From the Guidelines
Cold plunges should be approached with caution, particularly for those with underlying medical conditions, and individuals should consult their healthcare provider before starting, especially if they have heart conditions, high blood pressure, Raynaud's disease, or respiratory issues. Safety precautions include limiting initial exposure to 1-3 minutes in water between 50-60°F (10-15°C), never plunging alone, entering gradually to avoid shock, and exiting immediately if experiencing chest pain, severe headache, or confusion 1. Potential benefits of cold plunges include reduced inflammation, improved circulation, enhanced recovery after exercise, mood elevation through endorphin release, and possible immune system stimulation. The physiological response to cold exposure triggers vasoconstriction followed by vasodilation, which may help flush metabolic waste and reduce muscle soreness.
Some key considerations for cold water immersion include:
- Initial core temperature: the effectiveness of cooling methods varies based on the initial core temperature, with ice water immersion being the most effective for high initial core temperatures 1
- Cooling method: different cooling methods have varying effectiveness, with ice water immersion being the most effective, followed by colder water immersion, and then cold water immersion 1
- Target core temperature: the target core temperature for cooling is 39°C (102.2°F), and cooling methods should be adjusted accordingly 1
For beginners, it is recommended to start with shorter durations and warmer temperatures (around 60°F), gradually working toward colder temperatures and longer exposures as tolerance builds. Proper breathing techniques—slow, controlled breaths—help manage the initial cold shock response. Always warm up naturally afterward rather than using hot showers, which can cause rapid blood pressure changes. It is also important to note that cold water immersion may not be suitable for everyone, and alternative cooling methods such as commercial ice packs, cold showers, and evaporative cooling may be used instead 1.
In terms of specific guidelines, the 2024 American Heart Association and American Red Cross guidelines for first aid recommend immediate active cooling using whole-body cool- to cold-water immersion for 15 minutes or until neurological symptoms resolve for adults and children with heatstroke 1. However, for individuals with underlying medical conditions, it is crucial to consult with a healthcare provider before starting cold water immersion to discuss the potential risks and benefits and determine the best course of action.
From the Research
Safety Precautions for Cold Plunges
- Individuals with underlying medical conditions should consult their doctor before taking cold plunges, as it may exacerbate certain conditions 2, 3.
- It is essential to acclimate to cold water gradually to avoid shock and other adverse effects 2.
- Cold plunges should be taken in a safe and controlled environment, with proper supervision and emergency equipment available 4.
Potential Benefits of Cold Plunges
- Cold-water immersion (CWI) has been shown to reduce stress and improve mood, although the effects may be time-dependent 2.
- CWI may also improve sleep quality, quality of life, and immune function, although more research is needed to confirm these findings 2, 5.
- Cold plunges may be beneficial for athletes as a recovery strategy, although the evidence is mixed and more research is needed to determine its effectiveness 6.
Special Considerations for Underlying Medical Conditions
- Individuals with Raynaud's disease may benefit from cold plunges as a treatment, as it can increase digital temperatures and reduce symptoms 3.
- Pregnant women may also benefit from cold water swimming, as it can reduce stress and improve obstetric outcomes, although more research is needed to confirm these findings 5.
- Individuals with other underlying medical conditions, such as heart disease or high blood pressure, should exercise caution and consult their doctor before taking cold plunges, as it may exacerbate their condition 2.