Effects of cold-water, contrast-water therapy, and active recovery on blood biomarkers and pain in basketball players

Abstract Study aim This study evaluated the effects of active recovery (AR), cold-water immersion (CWI), contrast-water therapy (CWT), and a no-recovery control (CWR) on creatine kinase (CK), myoglobin (Mb), and pain pressure thresholds (PPT) in national-level basketball players across three time points: immediately post-match, 24 h, and 48 h post-match. Materials and methods Twenty professional players participated in a randomized crossover trial in which each underwent all four conditions. A single intervention was applied post-match, with CK and Mb levels assessed at each time point, and PPT measured on the quadriceps and triceps surae. Results All conditions showed peak CK and Mb levels at 24 h post-match, followed by a decline at 48 h. Significant time effects were observed ( p < 0.001), with condition × time interactions for all variables ( η 2 = 0.26–0.94). Unexpectedly, the CWR condition had the lowest CK and Mb concentrations and highest PPT values at 48 h, indicating better biochemical and nociceptive recovery. CWI resulted in significantly lower PPT compared to AR, CWT, and CWR ( p < 0.001). After accounting for baseline differences using analysis of covariance (ANCOVA), condition effects remained significant at both 24 h and 48 h post-match (all p < 0.01, η 2 p = 0.15–0.91). Conclusion While AR, CWI, and CWT affected muscle damage and pain sensitivity, CWR led to the most favorable outcomes, suggesting that a single recovery intervention may not outperform rest. Notably, CWI was less effective for pain sensitivity despite moderating biomarkers.