Icy temps, foam rollers and naps: How World Cup athletes recover

What are top soccer players' secrets to recovery? Portugal superstar Cristiano Ronaldo lounges in a chamber cooled to around minus-160 degrees. France's Karim Benzema covers his back with hickeys. Other soccer stars, at the World Cup and their home clubs, slip into icy water, roll their bodies over foam or squash their limbs into sausage tights.

These efforts are understandable, if a bit outlandish. Recovery is vital in sports. Without it, repeated, strenuous exertion can sap energy, damage muscles and impair subsequent performance, whether you are a starter at the World Cup or a middle-aged runner training for next spring's marathon.

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But which recovery techniques have scientific backing and which rely on magical thinking? Could some even be detrimental? With the World Cup entering its final stages and players battling soreness and fatigue, as well the opposing team, now seems a good time to scan research and talk with experts about what recovery methods work, which are iffy and whether those of us who exercise should freeze and pummel ourselves or, instead, just take a nap.

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Chilling evidence about ice baths

Ice baths are exactly that: tubs filled with water and ice, into which athletes ease themselves after hard sessions, typically for about 10 or 15 bitingly frigid minutes.

This icy dunking is thought to slow muscle damage, dampen inflammation in joints and limbs, and help athletes perform better in the coming days on the pitch or trails. Ice baths are ubiquitous in sports teams' locker rooms, and also popular among recreational runners, cyclists, triathletes and others.

Little science suggests the chill-axing has much effect. In a 2014 study entitled "Postexercise cold water immersion benefits are not greater than the placebo effect," men who steeped themselves after a hard workout in either freezing or tepid water (the placebo) shared subsequent levels of swelling, inflammation and fatigue. The ice bath was no better than the body-temperature soak.

There are hints that frequent ice baths might even blunt muscle building. In several, small studies, weight trainers who ice bathed showed "smaller gains in muscle mass" afterward than other lifters, said Jonathan Peake, a professor at Queensland University of Technology in Australia, who conducted some of the research. The cold temperatures seemed to impede the process of rebuilding muscle tissue frayed during exercise.

There is one area where ice baths deliver: After ice bathing, athletes feel less sore. "The bulk of the evidence points to analgesia as the most prominent effect" of sitting in cold water, said Robert Hyldahl, an exercise scientist at Brigham Young University in Provo, Utah, who co-wrote a 2020 review of research about recovery techniques.

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What about cryotherapy?

In cryotherapy, you enter a special chamber usually cooled to below minus-150 Fahrenheit, which is only slightly balmier than the moon's surface at night. You remain there for a minute or two.

But LeBron James, Steph Curry and many other basketball and American football players tout cryotherapy for recovery, as does the 37-year-old Ronaldo. At the Qatar World Cup, Brazilian superstars Neymar and Danilo both reportedly took to cryotherapy chambers in the tiny nation after they picked up painful ankle knocks in the tournament's early rounds. They returned to Brazil's lineup for their quarterfinal game.

Cryotherapy is thought to greatly decrease muscle soreness and inflammation, flush fluids and other substances from muscles and otherwise make athletes' bodies readier, quicker, for their next match, practice or run.

Does it? The evidence suggests not. In a 2019 study, cryotherapy was no better after a hard workout at reducing markers of inflammation or muscle damage than sitting quietly. A comprehensive 2015 Cochrane review of earlier studies concluded there was "insufficient evidence" to show cryotherapy sped up sports recovery in any physiologically meaningful way.

A word of warning about cryotherapy: do not wear damp clothing. In 2011, the American sprinter Justin Gatlin developed severe frostbite on his feet after entering a cryotherapy chamber in sweaty socks. Oakland Raiders wide receiver Antonio Brown likewise froze his feet in 2019, when he skipped protective footwear. Both eventually recovered.

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Cupping leaves its mark (but that's it)

Cupping, made famous by the champion Olympic swimmer Michael Phelps at the 2016 Olympics in Brazil, involves small suction cups attached, leech-like, to sore muscles that supposedly draw blood to the area and toxins from the tissue, advancing physical healing and recovery, while leaving small purple rings on the skin, similar to hickeys.

Benzema, a striker for France who is injured, posted a photo of himself on Twitter covered with cupping rings.

Science provides little support for effects beyond the aesthetic and psychological. A 2021 study with people experiencing back pain found cupping was "no better" at reducing pain or improving physical function than a sham, placebo version, in which cups were placed, but hardly any suction applied, said Hugo Jário Almeida Silva, a doctoral candidate at the Federal University of Rio Grande do Norte in Brazil, who led the study.

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Does compression clothing make a difference?

Athletes love compression clothing, not only at the World Cup but in almost every sport and activity. (I've worn compression socks during road races.)

Studies looking into whether these tight, squeezy garments lessen muscle soreness or improve later performance have been "largely equivocal," said Jonathon Weakley, a lecturer at the Sports Performance, Recovery, Injury & New Technologies Research Centre at Australian Catholic University in Brisbane, who has studied compression clothes.

Most research shows "they do not provide any real benefit to recovery or physical performance," he said.

But to some athletes, they feel effective, a perception with consequence. "If someone feels less fatigued, then this is likely beneficial and may improve performance," Weakley said.

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Foam rolling is a good bet. Massage guns might be.

Interestingly, the most valuable recovery techniques may be the lowest-tech. Foam rolling, for instance, in which you forcefully roll tired muscles for a few seconds over a tube of compressed foam (or vice versa) staved off soreness and contributed to better subsequent exercise performance in a 2014 study of men who had just finished an exhausting workout. Other research of foam rolling has produced similar results, although none show precisely how rolling might influence tissues.

"It seems from the extensive evidence that foam rolling does have positive physical ramifications," said David Behm, an exercise scientist at Memorial University of Newfoundland in Canada, who has studied foam rolling.

The evidence is more limited but promising for another popular recovery pummeling option, massage guns, reportedly in wide use among World Cup players. A small 2021 study found the device was as effective as foam rolling at reducing leg muscle stiffness after strenuous resistance exercise.

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Try chocolate milk and a good nap

The basics - rest and nutrition - also are key to sports recovery, scientists agree. Aim to replenish fluids and fuel as soon as possible, preferably with some combination of carbohydrates and protein to restock energy stores and help rebuild muscle. Or, for the sake of simplicity and delight, have some chocolate milk.

"We think chocolate milk is great," said Michael Nordvall, a professor at Marymount University in Virginia, who, with his colleague Alexei Wong and others, plied collegiate female badminton players with low-fat chocolate milk or a placebo drink after intense practices for a 2022 study. They found the women performed substantially better later if they recovered with chocolate milk.

Finally, there is my own preferred method of exercise recovery: a nice lie-down. A 2021 review of research about athletes and napping concluded an afternoon nap can be "beneficial for a range of outcomes that benefit athletes," a finding I will use to justify snoozing through halftime of the England-France quarterfinal match after my long run on Saturday.

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