Recovery- Doug Stacey CSTS March 2011

Maximizing PotentialMaximizing Potential

““The Science of Recovery”The Science of Recovery”

March 25, 2011

Doug Stacey, MSc, BHScPTSport Physiotherapist - Diploma

““HigherHigher

FasterFaster

Stronger”Stronger”

COST??COST??

– Fatigue?Fatigue?

– Injury?Injury?

– Over-training?Over-training?

Training ResponseTraining Response

Arja L.T. et al, 2001

FatigueFatigue

““A failure to maintain the required or A failure to maintain the required or expected force and power output; expected force and power output; or a reduction in the capacity to or a reduction in the capacity to generate force and power.”generate force and power.”

Central/Peripheral - Central/Peripheral - Metabolic FatigueMetabolic Fatigue

Decreased Energy Supply/ProductionDecreased Energy Supply/Production– GlycogenGlycogen– ATP & PCrATP & PCr

Accumulation of MetabolitesAccumulation of Metabolites– Lactate and pH - H+, PiLactate and pH - H+, Pi– AmmoniaAmmonia– Electrolytes – KElectrolytes – K++, Na, Na+, +, CaCa++

– HeatHeat– Magnesium ions (MgMagnesium ions (Mg2+2+))– Adenosine diphosphate (ADP)Adenosine diphosphate (ADP)– Reactive Oxygen SpeciesReactive Oxygen Species

Peripheral versus Central FatiguePeripheral versus Central Fatigue

CentralCentral-Reduction in recruitment/ -Reduction in recruitment/

activation of neurotransmittersactivation of neurotransmitters-CNS-CNS-motor neuron-motor neuron-muscle fiber surface -muscle fiber surface membranemembrane

PeripheralPeripheral-Reduction in muscle contraction-Reduction in muscle contraction

-Ca-Ca++++ binding to binding to troponintroponin-crossbridges – -crossbridges – actin actin

and and myosinmyosin-SR Ca-SR Ca++++ pump pump

Central/Peripheral - Central/Peripheral - Metabolic FatigueMetabolic Fatigue

Hargreaves, (2005)

““Fatigue”Fatigue” - the Numbers…. - the Numbers….

>60% of long distance >60% of long distance runners during their runners during their career career Urhausen, (2002)Urhausen, (2002)

> 50% of professional > 50% of professional soccer players during a 5 soccer players during a 5 month season month season Urhausen, (2002)Urhausen, (2002)

Expected incidence of 7-Expected incidence of 7-20% of elite athletes at 20% of elite athletes at any one time any one time Hooper, (1995)Hooper, (1995)

““Recovery”Recovery”

High usage with athletesHigh usage with athletes

LITTLE scientific validationLITTLE scientific validation

RecoveryRecovery

1.1. Low-Moderate Low-Moderate Intensity ExerciseIntensity Exercise

2.2. StretchingStretching

3.3. Nutrition and Nutrition and HydrationHydration

4.4. Therapeutic Therapeutic ModalitiesModalities

5.5. RestRest

1.1. Low-Moderate Low-Moderate

Intensity ExerciseIntensity Exercise

Low-Moderate Intensity ExerciseLow-Moderate Intensity Exercise

10-20 minutes @ 40-10-20 minutes @ 40-60% VO2max, Sub 60% VO2max, Sub AeT, or AeTAeT, or AeT

~50% reduction in La after ~50% reduction in La after

only 10 minonly 10 min Belcastro and Bonen, Belcastro and Bonen,

(1975)(1975)

Glycolytic Systemglucose / glycogen

pyruvate

NAD

NADH

(mitochondria)

NADH

NAD

H+ + e-

O2

lactate

LDH

acetyl CoAPDH


What’s the problem with increased lactate?

“ Lactic Acid ” H+ + Lactate –

muscle pH

“Metabolic inhibition”

( enzyme activity)

“Contractile inhibition”

( X-bridge cycling )


Metabolic FatigueMetabolic FatigueAccumulation of Metabolites – AcidosisAccumulation of Metabolites – Acidosis

HH++ and Pi and Pi– Inhibit the rate of force developmentInhibit the rate of force development– Inhibit velocity or cross-bridge cycle ratesInhibit velocity or cross-bridge cycle rates

BUTBUT……– Force production still evident despite high levels of Force production still evident despite high levels of

HH++ and Pi and Pi– Full recovery of La within 1 hr regardless of Full recovery of La within 1 hr regardless of

intervention – still performance deficitsintervention – still performance deficits– Acidosis may have a protective effectAcidosis may have a protective effect


Active RecoveryActive Recovery

10-20 minutes @ 40-60% VO2max10-20 minutes @ 40-60% VO2maxIncreased blood flowIncreased blood flow

– Resynthesizes high-energy phosphatesResynthesizes high-energy phosphates– Replenishes oxygen in the blood and muscleReplenishes oxygen in the blood and muscle– Restores body fluid homeostasisRestores body fluid homeostasis– Limits the harmful effects of immunosuppression Limits the harmful effects of immunosuppression

Dupont et al., (2004)Dupont et al., (2004)

Wigernaes et al., (2001)Wigernaes et al., (2001)Wigernaes et al., (2000)Wigernaes et al., (2000)Bangsbo et al., (1996)Bangsbo et al., (1996)

Take home points…Take home points…

2. Stretching2. Stretching

StretchingStretching

Widespread acceptanceWidespread acceptanceImproves flexibilityImproves flexibility

Reduces injury riskReduces injury risk

Improves performanceImproves performance

“Flexibility is the extent to which a muscle can be lengthened by a given amount of

force”

Limited scientific evidenceLimited scientific evidence


TechniquesTechniquesActiveActive

Static – hold 15-60 sStatic – hold 15-60 sIsometric – exert against fixed resistanceIsometric – exert against fixed resistanceBallistic – rapid muscle lengthening – bouncingBallistic – rapid muscle lengthening – bouncing

PassivePassiveAssisted – externally applied pressure – 15-60 sAssisted – externally applied pressure – 15-60 sProprioceptive Neuromuscular facilitation (PNF) Proprioceptive Neuromuscular facilitation (PNF) – contract/relax - ~5s– contract/relax - ~5s


FlexibilityFlexibility

Roberts and Wilson (1999)Roberts and Wilson (1999)15-30 s better than <15s or >30s15-30 s better than <15s or >30s

Laroche and Connolly (2006)Laroche and Connolly (2006)30s of static as effective as 30s 30s of static as effective as 30s ballisticballistic

Shrier (2004)Shrier (2004)Single stretching session good for Single stretching session good for ~90min~90minRegular stretching (3-5d/week) good Regular stretching (3-5d/week) good for many weeksfor many weeks


Injury PreventionInjury Prevention

Pope et al. (1998, 2000)Pope et al. (1998, 2000)Male army recruitsMale army recruits1284 – stretching group – 1284 – stretching group – 181181 injuriesinjuries1346 – control group – 1346 – control group – 200200 injuriesinjuries

** ** aerobic fitness a stronger aerobic fitness a stronger predictor of injury riskpredictor of injury risk

Thacker et al. (2004)Thacker et al. (2004)Review of 361 articles (6 Review of 361 articles (6 qualified)qualified)NO convincing evidenceNO convincing evidence for for pre-exercise stretchingpre-exercise stretching


