PT on the Net Research

Myths and Truths of Recovery Techniques


Recovery from exercise and sports training has become of more interest to personal trainers to improve the performance of clients.  Trainers have to use every tool available to improve their client’s fitness and performance.  Although there are many techniques that can used to recover from training, the most popular seem to be foam rolling and post work-out snack.  However, two lesser known techniques can also be considered: sleep and cold water baths.

Learning Objectives:

  1. Evaluate what the research on recovery techniques reveals as truth or myth.
  2. Explain to clients what recovery techniques will actually improve performance and fitness.
  3. Understand each recovery technique and how it impacts performance and fitness.

Sleep – Truth

Sleep may be the ultimate recovery technique because without proper quality and quantity of sleep, we simply don’t recover from exercise.  Gordon Sleivert, Ph.D., of the Canadian Sport Centre Pacific indicates: “A universal recovery strategy that is essential to both physiological adaptation and to the consolidation of skill development is sleep.”

One of the reasons sleep is so important for fitness and sports training is that we have release of human growth hormone during stages 3 and 4. As a result, the body does most of its repair work and regeneration during these two stages. Because of the release of human growth hormone in stages 3 and 4, some personal trainers call sleep “The Athletes Steroid.”  Human growth hormone helps maintain and repair muscle and cells and is key to improving fitness and sports performance. As such, it could be argued that sleep is the key to fitness and sports performance. In reality, the key to improved fitness and sports performance is the correct balance of training, rest, nutrition, and sleep. 

Samuels (2009) indicates there are critical metabolic and immune processes that occur during sleep. Therefore, a critical relationship exists between physical recovery during sleep and an athlete’s ability to train at maximum capacity with optimal results.  Human growth hormone peaks between midnight and 2:00 am, and testosterone between 6:00 am and 8:00 am. As such, it is important to pay attention to what time our clients are going to bed. Walker and Stickgold (2006) indicate there is a relationship between sleep and consolidation of skill memory and performance enhancement, concluding that sleep restriction poses a risk to sleep-dependent memory consolidation. Thus a causal relationship exists among sleep, memory, and performance. These results demonstrate the importance of adequate sleep for athletes to ensure optimal performance when cognitive tasks and psychomotor vigilance is required.

Athletic Performance

Although these studies do not research specific effects of sleep on recovery, they are important as it relates to our clients getting maximum benefit from exercise based on increased hours and quality of sleep.   

Mah, et al., (2011) investigated the effects of additional sleep on eleven male college basketball players who, for the first 2–4 weeks of the study, maintained their normal sleep patterns and time. The players were tested on an agility sprint test (baseline to half-court and back to baseline, then to full-court and back to baseline), number of successful free throws out of ten, 3-point field goals out of fifteen, and a self-rating of performance during and after practices and games. This was followed by a 5–7 week sleep extension period. Subjects obtained as much nighttime sleep as possible during sleep extension with a goal of 10 hours in bed each night. After the sleep extension the players improved a agility sprint  by 0.07 seconds,  free throws improved by 0.9, and 3-point field goals improved by 1.4, subject self-rating during/after practices (1-10) improved 6.9 to 8.8, and subject self-rating during/after games improved 7.8 to 8.8.

Mah (2010) studied seven Stanford University football players. For two weeks the football players slept whatever their normal time was. After the first two weeks the players aimed for ten hours of sleep each night. They were tested pre and post sleep extension, and their 20-yard shuttle run time decreased by 0.10 seconds, 40-yard dash time decreased by 0.10 seconds, and daytime sleepiness and fatigue scores also decreased significantly, while vigor scores significantly improved.

The verdict is that getting the proper amount and quality of sleep can help improve fitness and sports performance. Moreover, it is a very effective recovery technique that trainers could discuss with clients to get better results from their fitness training.

