Search Results for "rest, recover, regenerate"

Hopefully you have enjoyed my “Rest, Recover, Regenerate” series.  So far we have covered Overtraining Syndrome, Diaphragmatic Breathing, Contrast Therapy and Nutrition.

I wanted to finish up this 5-part series with the final insallment on massage.

Although massage has been a popular form of recovery from training and competition in athletics for a significant period of time, there is conflicting research on the potential benefits massage offers to an athlete.

Massage therapists commonly cite the following benefits of massage therapy:

• Improved joint range of motion
• Enhanced blood flow
• Improved lactic acid removal
• Decreased muscle soreness, increased relaxation and improved parasympathetic activity

Massage therapy research still has a long way to go as far as investigating what takes place under the skin and in the body during a massage, as well as validating (or refuting) many of the claims made by massage therapists around the world.  The goal of this article will be to talk about some of the purported benefits of massage listed above, and their application to athletic recovery.  Additionally, I will address some of the issues with massage therapy research (as there are many).

This article is in no way written to be an exhaustive review of the literature on massage or the benefits of massage in any other form other than recovery from exercise.  In future articles, I hope to address fascia and the brain, and how this may give us more information on what we think is taking place when an individual performs soft tissue massage therapy on you, and the potential affect this may have with regard to tissue quality.

Improved Joint Range of Motion

One of the main reasons an athlete sees a massage therapist is to enhance their joint range of motion.  This may be especially important following intense workouts or competition, when an athlete is sore or stiff.

A study conducted by McKechnie and associates looked at the effects that a 10-minute massage using two different massage techniques (vigorous petrissage and tapotment) would have on acute plantar flexor power and joint flexibility.  Both forms of massage showed significant improvements in ankle joint flexibility (dorsiflexion), and while the massage techniques did not improve power output (in a drop jump or concentric calf raise), it did not impair it.

Obviously massage is an inhibition of the nervous system, serving to increase relaxation, so I wouldn’t expect it to show improvements in power output.  Though I am still surprised that power output was not hindered by the two massage techniques.  Regardless, this paper does suggest that massage can play a beneficial role in increasing joint range of motion.   The mechanisms of how and why this works still need to be evaluated, as do further studies to determine what type of technique is the best approach to see these changes.

Enhanced Blood Flow

While one would expect massage to increase blood flow, research into this topic is rather scarce and conflicting.  Many of the studies are poorly conducted, making the results difficult to determine what the significance is.

Some evidence has been published that shows increases in and muscle temperature increase following massage, however, this local increase in temperature may not have high relevance to muscle blood flow.

Other studies show improvements in blood flow for a short period of time following various massage techniques ranging from 10-minutes up to 3-hours post massage intervention.  The length of time that muscle blood flow was improved was dependant on the length of time the massage was conducted in the study.

Hopefully future research will look more closely at muscle blood flow and massage to determine what exactly is taking place within the circulatory system when a massage is administered.

Improved lactic acid removal

Lactic acid has long been thought of as a reason that athletes get sore.  Additionally, it has been taught in massage schools that lactic acid is a “toxin” or “waste product” that we are trying “flush out” with massage techniques, in order to help athletes recover.

Unfortunately, there is no truth to either of these statements.  In fact, lactate is actually an important fuel for muscles during exercise and your body clears it out rather rapidly on its own.

Therefore, any of the studies looking at lactic acid removal as a potential benefit of massage therapy are looking at the wrong thing.  It really doesn’t matter!  Additionally, I don’t know many people that run out to get a massage following a highly anaerobic bout of exercise.  The idea that clearing lactic acid out following exercise would somehow improve performance on a subsequent exercise test is actually pretty silly.

Decreased Muscle Soreness, Increased Relaxation, and Improved Parasympathetic Activity

Improving relaxation is one of the main reasons that people seek out massage.  This alone can be a huge benefit to athletes following strenuous training or competition.  A study conducted by Arroyo-Morales and associates found that myofascial release after high intensity exercise favored the recovery of heart rate variability and diastolic blood pressure to pre-exercise levels following high-intensity exercise, assisting the recovery of the autonomic nervous system. 

Decreases in muscle stiffness and perceptions of fatigue are another reason why massage has been popular amongst athletes.  Ogai and colleagues looked at the effects of petrissage on fatigue following intense cycling.  Subjects performed a rigorous interval based cycling routine, and then were asked to rest on a bed in a supine position for 35 minutes before repeating the test.  The control group just rested, while the experimental group received petrissage for 10 minutes (from the 5th to 15th minute of rest).  Ogai et al. concluded that the massage group improved pedaling performance via decreased muscle stiffness and perceived lower-limb fatigue.  These improvements were independent of blood lactate levels.

Finally, several studies have shown a decreased perception of muscle soreness.  While researchers are still trying to determine what the mechanism for this is (psychological or physiological), this is one of the greatest benefits that massage can offer an athlete looking to recover from training/competition.