PerformancePerformance

Hayes and Walker (2007)Hayes and Walker (2007)Pre-exercise stretching has Pre-exercise stretching has NO NO impactimpact on running economy on running economy

Shrier (2004)Shrier (2004)NO benefitNO benefit of acute stretching on of acute stretching on isometric force production, isometric force production, isokinetic torque, or jumping heightisokinetic torque, or jumping heightRegular stretching improves Regular stretching improves strength, jump height and running strength, jump height and running speedspeed

Fowles et al. (2000) and Kokkonen Fowles et al. (2000) and Kokkonen et al. (1998)et al. (1998)

Strength reduced up to 1 hourStrength reduced up to 1 hour after after acute bout of stretchingacute bout of stretchingAlters visco-elastic behavior of Alters visco-elastic behavior of muscle and tendonmuscle and tendon


Take Home Points…Take Home Points…

Regular stretchingRegular stretching – post – post activity improves flexibility activity improves flexibility and performanceand performance

Pre-exercise stretching has Pre-exercise stretching has little effectlittle effect on Performance on Performance or Injury Preventionor Injury Prevention

3. Nutrition and Hydration3. Nutrition and Hydration

Nutrition and HydrationNutrition and Hydration

NutritionNutrition

HydrationHydration

Main Food Energy Sources in Exercise Metabolism

• glucose

• glycogen

• fatty acids

• triglycerides

• amino acids

95-100% of total energy production

Carbohydrates(CHO)

Lipids(Fats)

Protein

“fuel mix” depends on exercise intensity

NutritionNutrition

NutritionNutrition

Short Term RecoveryShort Term RecoveryRestore carbohydrate Restore carbohydrate storesstores

Long Term RecoveryLong Term RecoveryOptimize protein Optimize protein synthesissynthesis

StrategiesStrategies - - (sport, type of exercise, intensity, (sport, type of exercise, intensity, duration, time)duration, time)

Short TermShort Term - Glycogen Resynthesis - Glycogen Resynthesis

Begins immediately post-exerciseBegins immediately post-exerciseRapid during first 5-6 h of recoverRapid during first 5-6 h of recover

Goforth et al. (2003)Goforth et al. (2003)

1 - 1.5 g CHO/kg1 - 1.5 g CHO/kg body weight – every 2 hours body weight – every 2 hours until next mealuntil next meal

OR…OR…Greater recovery with Greater recovery with 1.2 g/kg/30min1.2 g/kg/30min over 5 hr over 5 hr period period

Especially with limited time between eventsEspecially with limited time between events

van Loon et al., (2000)van Loon et al., (2000)

NutritionNutrition

Short TermShort Term

Recovery of endurance running capacity 4 hr after the first run (70% VO2 for 90min) Fallowfield et al., (1995)

Time

NutritionNutrition

Long TermLong Term

Glycogen Resynthesis – Glycogen Resynthesis – Endurance PerformanceEndurance Performance

Recovery of endurance running capacity 22 hr after the first run (70% VO2 for 90min) Fallowfield et al., (1993)

Time

Glycogen Resynthesis – Glycogen Resynthesis – High-Intensity Performance High-Intensity Performance

Recovery of intermittent high-intensity performance (15-min shuttle run) 22 hr after the first bout. Nicholas et al., (1997)

# shuttle runs/15 min

NutritionNutrition

Long-Term - ProteinLong-Term - Protein

Daily RequirementsDaily Requirements

Dietary Reference Intake (DRI) – 0.8 g protein/kg/dDietary Reference Intake (DRI) – 0.8 g protein/kg/d - persons - persons >18yrs of age – irrespective of activity status>18yrs of age – irrespective of activity statusEndurance athletes-Endurance athletes- recovery with recovery with 1.2 -1.4 g/kg/d1.2 -1.4 g/kg/dResistance athletesResistance athletes – recovery with – recovery with 1.6 – 1.7 g/kg/d1.6 – 1.7 g/kg/d

(ACSM, ADA, DC)(ACSM, ADA, DC)

Protein ResynthesisProtein Resynthesis

Begins immediately post-exercise – last up to 24 hrsBegins immediately post-exercise – last up to 24 hrsRapid during first 5-6 h of recover with as little as 6g protein/hr until Rapid during first 5-6 h of recover with as little as 6g protein/hr until next mealnext mealNo further effect on performance or glycogen resynthesis No further effect on performance or glycogen resynthesis

Philips, (2004)Philips, (2004)

NutritionNutrition

Protein ResynthesisProtein Resynthesis

Net protein balance (synthesis minus breakdown) under the same condi-tions. AA, amino acid; RE, resistance exercise. Phillips, (2004)

NutritionNutrition

Protein and CHOProtein and CHO

Post-Exercise – a high-carbohydrate diet Post-Exercise – a high-carbohydrate diet ((10g/kg/d10g/kg/d) is essential for glycogen resynthesis) is essential for glycogen resynthesisShort-term – Greater recovery with Short-term – Greater recovery with 1.2 1.2 g/kg/30ming/kg/30min over 5 hr period over 5 hr periodBetter glycogen recovery = better performance Better glycogen recovery = better performance in both ST and LT activitiesin both ST and LT activities

NutritionNutrition


Protein is essential for muscle anabolism post Protein is essential for muscle anabolism post exercise – as little as exercise – as little as 6g6g will boost synthesis will boost synthesisProtein with CHO in recovery phase effective for Protein with CHO in recovery phase effective for glycogen re-synthesisglycogen re-synthesis

RecoveryRecoveryKarp et al., Karp et al., Chocolate milk as a post-exercise recovery aid. Int. J. Sport Nutr. Exerc.Int. J. Sport Nutr. Exerc. Metabol.,16:78-91. 2006. Metabol.,16:78-91. 2006.

The results of this study suggest that chocolate milk is an effective recovery aid between two exhausting exercise bouts.

NutritionNutrition

HydrationHydration

DehydrationDehydrationImpaired heat Impaired heat dissipationdissipation

Increased core Increased core temperaturetemperature

Increased Increased cardiovascular straincardiovascular strain

Impaired motor functionImpaired motor function

HydrationHydration

Exercise corresponding to an average intensity of 75% VO2max – 90 min soccer game

Players may lose sweat up to 2 liters/hour

Increases with -heat, humidity, altitude

330C, 40% humidity = fluid loss of 3.1 % body mass

>1% body mass will impair performance

Reilly and Ekblom, (2005)

Hydration Recommendations: Hydration Recommendations: Institute of Medicine (IOM) – 2004Institute of Medicine (IOM) – 2004

HydrationHydration

SedentarySedentaryMales – Males – 3.7 L/day3.7 L/day (16 cups of fluid) (16 cups of fluid)

Females – Females – 2.7 L/day2.7 L/day (12 cups of fluid) (12 cups of fluid)

Active/AthletesActive/AthletesMales/Females – Males/Females – 5-10 L/day5-10 L/day

Based on training conditionsBased on training conditions

Kenny, (2006)

Hydration Recommendations: Hydration Recommendations: Institute of Medicine (IOM) – 2004Institute of Medicine (IOM) – 2004