Foam Rolling For Recovery – Three Studies Show Positive Effects on Delayed Onset Muscle Soreness

MacDonald, et al., (2014) investigated the effectiveness of foam rolling on muscle soreness, range of motion, voluntary contractile properties, and vertical jump height.  They used a control group and a foam rolling group. All subjects participated in five testing sessions: 1) orientation and one repetition maximum back squat, 2) pretest measurements of 10 × 10 squat protocol, and post training measurements right after training, and measurements at 3) 24 hours after training, 4) 48 hours after training, and 5) 72 hours after training. The results indicate that foam rolling significantly reduced muscle soreness at all time points while improving range of motion. Voluntary contractile properties showed no between-group differences for all measurements besides voluntary muscle activation and vertical jump, with foam rolling improving muscle activation at all time points and vertical jump at POST-48. The authors conclude the most important findings of the study are that foam rolling was beneficial in decreasing muscle soreness while improving vertical jump height, muscle activation, and passive and dynamic range of motion.

MacDonald, et al., (2013) investigated if foam rolling would reduce delayed-onset-muscle-soreness in 20 physically active, male subjects with resistance-training experience. The subjects where put into to a foam rolling group or a control group. All subjects performed 5 different testing sessions, which included tests performed both pre- and post- (at 0, 24, 48 and 72 hours) workout that was intended to create delayed onset muscle soreness (10 sets of 10 reps of squats at 60% of 1RM, 4-second eccentric and 1-second concentric, 2 minutes rest between sets). The subjects in the foam rolling group performed several foam rolling exercises for 2 bouts of 60-seconds per exercise at 0, 24 and 48 hours. The researchers found that muscle soreness was significantly reduced in the foam rolling group in comparison with the control group at 24, 48 and 72 hours post-workout. The researchers concluded that foam rolling produced significant reductions in muscle soreness at all time points.

Jay, et al., (2014) investigated the effect of roller massage on hamstring soreness directly in one leg and also the potential cross-over effect to the non-roller massaged leg in 22 healthy untrained subjects. The subjects were in the roller massage group or a control group. On one day, all subjects performed 10 sets of 10 reps of stiff-legged deadlifts with a kettlebell, separated by 30 seconds of rest with a tempo of 1 – 2 seconds for the concentric and eccentric phases. Forty-eight hours post-workout, the subjects returned and rated their hamstring soreness using a visual analogue scale, and the researchers tested their pressure pain threshold through palpation. The subjects in the control group received no intervention but the subjects in the roller massage group received foam rolling treatment on one leg. Measurements of soreness, pressure pain threshold and flexibility were taken before and at 0, 10, 30 and 60 minutes post-foam rolling. The researchers indicate that the roller massage group displayed significantly reduced soreness and greater pressure pain threshold compared with the control group at 0, 10 and 30 minutes post-massage.

In summary, there are indications from limited research that foam rolling appears to improve post-work-out recovery by reducing acute and chronic delayed-onset muscle soreness. These findings can be important because with improved recovery, this can give trainers and their clients the opportunity to train harder and then reduce soreness with foam rolling. 

Athletic Performance

In addition to foam rolling’s effect on recovery some studies have looked at the effect of foam rolling on athletic performance. Acute effects of foam rolling on athletic performance has been investigated to find out if foam rolling before a workout or a competition would lead to reduced performance, as has been observed for static stretching.  In summary, the current evidence suggests that foam rolling does not adversely affect athletic performance measures, such as muscular strength, power, jumping and agility. Additionally, it seems that in this respect, foam rolling is superior to static stretching (Halperin, et al., 2014; Sullivan, et al., 2013; & Janot, et al., 2013).

Ice Baths – Not conclusive Evidence

Ihsan et al., (2013) investigated the effects of postexercise cold water bath on tissue oxygenation and blood volume changes after high intensity exercise. Nine runners ran for 30 minutes at 70% of their maximal treadmill velocity, followed by 10 bouts of interval running at V02max.  After the running, they put one leg in an ice bath up to the gluteal fold for 15 minutes and the other leg out of the water.The researchers measured physiological parameters in the runners' legs post-ice bath. The results show that hemoglobin levels were lower and tissue oxygenation was higher in the leg that had been in the ice bath.  In the words of the researchers, “there was decreased microvascular perfusion and muscle metabolic activity."  This can be interpreted that the ice bath reduced swelling and therefore can improve local muscle recovery.