Improved Immune Function

An interesting study published last year in the Journal of Strength and Conditioning Research looked at the benefits that massage has on immune function.  Following a wingate test on a cycle ergometer, the 60-subjects were given a saliva test to measure baseline levels of salivary cortisol and immunoglobulin A (IgA).  The subjects where then either placed in a placebo group (40-minutes of sham electrotherapy) or a 40-minute full-body massage group (experimental group).  Following each intervention, the subjects where then given another saliva test. 

The results showed changes in salivary cortisol levels between the placebo and massage groups.  Although they were not significant, they were positive changes, with cortisol levels being lowered in the massage group.  In addition, there were significant changes in salivary immunoglobulin A (sIgA).

Salivary IgA, an immunoglobulin found in the saliva, drops during intense exercise.  If one were to over-train, this would further suppress immunoglobulin A, placing our immune system in a compromised state and potentially exposing the athlete to sickness and/or infection.

That being said, if massage can potentially help to increase salivary IgA following intense exercise or competition, massage may play a vital role in recovery and regeneration of the athlete.

Issues with massage research

There are several issues with research in massage and athletics:

1. Time – The length of time that massage is administered in research is typically very short (usually around 5-10min) compared to what it would normally be in a real life setting.  Some of the beneficial results of a massage may not be seen with such a short intervention time.
2. Choice of therapist – Some studies don’t discuss much about the therapist being used, their background, or their experience.  Some studies conducted on massage and anxiety or relaxation are done in nursing facilities where the therapists chosen for the study are nurses, who are typically not skilled in soft tissue therapy techniques.
3. The Protocols Chosen – In order to maintain consistency, research uses a protocol-based approach to massage therapy (IE 5min of pettrisage, 5min of efflaurage, and 2min. of stretching on a particular muscle group).  Unfortunately, human beings are not a protocol, and rarely will they fit the mold of a protocol-based massage.  Experienced therapists have the ability to assess which muscles need more work than others, and which muscles may benefit from one technique over another.  However, this sort of improvisation does not lend itself well to the research model.

Conclusion

While there is not much research on massage therapy in athletics, it still remains to be a popular choice amongst athletes and coaches.  One of the main benefits that massage offers athletes is a decrease in perceived muscle soreness and improved relaxation.  Massage may also be beneficial to enhancing joint range of motion, which offers a significant benefit to athletes looking to improve mobility.  Additionally, there is some research to suggest that massage may offer potential benefits to immune function.

There are several issues with research conducted on massage therapy, and hopefully further research will help us gain a better understanding of the benefits of this type of therapy and how and when it would be best applied.

In future articles, I hope to go more in depth into fascia and the brain, and the potential affects that massage has on these systems, as well as some of the theories as to why it works.

Patrick
patrick@optimumsportsperformance.com
References

Weerapong P, Hume PA, Kolt GS. The Mechanisms of Massage and Effects of Performance, Muscle Recovery and Injury Prevention. Sports Med. 2005;35(3):235-65.

McKechnie GJ, Young WB, Behm DG. Acute Effects of Two Massage Techniques on Ankle Joint Flexibility and Power of The Plantar Flexors. J Sports Sci Med. 2007;6:498-504.

Gladden BL. A “Lactatic” Perspective on Metabolism. Med Sci Sports Exerc. 40(3): 477-85. 2008.

Martin NA, Zoeller RF, Robertson RJ, Lephart SM. The Comparative Effects of Sports Massage, Active Recovery and Rest in Promoting Blood Lactate Clearance After Supramaximal Leg Exercise. J Athl Train. 1998;33(1):30-35.

Arroyo-Morales M, Olea N, Martinez M, Moreno-Lorenzo C, Díaz-Rodríguez L, Hidalgo-Lozano A. Effects of Myo-Fascial Release After High Intensity Exercise: A randomized Clinical Trial. J Manipulative Phisol Ther. 2008;31(3):217-23.

Ogai R, Yamane M, Matsumoto T, Kosaka M. Effects of Petrissage Massage on Fatigue and Exercise Performance Following Intensive Cycle Pedaling. Br J Sports Med. 2008 Apr.

Arroyo-Morales M, Olea N, Ruiz C, del Castilo Jde D, Martinez M, Lorenzon C, Diaz-Rodriguez L. Massage After Exercise – Responses of Immunological and Endocrine Markers: Single-Blind Placebo-Controlled Study. J Strength Cond Res. 2009 Mar;23(2):638-44.

Nutrition plays an essential role in our ability to recover from a hard workout or competition.  With so much information out there on nutritional intake, various diets, and supplements, it can get extremely confusing about what you should be eating, and when you should be eating it. 

Because pre, during, and post workout nutrition are so critical to recovery, I have decided to focus this article on that topic.  However, 24-hour nutrition plays an important role in recovery and athletes should seek to establish healthy routines with regard to food consumption both in quantity and quality.  Hopefully this article will give you some general/practical recommendations regarding nutrition intake and how it can promote better recovery from training. 

