Do We Need A Cool-Down After Exercise A Narrative

Sports Med (2018) 48:1575–1595
https://doi.org/10.1007/s40279-018-0916-2
REVIEW ARTICLE
Do We Need a Cool-Down After Exercise? A Narrative Review

of the Psychophysiological Effects and the Effects on Performance,
Injuries and the Long-Term Adaptive Response
Bas Van Hooren1,2 • Jonathan M. Peake3,4
Published online: 16 April 2018

Ó The Author(s) 2018
Abstract It is widely believed that an active cool-down is respiratory systems. However, it is unknown whether this
more effective for promoting post-exercise recovery than a reduces the likelihood of post-exercise illnesses, syncope,
passive cool-down involving no activity. However, and cardiovascular complications. Most evidence indicates
research on this topic has never been synthesized and it that active cool-downs do not significantly reduce muscle
therefore remains largely unknown whether this belief is soreness, or improve the recovery of indirect markers of
correct. This review compares the effects of various types muscle damage, neuromuscular contractile properties,
of active cool-downs with passive cool-downs on sports musculotendinous stiffness, range of motion, systemic
performance, injuries, long-term adaptive responses, and hormonal concentrations, or measures of psychological
psychophysiological markers of post-exercise recovery. An recovery. It can also interfere with muscle glycogen
active cool-down is largely ineffective with respect to resynthesis. In summary, based on the empirical evidence
enhancing same-day and next-day(s) sports performance, currently available, active cool-downs are largely ineffec-
but some beneficial effects on next-day(s) performance tive for improving most psychophysiological markers of
have been reported. Active cool-downs do not appear to post-exercise recovery, but may nevertheless offer some
prevent injuries, and preliminary evidence suggests that benefits compared with a passive cool-down.
performing an active cool-down on a regular basis does not
attenuate the long-term adaptive response. Active cool-
downs accelerate recovery of lactate in blood, but not
Key Points
necessarily in muscle tissue. Performing active cool-downs
may partially prevent immune system depression and
Many individuals regularly perform 5–15 min of
promote faster recovery of the cardiovascular and
low- to moderate-intensity exercises within
approximately 1 h after their practice and
& Bas Van Hooren competition (i.e., active cool-downs) in an attempt to
[email protected]; facilitate recovery.
[email protected]
An active cool-down is largely ineffective at
1
Department of Nutrition and Movement Sciences, Maastricht improving sports performance later during the same
University Medical Centre?, NUTRIM School of Nutrition day when the time between successive training
and Translational Research in Metabolism,
Universiteitssingel 50, 6229 ER Maastricht, The Netherlands sessions or competitions is [ 4 h. It is most likely
2 ineffective at improving sports performance during
Institute of Sport Studies, Fontys University of Applied
Sciences, Eindhoven, The Netherlands the next day(s), but some beneficial effects have
3 been observed.
School of Biomedical Sciences and Institute of Health and
Biomedical Innovation, Queensland University of An active cool-down does likely not attenuate the
Technology, Brisbane, Australia
long-term adaptive response or prevent injuries.
4
Sport Performance Innovation and Knowledge Excellence,
Queensland Academy of Sport, Brisbane, Australia
123
Content courtesy of Springer Nature, terms of use apply. Rights reserved.

1576 B. Hooren, J. M. Peake
1 Introduction 2 Methods
It is widely assumed that promoting physiological and There are various passive cool-down interventions such as
psychological recovery after exercise allows individuals to sitting rest, saunas, pneumatic leg compression, and elec-
perform better during subsequent training sessions or trostimulation (see Table 1 for an overview) [15–23].
competition, and lowers the risk of injuries. Various However, most non-elite athletes do not have access to a
recovery interventions are therefore used to facilitate sauna or equipment for the other interventions, and most
recovery after exercise. The best known and most widely practitioners also lack the necessary knowledge about how
used post-exercise recovery intervention is (arguably) the best to apply these interventions (partly because of a lack
active cool-down, which is also known as an active of evidence-based guidelines). Even elite team sport
recovery or warm-down. Several surveys show that many players do not always have access to these recovery
team sport players and athletes participating in individual interventions when they play away games [24]. In the
sports regularly perform 5–15 min of low- to moderate- current review, we have therefore only included studies
intensity exercises within approximately 1 h after their that have compared an active cool-down with a passive
practice and competition to facilitate recovery [1–8]. For cool-down that consists of sitting, lying, or standing
example, a recent survey among collegiate athletic trainers (without walking). Active cool-downs that combine exer-
in the USA found that 89% of the trainers recommended a cise with cold water immersion [25] are also excluded. We
cool-down, with 53% of these trainers recommending have also restricted the review to studies that have inves-
jogging as the preferred active cool-down method [1]. tigated the effects of performing an active cool-down
There is currently no formal definition of an active cool- within approximately 1 h after exercise, because findings
down; here, we define it as an activity that involves vol- from a recent survey suggest that this most closely repli-
untary, low- to moderate-intensity exercise or movement cates the cool-down procedure of many recreational and
performed within 1 h after training and competition. professional athletes [7]. Studies that have applied an
Examples of active cool-down interventions and their active recovery for several days after exercise are only
suggested effects are shown in Fig. 1. The effects of discussed if they have (1) applied the active recovery
recovery interventions such as cold-water immersion within 1 h after exercise (i.e., active cool-down) and (2)
[9, 10], compression garments [11, 12], and cryotherapy evaluated recovery before applying the active recovery on
[13, 14] have been reviewed extensively. By contrast, the the next day. Finally, we primarily focus on how active
active cool-down has never been thoroughly reviewed. It cool-downs influence performance and psychophysiologi-
remains largely unknown whether an active cool-down cal variables during successive exercise sessions or com-
offers any benefits compared with a passive cool-down petitions [i.e., approximately [ 4 h after exercise, or
(i.e., no cool-down), and thus whether it is an appropriate during the next day(s)]. This type of recovery has also been
or effective recovery intervention. referred to as ‘training recovery’ [26]. Studies that have
The primary aim of this review is to synthesize the investigated the effects of active recovery between bouts of
evidence as to whether an active cool-down enhances exercise with relatively short rest periods (e.g., 20 min) are
sports performance more effectively than a passive cool- excluded from the review. As such, the findings of this
down when performance is measured after approxi- review will be of primary interest to athletes and practi-
mately [ 4 h after the initial exercise. This review also tioners who regularly use an active cool-down to facilitate
compares the physiological and psychological effects of an recovery between training sessions or competitions, but are
active cool-down to a passive cool-down, and discusses the interested in what evidence exists that supports the use of
effects of an active cool-down on injuries and the long- an active cool-down compared with a passive cool-down.
term adaptive responses to exercise training. The value of Relevant studies have been searched in the electronic
static stretching and foam rolling as cool-down interven- databases of Google Scholar and Pubmed using combina-
tions is briefly discussed in separate sections because these tions of keywords and Booleans that included (cool-down
interventions are both frequently performed in combination OR active recovery OR warm-down) AND (sports perfor-
with an active cool-down. mance OR recover OR recovery OR physiological OR
physiology OR psychological OR psychology OR injury
OR injuries OR long-term adaptive response OR adapta-
tion). Forward citation and reference lists of relevant arti-
cles were examined, and databases with e-published ahead
of print articles from relevant journals were searched to
identify additional articles.
123