Dunne, Crampton, and Egana (2013) investigated the effect of cold water baths as a recovery strategy on subsequent running performance in normal body temperature.  Nine endurance-trained men completed two submaximal exhaustive runs on three separate occasions. The running bouts (Ex1 and Ex2) were separated by 15-min of seated rest, 15-min of hip-level cold water bath at 8°C (CW8), or 15-min of hip-level cold water bath at 15°C (CW15). The subjects were measured on the following variables: blood lactate and heart rate during the bath or rest, and VO2, running economy and exercise times were recorded during the running sessions. The results indicate that running time to failure during Ex2 was significantly longer following CW8 than the control group, but there was no difference between CW15 and control group or CW8 and CW15. Interestingly, the results showed a 95% and 89% likely beneficial effect of CW8 and CW15 during Ex2 compared with the control group, respectively. Blood lactate, running economy and VO2 were not altered by cold water. The authors indicate that a 15-min period of cold water bath used between two high intensity running work-outs enhances post-cold bath running performance. The practical question is, when in “fitness training” do we perform a high intensity work-out followed closely by another work-out?  We do not do this kind of training. However, we may have clients who do running, biking, or cross-country skiing races Saturday and Sunday, in which case cold water baths may help them recovery and prepare for the next days’ race. We may also have clients who do extreme racing and perform multiple legs in a road relay or a mountain bike race.

Crystal, et al., (2013) investigated the effect of ice baths on the inflammatory response to muscle-damaging exercise. Twenty recreationally active males completed a 40-min run at a -10 % grade to induce muscle damage. Ten of the subjects sat in a 5 °C ice bath for 20 min and the other ten served as controls with no bath. Knee extensor peak torque, soreness rating, and thigh circumference were obtained pre- and post-run, and 1, 6, 24, 48, and 72 hours post-run. There were no differences between groups in knee extensor peak torque or soreness rating. The authors conclude that 20 minutes of ice bath was ineffective in reducing the strength decrement and soreness seen after muscle-damaging exercise, therefore in this study there was no benefit of using an ice bath after strenuous exercise. The lead investigator of this study, Naomi Crystal indicates, "It doesn't help you feel better and it doesn't help you perform better. Ice baths are very popular as a treatment, but the research is really mixed as to whether they're beneficial. They're miserable. If it doesn't work, you don't want to waste your time." "Use them sparingly. Use them in tournament situations, use them with an athlete who has done something extraordinary. But for day-to-day athletes, I wouldn't recommend them. They're painful, and they're time consuming." 

Higgins, Cameron, and Klimstein (2012) found only trends for improved performance on simulated rugby game performance and after three training sessions. Twenty-four male players were randomly divided into three groups: 1) cold water immersion therapy (2 X 5min 10C, 2) contrast bath therapy (5 cycles of 10C/38C), and 3) control group with 15-min passive recovery. However, no significant differences were identified between groups across simulated games, across dependent variables. In conclusion, Crystal, et al., (2013) suggest that there have been many studies since 2009 on the effect of ice baths on inflammation and recovery from high intensity, or muscle damaging exercise, and there is no clear consensus on its effectiveness. 

Post-Work-Out Snack – Truth about Its Importance

There is so much information about consuming a post work-out snack that it seems impossible to review it all in a relatively brief section in this article.  However, there was an elegant position stand published by the International Society of Sports Nutrition (Kerksick, et al., 2008). In this article, the authors have summarized the research on post work-out meal and the timing of the meal or snack. For ease of reading, the important points of the article will listed in bullet points.

