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Cooling During Exercise: An Overlooked Strategy for Enhancing Endurance Performance in the Heat

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Abstract

It is well established that endurance performance is negatively affected by environmental heat stress due to a complex interaction of physical, physiological and psychological alterations. Numerous scientific investigations have attempted to improve performance in the heat with pre-cooling (cooling prior to an exercise test), and as such this has become a well-established ergogenic practice for endurance athletes. However, the use of mid-cooling (cooling during an exercise test) has received considerably less research attention in comparison, despite recent evidence to suggest that the advantage gained from mid-cooling may outweigh that of pre-cooling. A range of mid-cooling strategies are beneficial for endurance performance in the heat, including the ingestion of cold fluids and ice slurry, both with and without menthol, as well as cooling of the neck and face region via a cooling collar or water poured on the head and face. The combination of pre-cooling and mid-cooling has also been effective, but few comparisons exist between the timing and type of such interventions. Therefore, athletes should experiment with a range of suitable mid-cooling strategies for their event during mock competition scenarios, with the aim to determine their individual tolerable limits and performance benefits. Based on current evidence, the effect of mid-cooling on core temperature appears largely irrelevant to any subsequent performance improvements, while cardiovascular, skin temperature, central nervous system function and psychophysiological factors are likely involved. Research is lacking on elite athletes, and as such it is currently unclear how this population may benefit from mid-cooling.

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References

  1. De Paula Viveiros J, Amorim FT, Alves MN, et al. Run performance of middle-aged and young adult runners in the heat. Int J Sports Med. 2012;33(3):211–7.

    Article  Google Scholar 

  2. Peiffer JJ, Abbiss CR. Influence of environmental temperature on 40 km cycling time-trial performance. Int J Sports Physiol Perform. 2011;6(2):208–20.

    Article  PubMed  Google Scholar 

  3. Racinais S, Alonso JM, Coutts AJ, et al. Consensus recommendations on training and competing in the heat. Br J Sports Med. 2015;49(18):1164–73.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Tyler CJ, Sunderland C, Cheung SS. The effect of cooling prior to and during exercise on exercise performance and capacity in the heat: a meta-analysis. Br J Sports Med. 2015;49(1):7–13.

    Article  PubMed  Google Scholar 

  5. Quod MJ, Martin DT, Laursen PB. Cooling athletes before competition in the heat: comparison of techniques and practical considerations. Sports Med. 2006;36(8):671–82.

    Article  PubMed  Google Scholar 

  6. Bongers CC, Thijssen DH, Veltmeijer MT, et al. Precooling and percooling (cooling during exercise) both improve performance in the heat: a meta-analytical review. Br J Sports Med. 2015;49(6):377–84.

    Article  PubMed  Google Scholar 

  7. Stevens CJ, Kittel A, Sculley DV, et al. Running performance in the heat is improved by similar magnitude with pre-exercise cold-water immersion and mid-exercise facial water spray. J Sport Sci. doi:10.1080/02640414.2016.1192294.

  8. Stevens CJ, Bennett KJM, Sculley DV, et al. A comparison of mixed-method cooling interventions on pre-loaded running performance in the heat. J Strength Cond Res. doi:10.1519/JSC.0000000000001532.

  9. Arngrimsson SA, Petitt DS, Stueck MG, et al. Cooling vest worn during active warm-up improves 5-km run performance in the heat. J Appl Physiol. 2004;96(5):1867–74.

    Article  PubMed  Google Scholar 

  10. Tyler CJ, Sunderland C. Cooling the neck region during exercise in the heat. J Athl Train. 2011;46(1):61–8.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Hasegawa H, Takatori T, Komura T, et al. Wearing a cooling jacket during exercise reduces thermal strain and improves endurance exercise performance in a warm environment. J Strength Cond Res. 2005;19(1):122–8.

    PubMed  Google Scholar 

  12. Luomala MJ, Oksa J, Salmi JA, et al. Adding a cooling vest during cycling improves performance in warm and humid conditions. J Therm Biol. 2012;37(1):47–55.

    Article  Google Scholar 

  13. Riera F, Tran Trong T, Sinnapah S, et al. Physical and perceptual cooling with beverages to increase cycle performance in a tropical climate. PLoS One. 2014;9(8):e103718.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Schulze E, Daanen HA, Levels K, et al. Effect of thermal state and thermal comfort on cycling performance in the heat. Int J Sports Physiol Perform. 2015;10(5):655–63.

    Article  PubMed  Google Scholar 

  15. Ansley L, Marvin G, Sharma A, et al. The effects of head cooling on endurance and neuroendocrine responses to exercise in warm conditions. Physiol Res. 2008;57(6):863–72.

