A cold, wet towel draped around the neck has become something of a summer running ritual, and for good reason, on the surface. The sensation of cool skin against your carotid arteries feels refreshing, almost medicinal. But the moment a sports coach pressed a digital thermometer against my ear after a 10-kilometre run and read out the result, something became clear: the towel had been managing my perception of heat, not my actual core temperature. Those are two very different things, and confusing one for the other can be surprisingly risky.
Key takeaways
- Your neck cooling strategy tricks your brain into ignoring dangerous core temperature rises
- The performance boost is real, but it comes from reduced perceived effort—not actual cooling
- A coach’s thermometer reading revealed what the towel had been hiding all summer
Why the neck is such a powerful cooling target
The neck is not an arbitrary choice for cooling. Research indicates that cooling the neck can produce thermal benefits comparable to cooling approximately 60% of the body surface area, a startling proportion for such a small patch of skin. This is because the neck sits in a thermally privileged location: close to the carotid arteries, rich in thermoreceptors, and just centimetres away from the hypothalamus, the brain’s primary thermostat.
When the body gains heat, its temperature rises, activating deep-body core and peripheral temperature sensors that send signals to the brain, primarily the hypothalamus. Cooling the skin near that region creates a rapid, powerful sensory signal, one the brain registers as “things are cooling down.” Cooling the head, face, and neck can have strong perceptual effects that contribute to improved performance. That is not a placebo. It is a genuine neurological response. The problem is what happens next.
Neck cooling is unlikely to reduce human brain temperature during exercise and has no effect on core body temperature; however, it can dampen the perceived magnitude of thermal strain, allowing individuals to tolerate higher core body temperatures and heart rates before volitional termination. Read that again slowly. The towel does not cool your core. It makes you feel as though your core is cooler than it actually is, which means you may keep pushing harder, for longer, while your internal temperature climbs unchecked.
The performance benefit that comes with a hidden cost
During prolonged sporting events, reducing intensity is not desirable, therefore cooling strategies such as water baths, ice vests, and cold towels applied before and during exercise are used to mitigate the development of heat-related performance decrements. Sports scientists have studied these strategies extensively, and a 2022 study found that, when placed on the neck during activity in the heat, cooling towels improve thermal perception and can boost endurance or sprint performance. This is real, measurable, and useful, in the right context.
But “the right context” matters enormously. Under hot and humid conditions, body core temperature rises rapidly due to metabolic heat production and external thermal load, and an elevated body core temperature significantly increases thermoregulatory and cardiovascular stress by reducing stroke volume and increasing heart rate, which in turn impairs exercise performance and raises the risk of heat-related illness. A cold towel does not slow that process. It simply makes it easier to ignore.
There is also the question of acclimatisation. A 2025 study published in Frontiers in Physiology found that neck cooling provides ergogenic effects in thermal perceptions and extends a greater improvement in time to exhaustion when applied after heat acclimation, suggesting that individuals should achieve physiological adaptation to the heat before neck cooling is introduced for perceptual or performance benefits. For recreational runners heading straight from an air-conditioned office into a 28°C afternoon run, that adaptation simply hasn’t happened. The cooling towel becomes a shortcut to a false sense of readiness.
What your body temperature is actually telling you
When that coach measured my temperature post-run, the reading was higher than expected for what had felt like a comfortable effort. That is the crux of the issue. Rating of perceived exertion is lower during neck-cooling exercise, and neck-cooling during exercise can improve repeated sprint Performance in a hot environment without altering physiological responses, with reduced RPE potentially explaining the performance improvement. Your effort feels easier, so you do more of it, while your body is working just as hard — or harder.
Exertional heat stroke is characterised by central nervous system abnormalities such as delirium, convulsions or coma, circulatory failure, thermoregulatory dysregulation, and potentially multiple organ and tissue dysfunction resulting from an excessively elevated body-core temperature induced by strenuous exercise and high environmental heat stress. This is the extreme end of the spectrum, certainly, but the path there is paved with precisely the kind of incremental overconfidence that a cold towel can encourage. Heat stroke is preceded by symptoms of heat exhaustion, such as feeling faint, profuse perspiration, and a rapid yet light pulse. Ignoring these symptoms can lead to more severe heat stroke symptoms, including headaches, confusion, nausea, lack of perspiration, red and warm skin, and seizures.
A 2025 randomised crossover trial tested neck cooling during exercise in a hot environment and found that neck cooling did not significantly affect core temperature or perceived exertion, concluding that maintaining close contact with the skin at sufficiently low temperatures or utilising cooling methods that prevent excessive negative feedback may be necessary to enhance the effectiveness of neck cooling. a loosely draped damp towel, the kind most of us actually use, may not even deliver the performance benefits, while still lulling you into a false sense of thermal safety.
How to use neck cooling intelligently
None of this means you should abandon your cold towel entirely. The evidence for its perceptual benefits is solid, and on a blistering British summer day (they do happen), any sensible tool that helps you manage effort is worth using, with eyes open.
The key shift is treating neck cooling as a monitoring aid, not a safety net. Keep checking in with genuine physiological signals: heart rate, sweat rate, the quality of your thinking. Research has shown that body cooling interventions can produce meaningfully lower skin temperature and heart rate compared to no-cooling conditions, but those effects are most reliable with purpose-designed cooling garments rather than an ordinary wet towel tucked around your collar.
Cooling towels work best when placed on pulse points and areas of skin more receptive to cooling, including the forehead, neck, and wrists. Rotating between those sites, keeping the towel genuinely cold (a quick dip in ice water works far better than a tepid re-wet), and pairing it with adequate hydration will get you closer to an actual benefit. Critically, don’t use the towel’s presence as a reason to ignore the signals your body is sending.
The coach who checked my temperature after that summer run wasn’t trying to alarm me. He was pointing out that running physiology doesn’t care how cool you feel. A genuinely useful piece of kit becomes a liability the moment you stop respecting what it can’t do, and a cold towel, for all its merit, cannot override a rising core temperature. It can only convince you that it has. Interestingly, some research suggests that regular heat acclimatisation training may do more for sustained heat performance than any external cooling device, since the body’s adaptations — expanded plasma volume, earlier sweating onset, lower resting heart rate in heat, address the cause rather than the perception.
Always consult your GP or a qualified sports medicine professional if you have concerns about your response to exercise in the heat.
Sources : onlinelibrary.wiley.com | frontiersin.org