HydrationHydration

SodiumSodiumRDA – RDA – 3.8 g/day3.8 g/day (upper level 5.8 g/day for athletes) (upper level 5.8 g/day for athletes)

Average American consumes 8-12 g table salt/dayAverage American consumes 8-12 g table salt/day

PotassiumPotassiumRDA - RDA - 4.7 g/day4.7 g/day

Sweat concentration rarely exceeds 10 mmol/LSweat concentration rarely exceeds 10 mmol/L

Kenny, (2006)

How to Rehydrate?How to Rehydrate?After the game/practice, drink After the game/practice, drink

2 cups of fluid for every 2 cups of fluid for every pound body weight lostpound body weight lost

Replace fluids lost due to Replace fluids lost due to sweating by drinking:sweating by drinking:

water, juices, sport drinkswater, juices, sport drinks

Or eating:Or eating:watery foods such as watery foods such as

soups, fruits, vegetablessoups, fruits, vegetables

HydrationHydration


HydrationHydration

SedentarySedentary

Daily Daily AllowanceAllowance

SedentarySedentary

Upper LimitUpper Limit

Active/AthleteActive/Athlete

Daily Daily AllowanceAllowance

Active/AthleteActive/Athlete

Upper LimitUpper Limit

WaterWater

3.7 L/day3.7 L/day

(male)(male)

2.7 L/day2.7 L/day

(female)(female)

NoneNone

3.7 L/day3.7 L/day

(male)(male)

2.7 L/day2.7 L/day

(female)(female)

NoneNone

SodiumSodium 1.5 g/day1.5 g/day

(3.8 g/day salt)(3.8 g/day salt)

2.3 g/day2.3 g/day

(5.8 g/day salt)(5.8 g/day salt)

>1.5 g/day>1.5 g/day

(>10 g/day salt)(>10 g/day salt)

NoneNone

PotassiumPotassium 4.7 g/day4.7 g/day NoneNone 4.7 g/day4.7 g/day NoneNone

IOM Guidelines, (2004)

4. Therapeutic modalities4. Therapeutic modalities

Therapeutic modalitiesTherapeutic modalities

A.A. HydrotherapyHydrotherapy

B.B. MassageMassage

A. HydrotherapyA. Hydrotherapy

CryotherapyCryotherapy

Contrast therapyContrast therapy

Thermo-therapyThermo-therapy

CryotherapyCryotherapy

Immersion in water that lowers the core body Immersion in water that lowers the core body temperaturetemperatureWater with a temperature <15Water with a temperature <1500 C for a duration of ~15-20 C for a duration of ~15-20 minmin

Decreased heart rate and cardiac outputDecreased heart rate and cardiac outputIncreased Oxygen consumption and metabolismIncreased Oxygen consumption and metabolismLocalized vasoconstriction Localized vasoconstriction reduced cellular, lymphatic and reduced cellular, lymphatic and capillary permeabilitycapillary permeabilityReduced inflammationReduced inflammationReduced pain and swelling Reduced pain and swelling

Wilcock et al., (2006)

HydrotherapyHydrotherapy

REST, LIGHT EXERCISE OR CRYOTHERAPY: REST, LIGHT EXERCISE OR CRYOTHERAPY: WHAT IS THE MOST EFFECTIVE WAY TO WHAT IS THE MOST EFFECTIVE WAY TO

RECOVER BETWEEN REPEATED BOUTS OF RECOVER BETWEEN REPEATED BOUTS OF INTENSE EXERCISE?INTENSE EXERCISE?

Doug StaceyDoug Stacey, BHScPT, BHScPT

Sport Physiotherapist – DiplomaSport Physiotherapist – Diploma

B.W. TimmonsB.W. Timmons†††† and M.J. Gibala and M.J. Gibala††. . ††Exercise Metabolism Research Group, Dept. of Exercise Metabolism Research Group, Dept. of Kinesiology, Kinesiology, ††††Children’s Exercise and Nutrition Children’s Exercise and Nutrition Center, McMaster University, Hamilton, ON Center, McMaster University, Hamilton, ON


MethodsMethods

Pre Week 1 Week 2 Week 3

Testing &Familiarization

Training – 3 boutsRandom intervention



Recovery Intervention – 20 min

Rest, Active, Cryo

Familiarization

VO2peak

Bout1 50KJ

Bout 3 50KJ

Bout 2 50KJ

Rest

Blood Sample and Questionnaires

Lactate, IL-6, CBC – RPE, VAS, Preparedness

lactate lactate


50 kJ Time Trial Performance

0

50

100

150

1 2 3

Bouts

Tim

e (s

ec) Cold tub

Active

Passive

* p .≤ .05 vs bout 1 (main effect).≤ .05 vs bout 1 (main effect)

* *


Blood Lactate

0.00

1.00

2.00

3.00

4.00

5.00

Time

Blo

od L

acta

te m

mol

/L

Cold tub

Active

Passive

Rest Post 1hrBout 2Bout 1 Bout 3

**

* p .≤ .05 vs Rest(main effect); ** .≤ .05 vs Rest(main effect); ** p .≤ .05 vs Passive, Cold.≤ .05 vs Passive, Cold

* * *


IL-6

0.00

2.00

4.00

6.00

Time

IL-6

(pg/

ml) Cold Tub

Active

Passive

Bout 2Rest Post 1hr

* p .≤ .05 vs Rest, Bout 2 (main effect).≤ .05 vs Rest, Bout 2 (main effect)

*


Lymphocytes

0.00

2.00

4.00

6.00

Time

lym

phoc

yte

cells

10

9/L

Cold Tub

Active

Passive

Post 1hrRest Bout 2

* p .≤ .05 vs Rest (main effect); **.≤ .05 vs Rest (main effect); **p .≤ .05 vs Active, Passive.≤ .05 vs Active, Passive

**

*

*


ConclusionsConclusions

The type of recovery intervention did not affect The type of recovery intervention did not affect the decline in exercise performance during the decline in exercise performance during repeated bouts of intense cycling,repeated bouts of intense cycling,

Blood lactate was slightly reduced after ACTIVE,Blood lactate was slightly reduced after ACTIVE,

CRYO caused greater perturbations in blood CRYO caused greater perturbations in blood immune markers and created the perception that immune markers and created the perception that subjects were better prepared for subsequent subjects were better prepared for subsequent exercise. exercise.


