By Carl Valle
Nearly every coach loves to train athletes, but recovery and regeneration techniques seem to be increasingly viewed as dated ways to help athletes perform better. I love recovery methods, but also know most techniques used by coaches are placebos, with only some of them actually helping athletes. Recovery techniques and recovery devices are big business, but the majority of them do little to nothing when researched.Most #recovery techniques are placebos, with only some of them actually helping athletes, says @spikesonly. Click To Tweet
What is also challenging for coaches is the sport science research being conflicting or even non-existent. In this article, I cover the details of why some recovery techniques are likely viable and why some are just bad even on paper. The science will not be too heavy, but the mention of some science will be necessary to bust through myths.
Recovery techniques are not magic or folklore—they have application in high-performance sport, but are limited if you are not aware of the complexities of the human body. Don’t worry, I have outlined enough details to make a difference.
Artificial Problems – Artificial Solutions
Sport is no longer a natural process that resembles what the ancient Greeks used to celebrate, so it’s time to move away from natural ways of supporting athletes. The hard line is that athletes are now entering a realm of health risks and lifelong injury patterns that can’t be mitigated by drinking chocolate milk and getting better sleep. The world of sports training has reached a point of no return, and something has to give. Placing our heads in the sand won’t work, and it isn’t possible to rely on the wisdom of the body when modern humans do things that we may not be designed to do. Add in synthetic interventions and ergogenic aids, and injuries and burnout may be unavoidable.
If you are going to fight fire with fire, you need to really know the underlying physiology and not just learn recipes. For example, in this article I do not include any thermotherapy work such as cold or hot treatments because they deserve an article on their own. I do build on earlier articles that got a lot of attention or should be referenced more.Neglect is hoping athletes can do everything naturally; wisdom is knowing when they need some help, says @spikesonly. Click To Tweet
In modern sport, we are correctly adapting to smaller windows of opportunity and smaller margins of errors. I have blamed congested schedules, poor long-term athletic development models, and even environmental challenges, but we can still do something more. Don’t fret or think you are helpless—just know when to let the chips fall and when to strike. The human body is a marvelous self-repairing and self-organizing machine that doesn’t need much. Neglect is hoping that the athlete can do everything naturally; wisdom is knowing when they need a little help.
Circulation – Deconstruction of Lymph and Blood Flow
I am a big fan of light exercise for circulatory benefits, but does a quick workout really help the body recover or does breaking a sweat trigger a few endorphin-like responses that help with mood? Blood flow is now the new manipulation, with restriction techniques increasing in popularity. The occlusion-like work that was referenced in the Friday Five with Chris Brandner is a great example of throttling up and throttling down metabolites for adaptation purposes, but increasing blood flow passively is not the potent river of life I once thought. Stem cell research is now retracted, and PRP (platelet rich plasma) injections are a thing of the past in some circles. So what should coaches believe when the science is, at times, questionable?
High school math isn’t exciting, but straightforward algebra and simple calculations are a good start when the science is conflicting. Small trickles of blood flow for short periods of time aren’t going to move the needle much. When you hear about mobility circuits and similar being great for conditioning and blood flow, the truth is those changes are not very exciting when you do the math.
The heart pumps based on very obvious needs: the more blood, the more oxygen there is being transported in general. An hour going hard is much different than 15 minutes barely breaking a sweat. That’s why most recovery workouts don’t work, as they are too short and too easy to cause a dramatic change in blood transport. Even if the workouts were more intense and didn’t cause more harm than good, basic blood flow won’t change the game dramatically. Boo Schexnayder has hinted about the value of lactate for stimulating growth, and I think the workouts he prescribes are at a threshold: not too hard to recover from, but hard enough to stimulate opiate changes and neurological growth.Most recovery workouts are too short and too easy to cause a dramatic change in blood transport, says @spikesonly. Click To Tweet
Technically, the lymphatic and circulatory systems are separate, but it’s not accurate to compartmentalize these wonderful body transporters. Transport systems such as the lymphatic system are growing in interest because impairment in the long run increases the risk of disease. Athlete performance is built on a foundation of wellness, and ensuring vegetative systems are in line is essential.
Boiling down this entire section to one question isn’t ideal, but most coaches want to know how bad the collateral damage of training is to the microcirculation of the body. Does an athlete who is training heavy clog their bodies up or is the cellular debris not a big deal?
My guess is that excessive delayed onset muscle soreness (DOMS) and microdamage are the culprits for maladaptation, and training that is too much and too hard will impair microcirculation. Whatever the sweet spot is, it won’t likely cause a backup of low-grade inflammation or free proteins. Constant excessive sweating isn’t a sign of good health, and many athletes spend the balance of their time in some sort of state that resembles an ICU patient.
