Recovery During Exercise Heat Acclimation: Will Post-Exercise Cooling Enhance or Interfere with Adaptation?

Abstract

Heat acclimation (HA) is regarded as the most important countermeasure to protect athlete health and performance when exercising in hot ambient conditions. HA involves passive or exercise heat stress applied intentionally to increase sweating, core temperature, and skin temperature. However, these responses can lead to significant physiological stress, increasing the risk of accumulated fatigue and overreaching. Post-exercise cooling is an effective strategy to restore neuromuscular function and perceptive recovery following hyperthermia-induced fatigue. However, the influence of post-exercise cooling on heat adaptation remains largely unexplored. This review discusses the potential impact of this recovery modality on heat adaptation. Studies investigating the interaction between hot and cold exposures in the context of thermal adaptation were reviewed. The examined literature collectively indicates: (1) no impairments in heat adaptation when cold exposures did not interfere with the physiological responses attained during the heat stress, (2) marginal compromises in thermal impulse during heat stress did not diminish the magnitude of heat adaptation, and may be compensated through enhanced absolute training intensity (3) while substantial cooling during heat stress can potentially impair sudomotor adaptations to HA, it is reasonable to expect no impairments in this context as recovery-based cooling does not influence the physiological responses garnered during heat stress. It is acknowledged that this conclusion is based on exploratory findings, as direct data on the effects of recovery cooling interventions on heat adaptations are currently lacking.

Keywords

Exercise / Hyperthermia / Thermoregulation / Fatigue / Cold water immersion

References

[1.] Buono MJ, Numan TR, Claros RM, Brodine SK, Kolkhorst FW. “Is active sweating during heat acclimation required for improvements in peripheral sweat gland function?”. Am J Physiol Regul Integr Comp Physiol, 2009, 297(4): R1082-R1085, pmcid: 2763815,

[2.] Choo HC, Nosaka K, Peiffer JJ, Ihsan M, Abbiss CR. Ergogenic effects of precooling with cold water immersion and ice ingestion: a meta-analysis. Eur J Sport Sci, 2017, 18(2): 170-181,

[3.] Choo HC, Nosaka K, Peiffer JJ, Ihsan M, Yeo CC, Abbiss CR. Peripheral blood flow changes in response to postexercise cold water immersion. Clin Physiol Funct Imaging, 2018, 38(1): 46-55,

[4.] Choo HC, Peiffer JJ, Pang JWJ, Tan FHY, Aziz AR, Ihsan M, Lee JKW, Abbiss CR. Effect of regular precooling on adaptation to training in the heat. Eur J Appl Physiol, 2020, 120(5): 1143-1154,

[5.] Choo HC, Lee M, Yeo V, Poon W, Ihsan M, Cheng H, Lee M, Yeo V, Poon W. The effect of cold water immersion on the recovery of physical performance revisited: a systematic review with meta-analysis. J Sport Sci, 2022, 40(23): 2608-2638,

[6.] Cotter JD, Taylor NAS. The distribution of cutaneous sudomotor and alliesthesial thermosensitivity in mildly heat-stressed humans: an open-loop approach. J Physiol, 2005, 565(1): 335-345, pmcid: 1464483,

[7.] Ely MR, Cheuvront SN, Roberts WO, Montain SJ. Impact of weather on marathon-running performance. Med Sci Sports Exerc, 2007, 39(3): 487-493,

[8.] Gibson OR, James CA, Mee JA, Willmott AGB, Turner G, Hayes M, Maxwell NS. Heat alleviation strategies for athletic performance: a review and practitioner guidelines. Temperature, 2019, 7(1): 3-36,

[9.] Glaser EM, Hall MS, Whittow GC. Habituating to heating and cooling of the same hand. J Physiol, 1959, 146(1): 152-164, pmcid: 1356897,

[10.] Glaser EM, Shephard RJ. Simultaneous experimental acclimatization to heat and cold in man. J Physiol, 1963, 169(3): 592-602, pmcid: 1368723,

[11.] Jose GA, Teller C, Andersen SL, Jensen FB, Hyldig T, Nielsen B. Influence of body temperature on the development of fatigue during prolonged exercise in the heat. J Appl Physiol, 1999, 86(3): 1032-1039,

[12.] Guy JH, Deakin GB, Edwards AM, Miller CM, Pyne DB. Adaptation to hot environmental conditions: an exploration of the performance basis, procedures and future directions to optimise opportunities for elite athletes. Sports Med, 2014, 45(3): 303-311,

[13.] Hayashi K, Honda Y, Ogawa T, Wada H, Kondo N, Nishiyasu T. Effects of brief leg cooling after moderate exercise on cardiorespiratory responses to subsequent exercise in the heat. Eur J Appl Physiol, 2004, 92(4–5): 414-420,

[14.] Hollander K, Klöwer M, Richardson A, Navarro L, Racinais S, Scheer V, Murray A, et al.. Apparent temperature and heat-related illnesses during international athletic championships: a prospective cohort study. Scand J Med Sci Sports, 2021, 31(11): 2092-2102,

