Cold Plunges

Pseudoscience or Just Bullshit?

On a recent podcast, my brother asked me what I thought of cold plunges and whether it might make some good fodder for the ol’ PUMPkin Patch.

I can’t remember exactly what I said, but it was probably something like, “Shut up, I’m trying to talk about something that happened related to my butthole.”

The Rise of the Lowering of the Temperature

Ice has long been a thing we’ve used to help with inflammation. In recent years, it’s been questioned more as we question everything these days, and my take on it is this:

• It’s almost definitely not causing harm

• Its reducing of inflammation is questionable

• Its pain reduction is pretty well-documented, as much as pain can be documented considering pain is very subjective

Overall, my guess about ice for injuries is that it’s been popular because it’s basically free, widely available, and if you’re a youth sports coach, you can’t give someone else’s 9 year old Tylenol anymore than you can give them Percocet or a cortisone shot, but you can reach in a big orange Gatorade jug and tell them to put some ice on it. By the time they’ve done that for 10 minutes or whatever, they probably feel fine because they’re kids and made out of smartfoam and dreams for the future.

Now, you might wonder why this hasn’t been more thoroughly and definitively studied, and I have a great answer for you, courtesy of easydoit2 on reddit:

The issues are 1. Who is going to stop a total knee patient from using ice as a control? 2. Who is going to give funding to do a study on ice?

Both excellent points. You’d have to find thousands of people who are willing to forgo ice after a painful event, and you’d have to find someone willing to give over money with zero chance of seeing one cent come back their way because as of now, it’s kinda hard to monetize water.

Well, it’s hard to monetize the freezing of water. Plenty of assholes out there monetized water.

Anyway, we’re probably in a bit of a holding pattern as far as that goes, but suffice to say that there’s almost certainly no harm in using ice, and because it’s pretty easy to get, if you want to do it, I’m sure your doctor would tell you to go for it.

Now, in more recent years, the full body cold plunge has become a lot more popular.

I’ve done this myself, in the bath tub with bags of ice and the tap running cold. I did it when I had a hip injury that was pretty hard to get at with ice, so I figured that was the best option.

And, I mean, it fuckin’ sucks. It’s not fun. I have distinct memories of listening to Chuck Palahniuk’s Choke, read by the author, on CD audiobook while I did it. Not because I remember the audiobook, but because the memories of doing that shit are so colorful. I hardly remember my wedding day from less than a year ago, and being in that bath tub, shivering, that’ll be with me until I die.

Life blows.

And for a long time, ice baths were the sort of thing you did if you were either a super athlete or you were an amateur, like me, who was desperate enough to feel better that you gave it a go.

Science Bros ATTACK!

A LOT of science bros are proponents of cold plunges. And when science bros start really pushing the benefits of something like this, I’m very skeptical.

Which isn’t 100% fair, science bros do some healthy things, but they also do a lot of bullshit.

I kind of have my trifecta of science bros I don’t really trust, or who, when they do something, I become instantly skeptical.

First on the list is Joe Rogan:

And a VERY close second is Andrew Huberman, especially when his clip has Joe Rogan in the still image:

And third, a more local flavor, is a nearby gym that does a lot of shit I find very questionable.

workoutwest

A post shared by @workoutwest

I mean, the thing is, a lot of nice people work here and work out here, but I’ll never trust a gym that offers tanning. Sorry, but we’ve looked at the receipts, that shit is a huge factor in cancers, and offering people the “opportunity” to increase their cancer risk is bullshit a gym just shouldn’t be a part of.

Why not add a smoker’s lounge? See a dude doing bicep curls while puffing on a cigar, that’s some old school circus strongman bullshit, for sure.

Here’s the problem with science bros: They’re always doing like 400 things. Cold plunges, supplements, weird diets, “protocols,” all kinds of shit, and the rest of us ain’t gonna do all that. Which we shouldn’t, every fitness bro is a sample size of one, and it’s entirely likely that a lot of what they’re doing is unnecessary.