Cool-Down after Exercise? 1577
Fig. 1 Infographic of active cool-down interventions and their commonly proposed psychophysiological effects
3 Effects on Sports Performance 3.1 Same-Day Performance
In principle, better psychophysiological recovery following Elite athletes often train or compete more than once a day,
exercise may attenuate or prevent performance decre- so recovery interventions between training sessions or
ments—or even enhance performance—during a subse- events may help to restore exercise performance. This
quent training session or competition [27]. The following section only discusses studies that have investigated the
sections discuss the effects of an active cool-down on effects of an active cool-down after at least 4 h of rest
measures of physical performance such as vertical jump between training sessions or competitions to reflect the
height and sprint performance measured later during the effects of an active cool-down on ‘training recovery’ [26].
same day or during the next day(s). Relatively few studies have investigated the benefits of
active cool-downs on performance measured [ 4 h after
123

Table 1 Overview of passive Sitting, standing, or lying rest Cold-water immersion

cool-down/recovery
interventions Sauna Hot-water immersion
Massage Contrast-water therapy
Pneumatic leg compression Cryotherapy
Peristaltic pulse dynamic compression Crycompression therapy
External counterpulsation therapy Flotation Restricted Environmental Stimulation
Compression garments Hyperbaric oxygen therapy
Intermittent negative pressure Foam rollinga
Vascular occlusion Static stretchinga
Local or whole-body vibration therapy Neuromuscular electrical stimulation
Ultrasound therapy Sustained heat treatment
Photo-/light-emitting diodes therapy
Passive recovery interventions are defined here as involving no or minimum voluntary/intentional exercise
or movement
a
These passive recovery interventions are frequently used in combination with active cool-downs
exercise, and these studies generally found trivial (statis- however, report trivial effects, with some studies reporting
tically non-significant effects), and sometimes even small beneficial effects and only a few studies reporting harmful
(non-significant) detrimental effects of an active cool-down effects. For example, a study on sport students found that
on performance [15, 28–30] (Table 2). For example, Tes- an aqua cycling active cool-down had small to trivial
sitore et al. [28] compared a 20-min active cool-down effects on recovery of maximum voluntary isometric con-
(consisting of either land-based or water-based aerobic traction (MVIC) force and muscular endurance at 24, 48, or
exercises and stretching) with a passive cool-down fol- 72 h post-exercise compared with a passive cool-down
lowing a standardized soccer training in elite youth players. [45]. In contrast, in a group of female netball players, a
After a 4-h rest period, the athletes performed several 15-min active cool-down consisting of low-intensity run-
anaerobic performance tests. Both active cool-down pro- ning resulted in a moderate magnitude decrease of 20-m
tocols had trivial to small (negative) non-significant effects sprint time and a small decrease in vertical jump height
on anaerobic performance, such as 10-m sprint time and 24 h after a simulated netball game compared with a pas-
vertical jump height. In a later study on futsal players, sive cool-down [44]. Interestingly, a study on well-trained
similar cool-down interventions also had trivial to small long-distance runners found that muscle power (as mea-
(negative) non-significant effects anaerobic sports perfor- sured during a leg press movement) was likely higher
mance measured 4.5 h after a friendly match compared 1 day after downhill running in the group that performed a
with a passive cool-down [29]. Therefore, whereas active water-based active cool-down compared with the group
recovery generally does benefit sports performance when that performed a passive cool-down, while whole-body
the time between successive performances is short reaction time showed a small decrease [40]. Finally, a
(10–20 min) [31–35], the findings from the studies above study on professional soccer players found that an active
indicate overall that an active cool-down does not improve cool-down had a likely beneficial effect on countermove-
sports performance later on the same day when time ment jump performance 24 h after a standardized training
between successive performances is [ 4 h and may even session, while 20-m sprint and agility performance showed
have small detrimental effects. However, more research on small harmful and trivial effects, respectively [50]. Overall,
the effects of active cool-downs following others forms of these conflicting findings may be related to the type of
exercise is needed. cool-down performed, the exercise that precedes the cool-
down, the training experience of the individuals and the
3.2 Next-Day(s) Performance individual preferences and believes. It should be noted that
all studies investigated high-intensity performances such as
Conflicting findings have been reported with regard to the jumping and sprinting and more research is required on
effects of an active cool-down on next-day(s) performance, endurance performance.
with some studies reporting small to moderate magnitude
benefits of an active cool-down compared with a passive
cool-down, and others reporting trivial effects or small
decreases (Table 2) [25, 30, 39–49]. Most studies,
123

Table 2 The effects of active cool-downs on same-day and next-day performance

Study Participants (mean Fatiguing exercise Active cool-down Interval Outcome Results (%
age ± standard duration, modality, between end measures difference; ± 90% CIs
deviation) and intensity cool-down for between-group
and comparison [when
subsequent available], qualitative
performance description of the
(h) probability and effect
magnitude)*
Same day performance

Cortis et al. [15] 8 military men Incremental 16 min shallow 4.5 CMJ Pre-afternoon training:
(21.9 ± 1.3 years) running test water-aerobic 0.0%, trivial
exercises at 60% Post-afternoon training:
HRmax and 4 min 0.0%, trivial
stretching
BJ Pre-afternoon training:
- 4.0%, small
Post-afternoon training:
- 7.8%, small
VO2 at 6 km/h: - 5.1%, small
various 8 km/h: 4.7%, small
running
10 km/h: - 3.1%, small
velocities
12 km/h: - 5.6%, small
Tessitore et al. 12 young 100 min 16 min low-intensity 4 SJ Dry: - 1.2%, trivial
[28] professional male standardized dry-aerobic Water: 1.5%, trivial
soccer players soccer training exercises and
CMJ Dry: - 1.7%, small
(18.1 ± 1.2 years) 4 min stretching or
16 min shallow Water: 2.9%, small
water exercises and BJ Dry: 0.0%, trivial
4 min stretching Water: - 4.2%, small
10-m sprint Dry: - 3.7%, moderate
Water: 0.0%, trivial
Tessitore et al. 10 male futsal 1 h futsal game 16 min low-intensity 4.5 CMJ Dry: - 2.8%, small
[29] players dry-aerobic Water: - 4.6%, small
(23 ± 2 years) exercises and
BJ Dry: - 3.7%, small
4 min stretching or
16 min shallow Water: - 1.7%, trivial
water exercises and 10-m sprint Dry: 0.0%, trivial
4 min stretching Water: - 1.1%, trivial
Reader et al. [30] 8 male and 1 female Olympic 15 min supervised 4.25 CMJ Session 1–2: -
elite weightlifters weightlifting rowing ergometer 4.6; ± 3.2%, likely
(26.5 ± 4.8 years) exercises and at 1 W/kg body small
various weight and stroke Session 3–4:
derivatives such frequency of \ 20/ 1.7; ± 3.9%, unclear,
as back squat min possibly trivial
and push press
Next day performance
Vanderthommen 19 healthy men 3 9 25 isometric 25 min pedaling on 24 MVC 4.7; ± 8.0%, unclear,
et al. [36] (23.4 ± 2.1 years) contractions of stationary bicycle possibly small
the knee at 60 rpm (approx.
extensors at 60 50% HRmax)
55 and 50% of
MVC
Weber et al. [37] 40 untrained Eccentric arm- 8 min upper body 24 MVIC 1.5%, trivial
females curls until ergometry at Peak torque - 7.5%, small
(22.9 ± 3.7 years) fatigue 60 rpm at 60̊/s
123

