RECOVER: Exploring How To Rest And Recover Well. Part 2: Newer Recovery Techniques.


In this this post we explore the newer recovery techniques that have been shown to benefit athletes and speed up the recovery process.

CRYOTHERAPY

Cryotherapy is a term which describes a range of therapeutic treatments aimed at lowering tissue temperature by the withdrawal of heat from the body. These treatments have a long history in medicine, with their use ranging from the removal of warts, to more conventional applications aimed to reduce swelling after tissue trauma, and the treatment of pain. Cryotherapy is used as an intervention for post-exercise recovery, particularly after exercise which raises body temperature, and causes inflammation of muscles. The basis for using cryotherapy is on the assumption that it is effective in decreasing metabolic rate, inflammation, blood flow, and skin, muscle and intra-articular temperatures.

Whole-body cryotherapy is, essentially, ice baths taken to a new and otherworldly level, and it is drawing considerable attention among athletes, both elite and recreational. In the cryotherapy chambers, the ambient temperature is lowered to a numbing minus 110 Celsius or minus 166 Fahrenheit. The chambers were originally intended to treat certain medical conditions,but athletes soon adopted the technology in hopes that supra-subzero temperatures would help them to recover from strenuous workouts more rapidly. That they would place faith in cold therapy is surprising, given that studies examining the effects of simple ice baths have been, at best, “inconclusive,” said Joseph Costello, a doctoral student in the physical education and sports sciences department at the University of Limerick in Ireland, who is studying the effects of whole-body cryotherapy.

A 2007 study of ice baths found that young men who completed a punishing 90-minute shuttle run and then eased themselves into a frigid bathtub (with the water cooled to 50 degrees Fahrenheit) for 10 minutes reported feeling markedly less sore a few days later than a control group who did not soak. But ice baths did not lower the runners’ levels of creatine kinase, often considered a hallmark of muscle damage. They felt better, but their muscles were almost as damaged as if they hadn’t soaked. Despite such findings, a growing number of elite soccer players, rugby teams, professional cyclists and track and field athletes in the United States and Europe have eagerly turned to whole-body cryotherapy. Because no agency in the United States or Europe regulates it, it’s impossible to say with any precision how many athletes are currently using the treatment, but researchers like Mr. Costello say the numbers are growing rapidly.

Before entering a cryo chamber, users must strip to shorts or a bathing suit, remove all jewelry and don several pairs of gloves, a face mask, a woolly headband and dry socks. Mr. Gatlin neglected that last precaution; his socks were sweaty from a previous workout and froze instantly to his feet. The athletes then move through an acclimatization chamber set to about minus 76 Fahrenheit and from there into the surface-of-the-moon-chilly cryotherapy chamber. At minus 110 degrees Celsius, whole-body cryotherapy is “colder than any temperature ever experienced or recorded on earth,” Mr. Costello said. The athletes remain in the chamber for no more than two or three minutes, stamping their feet and waving their arms to retain circulation. A Welsh rugby player described the experience as being in an “evil” sauna, but told British reporters that he believed that the sessions were helping him to recover more quickly from rigorous practices.

The science to support that optimistic appraisal is slim, though. A study by Mr.Costello, published earlier this year in the Scandinavian Journal of Medicine and Science in Sports, found that whole-body cryotherapy did not lessen muscle damage among a group of volunteers who’d completed grueling resistance exercises with their legs before entering the chamber. Another study, however, published in July in the Public Library of Science One, produced more encouraging results. For it, French researchers recruited a group of trained runners and put them through a simulated 48-minute trail run on a treadmill. Afterward, half of the runners entered a whole-body cryotherapy chamber once a day for five days. The rest sat quietly for 30 minutes a day for those five days. Blood was drawn from both groups throughout the experiment. From the first day onward, the runners who’d entered the chamber showed fewer blood markers of inflammation than the group who had recovered by sitting quietly. These results suggest that athletes could potentially “save two to three days” of training time compared with forgoing whole-body cryotherapy, But Alan Donnelly, a professor at the University of Limerick and Mr. Costello’s adviser and co-author, is unconvinced. Reducing inflammation, he points out, does not ensure that muscles have recovered. Such skepticism is not cooling enthusiasm among athletes, however.

