UNIVERSITY Recovery Tools and Aids Ice, Heat, Massage, and other techniques that may aid recovery 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, 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 it? 1.5-2 hours post exercise 30 Hot 96-105 degree F: hot Cold 50-68 degree F: 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 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 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 it? Most studies implement massage within 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 it? Roll medial to distal on a muscle for 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 > 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 Abaïdia 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  ... 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. .. 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 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