Table 2 continued
magnitude)*
Rey et al. [38] 31 professional 45 min 20 min low-intensity 24 CMJ 6.6; ± 5.3%, unclear,
male soccer standardized exercises (12 min likely moderate
players soccer training running at 65% 20-m sprint - 0.6; ± 3.5%, unclear,
(23.5 ± 3.4 years) maximum aerobic possibly trivial
velocity and 8 min
Balsom - 0.7; ± 0.7%, likely
stretching)
agility test trivial
Lane and 10 physically active 18-min 15 min cycling at 24 Work 1.7%, trivial
Wenger [39] men intermittent 30% VO2max completed
(26.3 ± 6.3 years) cycling protocol during a
cycling
protocol
Takahashi et al. 10 male long- 3 sets of 5-min 30 min of aqua 24 Muscle 15; ± 12%, unclear
[40] distance runners downhill exercises (walking, power of likely moderate
(20 ± 1 years) treadmill jogging, jumping) leg
running at a extensors
speed in leg
corresponding to press
their individual Whole-body - 2.4%, trivial
best 5000 m reaction
time time
Dawson et al. 17 Western Football matches 15 min of pool 14 6-s cycle 3.2; ± 2.7%, likely
[41] Australian walking sprint peak small
Football League power
(WAFL) players 6-s cycle - 2.7%, small
(24.2 ± 2.9 years) sprint time
to peak
power
6-s cycle 3%, small
sprint total
work
CMJ 8.1; ± 6.7%, unclear
likely moderate
King and 10 trained female 4 9 15 min 15 min low-intensity 24 5 CMJs in Pre-exercise: - 25%,
Duffield [42] netball players intermittent- exercise at 40% of 20 s small
(19.5 ± 1.5 years) sprint exercise maximum aerobic Post-exercise: - 29%,
circuit speed small
5 20-m Pre-exercise: 62%,
sprints moderate
Post exercise: - 6.1%,
trivial
Wahl et al. [43] 20 male sport 300 9 maximal 30 min aqua biking 24, 48, and MVIC 24 h: 4.0% , small
students effort CMJs at 65-75 rpm 72 48 h: 2.2% , trivial
(24.4 ± 2.2 years)
72 h: 3.1% , small
Repetitions 24 h: 4.7% , trivial
with 30% 48 h: 14% , small
MVIC
72 h: 11% , trivial
123

Table 2 continued
magnitude)*
Getto and 23 (13 male) and 10 Conditioning 2 sets of 30 s 24–28 CMJ 0.2%, trivial
Golden [44] female) Division I session that forward walking 20-m sprint - 18%, moderate
collegiate athletes included with variations on
(age not reported) sprinting, walking on
plyometrics and underwater
change of treadmill at 1.0–1.5
directions mph
Marquet et al. 11 world-class elite High-intensity Pedaling at 70% Next day, but Maximum Pre-training: 0.2%,
[45] BMX riders (7 interval training VO2max for hours are power trivial
male, 4 female; and maximum 2 9 5 min not Post-training: 1.7%,
20.9 ± 2.1 years) intensity separated by 5 min reported trivial
resistance passive recovery
Maximum Pre-training: - 2.1%,
training
cadence trivial
Post-training:
- 0.8; ± 0.6%, most
likely trivial
Taipale et al. 18 physically active Bilateral leg press Bilateral leg press 18 CMJ 33%, moderate
[46] men with 10 9 10 with 10 9 10 at MVIC 9.7%, trivial
(25.6 ± 3.5 years) reps at 70% of 30% 1RM with
1RM 5 min passive rest
between sets
Reilly and Rigby 14 male students Soccer match 5 min jogging, 5 min 24 and 48 Broad jump Significant improvement
[47] (soccer players; stretching, 5 min by 9 cm in active cool-
20.9 ± 1.5 years) leg ‘shake down’ down compared to
by other player deterioration by 7 cm
in passive cool-down
at 24 h. Difference
remained significant at
48 h
Vertical Significant improvement
jump by 2.5 cm in active
cool-down compared
to deterioration by
1 cm in passive cool-
down at 24 h.
Difference remained
significant at 48 h
3 30-m 0.22 s (5%) slower in
sprints passive cool-down
group at 24 h and 0.6 s
at 48 h
Sprint- At 48 h, mean
fatigue test performance was not
(7 30-m significantly different
sprints from baseline in active
with 20 s cool-down group
rest)
123

Table 2 continued
magnitude)*
Crowther et al. 34 recreationally 3 9 15 min 14 min jogging at 24 and 48 Time on 24 h: 0.4; ± 1.4%,
[25] active males simulated team- 35% of peak speed repeated- unclear, possibly
(27 ± 6 years) game circuit obtained during sprint test trivial
maximum sprints 48 h: - 0.9; ± 1.8%,
possibly trivial
CMJ relative 24 h: - 1.9; ± 1.6%,
peak likely trivial
power 48 h: - 0.6; ± 1.4%,
(best very likely trivial
jump)
CMJ relative 24 h: - 2.2; ± 1.7%,
peak possibly trivial
power 48 h: - 1.2; ± 1.6%,
(average likely trivial
of jumps)
Reader et al. [30] 8 male and 1 female Olympic 15 min supervised 16 CMJ Session 2–3:
elite weightlifters weightlifting rowing ergometer - 0.32; ± 4.4%, likely
(26.5 ± 4.8 years) exercises and at 1 W/kg body trivial
various weight and stroke Session 4-after:
derivatives such frequency of \ 20/ 0.92; ± 3.5%, possibly
as back squat min trivial
and push press
HRmax maximum heart rate, CMJ countermovement jump, SJ squat jump, BJ bounce jump, MVIC maximum voluntary isometric contraction,
VO2max maximum oxygen uptake, RM repetition maximum
*Percentage differences were calculated by first computing a factor difference within the active and passive cool-down group by dividing the post
cool-down mean (e.g., [ 4 h same-day or next-day performance) by the post fatiguing exercise, but pre-cool-down mean. When no post
fatiguing exercise, but pre-cool-down mean was reported, the pre-fatiguing exercise mean was used to calculate the within group factor
difference. The factor of the active cool-down group was then divided by the factor difference of the passive cool-down group and converted to a
percentage effect, whereby negative and positive values reflect worse and better performance of the active cool-down group, respectively. When
an exact p-value or p \ 0.05 was reported, a statistical spreadsheet [48] was used to derive 90% confidence intervals of the percentage difference.
Standardizes differences were calculated by first computing a standardized difference within the active and passive cool-down group and then
subtracting the passive cool-down standardized difference from the active cool-down standardized difference. The standardized difference for
each group was calculated by subtracting the post fatiguing exercise, but pre-cool-down mean from the post cool-down mean divided by the pre-
cool-down pooled standard deviation from both groups. The standardized difference was corrected for small sample size bias (i.e., Hedges’s gs)
as outlined by Lakens [49]. When no post fatiguing exercise, but pre-cool-down mean was reported, the pre-fatiguing exercise mean and standard
deviation were used to calculate the standardized difference. Standardized differences were expressed qualitatively using the following
scale: \ 0.2, trivial; 0.2–0.6, small; 0.6–1.2, moderate; 1.2–2.0 large; [ 2.0, very large [50]. When an exact p value or p \ 0.05 was reported, the
probability that the (true) difference in performance was better (beneficial), similar (trivial) or worse (harmful) in relation to the smallest
worthwhile change (0.2 multiplied by the pooled between-subject SD for measures of team sports performance and indirect measures of solo
sports performance) was calculated using a statistical spreadsheet [48]. Quantitative probabilities of beneficial, similar or worse performance
were assessed and reported qualitatively using the following scale: 25–75%, possibly; 75–95%, likely; 95–99.5, very likely; [ 99.5%, most likely.
If the probability of benefit was [ 25%, but the probability of harm was [ 0.5%, the true differences were considered unclear (i.e., clinical
magnitude-based inference). In this case, the largest probability for a change was reported to give an indication of the most likely change [50].
When insufficient data were reported for any of these calculations, these data were requested from the corresponding authors by e-mail