Note: Consult your physician before making dietary changes or ingesting over-the-counter supplements.  The information in this article is not meant to be offered as medical advice and should not be followed instead of a proper medical consultation.  For athletes looking to optimize their nutrition program, it would be best to consult with a registered dietician that specializes in sports nutrition.  These professionals can be located through the International Society of Sports Nutrition.

Carbohydrates post exercise

It has been known for sometime now that post workout nutrition plays an important role in jump-starting recovery following intense training.  Thirty to sixty minutes following exercise is often touted as the “window of opportunity” to get nutrients in.  This is due to the fact that exercise induces an increase in insulin sensitivity, as well as greater permeability of the muscle cell membrane to glucose (blood sugar).  Therefore, carbohydrate intake during this period is extremely beneficial for increasing glycogen storage (glycogen is the storage form of carbohydrates), which has been lowered following intense bouts of exercise.  Additionally, forgoing carbohydrate intake during the 30-60 minute window has been shown to lead to lower rates of glycogen storage, which may have a negative impact on ones ability to recover from training and be prepared for the following training day.

Burke, Kiens, and Ivy offer the following recommendations for daily carbohydrate intake:

• Immediately following exercise: Within a 0-4 hour window post-exercise, consume 1-1.2g per kilogram of bodyweight per hour, at frequent intervals.
• Daily recovery from moderate duration/low-intensity training: 5-7g per kilogram of bodyweight per day
• Daily recovery from moderate to heavy endurance training: 7-12g per kilogram of bodyweight per day
• Daily recovery from an extreme exercise program (4-6+ hours of training per day): 10-12+ grams per kilogram of bodyweight per day

Carbohydrate + Protein post exercise

While the effects of carbohydrate supplementation directly following a bout of exercise are encouraging, these effects appear to be enhanced when protein is combined with the carbohydrate.

Nine male cyclists performed a 2-hour cycling program.  The first 90min. of the program consisted 3 rounds of 15min cycling at 60-65% Vo2max, 15min cycling at 70-75% Vo2max.  The last 30min. of the training program consisted of 10min. cycling at 60-65% Vo2max, 10min. cycling at 70-75% Vo2max, 5min. cycling at 50% Vo2max and 5min. cycling at 80-85% Vo2max.  This training protocol, along with a 12 hour fast prior to training, was used to deplete the athletes’ muscle glycogen.  This program was performed three times during the study, each separated by 7-days.  Following the training program, the cyclists were given a different post workout supplement on all three occasions.  The supplement was administered both post workout and repeated again 2-hours later.  Contents of the supplement during each of the three trials was as follows:

1. 112g of carbohydrate
2. 40.7g of protein
3. 112g of carbohydrate + 40.7g of protein

Zawadzki and colleagues found that the carbohydrate only supplement had a significantly greater plasma glucose response than the carbohydrate + protein supplement.  This is because the carbohydrate + protein supplement had a significantly greater plasma insulin response than the carbohydrate supplement, leading to a significantly faster rate of muscle glycogen sythesis (due to insulin’s stimulating effect on muscle glycogen synthesis and glycogen synthase) compared to the carbohydrate supplement (which was faster than the protein supplement).

Similar findings were esstablished by Berardi et al, who found that muscle glycogen resynthesis was enhanced with a carbohydrate-protein (0.8g carbohydrate per kg of BW/0.4g protein per kg of BW) supplement relative to a carbohydrate supplement (1.2g carbohydrate per kg of BW) or placebo.

General recommendations for protein intake immediately following exercise are 0.4-0.6g protein per kg of bodyweight. 

Daily protein intake recommendations have varied depending on the source.  Some resources have established daily protein requirements to be 1.2-1.4g/kg of bodyweight for endurance athletes, and 1.6-1.7g/kg of bodyweight for strength training athletes.  Others have given the broad recommendation of 1.2-2.0g/kg of bodyweight; while the U.S. registered daily allowance (RDA) recommendations are more conservatively set at 0.8g/kg of bodyweight.  However, it should be noted that the RDA recommendation is designed to prevent protein deficiency, not enhance sport or exercise performance. 

Carbohydrate + Protein pre- and during workout

While post workout nutrition has been shown to be beneficial to an athletes’ recovery, more current research has shifted towards what the athletes are consuming both pre- and during training, in an attempt to optimize their nutritional strategy.