[15.] Ihsan M, Landers G, Brearley M, Peeling P. Beneficial effects of ice ingestion as a precooling strategy on 40-km cycling time-trial performance. Int J Sports Physiol Perform, 2010, 5(2): 140-151,

[16.] Ihsan M, Périard JD, Racinais S. How to integrate recovery during heat acclimation. Br J Sports Med, 2021, 55(4): 185-186,

[17.] Ihsan M, Watson G, Abbiss CR. What are the physiological mechanisms for post-exercise cold water immersion in the recovery from prolonged endurance and intermittent exercise?. Sports Med, 2016, 46(8): 1095-1109,

[18.] Journeay WS, Robert Carter III, Kenny GP. Thermoregulatory control following dynamic exercise. Aviat Space Environ Med, 2006, 77(11): 1174-1182,

[19.] Kenny GP, Webb P, Ducharme MB, Reardon FD, Jay O. Calorimetric measurement of postexercise net heat loss and residual body heat storage. Med Sci Sports Exerc, 2008, 40(9): 1629-1636,

[20.] Kenny GP, Journeay WS. Human thermoregulation: separating thermal and nonthermal effects on heat loss. Front Biosci., 2010, 15(1): 259-90,

[21.] Kenny GP, Mcginn R. Restoration of thermoregulation after exercise. J Appl Physiol, 2017, 122(4): 933-944,

[22.] Marino FE. Methods, advantages, and limitations of body cooling for exercise performance. Br J Sports Med, 2002, 36(2): 89-94, pmcid: 1724476,

[23.] McCubbin AJ, Allanson BA, Caldwell JN, Odgers MM, Cort RJS, Costa GR, Cox ST, Crawshay BD, Freney EG, Gaskell SK. Sports dietitians Australia position statement: nutrition for exercise in hot environments. Int J Sport Nutr Exerc Metab, 2020, 30(1): 83-98,

[24.] Minett GM, Duffield R, Billaut F, Cannon J, Portus MR, Marino FE. Cold-water immersion decreases cerebral oxygenation but improves recovery after intermittent-sprint exercise in the heat. Scand J Med Sci Sports, 2013, 24(4): 656-666,

[25.] Morris NB, Bain AR, Cramer MN, Jay O. Evidence that transient changes in sudomotor output with cold and warm fluid ingestion are independently modulated by abdominal, but not oral thermoreceptors. J Appl Physiol, 2014, 116(8): 1088-1095, pmcid: 4035792,

[26.] Morrison S, Sleivert G, Cheung S. Passive hyperthermia reduces voluntary activation and isometric force production. Eur J Appl Physiol, 2004, 91(5): 729-736,

[27.] Mountjoy M, Alonso J-M, Bergeron MF, Dvorak J, Miller S, Migliorini S. Hyperthermic-related challenges in aquatics, athletics, football, tennis and triathlon. Br J Sports Med, 2012, 46(11): 800-804,

[28.] Naito T, Haramura M, Muraishi K, Yamazaki M, Takahashi H. Cooling during short-term heat acclimation enhances aerobic capacity but not sweat capacity. Eur J Sport Sci, 2022, 22(4): 579-588,

[29.] Nybo L. Brain temperature and exercise performance. Exp Physiol, 2012, 97(3): 333-339,

[30.] Nybo L, Moller K, Pedersen BK, Nielsen B, Secher NH. Association between fatigue and failure to preserve cerebral energy turnover during prolonged exercise. Acta Physiol Scand, 2003, 179(1): 67-74,

[31.] Nybo L, Nielsen B. Hyperthermia and central fatigue during prolonged exercise in humans. J Appl Physiol, 2001, 91(3): 1055-1060,

[32.] Nybo L, Nielsen B. Perceived exertion is associated with an altered brain activity during exercise with progressive hyperthermia. J Appl Physiol, 2001, 91(5): 2017-2023,

[33.] Nybo L, Rasmussen P, Sawka MN. Performance in the heat-physiological factors of importance for hyperthermia-induced fatigue. Compr Physiol, 2014, 4(2): 657-689,

[34.] Ogawa T, Ohnishi N, Yamashita Y, Sugenoya J, Asayama M, Miyagawa T. Effect of facial cooling during heat acclimation process on adaptive changes in sweating activity. Jpn J Physiol, 1988, 38(4): 479-490,

[35.] Peiffer JJ, Abbiss CR, Watson G, Nosaka K, Laursen PB. Effect of a 5-min cold-water immersion recovery on exercise performance in the heat. Br J Sports Med, 2010, 44(6): 461-465,

[36.] Périard JD, Eijsvogels TMH, Daanen HAM. Exercise under heat stress: thermoregulation, hydration, performance implications, and mitigation strategies. Physiol Rev, 2021, 101(4): 1873-1979,

[37.] Périard JD, Caillaud C, Thompson MW. Central and peripheral fatigue during passive and exercise-induced hyperthermia. Med Sci Sports Exerc, 2011, 43(9): 1657-1665,

[38.] Périard JD, Cramer MN, Chapman PG, Caillaud C, Thompson MW. Cardiovascular strain impairs prolonged self-paced exercise in the heat. Exp Physiol, 2011, 96(2): 134-144,