And, see, they might be getting 90% of their benefit from doing something simple and easy, or by walking 30 minutes a day. You might not need 50 different supplements, or they may only be conferring a very tiny benefit, or maybe only like 5 of them actually work, or…

And my take on science bro, fitness bro protocol is that when it’s complicated, when it’s fancy, when they tell you that cold plunges should be done for X time at Y temperature every 17.25 hours, what they’re doing is designing a system that is essentially impossible to follow. And that way, when it doesn’t work, they can say, “Well, you’re not experiencing the benefits because you’re not following the program.”

Even if you’re cold plunging perfectly, if you’re not following Huberman’s highly questionable, seemingly unrelated advice of delaying caffeine intake, you’re not following the program, so it’s your fault you’re not seeing the benefits.

Oh, by the way, Tony Robbins just barely doesn’t make the list, but it should be noted that he’s also a proponent of the cold plunge. I don’t know how he came to be a motivational speaker, but I’m even less sure how he became a health and wellness bro. I guess because they both require the same experience: none experience.

What’s the Science Say?

Interestingly, I found a rare confluence: my local, bro-y gym and FUCKING NPR!

NPR did an article about cold plunges that profiled some folks who meet up once a week and do it, and they explored the proposed benefits. AND, the bro-y gym outlined, in the above linked post, the alleged benefits, and a lot of them are the same between both pieces of media!

Now, a key difference between NPR and the bro-y gym is that NPR has cited its sources, and the bro-y gym has not. But here’s what the bro-y gym had to say:

🌊❄️ Cold plunges are more than just a trend – they're a powerhouse for boosting your health and wellness! Here's why you should dive in:

Improved Circulation: The cold helps boost blood flow and can promote better cardiovascular health.

Reduced Inflammation: Cold water helps reduce muscle soreness and inflammation after intense workouts.

Stress Relief: Cold exposure triggers the release of endorphins, leaving you feeling refreshed and stress-free.

Increased Energy: Cold plunges can give you an instant energy boost and elevate your mood.

Boosted Immune System: Regular cold plunges strengthen the immune system by improving white blood cell count.

So take the plunge, reap the benefits, and enjoy the chill!

Okay, let’s go through these one-by-one, cited NPR article versus Work Out West, which I accuse of using cold plunge videos to drive engagement because it looks like all the cold plunges are women in bikinis.

Boosted Immune System: The results on this are inconclusive (which most people receive as meaning “Whatever you want it to be is more likely what it is”), and even positive potential results show increases in measured biological markers, but it’s my understanding that an increase in individual, specific biomarkers does not necessarily mean your immune system is “better” because immunity is a pretty complex system with a lot of moving parts.

Reduced Inflammation: Interestingly, a lot of the same people coming after ice as an inflammation reducer are big fans of cold plunges for basically the same thing. Again, jury’s out on this.

Improved Circulation: Again, because it’s been studied so little, there’s little to no evidence that the boost in circulation, if it exists at all, persists beyond the time you’re actually in the cold plunge. In addition, “improved” might be an interesting misnomer. For one, when you plunge, your heart beats faster, your blood pressure increases, and your breathing gets faster. So this may be unwise for anyone with a heart condition. Also of note, your blood circulates to your hands and feet, and this is part of how your body regulates its temperature (this is why people with artificial legs often wear shorts, not to show off their cool hardware, but because it’s really hard to regulate your body temperature when your blood has less room to roam). When your body is very cold, it brings more blood into your core in order to keep your vitals a tickin’ (this is why, for example, if you’ve ever done a cold plunge, you might’ve felt clumsy or sluggish when you got out). If you wanted to improve the blood flow to your feet, for example, I’m not sure that the well-understood biological processes support cold plunging as a way to do this.

Stress and Mood

This deserves its own section because, woo, it’s a doozy.