Baty and colleagues conducted a study on 34-untrained male subjects consuming either a carbohydrate-protein supplement or placebo before, during and after resistance training.  The subjects underwent a 3-week adaptation phase where they trained 3x’s/week and were instructed and trained on the 7-exercises that were going to be used during the experimental portion of the study.  The testing day occurred in week four, and the subjects, randomly placed in either an experimental/supplement group or a placebo group, underwent the following routine:

• Following a blood draw the subjects consumed 355ml of their liquid supplement – 16 receiving the carbohydrate-protein supplement and 18 receiving a placebo – and then rest quietly for 30min.  This was a double-blind experiment, so the subjects or the individual overseeing the experiment that day had no idea who was receiving the actual supplement and who was receiving a placebo.
• After their 30min. rest, the subjects received a second blood draw and then consumed another 177ml of the supplement or placebo.
• The subjects then performed the first 4-exercises in their routine.  After those exercises were complete, a third blood draw was conducted, and the subjects again consumed 177ml of their assigned liquid.  The subjects then completed the final three exercises in their routine
• Immediately following the last exercise, the fourth blood draw was conducted, and the subjects consumed another 355ml of their liquid drink.
• The subjects rested in the weight room, until a fifth blood drawn was then taken.
• Finally subjects were allowed to leave the weight room, however they had to return five hours later for the sixth blood draw (the subjects were asked not to consume food until after the sixth blood draw, when they could then eat freely).
• The seventh and final blood draw was conducted 24-hours post exercise.

What the researchers found was that markers of muscle damage (plasma myoglobin and creatine kinase) as well as cortisol levels were significantly elevated in the placebo group compared to the carbohydrate-protein group.  Additionally, those in the carbohydrate-protein group reported less muscular soreness 24-hours after training compared with the placebo group.  While the researchers did not find any significant differences between the two groups with regard to exercise performance, the noted results would certainly suggest that supplementation with a carbohydrate and protein beverage before, during and after training would be beneficial to the athletes recovery.  The findings of this study led the researchers to conclude; “These results suggest the use of a carbohydrate-protein supplement during resistance training to reduce muscle damage and soreness.”

Saunders et al, also sought to evaluate the potential benefits of a carbohydrate beverage on performance and muscle damage.  Fifteen male cyclists performed two rides 12-15 hours apart.  The first ride consisted of the subjects riding at a pace of 75% Vo2max to volitional exhaustion, while the second ride was performed at 85% Vo2max, again to volitional exhaustion.  The subjects consumed either 1.8ml per kilogram of bodyweight of either a carbohydrate only or a carbohydrate-protein beverage (randomly assigned) every 15min. of exercise, and 10ml per kilogram of bodyweight of the same beverage immediately following the ride.  The subjects were blinded to which beverage they consumed and were asked to then repeat the same training protocol 14-days later, when they were then given the opposite supplement that they consumed in the first trial.

Unlike the results from Baty and colleagues, the subjects in the carbohydrate-placebo group in this study saw performance improvements when compared to the carbohydrate only group.  During the first ride (75% Vo2max), those in the carbohydrate-protein group were able to ride 29% longer, while during the second ride (85% Vo2max), they were able to ride 40% longer.  Post exercise muscle damage, assessed by plasma creatine phosphokinase (CPK) levels, were 83% lower in the carbohydrate-protein group compared to the carbohydrate only group.  With these findings, it would appear that the co-ingestion of carbohydrate and protein has the potential to enhance exercise performance and decrease muscle damage.

In order to optimize training results and enhance recovery via better nutrition, athletes should seek to ingest carbohydrate-protein around the workout (before, during and after), as this is a critical time period to get nutrients into the body, and enhance the rebuilding processes following training. 

Taking a carbohydrate-protein supplement at other times of the day may lead to less than desirable results.  Cribb et al., found that when taken before and immediately after training, a supplement consisting of carbohydrate, protein and creatine monohydrate elicited greater results in lean-body mass and 1RM strength, as well as improved muscle creatine and glycogen stores, when compared to a those subjects taking the same supplement in the morning upon waking and in the evening, before bed, on each training day. 

Furthermore, because of it is of high quality, because it is rapidly digested, and because it contains a high level of amino acids, whey protein seems to be the protein of choice for post workout nutrition.  However, when ingested pre-workout, it does not appear to have the same effect on amino acid uptake, while a supplement containing essential amino acids (EAA) plus carbohydrates has been shown to improve muscle protein synthesis when take pre-workout, compared to post-workout intake.  For this reason, athletes may choose to consume an essential amino-acid and carbohydrate supplement prior to training, and a whey protein plus carbohydrate supplement post workout.

 Conclusions

Nutrition plays an important role in recovery from training and competition.  Athletes looking to maximize the results from their training should take their nutrition seriously, and establish a healthy meal plan that is tailored to their needs.  Additionally, nutrition around the work plays a critical role in helping to enhance recovery, improve glyogen resynthesis, and promote greater muscle protein synthesis.  This article contained general recommendations for the amount of protein and carbohydrate intake one should ingest around their workout and during the day.  For the best results, and for individualized recommendations, athletes should seek to consult with a registered dietician or sports nutritionist through the International Society of Sports Nutrition.

Patrick

patrick@optimumsportsperformance.com 

References

Burke LM, Kiens B, Ivy JL. Carbohydrates and Fat for Training and Recovery. J Sports Sciences 22:15-30. 2004.

Zawadzki KM, Yaspelkis BB, Ivy JL. Carbohydrate-protein complex increases the rate of muscle glycogen storage after exercise. J Appl Physiol 72(5):1854-1859. 1992.

