Post-Exercise Recovery Techniques:

What does the research say?

A brief overview of the literature about how to assist your body to heal with from post-exercise

“Nothing is better than your bodies natural ability to heal and recover itself.”

The Longevity Blog   •   March 23rd, 2020

For my friends, family, and followers

What difficult time we are all in right now, as I finalise this article, we have just been locked down with covid-19!

Alas, it gives me time to read, refelct, learn and share!

Post-Exercise Recovery Techniques

F

irstly I’d like to mention that nothing is better than your bodies natural ability to heal and recover itself.

It’s COMMON & NORMAL

It’s common and normal for muscle damage, tissue inflammation, delayed onset muscle soreness (DOMS) and increased perceived fatigue to occur as a result of exercise. 

It’s ESSENTIAL

It’s essential you find an optimal balance between exercise and recovery as this is where a the multitude of types & levels of fitness are developed.

Please head over to The 3 Pillars of optimal Physical Health, Performance and Wellbeing to understand that first the fundamentals of adequate sleep, hydration and nutrition must be priority first.

Strive for BALANCE

If the balance is out you may accumulate psychological and physiological stresses that may push or lead you in the wrong direction and as a result, maladaptation/injury may occur. 

WANT EXTRA?

Apart the the natural processes of the human body to heal itself, we often seek that extra boost, something that gets us above and beyond the norm to excel in our physical performance. 

Evidence has been gathering during the past few decades and more efficient training and recovery strategies for improving physical performance are being discovered.
So what does the RESEARCH say to help us get the extra boosts and assist us to recover faster and ideally perform better?

Maximizing the performance of an athlete is not only a matter of the training but healing faster between exercise bouts means your back out training quicker.  (Meeusen et al., 2013; Soligard et al., 2016).

Healing better also means you can train harder? (Whether training hard is actually beneficial is another topic of conversion).

I won’t go into the whole lot of depth with the cascade biochemical pathway of exercise/muscle contractions causing metabolic by-productins and micro damage leading to inflammatory markers leaking into blood and blah blah… Maybe for another article…

But to keep it simple…

Exercise causes:

Inflammation

Delayed on-set Muscle Soreness (DOMS)

Perceived Fatigue

The RESEARCH to support reducing of the above 

A recent meta analysis of 140 studies by Dupuy et al. (2018) attempted to find the best post exercise recovery technique.

Techniques looked at were:

  • Active Recovery+
  • Stretching
  • Massage++
  • Massage + Stretching
  • Electrostimulation
  • Compression Garment
  • Cold Water Immersion++
  • Contrast Water Therapy+
  • Cryotherapy++
  • Hyperbaric Oxygen Therapy (HBOT)
Findings:
  • The most powerful techniques for reducing inflammation were water Immersion and cold water immersion.
  • Active recovery, massage, compression garments, cold water immersion, contrast water therapy, and cryotherapy induced a small to large decrease of DOMS.
  • No benefits were found from stretching, electrostimulation or hyperbaric oxygen therapy.
  • Massage was found to be the most powerful technique for recovering from DOMS and fatigue.
  • In terms of muscle damage and inflammatory markers, a moderate decrease in creatine kinase was observed along with an overall small decreases in interleukin-6  and C-reactive protein

Another meta-analysis of the literature by Connolly et al. (2003) found 9 studies (total N=106) had no benefit in reducing DOMS with the use of a range NSAIDs. However, 7 studies (total N=102) were found in favour of the use of NSAIDs to treat DOMS

Findings
  • Anti-inflammatory drugs and antioxidants appear to have shown some potential in alleviation in some but not all symptoms of DOMS. However, variation in dosage and mode of damage used make generalisation of results difficult.
  • There appears to be some potential for the use of icing as a treatment.
  • Variations of treatment including acupuncture, herbal remedies, and HBOT appear to have limited effect.

A meta-analysis of 21 papers by Wiewelhove et al. (2019) and a stand along paper by Jay et al. (2014) looked at the effects of foam rolling on performance and recovery.

