Heat first, then cold. That's the standard order for contrast therapy, and it's what we run at Defiant. The honest caveat is that almost nobody has tested the reverse in a controlled setting, so the case for heat-then-cold rests more on practical reasoning and how people report feeling than on a stack of trials comparing the two sequences head to head.
The Quick Answer
Start with the sauna and finish with cryotherapy. Contrast therapy alternates heat and cold to drive repeated vasodilation and vasoconstriction, and a 2013 systematic review of 18 trials found contrast water therapy beat passive rest for muscle soreness and strength recovery at every follow-up point from under 6 hours out to 96 hours. No trial in that review compared starting hot against starting cold, so the sequencing rule you see everywhere is convention rather than a finding. At Defiant in Lisle, IL, we run sauna first for a practical reason too: the cryotherapy chamber requires completely dry skin.
The Short Version
Sauna, then cryotherapy, and end on the cold. Three reasons people give for that order, ranked from most to least defensible:
The practical one holds up best. Whole body cryotherapy uses refrigerated air, not water, and you need to be dry when you step in. Coming out of a sauna soaked in sweat and walking straight into a chamber at roughly -200°F is a problem, so if you're doing both, the sauna comes first and you towel off thoroughly in between.
The physiological reasoning is reasonable but untested. Heat opens peripheral blood vessels, cold clamps them down, and the theory is that a bigger swing between the two produces a stronger "pumping" effect through the tissue. That pumping theory shows up throughout the contrast therapy literature as the proposed mechanism, though researchers have been clear that the exact mechanisms haven't been established.1
The third reason is the weakest, and it's the one you hear most: that finishing cold leaves you alert and finishing hot leaves you sedated. Plenty of people report exactly that, and it may well be true for you. It just hasn't been isolated in a trial.
What the Research Actually Tested
The strongest evidence for contrast therapy comes from a 2013 systematic review and meta-analysis in PLoS ONE that examined 18 controlled trials.1 Pooling the 13 with usable data, contrast water therapy produced significantly greater improvements in muscle soreness than passive recovery at all five follow-up points, under 6 hours, 24, 48, 72, and 96 hours, and significantly reduced strength loss at each of those same points.
Every one of those 18 trials carried a high risk of bias, in the reviewers' own assessment. And when contrast therapy was compared against other recovery methods rather than against doing nothing, including cold water immersion alone, warm water immersion alone, compression, active recovery, and stretching, the authors concluded there was "little evidence for a superior treatment intervention."1
That's the fair summary of where contrast therapy stands. It appears to beat sitting on the couch. It doesn't clearly beat the other things you might do instead. The review's own framing is that the size of the effect "may be most relevant to an elite sporting population," which is a polite way of saying that if you're training twice a day for a living, a small edge matters more than it does for the rest of us.
Ordering never appears as a variable in that analysis. Not as a subgroup, not as a moderator, not as a limitation worth flagging. The trials were grouped by hot water temperature and study design instead. If sequence were a well-studied question, it would have shown up there.
The Protocols in the Studies Look Nothing Like the Internet Version
This is the detail that surprised me most when I went back through the review, and it's worth knowing before you build a routine around a YouTube protocol.
Across the trials, total immersion time per session ranged from 6 to 24 minutes. All but one applied cold water for exactly one minute per round. Hot rounds ran between one and three minutes. Cold water ranged from 8°C to 15°C (46°F to 59°F), and hot water from 35.5°C to 45°C (96°F to 113°F).1
| What the research used | What you'll see online | |
|---|---|---|
| Cold round | 1 minute | 3 to 5 minutes |
| Hot round | 1 to 3 minutes | 15 to 20 minutes |
| Total session | 6 to 24 minutes | 45 to 60 minutes |
| Cold temperature | 8°C to 15°C water | Ice bath at 3°C, or a cryo chamber at -200°F |
| Rounds | Typically 3 to 6 | "As many as you can handle" |
The evidence base for contrast therapy is built on short, brisk alternations. The hour-long sauna-and-plunge marathons that dominate wellness content aren't what was studied. That doesn't make them harmful, and longer sauna sessions have their own separate research base. It does mean that if someone tells you the "correct" protocol is 20 minutes hot and 5 minutes cold because that's what the studies show, they haven't read the studies.
One more mismatch: those trials used water immersion, and Defiant's cold side is a cryotherapy chamber. Those aren't interchangeable. In a randomized crossover study of 20 active men, a 4-minute exposure to -110°C whole body cryotherapy and 8°C cold water immersion produced similar drops in muscle temperature (at 1 cm depth, 1.6°C for cryo versus 2.0°C for water) and similar drops in core temperature, but cryotherapy dropped skin temperature significantly further.2 Air conducts heat poorly compared with water, so the cryo chamber hits the surface harder while reaching the deep tissue about the same. Whether that difference matters for how you feel afterward is still an open question.
Why We Run Heat First at Defiant
Our setup makes the sequence fairly easy to settle. The sauna is a Radia IR 300 hybrid cabin that runs either as an infrared session around 130°F or as a traditional dry heat session up to about 200°F. The cold side is an Everest CryoBuilt chamber with a hard stop at 3 minutes 30 seconds. We don't offer a cold plunge, only cryotherapy.