    CAS  PubMed  Google Scholar 

  16. Mundel T, King J, Collacott E, et al. Drink temperature influences fluid intake and endurance capacity in men during exercise in a hot, dry environment. Exp Physiol. 2006;91(5):925–33.

    Article  PubMed  Google Scholar 

  17. Kenny GP, Schissler AR, Stapleton J, et al. Ice cooling vest on tolerance for exercise under uncompensable heat stress. J Occup Environ Hyg. 2011;8(8):484–91.

    Article  PubMed  Google Scholar 

  18. McFarlin BK, Henning AL, Venable AS, et al. A shirt containing multistage phase change material and active cooling components was associated with increased exercise capacity in a hot, humid environment. Ergonomics. 2015. doi:10.1080/00140139.2015.1108460:1-7.

  19. Schlader ZJ, Simmons SE, Stannard SR, et al. The independent roles of temperature and thermal perception in the control of human thermoregulatory behavior. Physiol Behav. 2011;103(2):217–24.

    Article  CAS  PubMed  Google Scholar 

  20. Mundel T, Jones DA. The effects of swilling an L(−)-menthol solution during exercise in the heat. Eur J Appl Physiol. 2010;109(1):59–65.

    Article  PubMed  Google Scholar 

  21. Scheadler CM, Saunders NW, Hanson NJ, et al. Palm cooling does not improve running performance. Int J Sports Med. 2013;34(8):732–5.

    Article  CAS  PubMed  Google Scholar 

  22. Hsu AR, Hagobian TA, Jacobs KA, et al. Effects of heat removal through the hand on metabolism and performance during cycling exercise in the heat. Can J Appl Physiol. 2005;30(1):87–104.

    Article  PubMed  Google Scholar 

  23. Stevens C, Dascombe B. The reliability and validity of protocols for the assessment of endurance sports performance: an updated review. Meas Phys Educ Exerc Sci. 2015;19(4):177–85.

    Article  Google Scholar 

  24. Teunissen LP, de Haan A, de Koning JJ, et al. Effects of wind application on thermal perception and self-paced performance. Eur J Appl Physiol. 2013;113(7):1705–17.

    Article  CAS  PubMed  Google Scholar 

  25. Minniti A, Tyler CJ, Sunderland C. Effects of a cooling collar on affect, ratings of perceived exertion, and running performance in the heat. Eur J Sport Sci. 2011;11(6):419–29.

    Article  Google Scholar 

  26. Tyler CJ, Sunderland C. Neck cooling and running performance in the heat: single versus repeated application. Med Sci Sports Exerc. 2011;43(12):2388–95.

    Article  PubMed  Google Scholar 

  27. Tyler CJ, Wild P, Sunderland C. Practical neck cooling and time-trial running performance in a hot environment. Eur J Appl Physiol. 2010;110(5):1063–74.

    Article  PubMed  Google Scholar 

  28. Eijsvogels TM, Bongers CC, Veltmeijer MT, et al. Cooling during exercise in temperate conditions: impact on performance and thermoregulation. Int J Sports Med. 2014;35(10):840–6.

    Article  CAS  PubMed  Google Scholar 

  29. Barwood MJ, Corbett J, Thomas K, et al. Relieving thermal discomfort: effects of sprayed L-menthol on perception, performance, and time trial cycling in the heat. Scand J Med Sci Sports. 2015;25(Suppl 1):211–8.

    Article  PubMed  Google Scholar 

  30. Barwood MJ, Corbett J, White D, et al. Early change in thermal perception is not a driver of anticipatory exercise pacing in the heat. Br J Sports Med. 2012;46(13):936–42.

    Article  PubMed  Google Scholar 

  31. Barwood MJ, Corbett J, White DK. Spraying with 0.20% L-menthol does not enhance 5 k running performance in the heat in untrained runners. J Sports Med Phys Fit. 2014;54(5):595–604.

    CAS  Google Scholar 

  32. Stevens CJ, Thoseby B, Sculley DV, et al. Running performance and thermal sensation in the heat are improved with menthol mouth rinse but not ice slurry ingestion. Scand J Med Sci Sports. doi:10.1111/sms.12555.

  33. Maunder E, Laursen PB, Kilding AE. Effect of ad libitum ice slurry and cold fluid ingestion on cycling time-trial performance in the heat. Int J Sports Physiol Perform. 2016;. doi:10.1123/ijspp.2015-0764.

    Google Scholar 

  34. Lee JK, Shirreffs SM, Maughan RJ. Cold drink ingestion improves exercise endurance capacity in the heat. Med Sci Sports Exerc. 2008;40(9):1637–44.