CONTRAST TEMPERATURE THERAPY

Contrast temperature therapy consists of alternative cold and hot treatment through contrast temperature baths or warm and cold packs. A reduction in oedema and bruising, vasodilation and vasoconstriction of blood vessels, blood flow changes, and influences on the inflammatory responses have been attributed to this modality.The mechanism of action is however unclear as studies have shown that contrast therapy had little effect on deep muscle temperature.Therefore the theory that the effects of contrast therapy can be attributed to fluctuations in tissue temperature is not founded one experimental evidence. The data supporting the efficacy of this therapy is equivocal. For example, 20 rugby players performed are repeated sprint test and then were either allocated to a contrast temperature water therapy or active recovery.

The therapy consisted of three one-minute immersions in cold water (8 - 10°C) up to hip height, alternated with three one-minute hot water (38°C) showers. The active recovery consisted of six minutes of slow jogging. The contrast temperature group had a decrease in blood lactate concentration three minutes after the procedure and also had lower heart rates after the procedure and later when the subjects did a further set of exercise. There were no meaningful differences in sprinting performance one hour after either recovery treatment. Another study has also shown a reduction inplasma lactate after intense exercise, following contrast water immersion.

Although recommendations have been made about the ratio of warm to cold exposure and duration of treatment, there is a lack of scientific evidence to support the efficacy of any of these combinations. At best it can be said that any protocol involving contrast temperature therapy is based on anecdotal experience. Contrast therapy consists of immersing your legs in alternating containers of warm and cold water for several cycles over a 20-30 minute period. It’s much more labor-intensive than a simple ice bath, since it requires substantial set-up time and a good bit of work to ensure that both water containers are at the proper temperature. Nevertheless, it isn’t too much trouble to improvise a contrast bath setup at home for your foot or lower leg, so if there is some therapeutic benefit, even recreational runners might be interested.

Contrast bath and recovery

While some studies have shown that contrast therapy produces better recovery and reduces muscle swelling after intense exercise vs. passive recovery (i.e. doing nothing), only a few studies have compared contrast therapy to more simple forms of immersion therapy, like taking an ice bath. These studies have all found a benefit for both types of immersion over passive recovery, but no difference between the two. In a review on immersion therapy in general, Ian Wilcock, John Cronin, and Wayne Hing suggest that most of the benefits of contrast therapy are from the hydrostatic pressure from the water, not the variations in temperature. If this is the case, a complicated contrast setup is no better than a cold bathtub, or indeed even a dip in a lukewarm swimming pool or lake!

How to make your own contrast bath.

Since there is relatively little research on the practical applications of contrast therapy, there are not clear guidelines on what a“proper” contrast setup consists of. Here is what we do know from the research:

• Most studies alternate between water temperatures of 45-68° F for the cold water and 93-106° F for the hot water.

• Each immersion lasts between 3-5 minutes and the total immersion time is between 20and 30 minutes.

• Some studies end with heat, and others end with cold. The prevailing opinion now seems to be that it’s best to end on the cold bath, since that should retard inflammation. Contrast therapy’s role seems to be limited to replacing or supplementing active recovery (like jogging or walking) after a hard workout or race. It’s a complicated operation to set up, seeing as you need large containers of both hot and cold water. So, like many of the fads in exercise physiology, you probably aren’t missing out on much if you skip on contrast baths. However, you don’t really have anything to lose if you’ve got the time and will to try it, and you may find it has its use in your own training and recovery.

CUPPING

If you watched any of the Rio Olympics last year,then you may have noticed athletes with weird marks on their backs. These marks are from “cupping” therapy, an ancient Chinese medical treatment that purportedly has powerful health benefits. Cupping isn’t being used by the Chinese Olympic team. Instead, it’s been most commonly seen on US athletes like Michael Phelps. How does cupping therapy work? What are the benefits? Let’s take a closer look with 5 fast facts you need to know about the cupping therapy used by athletes in the 2016 Olympic Games in Rio de Janeiro.

There’s a Little Scientific Evidence Supporting It.