Standardized differences are estimated based on the results reported in Fig. 3 in reference [43]

The passive cool-down group also performed 5 min of jogging prior to the passive cool-down
123

4 Physiological Effects of an Active Cool-Down reducing the effects of exercise-induced acidosis, which
affects the functioning of glycolytic enzymes such as
An active cool-down is believed to have many physiolog- phosphorylase and phosphofructokinase. However, one
ical benefits compared with a passive cool-down, such as a study investigated the effects of an active and passive cool-
faster recovery of heart rate, less muscle soreness, and down on pH levels up to 16 min after exercise [74],
more rapid reduction of metabolic by-products [7]. The whereas the other study investigated pH levels until 80 min
evidence for these supposed physiological benefits is after exercise [64]. This latter study found no significant
reviewed in the following sections. effect of an active cool-down on blood pH levels 80 min
after exercise. The relevance of these findings for improved
4.1 Removal of Metabolic By-Products performance during a training session or competition later
on the same day (i.e., [ 4 h) or the next day(s) is therefore
High-intensity exercise can lead to an accumulation of questionable.
metabolic by-products in muscle such as lactate, which has In summary, compared with a passive cool-down, an
traditionally been associated with fatigue [51]. As a result, active cool-down generally leads to a faster removal of
the rate at which the lactate concentration is reduced in blood lactate when the intensity of the exercise is low to
blood—and to a lesser extent, muscle tissue—has fre- moderate. However, the practical relevance of this effect is
quently been used as an objective indicator of recovery questionable. Lactate is not necessarily removed more
from exercise. A large body of research has shown that a rapidly from muscle tissue with an active cool-down.
variety of low- to moderate-intensity active cool-down Finally, an active cool-down leads to a faster recovery of
protocols are more effective than a passive cool-down for pH to resting levels.
removing lactate from blood [52–69] and muscle tissue
[58, 64]. However, there are some conflicting findings, with 4.2 Delayed-Onset Muscle Soreness
some studies reporting no significant difference—and
sometimes even a slower removal of lactate in blood An active cool-down increases the blood flow to muscles
[44, 70] or muscle [66, 68]—as a result of an active cool- and skin [58, 75] (see Sect. 4.8). This increase in blood
down. Regardless, the functional benefit of faster lactate flow may reduce the accumulation of metabolic by-prod-
removal is debatable. For example, several studies found ucts and factors associated with muscle soreness (e.g.,
no significant difference between an active cool-down and cyclo-oxygenase and glial cell line-derived neurotrophic
a passive cool-down in the blood lactate concentration factor [76]) and accelerate muscle repair and remodeling.
measured more than 20 min after exercise [45, 67]. Blood Several studies have investigated whether an active cool-
lactate returns to resting levels after high-intensity exercise down does indeed attenuate delayed-onset muscle soreness.
within approximately 20–120 min—even without any post- It should be noted, though, that some studies
exercise activity [55, 60, 71]. Even elite athletes do not [40, 45, 48, 77, 78] used exercise protocols that induce
usually perform another training session within 90 min severe delayed-onset muscle soreness, but are seldom used
after the preceding session; faster removal of lactate by an in everyday athletic training. Therefore, the findings of
active cool-down may therefore be largely irrelevant [72]. these studies do not necessarily apply to ‘normal’ training
A decrease in blood lactate concentration may also not be sessions that induce less delayed-onset muscle soreness.
an appropriate indicator of recovery following exercise Most studies among both recreationally active individ-
[51, 72]. Among those studies that have reported a faster uals and professional athletes have found no significant
removal of blood lactate following an active cool-down, effect of an active cool-down on delayed-onset muscle
subsequent exercise performance was not always improved soreness or tenderness at different times following exercise
[67, 72]. (i.e., ranging from immediately after exercise up to 96 h
Although it has traditionally been assumed that lactic after exercise) compared with a passive cool-down
acid production results in metabolic acidosis, it has been [15, 25, 29, 40, 41, 45, 46, 48, 49, 77–80]. For example,
argued that lactate production coincides with cellular aci- Law and Herbert [77] compared the effects of an active
dosis, but is not a direct cause of and even retards meta- cool-down consisting of uphill walking versus a passive
bolic acidosis [73]. It is therefore important to consider the cool-down on delayed-onset muscle soreness in healthy
potential differential effects of an active cool-down on adults following backwards downhill walking on an incline
blood or muscle lactate removal and metabolic acidosis. treadmill (to induce muscle damage). The active cool-
An active cool-down results in a faster return of blood down did not significantly reduce delayed-onset muscle
plasma pH and intramuscular pH to resting levels [64, 74]. soreness or tenderness at 10 min, 24, 48 or 72 h following
This effect may preserve neuromuscular function by exercise. Interestingly, a study on netball players found that
an active cool-down consisting of low-intensity running
123