Berardi JM, Price TB, Noreen EE, Lemon PW. Postexercise muscle glycogen recovery enhanced with a carbohydrate-protein supplement. Med Sci Sport Exerc 38(6):1106-1113. 2006.

Tipton KD, Witard OC. Protein Requirements and Recommendations for Athletes: Relevance of Ivory Tower Arguments for Practical Recommendations. Clin Sports Med 26:17-36. 2006.

Phillips SM. Moore DR, Tang JE. A critical examination of dietary protein requirements, benefits and excesses in athletes. Int J of Sports Nutr and Exerc Metabolism 17:S58-S76. 2007.

Baty JJ, Hwang H, Ding Z, Bernard JR, Wang B, Kwon B, Ivy J. The effect of a carbohydrate and protein supplement on resistance exercise performance, hormonal response and muscle damage. J Strength Cond Res 21(2):321-29. 2007.

Saunders MJ, Kane MD, Todd MK. Effects of a carbohydrate-protein beverage on cycling endurance and muscle damage. Med Sci Sports Exerc 36(7):1233-1238. 2004.

Saunders MJ. Coingestion of Carbohydrate-Protein During Endurance Exercise: Influences on Performance and Recovery. Int J of Sports Nutr and Exerc Metabolism 17: S87-S103. 2007

Cribb PJ, Hayes A. Effects of Supplement Timing and Resistance Exercise on Skeletal Muscle Hypertrophy. Med Sci Sports Exerc 38(11):1918-1925. 2006.

Tipton KD, Tabatha AE, Cree MG, Aarsland AA, Sanford AP, Wolfe RR. Stimulation of net muscle protein syntehsis by whey protein ingestion before and after exercise. Am J Physiol Endocrinol Metab 292:E71-76. 2007.

Tipton KD, Rasmussen BB, Miller SL, Wolf SE, Owens-Stovall SK, Petrini BE, Wolfe RR. Timing of amino acid-carbohydrate ingestion alters anabolic response of muscle to resistance exercise. Am J Physiol Endocrinol Metab 281:E197-206. 2001.

Contrast therapy has been used as a method of recovery in athletics for a significant period of time.

This type of therapy alternates between the application of hot and cold in a repetitive fashion, with the theoretical goal being to enhance recovery, decrease delayed-onset of muscle soreness (DOMS), enhance blood lactate removal, and improve various other markers of inflammation.

Application of Hot and Cold

When using contrast therapy, several factors must be taken into consideration:

• The temperature of the hot and cold plunges
• The duration of time that one spends in the hot and cold plunge
• The number of times one should alternate between hot and cold
• Which intervention – hot or cold – should begin and end the therapy
• Method – some may choose to just place one body part into the hot/cold plunge (IE, lower leg or forearm), while others may choose to do a full body plunge or just a plunge up to their waist.  Additionally, some studies didn’t use a plunge, but rather alternated between hydrocollator (hot packs) and ice packs.

Many coaches and athletes probably have their favorite way of applying contrast therapy; however, the research seems to be up in the air as far as the best way to go about managing hot and cold.

In studies, the duration of time in the hot and cold tended to vary from 1min hot:1min cold all the way up to 10min. hot:1min cold.  The common trend seems to be to have the cold interval shorter than the hot interval, with a majority of the studies using 1min. for the cold plunge. 

One study used 5min hot:5min cold.  The cold intervention, however, was with an ice pack (rather than a cold pool) and the temperature was not noted in the study – this is important to note, as 5min. in an extremely low temperature cold plunge may not be well tolerated by the athletes.

The total duration of time that the athletes spent performing contrast therapy in studies varied.  This would alter the number of times athletes alternate between hot to cold, depending on the duration of time spent in the hot and cold.  Overall, total duration varied from as low as 6-minutes, all the way up to 31-minutes of contrast therapy.

The temperature of hot and cold was different amongst studies as well. 

The temperature during the hot intervention varied from 38° C up to 75° C (100.4° F up to 167° F).  It should be noted that the 75° C was applied via hydrocollator pack with a terry cloth and two layers of towels used to protect the subjects from excessive heat.  The highest temperature used in a study where subjects were submerged up to their waist was 42° C (107.6° F). 

For cold interventions, temperatures ranged from 8° C to 15° C (46.4° F to 59° F).

Starting with hot or cold differed amongst studies, with the majority of the studies electing to begin with heat and end with cold.

Enhancements in Recovery

Studies on contrast therapy have found that this intervention has been shown to change subcutaneous tissue temperature – possibly suggesting enhancements in peripheral circulation and cuteaneous sensation.  However, no studies to date have shown actual changes in intermuscular temperature.

One study showed significant fluctuations in blood flow during a 20min contrast therapy session, where changing from hot to cold showed decreases in blood flow and vice versa when going from cold to heat.  Additionally, when looking at blood marker changes, contrast therapy was shown to reduce creatine kinase (a marker of inflammation) and blood lactate concentration at a similar rate as active recovery, when compared to passive recovery following training.  These findings may suggest that contrast therapy has a potential benefit to athletic recovery.