There is a lot of anecdotal evidence about cold plunges and their psychological effects, and I want to talk about that a minute.

Watch any video, hit any Reddit thread, and you will run into a number of people who say cold plunges, or cold showers, or ice baths have cured their depression and got them off of SSRIs.

And…two things:

1. It may be that cold plunging helps with this, but that may have nothing to do with the physiological act and everything to do with the psychology of it. You’re doing something difficult. You’re engaging in a behavior that you think is healthy and maybe a bit unpleasant, and you’re getting through it. It may be that a lot of people doing cold plunges are doing them with groups, like the one profiled in the NPR article, and it may be that the social aspect of going out to the lake with a bunch of people has a psychological effect. Having somewhere you need to be, where people are expecting you, makes it harder to just get loaded on a Friday at home alone and then spend Saturday hung over and miserable. In other words: it might be cold plunges, but it might not be because cold plunges have a physical effect.

2. It may be that you were depressed, and cold plunging was something you were doing to get out of your depression. Now, I can’t be certain, but if you’re doing that, it’s entirely possible you were also doing other things to address your depression. I mean, I think it’s unlikely that a depressed person is depressed, and the one thing they do is a cold plunge, know what I mean? So we may be attributing to cold plunging what really should be attributed to the fact that you were coming out of depression enough to begin cold plunging. Lots of people do take depression medication and don’t stay on it forever, in fact, this is what about 3/4 of people are doing. So it’s not actually defying the odds to be depressed, take meds for a period, feel better, and be off medication. Which means that getting off the meds might mean the meds did exactly what they’re supposed to. Responsibly prescribed medication of this type also comes along with things like CBT. You might be exercising. You might be making an effort to reduce your anxiety in other ways. Point being: you’re probably doing other things to help with your depression, so attributing the results in improved mood to cold plunges is unscientific, at best.

What’s Fair to Say

Saying it’s “being explored” and that we’re “building evidence” is also the same as saying a simpler phrase: “We don’t know.”

And my take on health stuff where the answer is “We don’t know” is that you’re playing a game with your health.

Look, I’m guessing most people aren’t going to suffer adverse effects from jumping into a lake or an ice bath once a week. I’m not here to claim that you’ll be killed by doing this.

Instead, I like to think about these things as what’s to be gained versus what’s lost in terms of opportunity.

When you go do a cold plunge, what might you be doing instead with your time (and money, if you’re buying a tub or whatever) that might have a better researched benefit?

For example, is going to do a cold plunge better, in terms of health outcomes, than spending that time walking? Is it better than writing in a journal?

Overall, I tend to agree with Dr. Mike on this one: Cold plunges are probably only realistic for people who have a lot of money and a lot of time, and while there’s potential benefits, seeing as they are questionable and certainly don’t seem to be high level benefits, I wouldn’t necessarily recommend cold plunges.

Dr. Aaron Cypess also puts it nicely:

Cypess says he isn't ready to dismiss the potential benefits. But until he sees more compelling data, he's not likely to suggest it as a therapy. He has a bigger priority.

"The most important thing is to get the person to exercise," Cypess says. "There is no obvious added benefit to exercising in the cold."

And that’s kind of where I’m at on it.

If you want to plunge, plunge away. I’m not here to stop you.

But if you’re considering cold plunges before you’re getting in some goddamn exercise, you’re — and I rarely say this here — doing it wrong.

And if you do like to be a part of the plunge movement, I would ask you to stop short of spreading bad information, which is currently the only type of information that exists on the efficacy of cold plunges.

The problem with doing that is that when people DON’T get those effects you’re touting, they think they’re doing something wrong or that there’s something wrong with them, and they don’t need more garbage like that making them think they’re doing fitness wrong.

Most importantly, plunge if you like, but DON’T recommend that someone plunge instead of taking prescribed medication and/or going to therapy. Jesus, PLEASE don’t do that.