09 recovery tools and aids

Training must match your recovery capacity These tools can be expensive but those most effective recovery strategies are nearly free!... • Cryotherapy full body room, 3 minutes, -166 deg

Recovery Tools and Aids

Ice, Heat, Massage, and other techniques that may aid recovery

UNIVERSITY

Lesson Overview

• Cold Therapy

• Heat Therapy

• Contrast Therapy

• Compression Therapy

• Massage (deep tissue, ART, Graston, cupping)

• ESTIM and EMS

• FOAM ROLLING

• Other Mentions

Context to Recovery

Recovery Hierarchy:

Manage Training Stress > Sleep/rest/stress > Nutrition > Recovery tools

Following methods are small effect sizes compared to your primary recovery tools

If training recovery is that poor, address the primary issue TRAINING! Training must match your recovery capacity

These tools can be expensive but those most effective recovery

strategies are nearly free!

COLD THERAPY

What is it?

Any cold thermal based strategy

How it works?

Blunt inflammatory processes

Vasoconstricting

Can limit hypertrophy adaptations (some inflammation and cytokines important) Decrease in pain and fatigue perception

TYPES:

• Cold Water Immersion (body submerged to neck, 10minutes, temp 50-54 degrees F) Can be used acutely for very hard bout of training , but chronically not

recommended

• Cryotherapy (full body room, 3 minutes, -166 degree F)

• Less effective than cold water immersion

• Limited research in efficacy

• Not time or cost effective

• Localized Cold Therapy (15-20 minute ) Ice packs or cold compress

• Not shown to improve DOMS or improve muscle weakness post training

Recommendation:

Within bodybuilding, limited application for Cold Therapy

Exception within 15 minute of injured area

Hypertrophy primary goal

HEAT THERAPY

What is it?

Any form Heat Treatment (hot compress, heating pad, hot bath)

How it works?

Vasodilation

Increased Oxygenation

Increased Nutrient Delivery and uptake

Removal of localized waste

Physical and mental relaxation

Decreased DOMS and pain perception

Can increase inflammation close to training

Typical regiment:

96-105 degrees F for 20-25 minutes >2 hours post training

Recommendations:

Practical use at home for hot bath and relaxing

Use as needed following training

CONTRAST THERAPY

How it works?

Vasoconstriction + vasodilation

Blood pumping effect

Reduced edema and pain

Decrease in DOMS

May decrease hypertrophy adaptations

How to do it?

1.5-2 hours post exercise

30 min

Hot 96-105 degree F: 5 min hot

Cold 50-68 degree F: 5 min cold

Recommendations:

Highly impractical for most, local tissue is potentially feasible

Ice therapy to impeding on hypertrophy adaptations, limit usage as needed

COMPRESSION THERAPY

How it works?

Improved blood and lymph flow

Reduced DOMS

Reduced edema

More effective with muscle damaging exercise

What does it do?

Improved strength performance within 24-48 hours

Reduction is creatine kinase post resistance training

How to do it?

Shirts, shorts, pants can be purchased with pressure of ~15-30mmHg

CEP Compression Leggings (Ex: CEP, 2XU, Skins)

Dynamic compression at facilities (ie Compression boots)

Apply 2 hours following training session for 12-48 hours for clothing, 20-30minutes via Dynamic compression

Recommendations:

More applicable during high training volume periods and contest prep

Clothing is practical to utilize

Compression boots must consider time efficiency vs other modalities

MASSAGE

How it works?

Effect is via relaxation and increase in parasympathetic activity primarily Most effective for reduction of perception of fatigue

Reduction of DOMS and Creatine Kinase up to 48 to 72 hours post training greater effect than cold water immersion, compression, and contrast therapy

Large contributing factor is relaxation with decreases in cortisol

Social support another benefit

How to do it?

Most studies implement massage within 2 hours post training, but

benefits can be seen up to 72hours post training

Other Notes:

General massage can not remodel soft tissue

Instrument Assisted soft tissue mobilization (IASTM) more efficacious for tissue remodeling

Recommend:

Massage Therapy by Graston and Active Release Therapy Certified LMT Minimum once per mesocycle or EW or EOW if able

Vibration Therapy (massage gun) research for similar efficacy as massage Foam rolling may provide other alternative

ESTIM AND EMS

How it works?