Finally, following exercise, contrast therapy was shown to decrease girth measurements, increase joint range of motion, and improve perceptions of soreness.

Conclusions

Anecdotally, athletes and coaches have used contrast therapy as a means to enhance recovery following training and competition.

While studies on contrast therapy are limited and their quality has been questioned, the take home points for me are:

• Athletes perceive less soreness following contrast therapy.  The mind is incredibly important, and if this method makes athletes feel less sore and more relaxed/recovered, then its use can be validated in my book.
• Both contrast therapy and active recovery have been shown to improve markers of inflammation following exercise when compared to passive recovery.  This information is potentially beneficial, as active recovery – while helping to get athletes moving and improve recovery – is still dependant on the athletes performing exercise (even if it is low-intensity), which may add more joint stress to an athlete who is slightly overtrained.  Further, for athletes who are in the middle of a long season, the use of contrast therapy may be more appealing (psychologically) than trying to go out and get in another workout/training session (again, even if it is low-intensity).

Hopefully future research will look more closely at this method of recovery to help athletes and coaches come to conclusions about the best ratio, total duration, and application of contrast therapy.

Patrick
patrick@optimumsportsperformance.com

References

Hing WA, White SG, Bouaaphone A, Lee P. Contrast therapy – a systematic review. Physical Thearpy in Sport 2008;9:148-161.

Myrer JW, Measom G, Durrant E, Fellingham GW. Cold and Hot-pack contrast therapy: Subcutaneous and intramuscular change. J Athletic Training 1997;32(3):238-241.

Myrer JW, Draper DO, Durrant E. Contrast therapy and intramuscular temperature in the human leg. J Athletic Training 1994;29(4):318-322.

Breathing is essential for life.  Without oxygen, we cannot live.

I wrote about breathing in two pervious articles that I suggest checking out if you are interested in more information on this topic.  THE FIRST was about some of the negative things that take place in our body when breathing patterns are poor, while THE SECOND was a video example of how to evaluate breathing patterns in your clients (and these tests can then become the exercises/corrections when breathing is faulty).

Breathing and Recovery From Training/Competition

Breathing can also play an important role in our regeneration strategies, as proper diaphragmatic breathing can be extremely relaxing.

A 2009 study conducted by Martarelli et al, looked at diaphragmatic breathing and its potential in reducing exercise-induced oxidative stress.

Sixteen amateur (male) cyclists where evaluated during an extremely stressful training session.  Following the session, the individuals were divided into two groups:

• The control group spent 1-hour following training sitting in a quite space, relaxing and reading magazines.
• The experimental group, diaphragmatic breathing group, spent 1-hour focusing on diaphragmatic breathing – which was taught to them before beginning the study - in a similar quite space to that of the control group.

The researchers evaluated the athletes for:

• Oxidative stress
• Biological Antioxidant Potential
• Changes in cortisol levels
• Changes in melatonin levels

Oxidative Stress

While oxidative stress was increased following the exhaustive exercise session (as expected), those in the diaphragmatic breathing group significantly decreased their oxidative stress, as reported by the d reactive oxygen metabolite test (d-ROM test) which measures the plasma reactive oxygen metabolites produced by reactive oxygen species (which are free radicals).

Biological Antioxidant Potential, Cortisol and Melatonin

The biological antioxidant potential test is one that evaluates the plasma levels of antioxidants.  Those in the diaphragmatic breathing group showed significant improvements in biological antioxidant potential, which corresponds with reduced levels of cortisol and reactive oxygen metabolites, as well as increased levels of nocturnal melatonin (an important hormone involved in the reduction of oxidative stress, due to its antioxidant properties).

A greater decrease in cortisol, while not statistically significant in this study, was observed for the diaphragmatic breathing group, and the diaphragmatic breathing compared to the control subjects observed a statistically significant improvement in melatonin.

Researchers Conclusions

The researchers stated that, “If these results are confirmed in other intense physical activity programs, relaxation could be considered an effective practice to contrast the free radical-mediated oxidative damage induced by intense exercise.”

The researchers propose the following rationale for the reduced neuroendocrine response by relaxation as seen in the diaphragmatic breathing group:

• Intense exercise increases cortisol production
• A high plasmatic level of cortisol deceases the bodies antioxidant defense
• A high plasmatic level of cortisol correlates with a high level of oxidative stress
• Diaphragmatic breathing reduces the production of cortisol
• Diaphragmatic breathing increases melatonin levels
• Melatonin is a strong antioxidant
• Diaphragmatic breathing increases the biological antioxidant potential
• Diaphragmatic breathing reduces oxidative stress

For those that prefer a visual representation of this process:

Wrapping up

Diaphragmatic breathing is easy to teach, and educating the athletes on the importance of this technique and the importance of relaxation is a cost free way to help athletes rest, recover and regenerate following stressful training and competition.