Findings
  • Massage with a roller device reduce muscle pain sensation acutely ONLY (only up to 30 minutes)
  • It was determined that the effects of foam rolling on performance and recovery are rather minor and partly negligible
  • Pre-exercise rolling improves sprint performance and flexibility
  • Evidence seems to justify the widespread use of foam rolling as a warm-up activity rather than a recovery tool
  • As psychological aspects play an important role in most sports, the fact that an athlete feels less pain after pre-rolling might be sufficient to justify its use despite the absence of measurable physiological benefits (Poppendieck et al., 2016)

Three Key Take Aways from the research above…

Inflammation

  1. The most powerful techniques for reducing inflammation were massage and cold exposure with some potential for the use of icing as a treatment.
  2. Treatments including acupuncture, herbal remedies, and Hyperbaric Oxygen Therapy appear to have little or no effect reported.

DOMS

  1. Small to large improvements were seen for Active recovery, Massage, Compression Garments, Water Immersion, Contrast Water Therapy, and Cryotherapy.
  2. Some conventional approaches, such as Ultrasound, Stretching, Electrostimulation, Hyperbaric Oxygen Therapy appear less promising with little to no effect reported.

Foam Rolling

  1. Does not provide any long term benefits with muscle recovery or pain measures
  2. The evidence seems to justify the use as a warm-up activity rather than a recovery tool and shows minor improvements with sprint performance and flexibility​

Lastly,

I would love to know what you think?

Please leave a comment below!

“Knowledge withheld is knowledge wasted”

Accredited Exercise Physiologist

Jake Holness

References:
  • Cheatham, S. W., Kolber, M. J., Cain, M., & Lee, M. (2015). THE EFFECTS OF SELF‐MYOFASCIAL RELEASE USING A FOAM ROLL OR ROLLER MASSAGER ON JOINT RANGE OF MOTION, MUSCLE RECOVERY, AND PERFORMANCE: A SYSTEMATIC REVIEW. International Journal of Sports Physical Therapy, 10(6), 827–838.
  • Connolly, D. A. J., Sayers, S. P., & McHugh, M. P. (2003). Treatment and prevention of delayed onset muscle soreness. Journal of Strength and Conditioning Research, 17(1), 197–208. https://doi.org/10.1519/1533-4287(2003)017<0197:tapodo>2.0.co;2Dupuy, O., Douzi, W., Theurot, D., Bosquet, L., & 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. Frontiers in Physiology, 9. https://doi.org/10.3389/fphys.2018.00403
  • Dupuy, O., Douzi, W., Theurot, D., Bosquet, L., & 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. Frontiers in Physiology, 9, 403. https://doi.org/10.3389/fphys.2018.00403
  • Jay, K., Sundstrup, E., Søndergaard, S. D., Behm, D., Brandt, M., Særvoll, C. A., Jakobsen, M. D., & Andersen, L. L. (2014). SPECIFIC AND CROSS OVER EFFECTS OF MASSAGE FOR MUSCLE SORENESS: RANDOMIZED CONTROLLED TRIAL. International Journal of Sports Physical Therapy, 9(1), 82–91.
  • Meeusen, R., Duclos, M., Foster, C., Fry, A., Gleeson, M., Nieman, D., Raglin, J., Rietjens, G., Steinacker, J., Urhausen, A., European College of Sport Science, & American College of Sports Medicine. (2013). Prevention, diagnosis, and treatment of the overtraining syndrome: Joint consensus statement of the European College of Sport Science and the American College of Sports Medicine. Medicine and Science in Sports and Exercise, 45(1), 186–205. https://doi.org/10.1249/MSS.0b013e318279a10a
  • Poppendieck, W., Wegmann, M., Ferrauti, A., Kellmann, M., Pfeiffer, M., & Meyer, T. (2016). Massage and Performance Recovery: A Meta-Analytical Review. Sports Medicine (Auckland, N.Z.), 46(2), 183–204. https://doi.org/10.1007/s40279-015-0420-x
  • Wiewelhove, T., Döweling, A., Schneider, C., Hottenrott, L., Meyer, T., Kellmann, M., Pfeiffer, M., & Ferrauti, A. (2019). A Meta-Analysis of the Effects of Foam Rolling on Performance and Recovery. Frontiers in Physiology, 10. https://doi.org/10.3389/fphys.2019.00376
  • (PDF) How much is too much? (Part 1) International Olympic Committee consensus statement on load in sport and risk of injury. (n.d.). ResearchGate. Retrieved March 23, 2020, from https://www.researchgate.net/publication/306271510_How_much_is_too_much_Part_1_International_Olympic_Committee_consensus_statement_on_load_in_sport_and_risk_of_injury