Cryotherapy ResearchCryotherapy Research

BenefitBenefit

PerformancePerformancePournot et al., (2010)Pournot et al., (2010)Vaile et al., (2008)Vaile et al., (2008)Vaile et al., (2007)Vaile et al., (2007)Lane KN., (2004)Lane KN., (2004)Fowles et al. (2003)Fowles et al. (2003)Verducci, (2000, 1997)Verducci, (2000, 1997)

DOMSDOMSVaile et al., (2008)Vaile et al., (2008)Bailey et al., (2007)Bailey et al., (2007)

RPERPEMaw et al., (1993)Maw et al., (1993)Nelson et al., (1991)Nelson et al., (1991)


Cryotherapy ResearchCryotherapy Research

NO BenefitNO Benefit

PerformancePerformanceCrowe et al., (2007)Crowe et al., (2007)

Yamane et al., (2006)Yamane et al., (2006)

Schniepp et al., (2002)Schniepp et al., (2002)

DOMSDOMSSellwood et al., (2007)Sellwood et al., (2007)

RPERPENo available dataNo available data



Cryotherapy SummaryCryotherapy Summary

Performance benefits are questionablePerformance benefits are questionable

Seems effective in reducing pain Seems effective in reducing pain associated with DOMSassociated with DOMS

Effective at reducing RPEEffective at reducing RPE

Alternating temperature immersion, from a hot to Alternating temperature immersion, from a hot to cold bath and vice-versacold bath and vice-versaProtocols vary – 30-300 sec of one extreme Protocols vary – 30-300 sec of one extreme temperature, immediately followed by 30-300 sec temperature, immediately followed by 30-300 sec of the contrasting temperature – for 4-30 minof the contrasting temperature – for 4-30 min

Stimulates specific area blood flowStimulates specific area blood flowIncreases blood lactate removalIncreases blood lactate removalReduces inflammation and edemaReduces inflammation and edemaStimulates general circulationStimulates general circulationRelieves stiffness and painRelieves stiffness and painIncreases ROMIncreases ROMReduces DOMSReduces DOMS





– ““Vascular Exercise”Vascular Exercise”

Vaso-dilationVaso-dilation

Vaso-constrictionVaso-constriction


Testing the Water: Are the Effects of Testing the Water: Are the Effects of Hydrotherapy More Psychological Than Hydrotherapy More Psychological Than

Physiological?Physiological?

Doug StaceyDoug Stacey, , Sport PT – dip. Sport PT – dip.

K.K. Martin-GinisMartin-Ginis22, M. Poling, M. Poling11, and M.J. Gibala, and M.J. Gibala11. 1. Exercise Metabolism . 1. Exercise Metabolism

Research Group and 2. Health Psychology Laboratory, Dept. of Kinesiology, Research Group and 2. Health Psychology Laboratory, Dept. of Kinesiology, McMaster Univ., Hamilton, ON. McMaster Univ., Hamilton, ON.


Methods:

Pre Training Training Post Training

Familiarization trials

VO2max

Wingate

Challenge ride

VO2max

Wingate

Challenge ride

5 5 64 4

Numbers represent the # of Wingate tests / training session

Hydrotherapy N=6 Vs. Control N=6


TreatmentTreatment

ControlControl – 20 min rest20 min rest

HydrotherapyHydrotherapy– Contrast bath – 20 minContrast bath – 20 min– 2 min cold (102 min cold (1000C)C)– 3 min hot (403 min hot (4000C)C)


Results – AnaerobicResults – Anaerobic Power Power (sig.≤ .05)(sig.≤ .05)

prepost

Control

Treatment

0

200

400

600

800

1000

1200

1400

Wat

ts

Wingate Peak Power

Control 1219.833333 1343.166667

Treatment 1214.833333 1309.5

pre post

Results – PerformanceResults – Performance ( sig. ≤ .05) ( sig. ≤ .05)

prepost

Control

Treatment

0

200

400

600

800

1000

1200

Sec

250KJ Time Trial

Control 1130 1088

Treatment 1002 945

pre post


ConclusionsConclusions

– 5 days of HIT increased peak anaerobic power and 5 days of HIT increased peak anaerobic power and performance during a time trialperformance during a time trial

– The use of Hydrotherapy did not further enhance The use of Hydrotherapy did not further enhance physiological performancephysiological performance

– Hydrotherapy created the perception that subjects Hydrotherapy created the perception that subjects were better prepared for exercisewere better prepared for exercise


Contrast Therapy ResearchContrast Therapy Research


BenefitBenefitPournot et al., (2010)Pournot et al., (2010)

No BenefitNo BenefitVaile et al., (2008)Vaile et al., (2008)Vaile et al., (2007)Vaile et al., (2007)Gill et al., (2006)Gill et al., (2006)Coffey et al., (2004)Coffey et al., (2004)



Vascular Exercise?Vascular Exercise?

For physiological For physiological effects to occur, must effects to occur, must produce fluctuations in produce fluctuations in muscle temperaturemuscle temperature

Myrer et al. Myrer et al. 19941994


Contrast Therapy SummaryContrast Therapy Summary


No performance benefitsNo performance benefits

Perception of recovery greater in Contrast Perception of recovery greater in Contrast groupsgroups

ThermotherapyThermotherapy

Immersion in water that raises the core body Immersion in water that raises the core body temperaturetemperatureWater with a temperature >36Water with a temperature >3600 for a duration of for a duration of ~10-20 min~10-20 min

Increased cutaneous and subcutaneous tissue temperatureIncreased cutaneous and subcutaneous tissue temperaturePeripheral vasodilationPeripheral vasodilation inc. cutaneous blood flow inc. cutaneous blood flowIncreased heart rateIncreased heart rateIncreased permeability of cellular, lymphatic and capillary Increased permeability of cellular, lymphatic and capillary vesselsvesselsIncreased nutrient delivery and waste removalIncreased nutrient delivery and waste removalIncreased muscle elasticity, joint extensibilityIncreased muscle elasticity, joint extensibilityReduced pain and muscle spasm Reduced pain and muscle spasm



Thermotherapy ResearchThermotherapy Research


BenefitBenefitNo available dataNo available data

No BenefitNo BenefitVaile et al., (2007)Vaile et al., (2007)

Vaile et al., (2008)Vaile et al., (2008)


Hydrotherapy Benefits????Hydrotherapy Benefits????

Hydrostatic PressureHydrostatic PressureInward and upward Inward and upward displacement of body fluidsdisplacement of body fluids

Reduces edemaReduces edema

Increases extracellular fluid transfer into the vascular systemIncreases extracellular fluid transfer into the vascular system

Increases cardiac output (Increases cardiac output (greater blood flowgreater blood flow))

BuoyancyBuoyancyDecreases Decreases perception of fatigueperception of fatigue

Aides in Aides in energy conservationenergy conservation

Wilcock et al., (2006) Wilcock et al., (2006)


Take Home Points….Take Home Points….

Most limited benefits associated only with Most limited benefits associated only with cryotherapy – DOMS, Performancecryotherapy – DOMS, Performance


No recovery benefits associated with No recovery benefits associated with thermotherapy (limited research)thermotherapy (limited research)

Cryo and Contrast improve RPE Cryo and Contrast improve RPE associated with exerciseassociated with exercise

B. MassageB. Massage

Chinese writing - 2500 B.C.Chinese writing - 2500 B.C.Describes the use of massage for a Describes the use of massage for a variety of medical purposesvariety of medical purposes

Sports MassageSports MassageBenefits – post-exercise:Benefits – post-exercise:

Increases circulation and nutrition to Increases circulation and nutrition to recovering tissuesrecovering tissuesIncreases removal of blood LaIncreases removal of blood LaDecreases pain and swelling (including Decreases pain and swelling (including DOMS)DOMS)Improves subsequent performanceImproves subsequent performanceReduces excessive muscle toneReduces excessive muscle toneIncreases muscle flexibilityIncreases muscle flexibilityDeactivates symptomatic trigger pointsDeactivates symptomatic trigger pointsEnhances tissue healingEnhances tissue healing

Weerapong et al.,(2005)Weerapong et al.,(2005)

MassageMassage

Sport MassageSport Massage

““Defined as a collection of Defined as a collection of massage techniques performed massage techniques performed on athletes or active individuals on athletes or active individuals for the purpose of aiding for the purpose of aiding recovery or treating pathology.”recovery or treating pathology.”