after a simulated netball match actually resulted in greater Studies that have investigated the effects of an active
muscle soreness immediately after the active cool-down cool-down on indirect markers of muscle damage from
compared with a passive cool-down, but there was no immediately after exercise up to 84 h after exercise have
significant difference 24 h after the match [44]. The run- reported conflicting findings. Two studies observed sig-
ning cool-down itself may have caused extra muscle nificantly faster recovery of these markers as a result of an
damage, resulting in the higher rating of muscle soreness active cool-down [70, 83], whereas three other studies
immediately after the cool-down. Higher impact weight- found no significant difference [40, 45, 84]. For example,
bearing cool-down activities such as running may therefore Gill et al. [83] reported a significantly faster recovery of
exacerbate delayed-onset muscle soreness immediately creatine kinase activity in interstitial fluid in elite rugby
after exercise, but more research is required to substantiate players between 1 and 4 days after a rugby match com-
this notion. bined with a cycling-based active cool-down compared
In contrast with the studies above, another study with a passive cool-down. By contrast, a study comparing
involving young professional soccer players reported that an aqua-cycling active cool-down and a passive cool-down
the mean subjective rating of muscle soreness was signif- in sport students found no significant difference in serum
icantly lower 4–5 h after an active cool-down consisting of creatine kinase and lactate dehydrogenase activity, or
low-intensity exercises such as jogging compared with a myoglobin concentrations at 4, 24, 48, or 72 h after exer-
passive cool-down [28]. Interestingly, there was no sig- cise [45]. These conflicting findings may be related to
nificant difference in muscle soreness compared with a differences in the severity of muscle damage induced by
passive cool-down when these same exercises were per- exercise, the individual markers of muscle damage, and the
formed in water, suggesting that any hydrostatic effects of type of cool-down protocol. It should be noted that fre-
water immersion did not reduce muscle soreness. Simi- quently used indirect markers of muscle damage (e.g.,
larly, a study on world-class BMX riders found that an creatine kinase activity) may not accurately reflect actual
active cool-down consisting of 2 9 5 min of cycling at muscle damage [85–88]. Malm et al. [85] suggested that
70% of the maximum aerobic power reduced muscle serum creatine kinase activity is more related to muscle
soreness during the next day when compared with a passive adaptation than to muscle damage. Therefore, it is debat-
cool-down [47]. It could be argued that these conflicting able whether a faster recovery of these indirect markers
findings are related to differences in the physical fitness of accurately reflects enhanced recovery.
the individuals. For example, the netball players were not Measures of strength and power are also frequently used
as highly trained as the soccer players and BMX riders. For as indirect markers of muscle damage. A study on
non-elite athletes, an active cool-down therefore generally untrained females found no significant effect of an active
has no effect on delayed-onset muscle soreness, whereas it cool-down consisting of upper body ergometry on the
may have a beneficial effect for better trained individuals. recovery of the MVIC and peak torque 24 h after eccentric
However, other studies among well-trained individuals exercise of the elbow flexors [48]. Similar results were
have also reported no beneficial effects of active cool-down found in other studies on sport science students [45],
on delayed-onset muscle soreness [29, 41, 80], while a physically active men [43], and healthy men [49]. How-
study among student soccer players reported beneficial ever, most studies usually reported a slightly (non-signifi-
effects of an active cool-down combined with stretching cant) better recovery compared with the passive cool-down
and a ‘leg shake down’ on muscle soreness [42]. These group (Table 2).
findings suggest that other factors such as the intensity and In summary, there are conflicting findings with regard to
duration of the exercise and cool-down, and the timing of the effects of an active cool-down on indirect markers of
soreness assessment may also influence the effectiveness. muscle damage, with most studies reporting no significant
In summary, these findings indicate that an active cool- beneficial effect of an active cool-down. Moreover, the
down is generally not effective for reducing delayed-onset relation of some of these markers with actual muscle
muscle soreness following exercise. damage is questionable—that is, a faster recovery of these
markers does not necessarily correspond to a faster
4.3 Indirect Markers of Muscle Damage reduction in actual muscle damage.
The perception of muscle soreness does not necessary 4.4 Neuromuscular Function and Contractile
reflect actual muscle damage [81, 82]. Therefore, even Properties
though an active cool-down is generally not effective for
reducing delayed-onset muscle soreness, it may have High-intensity exercise can induce central and peripheral
beneficial effects on other markers of muscle damage. fatigue, which may impair exercise performance during
subsequent training or competition. Compared with a
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passive cool-down, Lattier et al. [89] did not find a sig- intermittent exercises and a 30 min of specific aerobic
nificant effect of an active cool-down consisting of 20 min endurance drill) [50].
of running on the recovery of neuromuscular function (e.g., In summary, these findings indicate that an active cool-
central activation, twitch mechanical, and M-wave char- down does not attenuate the decrease in range of motion or
acteristics) up to 65 min after high-intensity exercise. the increase in musculotendinous stiffness following
Similarly, a study on professional soccer players found no exercise.
significant effect of an active cool-down consisting of
combined low-intensity running and static stretching on 4.6 Muscle Glycogen Resynthesis
muscular contractile properties such as biceps femoris
contraction time and maximal radial displacement time (as High-intensity exercise can deplete muscle glycogen stor-
measured by tensiomyography) 24 h after exercise [80]. age, and this can impair subsequent high-intensity exercise
Finally, an active cool-down consisting of aqua exercises performance up to 24 h post-exercise [93]. Strategies that
also did not significantly affect whole-body reaction time, enhance the resynthesis of glycogen may therefore atten-
muscle contraction time or nerve reaction time in long- uate the decrease in performance and even enhance per-
distance runners 24 h after exercise [40]. formance. Athletes often consume carbohydrates after
In summary, these findings indicate that an active cool- exercise. An active cool-down may theoretically enhance
down does not significantly affect the recovery of neuro- glycogen resynthesis, because an increased blood flow and
muscular function or contractile properties. However, in all elevated muscle temperature could increase glucose
studies there were generally small but non-significant delivery to muscle tissue [94], while muscle contraction
positive effects of the active cool-down recovery on the may increase the expression of the GLUT-4 glucose
recovery of neuromuscular function and contractile transporter. However, studies have found either no signif-
properties. icant difference in the rate of glycogen resynthesis between
an active cool-down and passive cool-down [58, 66, 95], or
4.5 Stiffness and Range of Motion less glycogen resynthesis during an active cool-down
[64, 68, 96–98]. During the active cool-down, these studies
Damage to musculotendinous tissue as a result of exer- provided no carbohydrate [58, 64, 66, 68, 95], less carbo-
cise—specifically eccentric exercise—can increase the hydrate [96], or more carbohydrate [97, 98] than what is
stiffness of the musculotendinous unit. This stiffness can recommended (1.2 g/kg/h [99]) for restoring muscle
persist for several days following exercise [90]. The glycogen. Therefore, these findings suggest that an active
increased passive musculotendinous stiffness can reduce cool-down may interfere with muscle glycogen resynthesis,
the range of motion during subsequent training or compe- particularly within type I muscle fibers [64], because these
tition [90], and this may impair performance. Researchers fibers are preferentially recruited during a low- to moder-
and trainers frequently use perceived flexibility and mea- ate-intensity active cool-down. Although this effect may be
sures of flexibility such as the sit-and-reach test to assess beneficial to enhance cellular responses and adaptation
recovery [91]. Another common belief for using an active during a subsequent low- to moderate- intensity training
cool-down is that it attenuates the decrease in range of (i.e., ‘train low’ [100]), it may also decrease performance
motion [7] and increase in musculotendinous stiffness during high-intensity training or competition. It should be
following exercise. noted that several studies applied active cool-downs for a
The scientific evidence available suggests that an active duration that is rarely used in daily practice (e.g., 45 min
cool-down does not significantly attenuate the decrease in up to 4 h) [64, 66, 96–98]. For example, Kuipers et al.
range of motion and perceived physical flexibility, or compared glycogen resynthesis between a passive cool-
attenuate the increase in musculotendinous stiffness up to down and an active cool-down in which participants cycled
72 h after exercise [25, 40, 41, 45, 50, 67, 92]. Takahashi for 2.5 h at 40% of their maximum workload [97], or 3 h at
et al. [40] found that an active cool-down consisting of 40% of their maximum workload [64, 66, 96, 98]. In
30 min of water exercises did not significantly affect sit- contrast, studies that reported no significant (but also
and-reach score, ankle range of motion, stride length, or lower) difference in the rate of glycogen resynthesis
calf and thigh musculotendinous stiffness measured 1 day between an active cool-down and passive cool-down usu-
after 3 9 5 min of downhill running. Similarly, a study ally applied shorter active cool-down durations (i.e., 10, 15,
among professional soccer players found no significant and 45 min [58, 66, 95]), suggesting that shorter active
effect of an active cool-down consisting of 12 min sub- cool downs interfere less with glycogen resynthesis.
maximal running combined with 8 min of static stretching
on lower limb flexibility 24 h after a standardized training
program (consisting of 15 min of maximal intensity
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4.7 Recovery of the Immune System active cool-down [104]. By contrast, other studies found a
slower heart rate recovery during an active cool-down
During the recovery period from high-intensity or pro- compared with a passive cool-down. Nevertheless, these
longed exercise, there can be a temporary depression of the studies only monitored the heart rate for 60 s [106] or
immune system (also referred to as an ‘open window’) 5 min [107, 108] after exercise, and the practical relevance
during which microbial agents such as viruses have an of these findings with regard to ‘training recovery’ is
increased chance to cause an infection or illness [101]. A therefore limited.
faster recovery of the immune system following exercise An active cool-down has also been reported to lead to a
can potentially reduce the chance of upper respiratory ill- faster recovery of respiratory variables such as minute
nesses. A small number of studies have investigated the expiratory ventilation, although this primarily occurred
effects of an active cool-down on the recovery of the during the initial 20 s of the cool-down [109]. Other studies
immune system up to 72 h after exercise. found a lower breathing frequency (non-significant) after
Wigernaes et al. [70, 102] found that an active cool- an active cool-down [105] and a faster recovery of oxygen
down largely prevented the fall in white blood cell count debt during an active cool-down [55].
immediately after exercise compared with a passive cool- Finally, the period right after exercise can be considered
down. However, there was no significant difference as a vulnerable period during which individuals can
120 min after the exercise [70]. Similarly, two other experience post-exercise syncope, with symptoms such as
studies reported no significant difference between an active lightheadedness, tunnel vision, and blurred vision [110]. In
cool-down and passive cool-down on immune system severe circumstances, individuals may lose consciousness
markers 24 h after a soccer [103] and rugby match [84]. completely during this post-exercise period. It has been
In summary, these findings suggest that an active cool- suggested that an active cool-down may prevent post-ex-
down may partially prevent the depression of circulating ercise syncope and cardiovascular complications by: (1)
immune cell counts immediately after exercise, but this increasing blood flow to the heart and brain due to the
effect is probably negligible [ 2 h after exercise. No contractions of the muscles [108, 110], (2) decreasing
studies have investigated the effects of regular active cool- blood pooling in the lower extremities [104], and (3) the-
downs, so it remains unknown whether this leads to fewer oretically preventing an increase in the partial pressure of
