dubious recovery method that could actually do more harm than good — and that professional athletes who are conditioned to fight through pain to reach their goals are attracted to taking the plunge.

“All this agony feeds into a culture of sport that idolizes grit and assumes that pain equates to gain. The fact that icing feels so excruciating almost surely adds to whatever effectiveness the technique might have. Scientists call this an active placebo effect — our natural inclination to believe that if a treatment is painful, it must be very effective. If it hurts, you assume it must be working, and this can influence your assessment of how much it helped,” Aschwanden writes.

Finney-Smith asserts he can jump higher when he uses cold tubs regularly. 39-year-old Phoenix Suns guard Jamal Crawford likens it to tuning up an old car. Lee adds: “Get in the cold tub for a while, then I get out and I’ll go in the steam room, get my feel back and, once you get out of the steam room, you a new man.”

Maybe just the belief that ice baths help could help, which is the primary defense of the placebo effect. “The biggest thing is from a psychological standpoint people just feel better,” Batten warns. “If people are looking for a lot of science, it’s not really there.”

Despite the lack of scientific proof, there’s actually been an influx of more extreme cryotherapy as NBA teams have taken steps to keep its players fresher, longer. Cryotherapy chambers — a machine that runs on liquid nitrogen and can drop body temperatures to freezing — are getting more popular. According to Batten, there is even less research on these newer methods than for the ice bath. Players are only supposed to stay in for, at most, three minutes. Players who have left on sweaty socks after a workout or stayed in too long have incurred serious burns that have sidelined them for games.

Meanwhile, more and more players are experimenting with cryo chambers, and several franchises have even installed them in the team facility along with the traditional cold tubs. In fact, recovery technology is a booming business. More players are starting to use sequential compression devices, such as NormaTec, which promises to help “recover faster, increase circulation, conquer muscle soreness.” Like the ice bath, the benefits are short-lived, and maybe mostly mental. Millionaire athletes are always looking for an edge, and if they can shell out a few thousand for something that might work, they’ll often do it.

A lot of the research on cryotherapy is subjective reporting from athletes on whether or not they feel better. That’s not nothing, as mental health plays a big part in performance. “When you get to really high-caliber athletes, a lot of times what separates them is their mental preparation and their mental approach to their craft,” Batten said.

While the short-lived benefits could help between games and after practices, the concern for teams and players more and more is about long-term health and viability. Some recent studies show that the ice bath can indeed reduce pain temporarily, but could actually impede the process of recovery.

So when teams are looking for the best way to aid in recovery, putting players on ice in another way may be more beneficial. “The biggest thing is not overdoing it, and having a systematic approach to how you do things throughout the season and offseason,” Batten said. “How you manage loads.”

Proper training, nutrition, hydration and sleep. Making sure the body is rested, as opposed to overworking the body and then dunking it in 59-degree water. Ice baths may never go away, and there’s something to be said about the mental benefits it provides to players. The key, like most things, is in moderation.