I believe in protocols that incorporate necessary time frames for unloading in training that elicit adaptations that can be seen and measured. Either you will do a power flush of low-impact but high-intensity intervals or something extended when you have a chance. Being active is also necessary for a real recovery effect. With research looking at two-hour walks, I have very little faith that 30 minutes of junk circuits resembling an exercise library tornado will really make a difference.
Coaches are sophisticated enough to know the clearance of lactate won’t help a day later, but when you observe random exercises strung together to get “blood flow” or recovery, who really sees changes? Autonomic nervous system modulation is great and HRV is a fantastic compass, but harder explanations are needed to reveal how an athlete is improving. Without distilling things too much as it dumbs down the process, aquatic workouts after rough workouts and low-intensity land exercises recharge what is lost after intense workouts. Sure, coaches who sequence a lot of intermediate work will find success, and I still do that periodically, but I also find that non-functional overreaching occurs more than the potential for actually getting better. When in doubt, wait for the hard training session, but don’t baby the athlete either.
Massage and Bodywork
Most sports massage and manual therapy doesn’t work, but it does certainly feel good. Without repeating myself about why we need better ways to measure therapy interventions, let’s cover what may actually help an athlete. A massage session was recently researched and it worried me that it would not be seen as evidence of the limitations of bodywork.
To me, it’s impossible that the muscles of an entire limb would dramatically change with Myoton readings, since it takes a lot of time to calm a truly hypertonic tissue, and most recreational athletes train hard but don’t get near the strain of elites. I am not saying the tone of elites is higher, as sometimes an experienced athlete may have lower tonicity than low-level equivalents, but extrapolating a quick treatment to a few muscles and expecting a dramatic change that will show up on an instrument doesn’t replicate what most coaches and therapists see day to day. Generally, most massage studies that show no real change are right, as the modality is limited but has value with the right therapist. Most self-care does not create the responses we are looking for, but we are dermal creatures and enjoy massage therapy.
For the sake of making an argument for therapy, most treatments try to improve the function of the tissue by managing neuromuscular performance or range of motion, or removing soreness. Some therapy has had scientific research on swelling or immune responses, but when athletes seek treatment, most go to a clinic because they feel pain that isn’t typical or can tell when a muscle isn’t responding normally. I have chased the holy grail for 20 years and some lab coats may laugh, but my response is that massage therapy works only if you have the right therapist.
We have spent a small fortune studying our therapists and the results are clear: Manual therapy has an effect that is very repeatable and measurable, but the skill to get deep without bruising is so uncommon I still fly people to Florida for therapy. We do use some therapists here in the Northeast, but frankly, I don’t blame a researcher for being convinced that the average session just spreads oil. If you want to stimulate an endorphin-like release, a commercial massage can do that, but if you want to see elastography changes that allow a full return to sprinting, you must search far and wide.The human touch may be the most powerful performance resource, even if it’s not measurable, says @spikesonly. Click To Tweet
Are comfort and feeling good strong enough influences to warrant therapy? If you asked me that question a few years ago, I would have recommended not wasting the time. However, in a sporting world that is sometimes dark and lonely, even with a hyper-connected social media, the human touch is perhaps the most powerful performance resource now. We don’t know how sensitive the body is, and when zoos have professional huggers for pandas and the research of pets helping ensure physiological response, something is there that matters.
It may not show up on a force plate or weight training device, but it isn’t a placebo. We are wired animals and designed to be social and haptic, and massage connects deeper than just muscle. My mantra is massage tone and restore range, but don’t rush back into training. Just come back when you are ready and the combination is likely to work better than one or the other.
Electrical Stimulation of Muscle and Nerve
The body is truly an organic electrical system, but how much can we really do with stimulation? If you are curious about how stimulators work, plenty of research exists on the topic and several SimpliFaster articles are available to read at your convenience. My recommendation is to go straight to the research-supported workouts and the article questioning the value of transcranial stimulation in sport. In short, I don’t believe transcranial direct current stimulation (tDCS) is potent enough to be worth investing time into for most athletes, especially for performance. I do support the notion that EMS and training in combination have limited results, but are worth doing. But does it work for recovery, and if so, how much?
Sport recovery is a tricky area, but the research on restoration of the body from exercise is scant, and if the research does support it, it’s very small. Reducing lactate using EMS or other electrotherapy is not my cup of tea, as time will clear the by-product and, from a practical standpoint, it’s not interesting to me to use external devices for internal problems. So what’s left? Complex circulatory issues from artificial problems such as travel and injury.
Microvascular factors are really important but very difficult to study, as most research is on acute outcomes of training—something that is more performance-oriented— rather than symptom management. My main interests are post-surgery needs and deep vein thrombosis with air travel or contusions. Realistically, two options exist: stimulating the peroneal nerve and creating a leg pump or specific electrode placement on the affected area. I have read the research on foot stimulation with standing subjects, but the effects are weak and the practical needs of standing aren’t useful for me. Extending the time period for multiple hours with the legs horizontal or sling-elevated works wonders when swelling is really problematic.
