How can I help athletes recover?

You are no doubt familiar with many of the recovery methods used for athletes within sport, often utilising a variety of modalities in order to return your athlete to full functional fitness and performance. Reduced recovery can cause a reduction in muscle force, joint position sense, physical performance and potentially lead to an increased risk of injury (Dupuy et al. 2018)


So what methods have you used?


Common methods of recovery include compression garments, soft tissue massage, cryotherapy, electrical stimulation and stretching. It is not the place of this blog to investigate the variety of different methods of delivery of each of these methods, rather an opportunity to explore some of the literature on recovery methods themselves.


To understand the effects of recovery modalities it is important to understand the outcome measures that are being used to assess what happens when the interventions are applied. When reading the literature you should consider what outcome measure the study has used. Was it range of motion, perceived pain, perceived stiffness, performance of a task, joint position sense, reduced risk of injury or biomarkers such as creatine kinase.


When reading the literature you should consider what outcome measure.


Cryotherapy is one of the most common recovery modalities within the literature. There appears to be some short-term effects for cold water immersion but we are only just starting to understand the potential blunting adaptations if it is used regularly. In my personal opinion I think it has a time and place at times of multiple competition in short periods of time but not after regular training or competition. Perceived soreness from DOMS appears to be decreased following cold water immersion when compared to audio and relaxation techniques (Goth, 2019), while sprint performance 24 hours post intense exercise also seems to benefit from the intervention (Leeder et al. 2019).





Soft tissue massage contributes to 45% of treatments during sporting competition with mixed results for improvements in performance and potentially lacking effect on outcome measures 3-minutes post treatment (Kong et al. 2018). It is interesting to consider whether the effects of massage are more neurological in nature as opposed to having physiological effects on the tissues. The study by Kong et al. on the effects on DOMS from downhill running demonstrated that soft tissue massage may indeed change perceived soreness and stiffness, but only in some (not all) muscles tested.





Finally, the use of other modalities such as electrical stimulation can't be ruled out as an appropriate recovery intervention. von Stengel (2018) demonstrated that the use of transcutaneous electrical nerve stimulation style ossicallation can have positive effects on performance recovery.


There are some relatively obvious limitations to the intervention studies. Although the testers can be blinded to the intervention that the participants have received, often the participants themselves can't be blinded due to the knowledge of what treatment that they have had. As we mentioned at the start of the blog, it is also dependent upon the outcome measures that are being used - are they performance based, subjectively assessed or an objective clinical measure? Ultimately, we are no doubt aware that we are dealing with human beings who may be influenced in performance by a myriad of factors many of which are not assessed as part of these studies.


References:


Dupuy O, Douzi W, Theurot D, Bosquet L and Dugué B (2018) 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. 9:403.


Muhd Ghoth, M. H., Amir, N. H., Ahmad Radzi, J., Mohd Aznan, E. A., Md Japilyus, S. J., & Mohd Ramle, M. Y. (2019). Comparison between two recovery methods: Cold water immersion versus progressive muscle relaxation in reducing DOMS among young athletes. Malaysian Journal of Movement, Health & Exercise, 8(2), 67-80.


Kong et al. 2018. Effect of Post-Exercise Massage on Passive Muscle Stiffness Measured Using Myotonometry – A Double-Blind Study. Journal of Sports Science and Medicine. 17(4), 599-606.


Jonathan D. C. Leeder, Matthew Godfrey, Daniel Gibbon, David Gaze, Gareth W. Davison, Ken A. Van Someren & Glyn Howatson, (2019). Cold water immersion improves recovery of sprint speed following a simulated tournament, European Journal of Sport Science, 19:9, 1166-1174.


von Stengel et al. 2018. Effect of deep oscillation as a recovery method after fatiguing soccer training: A randomized cross-over study. Journal of Exercise Science & Fitness, 16(3), 112-117.