illnesses. arterial carbon dioxide [111]. Indeed, an active cool-down
has been reported to result in a higher blood flow to the legs
4.8 Cardiovascular and Respiratory Variables [58, 104] and forearm [75], but whether these effects pre-
vent post-exercise syncope and cardiovascular complica-
The cardiovascular and respiratory systems are highly tions remains unknown.
active during exercise to supply the exercising muscles In summary, these findings suggest that an active cool-
with blood and oxygen. These systems do not immediately down may result in a faster recovery of the cardiovascular
return to resting levels after exercise, but remain activated and respiratory system after exercise. However, it is
for a considerable amount of time. For example, heart rate unknown whether this also leads to a reduction in the
remains slightly elevated above resting heart rate for a incidence of post-exercise syncope and cardiovascular
relatively long time after exercise, with the exact period complications.
dependent on the intensity and duration of the exercise
[104]. An active cool-down is frequently performed in an 4.9 Sweat Rate and Thermoregulation
attempt to restore normal activity of these systems after
exercise [7]. Similar to the cardiovascular and respiratory systems,
In a comparison between a passive cool-down and two muscle and core temperature can remain elevated above
cycling-based active cool-down protocols, Takahashi and resting levels up to 90 min after exercise. Sweat rate is
Miyamoto [104] found that heart rate initially recovered in higher after exercise to reduce the core temperature to
a nearly identical way, but 10 min after the exercise (3 min resting levels [112]. Although an active cool-down on a
after the active cool-down), heart rate was significantly stationary bike results in a higher sweat rate compared with
lower for the active cool-down interventions. A later study a passive cool-down, core temperature is not lower even
confirmed these findings, and suggested that this response after 30 min of active cool-down [65, 75, 113–116].
to active cool-down reflected a faster restoration of vagal Therefore, an active cool-down performed on a stationary
and sympathetic tone [105]. In one additional subject, it bike does not result in a faster recovery of core temperature
was shown that the heart rate following a passive cool- compared to a passive cool-down. Whether an active cool-
down was still higher 30 min after exercise than the resting down performed while moving (e.g., running outside dur-
heart rate, whereas it had returned to resting levels after the ing which sweat may evaporate faster compared with
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stationary biking) results in a faster recovery of core tem- Most studies have not reported any significant effect of
perature compared with a passive cool-down requires fur- an active cool-down on measures of psychological recov-
ther investigation. ery such as the score on the Profile of Mood States (POMS)
or rest-Q sport questionnaire. Nevertheless, the participants
4.10 Hormone Concentrations usually perceived an active cool-down as more beneficial
than a passive cool-down [15, 25, 29, 30, 39, 41, 46,
It has been proposed that the rate at which hormone con- 47, 67, 119]. For example, a study among well-trained
centrations return to resting levels can be used to charac- futsal players reported that the players perceived the active
terize physiological stress [43] and psychological recovery cool-down consisting of low-intensity exercises on land
[29]. The findings of four studies suggest that an active and especially the active cool-down consisting of water-
cool-down does not facilitate the recovery of hormone based exercises as more beneficial than a passive cool-
concentrations compared with a passive cool-down down—even though there was no significant effect on the
[29, 43, 64, 102]. A study on well-trained futsal players, for recovery-stress state and the amount of sleep [29]. Another
example, found no significant effect of an active cool-down study among military men also did not demonstrate any
on hormone concentrations measured 5 h after a futsal significant effect of an active cool-down consisting of
game or measured the next morning [29]. An active cool- water exercises on sleep, rest-recovery score or rating of
down consisting of uphill treadmill running actually perceived exertion during submaximal exercise after a 6-h
resulted in a slower acute restoration of plasma adrenaline, rest period [15]. However, the participants in this study did
noradrenaline and cortisol concentrations compared with a rate the water-based active cool-down as more beneficial
passive cool-down [102]. However, from 30 min post-ex- than the passive cool-down. Interestingly, a study on sport
ercise onwards, there were no significant differences in the students found no significant difference between a passive
hormone concentrations. The relevance of this finding is cool-down and an aqua-cycling active cool-down for per-
therefore questionable. A later study reported similar ceived physical state 4, 24, 48, or 72 h after performing
findings, with the hormonal concentrations returning more 300 countermovement jumps, but the perceived physical
slowly to resting levels compared with a passive cool- fitness and energy were slightly lower 24 h after the active
down, but there was no significant difference beyond cool-down [45]. Similarly, a study on recreational netball
30 min post-exercise [64]. Finally, Taipale et al. [43] players reported that rating of perceived exertion was sig-
reported that an active cool-down consisting of 10 9 10 nificantly higher following a 15-min running-based active
repetitions of leg press at 30% of the 1 repetition maximum cool-down compared with a passive cool-down [44]. These
did not result in significant between-group differences for findings possibly reflect the greater energy expenditure
several hormonal concentrations during the next morning. associated with an active cool-down versus a passive cool-
In summary, these findings suggest that an active cool- down. By contrast, a study among 15 rugby players found
down may result in a slower recovery of hormone con- that the ‘tension’ score on the POMS questionnaire was
centrations immediately after exercise, but does not sig- significantly lower two days after a rugby match in the
nificantly affect the recovery of hormonal concentrations group that performed a 1-h active cool-down once a day
beyond 30 min post-exercise compared with a passive compared with another group that performed a passive
cool-down. In support of this, plasma concentrations for cool-down [84]. However, there was no significant effect
several hormones have been reported to return to resting on any of the other POMS scores, and no significant dif-
levels within 60–120 min post-exercise even with a passive ference on the day after the match, when only one active
cool-down [117]. cool-down session was performed. These findings imply
that an active cool-down can potentially interfere with
4.11 Mood State, Self-Perception, and Sleep psychological recovery in untrained or recreationally
trained individuals, whereas it likely has no (or a slight)
Most research has investigated the physiological effects of positive effect on psychological recovery in better trained
an active cool-down and a passive cool-down, yet psy- individuals. In support of this, even though most individ-
chological effects are intimately linked to the physiological uals perceive an active cool-down as more beneficial, some
effects, and are also of major importance for performance. (recreationally active) individuals may perceive it as ‘more
A recent systematic review even proposed that subjective exercise’ or increasing stiffness [25]. This may explain
measures of well-being better reflect training loads than do why elite rugby players rated an active cool-down as more
objective measures [118]. Therefore, the psychological effective than amateur rugby players in a recent survey [6].
effects of an active cool-down are also important to con- In summary, an active cool-down generally does not
sider in relation to recovery. substantially influence measures of psychological recovery
after exercise, but most individuals nevertheless perceive
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an active cool-down as more beneficial than a passive cool- of injuries. Specifically, the group performing a 15-min
down. Reasons reported for doing an active cool-down cool-down showed a lower injury rate than the 5- and
include relaxation, socializing and time to reflect on the 10-min cool-down groups [126], but no control group was
training or match [7]. Not all of these aspects are specifi- included for comparison. Therefore, a cool-down generally
cally assessed with the POMS and rest-Q. Therefore, it is does not affect injury rates, although more research is
debatable whether questionnaires such as the POMS and required to investigate the effects of the type of cool-down,
rest-Q sport do adequately assess psychological recovery. its duration, and the type of sport.
However, the perceived benefit could also reflect a placebo
effect, whereby individuals believe that the active cool- 4.14 Long-Term Adaptive Response
down is more beneficial than a passive cool-down due to
the popularity in society and its proposed benefits. Cook Exercise stimulates the release of various biochemical
and Beaven [27] for example found a correlation between messengers that activate signaling pathways, which in turn
the perception of the effectiveness of a recovery modality regulate molecular gene expression that elicits an adaptive
and subsequent performance that was of similar magnitude response [100]. Some recovery interventions such as
to the correlation observed between physiological recovery antioxidant supplementation, nonsteroidal anti-inflamma-
and performance, suggesting that the perception of a tory drugs, and cold-water immersion can influence sig-
recovery modality can also have a major influence on its naling pathways, thereby attenuating the long-term
effects. adaptive response to exercise [100, 127, 128]. For example,
several studies have shown that cold-water immersion after
4.12 Long-Term Effects of an Active Cool-Down each training session reduces blood flow and influences
signaling pathways, thereby leading to reduced gains in
All studies discussed so far have investigated the acute or muscular strength and endurance compared to an active
short-term (\ 1 week) effects of an active cool-down and a cool-down or passive cool-down [129–133]. Similarly,
passive cool-down. In the following two sections we dis- chronic intake of some antioxidants can also have a
cuss the long-term effects of an active cool-down on harmful effect on mitochondrial biogenesis and perfor-
injuries and the adaptive response. mance [100, 127, 134]. Preliminary evidence suggests that
an active cool-down consisting of 15 min moderate-inten-
4.13 Injury Prevention sity jogging does not attenuate the long-term adaptive
response in well-trained intermittent sport athletes [135].
An active cool-down can theoretically reduce the risk of Interestingly, the group that regularly performed an active-
injuries during a subsequent training session, because a cool down after training even obtained a higher anaerobic
better recovery may result in less neuromuscular fatigue lactate threshold after 4 weeks of training compared with
(see small, non-significant positive effects in Sect. 4.4) and the passive cool-down group. This could be related to the
thereby decrease injury risk. Only a few studies have extra training volume completed during an active cool-
investigated the effects of an active cool-down on injuries, down. However, conflicting evidence for the attenuating
and this has usually been investigated in combination with effects of other recovery modalities such as cold-water
stretching and a warm-up. In three prospective cohort immersion has been reported [136], and more research
studies on runners, regular use of a cool-down did not investigating the effects of an active cool-down on the
significantly reduce the incidence of running injuries long-term adaptive response with other exercise modalities
[120–122]. In another prospective study on runners, a (e.g., following strength training and using swimming or
health education intervention program consisting of a cycling during the active cool-down) and populations (e.g.,
warm-up, cool-down, and stretching exercises also did not untrained individuals, elderly) is therefore required.
significantly reduce the incidence of running injuries [123].
However, a potential confounder in this study was that
most participants in the control group also already per- 5 Combination with Other Recovery Interventions
formed these practices of their own volition. Finally, per-
forming a regular cool-down after exercise was also not This review has focused on the effects of an active cool-
significantly associated with a reduction in injuries among down consisting of low-intensity exercises such as cycling
triathletes [124] or with finishing a marathon versus not or running on measures of sports performance, psy-
finishing a marathon in recreational runners [125]. In chophysiological recovery, injuries, and the long-term
contrast with the evidence from the studies above, a study adaptive response. However, most individuals usually
on dance aerobics instructors found a significant associa- perform a combination of recovery interventions, and this
tion between the duration of the cool-down and the number combination may have different effects than an active cool-
123