That last point drives the order. You cannot walk from a sauna into a cryotherapy chamber with damp skin. Moisture on the skin in air that cold is uncomfortable at best, and it raises the risk of a cold burn. So the flow is sauna, then a thorough towel-off and a few minutes to stop sweating, then the chamber. If you were doing sauna and an ice bath at home, the wet-skin constraint disappears and the ordering question genuinely opens back up.
The second reason is closer to preference than physiology. Most people who come in for contrast therapy in Lisle tell us they want to leave sharp rather than sleepy, and cold last tends to deliver that. If your goal is to sleep well two hours later, you may prefer to finish warm. Try it both ways and trust your own read.
When Starting Cold Makes Sense
A few situations flip the order, or at least make it worth flipping:
You're using the session to wake up rather than to recover. Cold first, then heat, then out the door. Cold exposure produces a large catecholamine response, and the number everyone quotes comes from a 2000 study in which one hour of head-out immersion at 14°C raised plasma noradrenaline by 530% and dopamine by 250%.3 Keep the context in mind. That was a full hour in cold water, not three and a half minutes in a chamber, and the study didn't measure how long the effect lasted afterward. The direction of the response is well established. The magnitude you'd get from a short cryo session is not the same number.
You've got heat-reactive skin. Rosacea, active flushing, or heat-triggered irritation can make going straight into the sauna uncomfortable. Some people find a brief cold exposure first settles things down.
You're doing cryo alone and adding sauna as an afterthought. Then the order is whatever fits your schedule. A single cold session isn't contrast therapy, and nothing about the research suggests you need to bolt heat onto it.
The One Timing Rule With Real Evidence Behind It
If you only change one thing after reading this, change this one, and it has nothing to do with sequence.
Don't take cold immediately after a lifting session if building muscle is the goal. In a 2015 study published in The Journal of Physiology, 21 physically active men strength trained twice a week for 12 weeks, with either 10 minutes of cold water immersion or active recovery after every session. Strength and muscle mass increased more in the active recovery group. Cold water immersion also attenuated the training-induced increases in muscle fiber cross-sectional area and whole-limb size, and blunted the acute anabolic signaling that follows a hard set.4
That study used cold water immersion, not a cryotherapy chamber, and the two cool tissue somewhat differently.2 Still, the fix costs you nothing: if you lifted for hypertrophy, put several hours between the gym and the cold, or use your contrast session on a rest day or after conditioning work instead. If you're recovering from a competition, a long ride, or a brutal week and adaptation isn't the priority right now, that concern mostly goes away.
A Session You Can Actually Run
Here's a reasonable starting structure using our equipment. Adjust once you know how you respond.
| Round | What | How long |
|---|---|---|
| 1 | Infrared or dry heat sauna | 10 to 15 min |
| Transition | Towel off completely, cool down | 3 to 5 min |
| 2 | Cryotherapy chamber | 2 to 3 min |
| 3 | Sauna again (optional second cycle) | 8 to 10 min |
| Transition | Towel off completely | 3 to 5 min |
| 4 | Cryotherapy to finish | 2 to 3 min |
Total time in the room is roughly 40 minutes with the transitions, which is longer than the research protocols but matches how the equipment actually works. Hydrate before you start. If you're new to either side, do a single cycle first and see how you feel the next morning before you add a second.
New client pricing at Defiant is $25 for a first cryotherapy session and $25 for a first 30-minute sauna session, so trying both separately before committing to a full contrast protocol is inexpensive. Single whole body cryotherapy sessions are $50, and infrared and dry heat sauna sessions start at $45 for 30 minutes.
- Heat first, cold last is the standard contrast therapy order, and at Defiant it's also a practical requirement because the cryotherapy chamber needs completely dry skin.
- A 2013 meta-analysis of 18 trials found contrast water therapy improved muscle soreness and reduced strength loss versus passive rest at every follow-up from under 6 hours to 96 hours, though all 18 trials carried a high risk of bias.1
- The same review found little evidence that contrast therapy outperforms cold water immersion, compression, active recovery, or stretching.
- No trial in that review compared starting hot against starting cold, so sequencing advice online is convention rather than a research finding.
- Research protocols were short: 1-minute cold rounds, 1 to 3 minute hot rounds, 6 to 24 minutes total, which is far briefer than typical online recommendations.
- The timing rule with the strongest evidence is unrelated to order: cold immediately after resistance training may blunt strength and muscle gains over 12 weeks.4
Frequently Asked Questions
Hot, Then Cold.
Contrast therapy pairs our infrared and dry heat sauna with the cryotherapy chamber in a single guided session. New clients can try either side for $25.
Keep Reading
Last updated September 8, 2026.
References
- Bieuzen F, Bleakley CM, Costello JT. Contrast Water Therapy and Exercise Induced Muscle Damage: A Systematic Review and Meta-Analysis. PLoS ONE. 2013;8(4):e62356. PLoS ONE
- Costello JT, Culligan K, Selfe J, Donnelly AE. Muscle, Skin and Core Temperature after −110°C Cold Air and 8°C Water Treatment. PLoS ONE. 2012;7(11):e48190. PLoS ONE
- Šrámek P, Šimečková M, Janský L, et al. Human physiological responses to immersion into water of different temperatures. European Journal of Applied Physiology. 2000;81(5):436-442. PubMed
- Roberts LA, Raastad T, Markworth JF, et al. Post-exercise cold water immersion attenuates acute anabolic signalling and long-term adaptations in muscle to strength training. The Journal of Physiology. 2015;593(18):4285-4301. PubMed