There’s little scientific evidence that cupping provides any health benefits – although the same can be said for virtually every traditional Chinese medicine practice. Most of these procedures lack Western scientific evidence, but many people continue to swear by them. One of the few high-quality major studies on cupping was performed in 2014 by the Beijing University of Chinese Medicine. That study revealed that cupping therapy has a “potential positive short-term effect” in terms of reducing the intensity of pain. Researchers in that study compared cupping to no treatment, heat therapy, and conventional pain killers. Another study published in 2012 reviewed over 135 controlled clinical trials performed around the world.

Researchers in that study found that cupping therapy – when combined with treatments like acupuncture or medications – provided “significant benefits over other treatments alone in effecting a cure” for conditions like shingles, acne, facial paralysis, or age-related wear and tear of spinal discs. Unfortunately, authors in this study found that 85% of the reviewed studies displayed or were at risk for displaying significant bias. Ultimately, cupping was clearly a popular treatment among athletes at the Rio Olympics in 2016. Michael Phelps’s performance on day 2winning gold, cupping certainly appeared to work for him.

Why They Do It

One US-based trainer cited by USA Today claims that the objective of cupping is “sort of flossing the soft tissue as we glide up and down and across the muscle tissue.” That coach claims it increases motion and gets rid of subtle tissue lesions within certain areas of the body. Other benefits include faster recovery times after athletic performance along with increased muscle movement.

Why It Discolors the Skin

The reason cupping discolors the skin is because it breaks up capillaries on the surface of your skin. That’s why athletes have been seen with cupping spots all over their bodies. There’s an increase to blood flow in the area and the capillaries on the surface break down. The discoloration can last about a week.Despite the weird marks, the procedure is reportedly perfectly safe.

How It Works

Cupping involves a process similar to the action of a suction cup on a wet window. When you apply a suction cup to a wet window, it stays there and creates suction underneath. Similarly, cupping creates a vacuum that lifts the skin up in that space, creating a lift of all the soft tissue beneath.The longer you leave that cup in place, the more fluid gets drawn into that area of the body. It increases blood flow to the area, which comes with all sorts of health benefits.There are actually different types of cups and cupping techniques. Dry cupping, for example, involves using cups that tug at the skin without breaking it. Some cupping procedures involve using mechanical devices – like hand or electrical pumps – to create suction. Others use fire cups, which use heat to increase suction. Wet cupping is a little more intense. With wet cupping, a therapist will puncture the skin using a toothbrush-like device that uses tiny spikes instead of bristles. These spikes break the skin, causing the suction cups to slowly fill with blood.

It’s Primarily Used by US Olympians

You might think that the Chinese Olympic teams would be the first ones to use ancient Chinese medicinal techniques. However, cupping isn’t really being seen on Chinese athletes or athletes from other Asian countries. Instead, it’s primarily being seen on US Olympians. LaShawn Merritt, for example, recently recorded the top time in the world this year in the 400 meter swim with visible cupping marks on his body. Michael Phelps has also been spotted with suction cup marks.

COMPRESSION GEAR

Compression is a therapeutic technique whereby external compression is applied following exercise or an injury. The theory behind this modality suggests that the external pressure reduces oedema by creating an external pressure gradient, thereby reducing the efflux of fluid from capillaries. Furthermore, the space available for fluid leakage is reduced, minimising haemorrhage and haematoma formation. Certain types of compression treatments involve a dynamic immobilisation that reduces movement during the recovery process. Although the evidence for the efficacy of this treatment was largely anecdotal, recent studies suggest that compression can be effective in minimising swelling, improving the alignment and mobility of soft issue, and improving proprioception in an injured joint.

The only study on compression garments and recovery from rugby showed that the players who wore lower-body compression garments for12 hours after the match showed similar signs of recovery (defined by clearance of creatine kinase from transdermal exudate) to players treated with active recovery and contrast temperature water immersion. All these treatments were better than no treatment at all. Unlike cold therapy, which should be applied intermittently, compression treatment should be applied constantly for at least 72 hours.Furthermore, it is important that the pressure of the compression garment does not exceed diastolic pressure, which is about 40 to 60mmHg for the upper limbs and 60 to 100mmHg for the lower limbs.