Importance of a post work-out snack is accentuated when the exercise is 60 – 90 minutes of moderate to high intensity exercise that reduces glycogen stores, and good timing of nutrient consumption can help replenish glycogen stores. 

 

References:

Crystal N.J., et al., 2013, Effect of cryotherapy on muscle recovery and inflammation following a bout of damaging exercise. Eur J Appl Physiol.  113(10):2577-86. doi: 10.1007/s00421-013-2693-9. Epub 2013 Jul 20.

Dunne, A., Crampton, D., and Egana, M., 2012, Effect of post-exercise hydrotherapy water temperature on subsequent exhaustive running performance in normothermic conditions.  J Sci Med Sport, 16(5):466-71. doi: 10.1016/j.jsams.2012.11.884. Epub 2012 Dec 14.

Halperin, I. et al., 2014, Roller massager improves range of motion of plantar flexor muscles without subsequent decreases in force parameters.  Int J Sports Phys Ther, 9(1):92-102.

Ihsan, M, et al., 2013, Influence of postexercise cooling on muscle oxygenation and blood volume changes.Med Sci Sports Exerc., 45(5):876-82. doi: 10.1249/MSS.0b013e31827e13a2.

Jay, K., et al., 2014, Specific and cross over effects of massage for muscle soreness: randomized controlled trial. Int J Sports Phys Ther, 9(1):82-91.

Kerksick, C., et al., 2008, International Society of Sports Nutrition position stand: Nutrient timing, Journal of the International Society of Sports Nutrition, 5:17 doi:10.1186/1550-2783-5-17

Mah, C.D., et al. 2011. The effects of sleep extension on the athletic performance of collegiate basketball players. Sleep, 34(7):943-950.  http://www.ncbi.nlm.nih.gov/pubmed/21731144

Mah, C.D., Mah, K.E., & Dement, W.C. 2010. Sleep Extension and Athletic Performance in Collegiate Football, Sleep, 0304 A105 33.   http://www.aasmnet.org/articles.aspx?id=1731

Macdonald, G.Z., et al., 2014.Foam rolling as a recovery tool after an intense bout of physical activity.Med Sci Sports Exerc, 46(1):131-42. doi:0.1249/MSS.0b013e3182a123db.

MacDonald, G.Z.,, et al., 2013. An acute bout of self-myofascial release increases range of motion without a subsequent decrease in muscle activation or force.  J Strength Cond Res. 27(3):812-21. doi: 10.1519/JSC.0b013e31825c2bc1.

Pritchett, K. and Pritchett R. 2012, Chocolate milk: a post-exercise recovery beverage for endurance sports, Med Sport Sci. 59:127-34. doi:10.1159/000341954. Epub 2012 Oct 15.

Walker, M.P. and Stickgold, R. 2006,  Sleep, memory, and plasticity. Annu. Rev. Psychol.  57:139–66.

Quotes

Cheri Mah, Ph.D., of the Stanford University Sleep Disorders Clinic and Research Laboratory indicates that “Sleep duration may be an important consideration for an athlete’s daily training regimen.”  http://www.aasmnet.org/articles.aspx?id=1731

Gordon Sleivert, Ph.D., former Vice President of Sport Performance, Canadian Sport Centre Pacific indicates that sleep is “A universal recovery strategy that is essential to both physiological adaptation and to the consolidation of skill development is sleep.”  http://schoolstarttime.org/early-school-start-times/athletic-performance/

Cheri Mah, Ph.D. further indicates that “sleep is an important factor in peak athletic performance” and that “athletes may be able to optimize training and competition outcomes by identifying strategies to maximize the benefits of sleep.”  http://med.stanford.edu/ism/2011/july/sleep.html

Naomi Crystal, lead researcher in the study, “Effect of cryotherapy on muscle recovery and inflammation following a bout of damaging exercise,” published in the European Journal of Applied Physiology, was quoted by Marie Ellis on the web site, Medical News Today: http://www.medicalnewstoday.com/articles/265047.php