Patrick

patrick@optimumsportsperformance.com

References

Martarelli D, Cocchioni M, Scuri S, Pompei P. Diaphragmatic Breathing Reduces Exercise-Induced Oxidative Stress. Evidence Based Complimentary Alternative Medicine. Oct 2009: 1-9.

Recovery is an essential aspect of the training process. Put simply, if we aren’t recovering from the stresses we are placing on our bodies, we can’t improve.

We typically discuss various training methods and strategies to help improve sports performance, often overlooking the importance of recovery and what we are doing outside of the gym as a way to maximize what we are doing inside of it.

I’ll admit, talking about recovery may not be as exciting as talking about training or ways to create a program that will lead us to athletic dominance. However, it is an important topic that needs to be covered if you want to get the most out of training and prevent injuries and overtraining.

Over the next few articles, we will take a look at some methods of helping to improve recovery and (hopefully) prevent overtraining.  In this first part, I just want to give a little background of what overtraining syndrome is, how it happens and some of the signs and symptoms of overtraining.

Overtraining Syndrome

In a nut-shell, overtraining is the accumulation of stress (both training and non-training stressors) which, when not tended to properly, leads to a decrease in performance with physiological and/or psychological symptoms that may take weeks or months to recover from.

I think she missed the warning signs.

Whenever an imbalance between training/competing and recovery occur, there is a possibility for overtraining.  On a small scale, some overtraining is thought to be beneficial, and is often referred to as “overreaching” - a process where the athlete purposefully overtrains slightly with the idea that they will increase recovery at the end of the overreaching phase of training and take advantage of “supercompensation”, which occurs when fatigue dissipates and the new level of fitness is able to manifest itself.  The needed period of recovery from overreaching may last a few days to a week, and athletes will show signs of overtraining (decreases in performance, fatigue, delayed recovery between training bouts, poor sleep patterns, etc); however, the athlete should be monitored to ensure that none of these red flags of overtraining get out of control – often athletes will be asked to train to an 8-10% decrease in performance before going into the recovery phase and allowing supercompensation to take effect.

The concept of overreaching is a controversial one, as many coaches don’t want to put their athletes into these overtrained situations, even it is only for a brief period of time.  I also tend to err more on the side of caution and feel that putting someone purposefully into an overtrained state should not be the goal of the training program.  Additionally, when working with athletes who play in sports that have long competive seasons or play multiple competitions per week (baseball, basketball, hockey, football, etc…), the goal should really be to keep the athlete healthy and free from overtraining, so that they can perform optimally come game time.

Stress and Overtraining

Things like travel schedules, long flights across time zones, poor nutrition/food choices on the road, and stresses imposed on the athletes by their coaches all may add more stress on the athlete, leading to a further potential for overtraining/under recovery.  If the stress of training and competition is not bad enough, athletes also have to worry about the stress of their everyday lives.  Things like social stress, financial stress, and family stress can all play a role in decreasing ones ability to recover from training/competition. 

Athletes of all ages, from high school through the professional ranks face life stresses that need to be taken into consideration when evaluating the overall program and the amount of stress you are placing on a given athlete.  Bartholomew and colleagues showed that high amounts of life stress impact ones ability to adapt to a strength-training program, with low-stress individuals showing significantly greater improvements in squat and bench press strength than those with high-stress levels.  This study was conducted on 135-undergraduate students who trained twice a week (1.5-hour training sessions) for 12-weeks.  This amounts of 3-hours of total training per week, is a far cry from what is expected of an athlete at the college level (between practice, training and competition) and in most cases, high school athletes are even exceeding this amount of training per week.

Inflammation, Tissue Trauma and Overtraining

Several authors have set out to understand the underlying cause of overtraining syndrome and how the overtraining processes is initiated.  Some of the proposed mechanisms have been:

• Glycogen Hypothesis, which has looked at reduced levels of glycogen as markers of fatigue and overtraining.
• Central Fatigue Hypothesis, which looks at, reduced levels of circulating tryptophan (an amino acid), which cause it to be taken up in the brain to a greater extent.  Tryptophan is a precursor to serotonin, a neurotransmitter which, when elevated has effects on the body such as increased need for sleep and reduction in appetite (both are tell-tale signs of overtraining).
• Glutamine Hypothesis, which seeks to explain the decrease in immune function and increase in illness during periods of overtraining, as glutamine is an important amino acid used for fuel by lymphocytes in the immune system.
• Hypothalmus and Hypothamic-pituitary-adrenal axis implications, where the blood catecholamine, glucocorticoid and testosterone levels are altered.
• Lack of day-to-day variations in training, which expose the athletes to “burn-out” and potential overuse injuries.

Together, all of the above theories explain some aspect of overtraining syndrome, yet a definite underlying cause has not been concluded upon.

Researcher Lucille Lakier Smith has proposed the idea that overtraining may begin with (and be caused by) tissue trauma. 