Bandy et al., (2008)Bandy et al., (2008)

Includes:Includes:EffleurageEffleuragePetrissagePetrissageDeep transverse friction massageDeep transverse friction massage

Massage - ResearchMassage - Research

Blood FlowBlood Flow


No BenefitNo BenefitWiltshire et al., (2010)Wiltshire et al., (2010)

Hinds et al., (2004)Hinds et al., (2004)

Tiidus and Shoemaker, (1995)Tiidus and Shoemaker, (1995)

Doppler US studies – no increase in Doppler US studies – no increase in muscle blood flow during or post muscle blood flow during or post sport massagesport massage


Lactate ClearanceLactate Clearance


No BenefitNo BenefitWiltshire et al., (2010)Wiltshire et al., (2010)Ogai et al., (2008)Ogai et al., (2008)Robertson et al., (2004)Robertson et al., (2004)Monedero et al., (2000)Monedero et al., (2000)Martin et al., (1998)Martin et al., (1998)Gupta et al., (1996)Gupta et al., (1996)Dolgener et al., (1993)Dolgener et al., (1993)Bale et al., (1991)Bale et al., (1991)

Combination of massage techniques from Combination of massage techniques from 10-20 min post exercise10-20 min post exerciseMassage failed to reduce blood lactate Massage failed to reduce blood lactate levels significantly greater than passive restlevels significantly greater than passive rest


D.O.M.S.D.O.M.S.

BenefitBenefitZainuddin et al., (2005)Zainuddin et al., (2005)Hilbert et al., (2003)Hilbert et al., (2003)Farr et al., (2002)Farr et al., (2002)Tiidus et al., (1995)Tiidus et al., (1995)Rodenburg et al., (1994)Rodenburg et al., (1994)Smith et al., (1994)Smith et al., (1994)

No BenefitNo BenefitHart et al., (2005)Hart et al., (2005)Hasson et al., (1992)Hasson et al., (1992)Wenos et al., (1990)Wenos et al., (1990)

NO significant improvement in strength NO significant improvement in strength force or torque for any studiesforce or torque for any studies


Performance (post muscle fatigue)Performance (post muscle fatigue)

BenefitBenefitOgai et al., (2008)Ogai et al., (2008)Monedero et al., (2000)Monedero et al., (2000)Rinder et al., (1995)Rinder et al., (1995)Ask et al., (1987)Ask et al., (1987)

No BenefitNo BenefitFletcher, IM. (2010)Fletcher, IM. (2010)Zainuddin et al., (2005)Zainuddin et al., (2005)Young et al., (2005)Young et al., (2005)Robertson et al., (2004)Robertson et al., (2004)Hemming et al., (2000)Hemming et al., (2000)Newman et al., (1996)Newman et al., (1996)Tiidus and Shoemaker, (1995)Tiidus and Shoemaker, (1995)Carafelli et al., (1990)Carafelli et al., (1990)

Variable methodology and massage Variable methodology and massage techniques – questionable conclusionstechniques – questionable conclusionsBenefits more with low intensity activity than Benefits more with low intensity activity than maximal effortsmaximal effortsInconclusive as to true benefit for recovery Inconclusive as to true benefit for recovery from muscle fatiguefrom muscle fatigue


PsychologicalPsychological

BenefitBenefitOgai et al., (2008)Ogai et al., (2008)Hemming et al., (2000)Hemming et al., (2000)Tyurin, (1986)Tyurin, (1986)

No BenefitNo BenefitDrews et al., (1990)Drews et al., (1990)

Most benefits to mood states are found Most benefits to mood states are found in studies with non-athletic populationsin studies with non-athletic populationsIn athletic populations all benefits are In athletic populations all benefits are associated with ratings of perceived associated with ratings of perceived exertion (RPE) exertion (RPE)


Take Home Points….Take Home Points….

NO effect on blood flowNO effect on blood flow or blood La or blood La removalremoval

Variable Variable improvements in painimprovements in pain related to DOMS, although NO related to DOMS, although NO significant improvement in strength significant improvement in strength force or torqueforce or torque

Improvements in recovery of Improvements in recovery of muscle fatigue are more associated muscle fatigue are more associated with with low intensitylow intensity versus high versus high intensity exerciseintensity exercise

Increased ratings of perceived Increased ratings of perceived exertion and exertion and perception of recoveryperception of recovery

5. Rest5. Rest

RestRest

Research in Aviation, Research in Aviation, Transportation and MilitaryTransportation and Military

SleepSleepActive physiological stateActive physiological state

Critical metabolic, Critical metabolic, immunological and immunological and cognitive/memory processes cognitive/memory processes occuroccur

Samuels, (2008)

Sleep Deprivation studiesSleep Deprivation studies

Negative effect on:Negative effect on:–Glucose metabolismGlucose metabolism Spriegel, (1999)Spriegel, (1999)

–Neuroendocrine and immune functionNeuroendocrine and immune function Basta, ( 2007)Basta, ( 2007)

–AppetiteAppetite Spriegel, (1999)Spriegel, (1999)

–Fat depositionFat deposition Spriegel, (1999)Spriegel, (1999)

–Neural plasticityNeural plasticity VanDongen, (2004)VanDongen, (2004)

–Cognitive performanceCognitive performance VanDongen, (2004)VanDongen, (2004)

RestRest

Take home points….Take home points….

RestRest

Sleep time – Sleep time – 7-10 hrs7-10 hrsCausal relationship exists between sleep, memory Causal relationship exists between sleep, memory and performance and performance Walker and Stickgold, (2005)Walker and Stickgold, (2005)

Sleep quality – Sleep quality – undisturbed or restorativeundisturbed or restorativeArousal and awakening during sleep are associated Arousal and awakening during sleep are associated with a sympathoadrenal response that negatively with a sympathoadrenal response that negatively affects sleep quality affects sleep quality impair performance impair performance

Vgontzas, (2004)Vgontzas, (2004)

Sleep Timing – Sleep Timing – circadian phase (REM)circadian phase (REM)Circadian phase directly affects sleep length and Circadian phase directly affects sleep length and quality – timing important quality – timing important Samuels, (2008)Samuels, (2008)

Current interventions are still based largely on clinical experience and Current interventions are still based largely on clinical experience and evidence derived from research in other fields (removed from elite evidence derived from research in other fields (removed from elite athletes)athletes)

““It is ironic that despite the It is ironic that despite the wonders of modern wonders of modern medicine, medicine, RESTREST and and NUTRITIONNUTRITION may be the may be the most potent healing most potent healing agents.”agents.”