Vasodilation

Inhibit nociceptor signaling (decrease pain)

Increased motor unit firing and muscle contraction

May increase fatigue variables

Neufit:

DC current and EMS machine

Pretraining potential with Neufit and retraining neural firing patterns Improved range of motion post training

Potential for training with low load and stimulating hypertrophy Mixed research results on DOMS , no research on Neufit

Recommendations:

Higher cost to entry and research efficacy is low

Neufit therapy anecdotally effective rehab strategy

Low evidence for hypertrophy training recovery tool

FOAM ROLLING

How it works?

Reduction in tissue adherence and stiffness

Analgesic effect

Increased blood flow

Parasympathetic response

What does it do?

Acute improvement in ROM no more than stretching

Pretraining: short term improvement in ROM without performance decrease *cation: Analyze why ROM is poor to begin with

Post training: slight change in DOMS, but minimal effectiveness

Poor mans self massage?

How to do it?

Roll medial to distal on a muscle for 5 second duration for 30-60 seconds total, stop on trigger points for 10 seconds then continue rolling

Recommendation:

Rolling “tight spots” pre training effective for ROM without reduction in performance

Can be utilized post training, but small effects seen in recovery

Other Therapies

Stretching: No effect on DOMS or recovery enhancement, might increase DOMS

NSAIDS: blunt hypertrophy adaptations and slow recovery process, mask pain response Limit usage as needed

Cupping: No evidence to support improved recovery capacity outside

of relaxation, however increased tissue trauma can add fatigue

Float Tanks: Relaxation technique indirect effect on recovery

Active Recovery: No effect of recovery directly, may generate more fatigue (EX: light cardio post leg training)

Practical Takeaway

• Focus on Primary Recovery Strategies First (sleep, relax, rest, nutrition)

• Techniques that promote relaxation and social support show greatest benefit

• Limit Ice Therapy to immediate injuries and avoid otherwise

• Hot tub soaks for 20min practical and won’t limit hypertrophy

adaptations Implement > 2 hours post training Use as needed

• Massage work shows greatest efficacy post training recover, potential benefit for self massage techniques as well Implement 2-72 hours post training For cost consideration, implement during deload phases every 4-8 week or as needed

• Foam rolling pretraining not detrimental but evaluate if “tightness” is from poor connective tissue recovery and/or movement dysfunction patterns Do NOT force a ROM if the body says NO

• 2nd most efficacious strategies from massage is a compression garment worn post training for 2-12 hours More applicable during contest prep with heavy cardio work

REFERENCES

Nogueira, N.M., Felappi, C.J., Lima, C.S et al Effects of local cryotherapy for recovery of

delayed onset muscle soreness and strength following exercise-induced muscle damage:

systematic review and meta-analysis Sport Sci Health 16, 1–11 (2020)

https://doi.org /10.1007/s11332-019-00571-z

Wilke, J., Müller, A., Giesche, F et al Acute Effects of Foam Rolling on Range of Motion in

Healthy Adults: A Systematic Review with Multilevel Meta-analysis Sports Med 50, 387–402 (2020) https://doi.org /10.1007/s40279-019-01205-7

Brown F, Gissane C, Howatson G, van Someren K, Pedlar C, Hill J Compression Garments and

Recovery from Exercise: A Meta-Analysis Sports Med 2017;47(11):2245-2267

doi:10.1007/s40279-017-0728-9

Abạdia AE, Lamblin J, Delecroix B, et al Recovery From Exercise-Induced Muscle Damage:

Cold-Water Immersion Versus Whole-Body Cryotherapy Int J Sports Physiol Perform

2017;12(3):402-409 doi:10.1123/ijspp.2016-0186

Dupuy O, Douzi W, Theurot D, Bosquet L, Dugué B An Evidence-Based Approach for

Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage,

Soreness, Fatigue, and Inflammation: A Systematic Review With Meta-Analysis Front

Physiol 2018;9:403 Published 2018 Apr 26 doi:10.3389/fphys.2018.00403

Hauswirth C, Mujika, I Recovery for Performance in Sport Champaign, IL: Human Kinetics;

2013