[39.] Pichan G, Sridharan K, Swamy YV, Joseph S, Gautam RK. Physiological acclimatization to heat after a spell of cold conditioning in tropical subjects. Aviat Space Environ Med, 1985, 56(5): 436-440,

[40.] Racinais S, Alonso J-M, Coutts AJ, Flouris AD, Girard O, González-Alonso J, Hausswirth C, Jay O, Lee JKW, Mitchell N. Consensus recommendations on training and competing in the heat. Scand J Med Sci Sports, 2015, 25: 6-19,

[41.] Racinais S, Casa DJ, Brocherie F, Ihsan M. Translating science into practice: the perspective of the Doha 2019 IAAF World Championships in the heat. Front Sports Active Living, 2019, 1: 39,

[42.] Racinais S, Havenith G, Aylwin P, Ihsan M, Taylor L, Adami PE, Adamuz M-C, Alhammoud M, Alonso JM, Bouscaren N, Buitrago S, Cardinale M, van Dyk N, Esh CJ, Gomez-Ezeiza J, Garrandes F, Holtzhausen L, Labidi M, Lange G, Lloyd A, Moussay A, Mtibaa K, Townsend N, Wilson MG, Bermon S. Association between thermal responses, medical events, performance, heat acclimation and health status in male and female elite athletes during the 2019 Doha World Athletics Championships. Br J Sports Med., 2022, 56(8): 439-45,

[43.] Racinais S, Ihsan M, Taylor L, Cardinale M, Adami PE, Alonso JM, Bouscaren N, Buitrago S, Esh CJ, Gomez-Ezeiza J, Garrandes F, Havenith G, Labidi M, Lange G, Lloyd A, Moussay S, Mtibaa K, Townsend N, Wilson MJ, Bermon S. Hydration and cooling in elite athletes: relationship with performance, body mass loss and body temperatures during the Doha 2019 IAAF World Athletics Championships. Br J Sports Med., 2021, 55(23): 1335-41,

[44.] Reeve T, Gordon R, Laursen PB, Lee JKW, Tyler CJ. Impairment of cycling capacity in the heat in well-trained endurance athletes after high-intensity short-term heat acclimation. Int J Sports Physiol Perform, 2019, 14(8): 1058-1065,

[45.] Saat M, Sirisinghe RG, Singh R, Tochihara Y. Effects of short-term exercise in the heat on thermoregulation, blood parameters, sweat secretion and sweat composition of tropic-dwelling subjects. J Physiol Anthropol Appl Hum Sci, 2005, 24(5): 541-549,

[46.] Schmit C, Duffield R, Hausswirth C, Brisswalter J, Le Meur Y. Optimizing heat acclimation for endurance athletes: high- versus low-intensity training. Int J Sports Physiol Perform, 2018, 13(6): 816-823,

[47.] Stanley J, Peake JM, Buchheit M. Consecutive days of cold water immersion: effects on cycling performance and heart rate variability. Eur J Appl Physiol, 2013, 113(2): 371-384,

[48.] Stein HJ, Eliot JW, Bader RA. Physiological reactions to cold and their effects on the retention of acclimatization to heat. J Appl Physiol, 1949, 1(8): 575-585,

[49.] Stephens JM, Sharpe K, Gore C, Miller J, Slater GJ, Versey N, Peiffer J, Duffield R, Minette GM, Crampton D, Dunne A, Askew CD, Halson SL. Core temperature responses to cold-water immersion recovery: a pooled-data analysis. Int J Sports Physiol Perform., 2018, 13(7): 917-25,

[50.] Stevens CJ, Taylor L, Dascombe BJ. Cooling during exercise: an overlooked strategy for enhancing endurance performance in the heat. Sports Med, 2017, 47(5): 829-841,

[51.] Taylor NAS, Cotter JD. Heat adaptation: guidelines for the optimisation of human performance. Int SportMed J, 2006, 7(1): 33-57

[52.] Tyler CJ, Reeve T, Hodges GJ, Cheung SS. The effects of heat adaptation on physiology, perception and exercise performance in the heat: a meta-analysis. Sports Med, 2016, 46(11): 1699-1724,

[53.] Vaile J, Halson S, Gill N, Dawson B. Effect of cold water immersion on repeat cycling performance and thermoregulation in the heat. J Sports Sci, 2008, 26(5): 431-440,

[54.] Vaile J, Halson S, Gill N, Dawson B. Effect of hydrotherapy on recovery from fatigue. Int J Sports Med, 2008, 29(7): 539-544,

[55.] Waldron M, Jeffries O, Tallent J, Patterson S, Nevola V. The time course of adaptations in thermoneutral maximal oxygen consumption following heat acclimation. Eur J Appl Physiol, 2019, 119(10): 2391-2399, pmcid: 6763528,

[56.] Willmott AGB, Hayes M, James CA, Gibson OR, Maxwell NS. Heat acclimation attenuates the increased sensations of fatigue reported during acute exercise-heat stress. Temperature, 2020, 7(2): 178-190,