Smith, MSSE, 1999Smith, MSSE, 1999

““Art vs. Science”Art vs. Science”

Research IssuesResearch IssuesPoor study designPoor study design

RandomizationRandomizationControlsControls

Small Sample SizeSmall Sample SizeType 2 errorType 2 errorStatistical significanceStatistical significanceAppropriate subjects – Appropriate subjects – high level athleteshigh level athletes

Optimal Regime?Optimal Regime?Underlying Underlying Mechanisms?Mechanisms?Outcome measures?Outcome measures?Sport Specific?Sport Specific?

““Experience”Experience”

““Your mind is like Your mind is like a parachute… a parachute…

..it only works ..it only works when it is open”when it is open”

Thank - YouThank - You

Questions??Questions??

ReferencesReferencesFatigueFatigue

Fitts RH, Cellular Mechanisms of Muscle Fatigue. Fitts RH, Cellular Mechanisms of Muscle Fatigue. Physiol. Rev.Physiol. Rev. 74(1); 49- 74(1); 49-94. 1994.94. 1994.Fitts RH. Muscle Fatigue: The Cellular Aspects. Fitts RH. Muscle Fatigue: The Cellular Aspects. Am. J. Sports Med.Am. J. Sports Med. 24(6); 24(6); S9-S13. 1996.S9-S13. 1996.Hargreaves M. Metabolic factors in fatigue. Hargreaves M. Metabolic factors in fatigue. GSSI Sports Sci. ExchGSSI Sports Sci. Exch. . 18(1):98. 2005.18(1):98. 2005.Hooper SL, and MacKinnon LT. Monitoring overtraining in athletes: Hooper SL, and MacKinnon LT. Monitoring overtraining in athletes: Recommendations. Recommendations. Sports MedSports Med., 20(5):321-327. 1995.., 20(5):321-327. 1995.Roberts et al., Biochemical Aspects of Peripheral Muscle Fatigue. A review. Roberts et al., Biochemical Aspects of Peripheral Muscle Fatigue. A review. Sports MedicineSports Medicine. 7: 125-138. 1989.. 7: 125-138. 1989.Urhausen A and Kindermann W. Diagnosis of Overtraining: What tools do Urhausen A and Kindermann W. Diagnosis of Overtraining: What tools do we have? we have? Sports MedSports Med. 32(2):95-102. 2002.. 32(2):95-102. 2002.Westerblad et al., Cellular mechanisms of fatigue in skeletal muscle. Westerblad et al., Cellular mechanisms of fatigue in skeletal muscle. Am. J. Am. J. Physiol.Physiol. 261; C195-209. 1991. 261; C195-209. 1991.

ReferencesReferencesLight ExerciseLight Exercise

Fitts RH. Cellular mechanisms of muscle fatigue. Fitts RH. Cellular mechanisms of muscle fatigue. Physiol. Rev.Physiol. Rev. 74(1): 49-94. 1994. 74(1): 49-94. 1994.

Belcastro AN, and Bonen A. Lactic acid removal rates during controlled and Belcastro AN, and Bonen A. Lactic acid removal rates during controlled and uncontrolled recovery exercise. uncontrolled recovery exercise. J. Appl. Physiol.J. Appl. Physiol. 39:932-935, 1975. 39:932-935, 1975.

Bangsbo J, Madsen K, Kiens B, and Richter EA. Effect of muscle acidity on muscle Bangsbo J, Madsen K, Kiens B, and Richter EA. Effect of muscle acidity on muscle metabolism and fatigue during intense exercise in man. metabolism and fatigue during intense exercise in man. J. Physiol.J. Physiol. 495(2): 587-596, 495(2): 587-596, 1996.1996.

Dupont G, Moalla W, Guinhouya C, Ahmaidi S, and Berthoin S. Passive versus Dupont G, Moalla W, Guinhouya C, Ahmaidi S, and Berthoin S. Passive versus active recovery during high-intensity intermittent exercises. active recovery during high-intensity intermittent exercises. Med. Sci. Sports Exerc.Med. Sci. Sports Exerc. 36(2):302-308, 2004.36(2):302-308, 2004.

Wigernaes I, Hostmark AT, Kierulf P, and Stromme SB. Active recovery reduces the Wigernaes I, Hostmark AT, Kierulf P, and Stromme SB. Active recovery reduces the decrease in circulating white blood cells after exercise. decrease in circulating white blood cells after exercise. Int. J. Sports Med. Int. J. Sports Med. 21(8):608-612, 2000.21(8):608-612, 2000.

Wigernaes I, Hostmark AT, Stromme SB, Kierulf P, and Birkeland K. Active recovery Wigernaes I, Hostmark AT, Stromme SB, Kierulf P, and Birkeland K. Active recovery and post-exercise white blood cell count, free fatty acids, and hormones in endurance and post-exercise white blood cell count, free fatty acids, and hormones in endurance athletes. athletes. Eur. J. Appl. PhysiolEur. J. Appl. Physiol. 84: 358-366, 2001.. 84: 358-366, 2001.

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ReferencesReferencesNutrition and HydrationNutrition and Hydration

Beelen M, LM Burke, MJ Gibala and LJC van Loon. Nutritional strategies to Beelen M, LM Burke, MJ Gibala and LJC van Loon. Nutritional strategies to promote post exercise recoverypromote post exercise recovery. Int J Sport Nutr Exerc Metab. Int J Sport Nutr Exerc Metab. 20(6):515-32, . 20(6):515-32, 20102010..Fallowfield J and Williams C. Carbohydrate intake and recovery from prolonged Fallowfield J and Williams C. Carbohydrate intake and recovery from prolonged exercise. exercise. Int. J. Sport NutrInt. J. Sport Nutr. 3:150-164. 1993.. 3:150-164. 1993.Fallowfield J, Williams C and Singh R. The influence of ingesting a carbohydrate-Fallowfield J, Williams C and Singh R. The influence of ingesting a carbohydrate-electrolyte solution during 4 hours recovery from prolonged running on endurance electrolyte solution during 4 hours recovery from prolonged running on endurance capacity. capacity. J. Sport NutrJ. Sport Nutr. 5:285-299. 1995.. 5:285-299. 1995.Goforth H, Laurent D, Prusaczyk W, schneider K, Falk K, and Shulman G. Effects of Goforth H, Laurent D, Prusaczyk W, schneider K, Falk K, and Shulman G. Effects of depletion exercise and light training on muscle glycogen supercompensation in men. depletion exercise and light training on muscle glycogen supercompensation in men. Am. J. Physiol. Endocrinol. MetabAm. J. Physiol. Endocrinol. Metab. 285:1304-1311. 2003.. 285:1304-1311. 2003.Institute of Medicine. Dietary reference intakes for water, sodium, potassium, Institute of Medicine. Dietary reference intakes for water, sodium, potassium, chloride and sulfate. Washington, DC. chloride and sulfate. Washington, DC. The National Academics PressThe National Academics Press. 2004.. 2004.Karp et al., Karp et al., Chocolate milk as a post-exercise recovery aid. Int. J. Sport Nutr. Exerc.Int. J. Sport Nutr. Exerc. Metabol.,16:78-91. 2006.Metabol.,16:78-91. 2006.Kenny WL. Dietary water and sodium requirements for active adults. Kenny WL. Dietary water and sodium requirements for active adults. GSSI Sports GSSI Sports Science ExchangeScience Exchange. 17(1). 2004.. 17(1). 2004.Nicholas C, Green R, Hawkins R, and Williams C. Carbohydrate intake and recovery Nicholas C, Green R, Hawkins R, and Williams C. Carbohydrate intake and recovery of intermittent running capacity. of intermittent running capacity. Int. J. Sport NutrInt. J. Sport Nutr. 7:251-260. 1997.. 7:251-260. 1997.Phillips SM. Protein requirements and supplementation in strength sports. Phillips SM. Protein requirements and supplementation in strength sports. NutritionNutrition. . 20:689-695. 2004.20:689-695. 2004.Reilly T and Ekblom B. The use of recovery methods post-exercise. Reilly T and Ekblom B. The use of recovery methods post-exercise. J. Sports SciJ. Sports Sci. . 23(6):619-627.23(6):619-627.Van Loon L, Saris W, Kruijshoop M, and Wagenmakers A. Maximizing postexercise Van Loon L, Saris W, Kruijshoop M, and Wagenmakers A. Maximizing postexercise muscle glycogen synthesis: Carbohydrate supplementation and the application of muscle glycogen synthesis: Carbohydrate supplementation and the application of amino acid or protein hydrolysate mixtures. amino acid or protein hydrolysate mixtures. Am. J. Clin. NutrAm. J. Clin. Nutr. 72:106-111. 2000. . 72:106-111. 2000.