    Article  PubMed  Google Scholar 

  35. Tran Trong T, Riera F, Rinaldi K, et al. Ingestion of a cold temperature/menthol beverage increases outdoor exercise performance in a hot, humid environment. PLoS One. 2015;10(4):e0123815.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Nybo L, Rasmussen P, Sawka MN. Performance in the heat—physiological factors of importance for hyperthermia-induced fatigue. Compr Physiol. 2014;4(2):657–89.

    Article  PubMed  Google Scholar 

  37. Cheung SS. Interconnections between thermal perception and exercise capacity in the heat. Scand J Med Sci Sports. 2010;20(Suppl 3):53–9.

    Article  PubMed  Google Scholar 

  38. Cheung SS, Sleivert GG. Multiple triggers for hyperthermic fatigue and exhaustion. Exerc Sport Sci Rev. 2004;32(3):100–6.

    Article  PubMed  Google Scholar 

  39. Lee DT, Haymes EM. Exercise duration and thermoregulatory responses after whole body precooling. J Appl Physiol. 1995;79(6):1971–6.

    CAS  PubMed  Google Scholar 

  40. Olschewski H, Bruck K. Thermoregulatory, cardiovascular, and muscular factors related to exercise after precooling. J Appl Physiol. 1988;64(2):803–11.

    CAS  PubMed  Google Scholar 

  41. Brisson GR, Boisvert P, Peronnet F, et al. Face cooling-induced reduction of plasma prolactin response to exercise as part of an integrated response to thermal stress. Eur J Appl Physiol Occup Physiol. 1989;58(8):816–20.

    Article  CAS  PubMed  Google Scholar 

  42. Gisolfi CV, Copping JR. Thermal effects of prolonged treadmill exercise in the heat. Med Sci Sports. 1974;6(2):108–13.

    CAS  PubMed  Google Scholar 

  43. Filingeri D, Fournet D, Hodder S, et al. Mild evaporative cooling applied to the torso provides thermoregulatory benefits during running in the heat. Scand J Med Sci Sports. 2015;25(Suppl 1):200–10.

    Article  PubMed  Google Scholar 

  44. Morris NB, Coombs G, Jay O. Ice slurry ingestion leads to a lower net heat loss during exercise in the heat. Med Sci Sports Exerc. 2016;48(1):114–22.

    Article  PubMed  Google Scholar 

  45. Sawka MN, Cheuvront SN, Kenefick RW. High skin temperature and hypohydration impair aerobic performance. Exp Physiol. 2012;97(3):327–32.

    Article  PubMed  Google Scholar 

  46. Gonzalez-Alonso J, Teller C, Andersen SL, et al. Influence of body temperature on the development of fatigue during prolonged exercise in the heat. J Appl Physiol. 1999;86(3):1032–9.

    CAS  PubMed  Google Scholar 

  47. Tatterson AJ, Hahn AG, Martin DT, et al. Effects of heat stress on physiological responses and exercise performance in elite cyclists. J Sci Med Sport. 2000;3(2):186–93.

    Article  CAS  PubMed  Google Scholar 

  48. Ely BR, Cheuvront SN, Kenefick RW, et al. Aerobic performance is degraded, despite modest hyperthermia, in hot environments. Med Sci Sports Exerc. 2010;42(1):135–41.

    Article  PubMed  Google Scholar 

  49. Drinkwater E. Effects of peripheral cooling on characteristics of local muscle. Med Sport Sci. 2008;53:74–88.

    Article  PubMed  Google Scholar 

  50. Nybo L, Nielsen B. Hyperthermia and central fatigue during prolonged exercise in humans. J Appl Physiol. 2001;91(3):1055–60.

    CAS  PubMed  Google Scholar 

  51. Nybo L, Gonzalez-Alonso J. Critical core temperature: a hypothesis too simplistic to explain hyperthermia-induced fatigue. Scand J Med Sci Sports. 2015;25(Suppl 1):4–5.

    Article  PubMed  Google Scholar 

  52. Veltmeijer MT, Eijsvogels TM, Thijssen DH, et al. Incidence and predictors of exertional hyperthermia after a 15-km road race in cool environmental conditions. J Sci Med Sport. 2015;18(3):333–7.

    Article  PubMed  Google Scholar 

  53. Taylor L, Mauger AR, Watkins SL, et al. Precooling does not improve 2,000-m rowing performance of females in hot, humid conditions. J Strength Cond Res. 2014;28(12):3416–24.

    Article  PubMed  Google Scholar 

  54. Tucker R, Rauch L, Harley YX, et al. Impaired exercise performance in the heat is associated with an anticipatory reduction in skeletal muscle recruitment. Pflügers Archiv. 2004;448(4):422–30.