Stimulating the nerves directly is shown to be effective in the research, so even if you can only do one session, the literature supports a difference in vertical jump height. It doesn’t bring back power to what it was before the fatigue and tissue damage, but it’s better than nothing. The question is what happens when multiple sessions are performed in connection with other therapies? Does everything stack and work in synergy or does a “hard cap” to recovery methods exist? The truth is, we need a lot of time to study great therapy and methods, not just replicate a situation that seems to never be the same in a lab. Even if a clinical research investigation seems to be limited, it’s rare to see therapists and recovery experts involved outside of a few studies.
I personally don’t believe any electrotherapy will help an athlete remodel or grow tissue unless it’s a surgical intervention. While it’s nice to hope that Frankenstein- or science-fiction-type responses occur from adding current, recovery and rehabilitation will always be assisted by EMS and TENS. I don’t treat pain with any external device, and I leave that area to the professionals who are proactive in the clinical evaluation of athletes. Generally, reducing an overreaction of the body or training error to edema is the advantage, and based on the research, NMES (neuromuscular electrical stimulation) has enough worthwhile change to add it in. If a therapy is passive and not a big burden on someone, toss it in, as plenty of travel and downtime exists in sport.
Is Active Recovery Dead?
I wrote a summary about active recovery, but I wish I waited one month because some interesting research showed up that made me rethink low-intensity training after heavy training. Of course, expecting that a jog or few timely stretches will make a big difference is not surprising. It wasn’t that a new discovery changed my opinion, it was that I had a few fresh perspectives that made a nice argument to rethink everything.
While active recovery is a low-intensity activity that is constantly scrutinized with a microscope or syringe, maybe instead of calling it a placebo we can target the brain better. It’s easy to scoff at methods that athletes crave as ritual instead of routine, but if you are going to summarize something like a placebo as imaginary, why not go further into the science that is less accessible?
Note: If I could add some information to my earlier article on active recovery, I would share the following two points of why I believe in active recovery. It’s not a magical option and you shouldn’t expect dramatic changes, but it’s worth factoring in like any other variable.
Motor Learning: The first article I wrote was in 2002, I believe, and it was very rough around the edges. My second wasn’t great, but I still agree with the points I tried to make in it. BDNF is a cool topic, and it should be. Its nickname—“brain fertilizer”—is a primitive term and, while not perfect for what it really does, I believe in it.
Instead of studying darts and archery, it would be great to see more research on how a conventional cooldown enhances retention and acquisition. Remember: Performance isn’t about an isokinetic test of the quadriceps only; it’s a little more complicated. Warm-downs are indeed aerobically mixed short sessions, but don’t think a jog on the grass will cause confusion to the genes and turn speed and power athletes into skinny marathoners.
Recreation: I think it’s a bad idea to replicate physical education by watering down a professional teaching period into a commercialized training session. I love what Jeremy Frisch is doing, but I remember talking about children moving 15 years ago, so what we see on social media is misleading if a coach wants to repurpose professional educators. I do think it is appropriate to think big picture about concepts that matter, such as the value of free play and expression.Natural surfaces and natural surroundings are not a privilege; they’re a necessity, says @spikesonly. Click To Tweet
In addition to those general principles, getting outside the concrete jungle and back to nature is vital. Natural surfaces and natural surroundings are not a privilege; they’re a necessity. Runs in the woods are great for fitness and endurance sport, and we need a voice of reason to share how to train in the woods without relying on lumberjack workouts for some boot camps. I don’t expect any research to prove a few sessions in Mother Nature will show up on a microscope slide, but I do know that over time it matters.
More evidence on the value of activity that is hard enough to consider fitness but low enough to not create a problem will show up in the research. It’s not that the earlier information was wrong or the science was poor, it simply did exactly what it was supposed to do—show what didn’t work and why, with specifics.
Sometimes the Little Things Do Matter
After reading this article, you may be a little disappointed and view recovery and regeneration as overrated or just hype. It’s not that recovery doesn’t matter, it just means recovery techniques won’t turn a bad program around just because you have a budget or interest in therapies and devices. Recovery will likely show up with the athlete feeling better when they are resting, but don’t expect athletes to max out jump testing or other performance measures later.Recovery won’t turn a bad program around just because you have a budget for therapies and devices, says @spikesonly. Click To Tweet
Time is the biggest variable in recovery, along with sleep and general nutrition. Still, a narrow gray area exists between busy work that is just a placebo and what is actually a viable way to get better. Embrace the little things, as they add up over time and make a difference when there is just a small margin between winning and losing.