First, it is important to note that some level of tissue trauma is not bad.  In fact, a little bit of trauma is needed in order to force an adaptation (hence the name Adaptive Microtrauma).  If we don’t impose some level of stress on our bodies, then we have nothing to adapt to, and no improvements are made.  The pattern then looks like this:

Train (impose a stress on the body) –> Recover from that stress (heal)–> Train again (breakdown a little more) –> Rinse and repeat

Training leads to trauma, which leads to a local inflammatory process and the release of cytokines.  Cytokines are basically like messengers which, transfer information from cell to cell and, when they are found in increased concentrations in the blood, they can transfer information around the whole body, having a more systemic effect.  There are various types of cytokines with some having pro-inflammatory properties and others having anti-inflammatory properties.  Three important pro-inflammatory cytokines are interlukin-1ß, interlukin-6, and tumor necrocis factor-? (NOTE: interlukin-6 can have anti-inflammatory properties as well). 

During phases of training where recovery is not optimal (overtraining) and inflammation is elevated, or during periods of injury, pro-inflammatory cytokines may play a large role in communicating to the body that something is wrong. 

Houston, we have a problem!

In the end, these cytokines may lead to the signs and symptoms that we get when we are in an overtrained state.  If we are smart, we heed our bodies warning and back off of the training stimulus to allow for recovery to take place.

Signs and Symtoms

As you can see from the diagram above, overtraining syndrome has a negative effect on many of the bodies processes and recovery from severe overtraining can be a substantial task. 

Here are a few signs and symptoms to look out for:

Physiological

• changes in blood pressure
• changes in heart rate at rest, during exercise, and during recovery
• increased frequency of respiration
• increased oxygen consumption at submaximal exercise intensities
• decreased lean body mass

Psychological/behavioral

• constant fatigue
• reduced appetite
• changes in sleep pattern
• depression
• general apathy
• emotional instability
• decreased self-esteem
• fear of competition
• gives up when the going gets tough

Information processing

• loss of coordination
• difficulty concentrating
• reduced capacity to correct technical faults

Biochemical Parameters

• rhabdomyolysis
• negative nitrogen balance
• elevated C-reactive protein
• depressed muscle glycogen levels
• decreased free testosterone
• increased serum cortisol

Immunological Parameters

• constant fatigue
• headaches
• nausea
• complaints of muscle and joint aches and pains
• gastrointestinal disturbance
• muscle soreness tenderness
• one-day colds
• swelling of lymph glands
• bacterial infections
• increased susceptibility to and severity of illness, colds, and allergies

Monitoring your training

The question always becomes, “how much stress is too much, and how much is just enough?”  Truth be told, the answer is probably going to be found in the individual, as different athletes will adapt better to different training interventions. 

Having a training journal and a periodized training program is a great way to ensure that you prevent overtraining, as you can look back at what you have been doing when you start to feel some of these symptoms come on, and in turn, plan properly for future training blocks – which should include blocks of recovery and restoration.

If you are a coach in a team setting, it may be more difficult to properly plan training around the individual.  Knowing your athletes is an important aspect of coaching, and many coaches have employed the use of rate of perceived exertion (RPE) scales from the athletes, to help plan training.  I talked briefly about this in my article on flexible non-linear periodization a week ago.

A recommendation by Robson-Ansley and colleagues is to have athletes complete a session RPE document following a non-steady state aerobic training session (IE, weight training, interval training, speed work, competition, etc).  The athletes are to complete the document at least 30-minutes following training, to ensure that they make a proper appraisal of the days training session, and don’t just rate it has highly fatiguing based on how they felt right after completing the last part of an intense workout.

Conclusion

Overtraining syndrome is a very serious issue that affects many athletes and should be avoided at all cost.  Several processes are involved in overtraining syndrome and it appears that tissue trauma due to inadequate rest/recovery may be the potential underlying factor which begins the whole processes.  There are many signs and symptoms of overtraining and they can affect psychological, pysiological and performance processes.

In an effort to help athletes better recover from training; the following series of articles will be focused on methods of recovery and regeneration.

Patrick
patrick@optimumsportsperformance.com

References

Meeusen R, Duclos M, Gleeson M, Rietjens G, Steinacker A, Urhausen A. Prevention, Diagnosis & Treatment of Overtraining Syndrome. European Journal of Sports Science March 2006;6(1):1-14.

Bartholomew JB, Stults-Kolehmainen MA Elrod C C, Todd JS. Strength Gains after Resistance Training: The Effect of Stressful, Negative Life Events. Journal of Strength Cond Res 2008; 22(4):1215-1221.

Smith LL. Cytokine hypothesis of overtraining: a physiological adaptation to excessive stress. Med Sci Sport Exer 2000;32(2):317-331.

Smith LL. Tissue trauma: the underlying cause of overtraining syndrome?
 Journal of Strength Cond Res 2004;18(1): 185-193.

Robson-Ansley PJ, Gleeson M Ansley L. Fatigue Management in Preparation of Olympic Athletes. Journal of Sports Sciences, Feb 2009;1-12.