References (Cont’d)References (Cont’d)Recovery ModalitiesRecovery ModalitiesHydrotherapyHydrotherapy

Bailey DM, Erith SJ, Griffin PJ, Dowson A, Brewer DS, Gant N, and Williams C. Bailey DM, Erith SJ, Griffin PJ, Dowson A, Brewer DS, Gant N, and Williams C. Influence of cold-water immersion on indices of muscle damage following prolonged Influence of cold-water immersion on indices of muscle damage following prolonged intermittent shuttle running. intermittent shuttle running. J Sports SciJ Sports Sci. 25(11):1163-1170, 2007.. 25(11):1163-1170, 2007.Coffey V, Leveritt M and Gill N. Effect of recovery modality on 4-hour repeated Coffey V, Leveritt M and Gill N. Effect of recovery modality on 4-hour repeated treadmill running performance and changes in physiological variables. treadmill running performance and changes in physiological variables. J. Sci. Med. J. Sci. Med. SportSport. 7:1-10. 2004.. 7:1-10. 2004.Crowe MJ, O’Connor D, and Rudd D. Cold water recovery reduces anaerobic Crowe MJ, O’Connor D, and Rudd D. Cold water recovery reduces anaerobic performance. performance. Int J Sports MedInt J Sports Med. 28:994-998, 2007.. 28:994-998, 2007.Fowles et al. Med. Sci. Sports Exerc., 2003Fowles et al. Med. Sci. Sports Exerc., 2003Gill ND, Beaven CM and Cook C. Effectiveness of post-match recovery strategies in Gill ND, Beaven CM and Cook C. Effectiveness of post-match recovery strategies in rugby players. rugby players. Br. J. Sports MedBr. J. Sports Med., 40:260-263. 2006.., 40:260-263. 2006.Lane KN and Wenger HA. Effect of selected recovery conditions on performance of Lane KN and Wenger HA. Effect of selected recovery conditions on performance of repeated bouts of intermittent cycling separated by 24 hours. repeated bouts of intermittent cycling separated by 24 hours. J Strength Cond ResJ Strength Cond Res. . 18(4):855-860. 2004.18(4):855-860. 2004.Maw et al. Eur. J. Appl. Physiol., 1993 Maw et al. Eur. J. Appl. Physiol., 1993 Myrer WJ, Draper DO, and Durrant E. Contrast therapy and intramuscular Myrer WJ, Draper DO, and Durrant E. Contrast therapy and intramuscular temperature in the human leg. temperature in the human leg. J. Athletic Train.J. Athletic Train. 29:318-322, 1994. 29:318-322, 1994.Nelson et al. Behav. Med., 1991Nelson et al. Behav. Med., 1991Pournot H, F Bieuzen, R Duffield, PM Lepretre, C Cozzolino, and C Hausswirth. Pournot H, F Bieuzen, R Duffield, PM Lepretre, C Cozzolino, and C Hausswirth. Short term effects of various water immersions on recovery from exhaustive Short term effects of various water immersions on recovery from exhaustive intermittent exercise. intermittent exercise. Eur J Appl PhysiolEur J Appl Physiol. Dec: 4, 2010.. Dec: 4, 2010.

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Schniepp J, Campbell TS, Powell KL, and Pinivero DM. The effects of cold-water Schniepp J, Campbell TS, Powell KL, and Pinivero DM. The effects of cold-water immersion on power output and heart rate in elite cyclists. immersion on power output and heart rate in elite cyclists. J Strength Cond ResJ Strength Cond Res. . 16(4):561-566, 2002.16(4):561-566, 2002.Sellwood KL, Bruker P, Williams D, Nicol A, and Hinman R. Ice-water immersion and Sellwood KL, Bruker P, Williams D, Nicol A, and Hinman R. Ice-water immersion and delayed-onset muscle soreness: a randomized controlled trial. delayed-onset muscle soreness: a randomized controlled trial. Br J Sports MedBr J Sports Med. 41:392-. 41:392-397, 2007.397, 2007.Vaile J, Halson S, Gill n, and Dawson B. Effect of cold water immersion on repeat cycling Vaile J, Halson S, Gill n, and Dawson B. Effect of cold water immersion on repeat cycling performance and thermoregulation in the heat. performance and thermoregulation in the heat. J Sports SciJ Sports Sci, 26(5):431-440. 2008., 26(5):431-440. 2008.Vaile J, Halson S, Gill N. and Dawson D. Effect of hydrotherapy on the signs and Vaile J, Halson S, Gill N. and Dawson D. Effect of hydrotherapy on the signs and symptoms of delayed onset muscle soreness. symptoms of delayed onset muscle soreness. Eur J Appl PhysiolEur J Appl Physiol. 102:447-455, 2008.. 102:447-455, 2008.Vaile J, Halson S, Gill N, and Dawson B. Effect of hydrotherapy on recovery from fatigue. Vaile J, Halson S, Gill N, and Dawson B. Effect of hydrotherapy on recovery from fatigue. Int J Sports MedInt J Sports Med. 2007.. 2007.Verducci, F.M. Interval cryotherapy and fatigue in university baseball pitchers. Verducci, F.M. Interval cryotherapy and fatigue in university baseball pitchers. In: Fourth In: Fourth International Olympic Committee World Congress on Sports Sciences: Congress International Olympic Committee World Congress on Sports Sciences: Congress ProceedingsProceedings; October 22-25, 1997. p. 107.; October 22-25, 1997. p. 107.Verducci, F.M. Intermittent cryotherapy decreases fatigue during repeated weight lifting. Verducci, F.M. Intermittent cryotherapy decreases fatigue during repeated weight lifting. J. J. Athletic Train.Athletic Train. 35(4):422-425, 2000. 35(4):422-425, 2000.Wilcock IM, Cronin JB, and Hing WA. Physiological response to water immersion: A method for sport recovery? Sports Med. 36(9):747-765, 2006.Yamane M, Teruya H, Nakono M, Ogai R, Ohnishi N, and Kosaka M. Post-exercise leg Yamane M, Teruya H, Nakono M, Ogai R, Ohnishi N, and Kosaka M. Post-exercise leg and forearm flexor muscle cooling in humans attenuates endurance and resistance and forearm flexor muscle cooling in humans attenuates endurance and resistance training effects on muscle performance and on circulatory adaptation. training effects on muscle performance and on circulatory adaptation. Eur J Appl PhysiolEur J Appl Physiol. . 96:572-580, 2006.96:572-580, 2006.

