{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:08:07Z","timestamp":1785434887270,"version":"3.56.0"},"reference-count":45,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Axanova AG"},{"name":"University of Applied Sciences and Arts of Southern Switzerland"},{"id":[{"id":"https:\/\/ror.org\/05ep8g269","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Local cryotherapy is widely used to support recovery after exercise-induced muscle damage, but the optimal timing of cold application remains unclear. This study evaluated whether immediate or delayed local cooling influences recovery from exercise-induced muscle fatigue. Methods: Forty-eight healthy adults (39 women, 9 men; age 22 \u00b1 3 years) performed a single-leg eccentric leg-extension protocol to induce delayed-onset muscle soreness (DOMS) and were randomized to immediate cooling (ICG), delayed cooling (DCG; starting 24 h post-exercise), or control (CG) in a 1:1:1 ratio. Reusable gel packs (20 min per session) were applied to the vastus lateralis. DOMS, maximal voluntary isometric contraction (MVIC), creatine kinase (CK), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and ultrasound-derived muscle thickness (MT) were assessed at baseline and at 24, 48 and 72 h post-exercise and analyzed using linear mixed-effects models. Results: No condition or condition-by-time interactions were detected for the primary outcomes (DOMS, MVIC). Significant linear time effects were observed for DOMS, CK and ESR; MVIC decreased acutely and gradually recovered. A contrast-specific time-by-condition interaction for CRP did not indicate a systematic recovery advantage, and MT showed only minor temporal fluctuations. Conclusion: Neither immediate nor delayed cooling provided a meaningful recovery advantage over the control. The protocol reproducibly elicited fatigue and recovery dynamics, supporting its utility as a framework for future cryotherapy research.<\/jats:p>","DOI":"10.3390\/ijerph23070887","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T16:16:44Z","timestamp":1783613804000},"page":"887","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Immediate and Delayed Repeated Cold Exposure After Physical Exertion: A Randomized Controlled Trial"],"prefix":"10.3390","volume":"23","author":[{"given":"Callum","family":"Buehler","sequence":"first","affiliation":[{"name":"Rehabilitation and Exercise Science Laboratory (RESlab), Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 7302 Landquart, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronja","family":"Romitti","sequence":"additional","affiliation":[{"name":"Rehabilitation and Exercise Science Laboratory (RESlab), Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 7302 Landquart, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1788-2401","authenticated-orcid":false,"given":"Vanessa","family":"Wellauer","sequence":"additional","affiliation":[{"name":"Rehabilitation and Exercise Science Laboratory (RESlab), Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 7302 Landquart, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7125-5332","authenticated-orcid":false,"given":"Ron","family":"Clijsen","sequence":"additional","affiliation":[{"name":"Rehabilitation and Exercise Science Laboratory (RESlab), Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 7302 Landquart, Switzerland"},{"name":"Department of Physiotherapy, International University of Applied Sciences THIM, 7302 Landquart, Switzerland"},{"name":"School of Health Professions, Division of Physiotherapy, Bern University of Applied Sciences, 3012 Bern, Switzerland"},{"name":"Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1050 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2101-0211","authenticated-orcid":false,"given":"Erich","family":"Hohenauer","sequence":"additional","affiliation":[{"name":"Rehabilitation and Exercise Science Laboratory (RESlab), Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 7302 Landquart, Switzerland"},{"name":"Faculty of Sport Sciences, University of Poitiers, 86000 Poitiers, France"},{"name":"Department of Movement and Sport Sciences, Faculty of Medicine, University of Fribourg, 1700 Fribourg, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"ref_1","first-page":"1201","article-title":"Recovery and Performance in Sport: Consensus Statement","volume":"48","author":"Kellmann","year":"2018","journal-title":"Sport. 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