down in isolation. Two recovery interventions that are an increasing body of research suggests that it has little to
frequently performed in combination with an active cool- no effect on the prevention of degenerative injuries [140].
down are stretching and, more recently, foam rolling. The Therefore, although stretching is historically a widely
effects of these cool-down interventions are briefly dis- practiced cool-down activity, it may not necessarily aid
cussed in the following sections. recovery from exercise.
5.1 Static Stretching 5.2 Foam Rolling
Stretching—especially static stretching—is frequently Foam rolling has more recently also been incorporated in
incorporated in an (active) cool-down [15, 28, 29, 42] many cool-downs, although to a lesser extent than
(Table 2). For example, a study among recreational mara- stretching. A small proportion (4%) of Asian and moderate
thon runners reported that 64% of the runners performed proportion (38%) of UK elite adolescent athletes report
stretching after training [122]. Another survey on elite using foam rolling after training [91]. Foam rolling is
adolescent athletes found that 23% of the Asian and 68% of frequently performed to reduce muscle soreness and to
the UK athletes used stretching after a training session [91]. attenuate the effects of exercise on the reduced range of
Finally, a survey among collegiate athletic trainers in the motion. Indeed, foam rolling performed after exercise has
USA found that 61% recommended static stretching to be been found to reduce delayed onset of muscle soreness,
included as a recovery method after exercise [1]. Surveys increase range of motion, and enhance sports performance
among coaches from other sports report similar results during the next day [142, 143]. For example, MacDonald
[2, 3, 5, 137]. et al. [142] found that the foam rolling group demonstrated
Stretching is usually performed to reduce muscle sore- less muscle soreness and better dynamic (but not passive)
ness and increase range of motion. Many practitioners also range of motion of the hamstrings and vertical jump per-
believe that stretching reduces the risk of injuries and formance. However, foam rolling also reduced evoked
improves performance [1, 3–5]. Contrary to common contractile properties during the next day. Similarly, Rey
belief, however, static stretching performed either before or and co-workers [144] reported that 20 min of foam rolling
after exercise does not reduce muscle soreness [41, 138]. following a soccer practice improved agility performance,
Although stretching can reduce muscle stiffness (when the perception of recovery and reduced muscle soreness in
performed as constant-torque stretching [139]) and increase professional soccer players. However, foam rolling did not
the range of motion [67], these effects are also not always significantly improve sit-and-reach performance or 5- and
in the athlete’s interest. Long-distance runners with a better 10-m sprint performance. Therefore, foam rolling may
running economy are (for example) actually less flexible, facilitate recovery from exercise, but more research is
and increasing flexibility can potentially negatively affect needed.
running economy [72, 140]. Finally, although static
stretching may have some effects on strain injuries [141],
Fig. 2 Evidence heatmap Physiological effects