If the pressure exceeds these values, blood flow will be impeded. Ideally, the garment should create a distal to proximal pressure gradient to facilitate the removal of metabolites from the periphery towards the central circulation. This encourages fluid to move away from the high-pressure areas (site of injury) to the lower pressure areas. The commercial production of garments with these characteristics, designed to fit both the upper and lower body, has popularised this form of recovery treatment among rugby players.

Many recovery strategies for elite athletes are based on medical equipment or therapies used in patient populations. Compression clothing is one of these strategies that has been traditionally used to treat various lymphatic and circulatory conditions. Compression garments are thought to improve venous return through application of graduated compression to the limbs from proximal to distal (Bochmann et al., 2005). The external pressure created may reduce the intramuscular space available for swelling and promote stable alignment of muscle fibres, attenuating the inflammatory response and reducing muscle soreness (Kraemer et al., 2001).

Recreational runners wearing compression garments have been examined during and after intermittent and continuous running (Ali et al., 2007). The authors found that there was a reduction in delayed onset muscle soreness 24 h after wearing compression garments during a continuous exercise task (10 km). While not statistically significant, there was a trend for participants in the compression trial to perform the 10 km in a faster time than when not wearing the compression garments. Subjects wore commercially available graduated compression stockings, with the compression highest at the ankle (18-22 mmHg) and reduced by 70% to the top of the stocking, which ended below the knee. Recently, a reduction in the perception of muscle soreness after wearing compression garments during sprinting and bounding exercise and for 24 h after exercise was reported (Duffield et al, 2010). While perceptions of soreness were reduced, there was no change in sprint performance while wearing the garments.

While there is currently minimal research into compression garments and recovery for endurance athletes, the small amount of data suggests that there may be some small benefits and there is no indication that they impede the recovery process (Hill et al., 2013)

COMPRESSION AND PULSE RECOVERY SYSTEMS

Normatec describe their compression and pulse recovery product for us: "Our goal is to establish recovery as an integral part of every athlete’s training, and we feel NormaTec systems are the best way to accomplish that. The NormaTec PULSE Recovery Systems are dynamic compression devices designed for recovery and rehab. All of our systems use NormaTec's patented PULSE technology to help athletes recover faster between trainings and after performance. Our systems include a control unit and attachments which go on the legs, arms, or hips. They use compressed air to massage your limbs, mobilize fluid, and speed recovery with our patented NormaTec Pulse Massage Pattern.

When you use our systems, you will first experience a pre-inflate cycle, during which the connected attachments are molded to your exact body shape. The session will then begin by compressing your feet, hands, or upper quad (depending on which attachment you are using). Similar to the kneading and stroking done during a massage, each segment of the attachment will first compress in a pulsing manner and then release. This will repeat for each segment of the attachment as the compression pattern works its way up your limb. "

How the Human Body Removes Metabolic Waste

Our lymphatic system and blood vessels work together to flush waste from our cells naturally.Muscular movement, however, is needed to stimulate this process because the lymphatic system does not have a pump, like the heart does. Often athletes will perform light exercise to achieve this muscle contraction and increase circulation in the body, thereby reducing soreness in the muscles.

Compression & Pulse Systems expedites Post-Workout Recovery

Although the human body naturally excises waste that causes soreness and fatigue, this takes time. Compression & pulse systems delivers serious athletes an aggressive but very natural alternative to passive recovery that far exceeds the results achieved from many traditional modes of recovery. The system simulates localized "active recovery" in a passive manner because the therapy is conducted at rest.

What Happens When You Use Your Compression & Pulse System? Active sequential compression increases venous return, rapidly accelerating the body's reabsorption of the elements causing soreness and fatigue in the muscle. Specific levels of compression,measured in mmHg, increase circulation at all levels of the venous system - Deep Veins, Saphenous Veins, Superficial and Perforator Veins - effectively removing metabolic waste faster than any traditional mode of recovery or rest alone. Compression and pulse systems aim to speed up your body's own natural means of recovery and allow you to quickly climb back to your peak performance levels with the proven technology that addresses muscle pain at its source.

Recovery is all about finding methods and techniques that allow your body to recover from excessive training and over excertion. Some techniques may work for you and others not, but the main goal is to allow your body the correct time to rest and recover.

#recovery

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