    Article  CAS  PubMed  Google Scholar 

  55. Siegel R, Mate J, Watson G, et al. The influence of ice slurry ingestion on maximal voluntary contraction following exercise-induced hyperthermia. Eur J Appl Physiol. 2011;111(10):2517–24.

    Article  PubMed  Google Scholar 

  56. Duffield R, Green R, Castle P, et al. Precooling can prevent the reduction of self-paced exercise intensity in the heat. Med Sci Sports Exerc. 2010;42(3):577–84.

    Article  PubMed  Google Scholar 

  57. Randall CA, Ross EZ, Maxwell NS. Effect of practical precooling on neuromuscular function and 5-km time-trial performance in hot, humid conditions among well-trained male runners. J Strength Cond Res. 2015;29(7):1925–36.

    Article  PubMed  Google Scholar 

  58. Morrison S, Sleivert GG, Cheung SS. Passive hyperthermia reduces voluntary activation and isometric force production. Eur J Appl Physiol. 2004;91(5–6):729–36.

    Article  PubMed  Google Scholar 

  59. Wilson TE, Cui J, Zhang R, et al. Heat stress reduces cerebral blood velocity and markedly impairs orthostatic tolerance in humans. Am J Physiol Regul Integr Compr Physiol. 2006;291(5):R1443–8.

    Article  CAS  Google Scholar 

  60. Bridge MW, Weller AS, Rayson M, et al. Responses to exercise in the heat related to measures of hypothalamic serotonergic and dopaminergic function. Eur J Appl Physiol. 2003;89(5):451–9.

    Article  CAS  PubMed  Google Scholar 

  61. Low D, Purvis A, Reilly T, et al. The prolactin responses to active and passive heating in man. Exp Physiol. 2005;90(6):909–17.

    Article  CAS  PubMed  Google Scholar 

  62. Mundel T, Bunn SJ, Hooper PL, et al. The effects of face cooling during hyperthermic exercise in man: evidence for an integrated thermal, neuroendocrine and behavioural response. Exp Physiol. 2007;92(1):187–95.

    Article  PubMed  Google Scholar 

  63. Stevens C, Dascombe B, Sculley D, et al. Ice slurry ingestion during cycling improves Olympic distance triathlon performance in the heat. J Sports Sci. 2013;31(12):1271–9.

    Article  PubMed  Google Scholar 

  64. Cotter JD, Taylor NA. The distribution of cutaneous sudomotor and alliesthesial thermosensitivity in mildly heat-stressed humans: an open-loop approach. J Physiol. 2005;565(1):335–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Laursen P. From science to practice: development of a thermally-insulated ice slushy dispensing bottle that helps athletes “keep their cool” in hot temperatures. Temperature. 2016;3(2):187.

    Article  Google Scholar 

  66. Cureton KJ, Sparling PB, Evans BW, et al. Effect of experimental alterations in excess weight on aerobic capacity and distance running performance. Med Sci Sports. 1978;10(3):194–9.

    CAS  PubMed  Google Scholar 

  67. Tonnessen E, Haugen TA, Hem E, et al. Maximal aerobic capacity in the winter-Olympics endurance disciplines: Olympic-medal benchmarks for the time period 1990–2013. Int J Sports Physiol Perform. 2015;10(7):835–9.

    Article  PubMed  Google Scholar 

  68. Cheung SS, McLellan TM. Heat acclimation, aerobic fitness, and hydration effects on tolerance during uncompensable heat stress. J Appl Physiol. 1998;84(5):1731–9.

    CAS  PubMed  Google Scholar 

  69. Astokorki AH, Mauger AR. Tolerance of exercise-induced pain at a fixed rating of perceived exertion predicts time trial cycling performance. Scand J Med Sci Sports. doi:10.1111/sms.12659.

  70. Schmit C, Le Meur Y, Duffield R, et al. Heat-acclimatization and pre-cooling: a further boost for endurance performance? Scand J Med Sci Sports. 2015;. doi:10.1111/sms.12629.

    PubMed  Google Scholar 

  71. Morrison SA, Cheung S, Cotter JD. Importance of airflow for physiologic and ergogenic effects of precooling. J Athl Train. 2014;49(5):632–9.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Morris NB, Jay O. To drink or to pour: how should athletes use water to cool themselves? Temperature. 2016;3(2):191–4.

    Article  Google Scholar 

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Correspondence to Christopher J. Stevens.

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Christopher Stevens, Lee Taylor and Ben Dascombe declare that they have no conflicts of interest relevant to the content of this review.

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Stevens, C.J., Taylor, L. & Dascombe, B.J. Cooling During Exercise: An Overlooked Strategy for Enhancing Endurance Performance in the Heat. Sports Med 47, 829–841 (2017). https://doi.org/10.1007/s40279-016-0625-7

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