References (Cont’d)References (Cont’d)Recovery ModalitiesRecovery ModalitiesMassageMassage

Bale P and James H. Massage, warmdown and rest as recuperative measures after short term Bale P and James H. Massage, warmdown and rest as recuperative measures after short term intense exercise. intense exercise. Physiother. SportPhysiother. Sport. 13:4-7. 1991.. 13:4-7. 1991.Brummitt J. The role of massage in sports performance and rehabilitation: current evidence and Brummitt J. The role of massage in sports performance and rehabilitation: current evidence and future direction. future direction. N.A. J. Sports Phys. TherN.A. J. Sports Phys. Ther. 3(1):7-21. 2008.. 3(1):7-21. 2008.Dolgener F, and Morien A. The effect of massage on lactate disappearance. Dolgener F, and Morien A. The effect of massage on lactate disappearance. J. Strength Cond. J. Strength Cond. ResRes. 7:159-162. 1993. . 7:159-162. 1993. Fletcher IM. The effects of precompetition massage on the kinematic parameters of 20-m sprint Fletcher IM. The effects of precompetition massage on the kinematic parameters of 20-m sprint performance. performance. J Strength Cond ResJ Strength Cond Res. 24(5): 1179-1183, 2010.. 24(5): 1179-1183, 2010.Gupta S, Goswami A, Sadhukhan AK, and Mathur DN. Comparative study of lactate removal in Gupta S, Goswami A, Sadhukhan AK, and Mathur DN. Comparative study of lactate removal in short term massage of extremities, active recovery and a passive recovery period after short term massage of extremities, active recovery and a passive recovery period after supramaximal exercise sessions. supramaximal exercise sessions. Int. J. Sports MedInt. J. Sports Med. 17:106-110. 1996.. 17:106-110. 1996.Hinds T, McEwan I, and Perkes J. Effects of massage on limb and skin blood flow after Hinds T, McEwan I, and Perkes J. Effects of massage on limb and skin blood flow after quadriceps exercise. quadriceps exercise. Med. Sci. Sports ExercMed. Sci. Sports Exerc. 36:1308-1313. 2004.. 36:1308-1313. 2004.Monedero J and Donne B. Effect of recovery interventions on lactate removal and subsequent Monedero J and Donne B. Effect of recovery interventions on lactate removal and subsequent performance. performance. Int. J. Sports MedInt. J. Sports Med. 21:593-593. 2000.. 21:593-593. 2000.Ogai R, yamane M, Matsumoto T, and Kosaka M. Effects of petrissage massage on fatigue and Ogai R, yamane M, Matsumoto T, and Kosaka M. Effects of petrissage massage on fatigue and exercise performance following intensive cycle pedaling. exercise performance following intensive cycle pedaling. Br. J. Sports MedBr. J. Sports Med. 2: 2008.. 2: 2008.Robertson A, Watt JM and Galloway SD. Effects of leg massage on recovery from high intensity Robertson A, Watt JM and Galloway SD. Effects of leg massage on recovery from high intensity cycling exercise. cycling exercise. Br. J. Sports Med. Br. J. Sports Med. 38:173-176. 2004.38:173-176. 2004.Tiidus PM and Shoemaker JK. Effleurage massage, muscle blood flow and long-term post-Tiidus PM and Shoemaker JK. Effleurage massage, muscle blood flow and long-term post-exercise strength recovery. exercise strength recovery. Int. J. Sports MedInt. J. Sports Med. 16:478-483. 1995.. 16:478-483. 1995.Weerapong P, Hume PA, Kolt GS. The mechanisms of massage and effects on performance, Weerapong P, Hume PA, Kolt GS. The mechanisms of massage and effects on performance, muscle recovery and injury prevention. muscle recovery and injury prevention. Sports MedSports Med. 35:236-256. 2005.. 35:236-256. 2005.Wiltshire EV, V Poitras, M Pak, T Hong, J Rayner and ME Tschakovsky. Massage impairs Wiltshire EV, V Poitras, M Pak, T Hong, J Rayner and ME Tschakovsky. Massage impairs postexercise muscle blood flow and “lactic acid” removal. postexercise muscle blood flow and “lactic acid” removal. Med Sci Sports ExercMed Sci Sports Exerc. 42(6): 1062-. 42(6): 1062-1071, 2010.1071, 2010.

References (Cont’d)References (Cont’d)RestRest

Basta M, Chrousos GP, Vela-Bueno A. Chronic insomnia and the stress Basta M, Chrousos GP, Vela-Bueno A. Chronic insomnia and the stress system. system. Sleep Med. ClinSleep Med. Clin. 2(2):279-291. 2007.. 2(2):279-291. 2007.Knutson KL, Spiegel K, Penev P, and VanCauter E. The metabolic Knutson KL, Spiegel K, Penev P, and VanCauter E. The metabolic consequences of sleep deprivation. consequences of sleep deprivation. Sleep Med. RevSleep Med. Rev. 11:163-178. 2007.. 11:163-178. 2007.Samuels C. Sleep, recovery and performance: The new frontier in high-Samuels C. Sleep, recovery and performance: The new frontier in high-performance athletics. performance athletics. Neurol. ClinNeurol. Clin. 26:169-180. 2008.. 26:169-180. 2008.Spriegel K, Leproult R, VanCauter E. Impact of sleep debt on metabolic Spriegel K, Leproult R, VanCauter E. Impact of sleep debt on metabolic and endocrine function. and endocrine function. LancetLancet. 254:1435-1439. 1999.. 254:1435-1439. 1999.VanDongen HPA, Baynard MD, Maislin G. Systematic interindividual VanDongen HPA, Baynard MD, Maislin G. Systematic interindividual differences in neurobehavioral impairment from sleep loss. differences in neurobehavioral impairment from sleep loss. SleepSleep. . 27(3):423-433. 2004.27(3):423-433. 2004.Vgontzas AN. Understanding insomnia in the primary care setting: a new Vgontzas AN. Understanding insomnia in the primary care setting: a new model. model. Insomnia SeriesInsomnia Series. 9(2):1-7. 2004.. 9(2):1-7. 2004.Walker MP and Stackgold R. It’s practice, with sleep, that makes perfect: Walker MP and Stackgold R. It’s practice, with sleep, that makes perfect: implications of sleep-dependent learning and plasticity for skill performance. implications of sleep-dependent learning and plasticity for skill performance. Clin. Sports MedClin. Sports Med. 24(2):301-318. 2005.. 24(2):301-318. 2005.

Recovery- Doug Stacey CSTS March 2011

Health & Medicine

Transcript of Recovery- Doug Stacey CSTS March 2011