What question did this study set out to answer?

To evaluate the impact of contrast therapy on recovery from climbing-specific forearm fatigue in amateur climbers.

June 27, 2026Open Access

Effects of Repeated Contrast Therapy on Forearm Microcirculatory and Neuromechanical Recovery After Climbing-Specific Fatigue in Amateur Climbers: A Randomized Controlled Trial

MHMagdalena Hagner–DerengowskaNicolaus Copernicus University BKBartłomiej KacprzakGdansk University of Physical Education and Sport AMAnna MichalskaNicolaus Copernicus University

Key Points

To evaluate the impact of contrast therapy on recovery from climbing-specific forearm fatigue in amateur climbers.
Randomized controlled trial with 40 amateur climbers assigned to passive recovery or contrast therapy.
Intervention involved bilateral forearm treatment with alternating cold and heat phases for 20 min, administered post-fatigue and bi-weekly for 8 weeks.
Outcomes measured included perfusion, hyperemia, stiffness, pain threshold, grip strength, and biomarkers at various time points.
Contrast therapy improved resting perfusion at 24 h (+7.28 percentage points, 95% CI 6.58 to 7.98) and 48 h (+7.62, 95% CI 6.94 to 8.31; both p < 0.001).
At week 8, contrast therapy resulted in enhanced peak hyperemic perfusion (+6.21 PU, 95% CI 5.62 to 6.79; p < 0.001).
Recovery benefits included reduced stiffness (-71.7 N/m, 95% CI -75.6 to -67.8), improved pain threshold (+8.1 N/cm2, 95% CI 7.3 to 8.8), and increased grip strength (+7.8 kgf, 95% CI 7.3 to 8.3; all p < 0.001).

Abstract

Objective: To determine whether contrast therapy improves recovery after climbing-specific forearm fatigue in amateur climbers. Methods: In a randomized repeated-measures trial, 40 climbers were allocated to passive recovery (n = 20) or Game Ready contrast therapy (n = 20). Both groups completed a fixed-task intermittent fingerboard protocol on a 20 mm edge using a half-crimp grip, with 7 s of work and 3 s of rest for five sets; the load was not individualized to climbing-specific maximal finger-flexor force. The intervention group received bilateral forearm treatment consisting of alternating 1 min cold (3 °C) and heat (45 °C) phases combined with pneumatic compression ranging from 15 to 75 mmHg. Sessions lasted 20 min and were administered immediately after post-fatigue testing, at 24 h and 48 h, and then three times weekly on alternate days for 8 weeks, for a total of 27 sessions. Outcomes were assessed at baseline, immediately after fatigue, at 24 h and 48 h, and after 8 weeks. Outcomes included perfusion, reactive hyperemia, stiffness, pressure pain threshold, grip strength, perceived recovery, creatine kinase, and interleukin-6. Results: Immediate post-fatigue responses were comparable. Contrast therapy produced greater 24 h and 48 h resting perfusion responses (+7.28 percentage points, 95% CI 6.58 to 7.98; +7.62, 95% CI 6.94 to 8.31; both adjusted p < 0.001). At week 8, peak hyperemic perfusion improved more with contrast therapy (+6.21 PU, 95% CI 5.62 to 6.79; p < 0.001). Recovery favored contrast therapy for stiffness at 48 h (−71.7 N/m, 95% CI −75.6 to −67.8), pressure pain threshold at week 8 (+8.1 N/cm2, 95% CI 7.3 to 8.8), and grip strength at 48 h (+7.8 kgf, 95% CI 7.3 to 8.3; all p < 0.001). CK and IL-6 differences were transient, and no serious adverse events or intervention-related discontinuations were recorded. Conclusions: Contrast therapy was associated with more favorable cutaneous perfusion, post-occlusive reactive hyperemia-derived, and neuromechanical recovery outcomes, whereas biochemical differences were limited and time-dependent. The vascular findings do not establish improved endothelial function or nitric-oxide-mediated vasodilation because these mechanisms were not directly assessed. Trial registration: ISRCTN49499065 on 23 June 2025.

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