showing the effects of an active Blood lactate >18 1 1
cool-down on markers of Muscle tissue lactate 2 1 1
psychophysiological recovery, Delayed onset muscle soreness 2 14
sports performance, and long- Indirect markers of muscle damage 2 6
term effects. Numbers represent Neuromuscular function and contractile properties 3
the number of studies Stiffness and range of motion 7
demonstrating a significant Muscle glycogen resynthesis 3 5
benefit (green), no significant Immune system 2 2
difference or an inconclusive Cardiovascular and respiratory system 5 2 2
effect (blue), or significant harm Sweat rate and thermoregulation 6
(red) of an active cool-down on Hormone concentrations 4
the variable of interest Psychological effects
compared to a passive cool- Mood state, self-perception and sleep 12 1
down Sports performance
Same day performance 4
Next day performance 14
Long-term effects
Injury prevention 1 6
Adaptive response 1
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6 Conclusions and Practical Applications The mode, intensity, and duration of a cool-down and
activity preceding the cool-down will likely influence the
Although there are many proposed benefits of an active effectiveness of the cool-down on recovery and these
cool-down compared with a passive cool-down (Fig. 1), effects may also differ between individuals. It is therefore
this review shows that only a few of these benefits are difficult to recommend one optimal active cool-down
supported by research (Fig. 2). Most importantly, we have protocol for all individuals in all situations. Some general
provided evidence that an active cool-down generally does guidelines can, however, be provided. An active cool-down
not improve and may even negatively affect performance should: (1) involve dynamic activities performed at a low
later during the same day when the time between succes- to moderate metabolic intensity to increase blood flow, but
sive training sessions or competitions is [ 4 h. Similarly, prevent development of substantial additional fatigue; (2)
an active cool-down has likely no substantial effects on involve low to moderate mechanical impact to prevent the
next-day(s) sports performance, but can potentially development of (additional) muscular damage and delayed-
enhance next-day(s) performance in some individuals onset muscle soreness; (3) be shorter than approximately
(Table 2). With regard to the long-term effects, a cool- 30 min to prevent substantial interference with glycogen
down does likely not prevent injuries, and preliminary resynthesis; and (4) involve exercise that is preferred by the
evidence suggests that an active cool-down after every individual athlete. Some evidence also suggests that an
training sessions does not attenuate and may even enhance active cool-down should involve the same muscles as used
the long-term adaptive response. during the preceding activity [145].
Several psychophysiological mechanisms are believed More research is required to investigate the differences
to underlie the potential beneficial effects of an active cool- between different active cool-down interventions (e.g.,
down. This review shows that an active cool-down does land-based vs. water-based active cool-downs), the effects
generally lead to a faster removal of lactate in blood, but of different exercise protocols that precede the cool-down,
the practical relevance of this findings is questionable, and the effect of active cool-downs in various populations
especially because lactate is not necessarily removed faster (e.g., elderly). It is also important to consider that most
from muscle tissue and because lactate may not be the studies have investigated the effects on untrained or
cause of metabolic acidosis. Furthermore, an active cool- recreationally trained individuals, because the detrimental
down can partially prevent the depression of circulating effects of training are easier to induce (to show greater
immune cells counts after exercise. However, it is effects of recovery interventions). These findings may not
unknown whether this also leads to fewer infections and necessarily transfer to better trained athletes. Finally, sev-
illnesses. An active cool-down can also result in a faster eral studies have used protocols that are rarely used in daily
recovery of the cardiovascular and respiratory system after practice and more research is required on practical active
exercise, but it remains unknown whether this leads to a cool-downs and the effects of active cool-downs on
reduction in the number of post-exercise syncopes and endurance performance.
cardiovascular complications. In contrast, an active cool-
down generally does not significantly reduce delayed-onset Acknowledgements The authors would like to thank Björn Ekblom
from the Swedish School of Sport and Health Sciences for his com-
muscle soreness or improve the recovery of indirect ments on a preliminary version of this manuscript, Will Hopkins from
markers of muscle damage. It also does not significantly Victoria University for his suggestions on the statistical analysis of
alter the recovery of the neuromuscular and contractile the data in Table 2, and Bianca Cattelini contracted through the
properties, improve range of motion, or attenuate muscu- Queensland Academy of Sport for her assistance with the infographic.
lotendinous stiffness following exercise, and may even
Author contributions BVH conceived the study and wrote the first
interfere with glycogen resynthesis. Furthermore, an active draft of the manuscript. JMP provided suggestions, revisions, and
cool-down does generally not significantly facilitate the edits.
recovery of hormonal concentrations, and it also does not
affect measures of psychophysiological recovery. How- Compliance with ethical standards
ever, most individuals nevertheless perceive an active cool- Conflicts of interest Bas Van Hooren and Jonathan Peake declare
down as more beneficial than a passive cool-down. The that they have no conflicts of interest.
effectiveness of an active cool-down may differ depending
on the individual preferences and beliefs; recovery inter- Funding The Open Access fee was paid by Maastricht University.
No other funding was received for this manuscript.
ventions should therefore be individualized [28, 30]. Some
athletes may benefit more from an active cool-down, Open Access This article is distributed under the terms of the
whereas others may prefer to perform no cool-down at all. Creative Commons Attribution 4.0 International License (http://
creativecommons.org/licenses/by/4.0/), which permits unrestricted
use, distribution, and reproduction in any medium, provided you give
123

appropriate credit to the original author(s) and the source, provide a 2015;10(9):e0139028. https://doi.org/10.1371/journal.pone.
link to the Creative Commons license, and indicate if changes were 0139028.
made. 14. Costello JT, Baker PR, Minett GM, Bieuzen F, Stewart IB,
Bleakley C. Cochrane review: whole-body cryotherapy (extreme
cold air exposure) for preventing and treating muscle soreness
after exercise in adults. J Evid Based Med. 2016. https://doi.org/
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Sports Med (2018) 48:1575–1595

Do We Need a Cool-Down After Exercise? A Narrative Review

Published online: 16 April 2018

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3 Effects on Sports Performance 3.1 Same-Day Performance

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Table 1 Overview of passive Sitting, standing, or lying rest Cold-water immersion

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Table 2 The effects of active cool-downs on same-day and next-day performance

Same day performance

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5.1 Static Stretching 5.2 Foam Rolling

Fig. 2 Evidence heatmap Physiological effects

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