Recovery: The

most important

workoutLOUISIANA STATE NSCA CLINIC, DEC. 6, 2014

CHARLIE HOOLIHAN, CSCS, CES, PES

Exercise can prevent and cause illness

and injury. It can keep you out of and put

you into a hospital.

Immuno-enhancing. Immunosuppressive

Marathon finishers have elevated troponin levels akin to heart attack victims.

Iowa Strength and Conditioning staff put 13 members of their team into the hospital w myoglobin numbers approaching kidney failure. 100 backsquats @ 50% max followed by a similar upper body workout.

Conundrum

Does our personal knowledge database have more information on how to put our athletes/clients in a hospital?

Do our athlete’s clients have more desire to be injured than healthy?

Is the culture of HIIT overwhelming sensible training.

What is the measure of a successful workout/training plan.

Homeostasis and Allostasis

Workouts have to challenge homeostasis – the internal balance of

all the physiological processes at the chemical, molecular and

tissue levels. These challenges create a state of Allostasis

Allostasis reactions

Exercise stressors alert the body that more strength, speed and cardiovascular fitness are needed to survive in a new and challenging environment

Damaged muscle contractile tissue

loss of strength

decreased speed and oxygen delivery.

Inflammation and immune system hormones and chemicals begin circulating in order

to help minimize and repair the damage.

Swelling and muscle soreness complete process.

After all this good stuff is done, the body is said to be in a state of allostasis– or a disrupted, out of balanced internal state of physiological processes

(Flores et al, 2011)

Highest incidence of muscle

damage or immunosuppression

High Intensity cardiovascular training beyond 20-40 minutes

Long cardio sessions exceeding 60-90 minutes

Heavy eccentric training loads

Disrupted and out of balance!

But it’s good for me right!

Recovery and restoration

Planned recovery is designed to minimize the accumulation of

the byproducts of physical stressors from workouts as well as similar

byproducts from mental, emotional and environmental stressors

that are also affecting the exerciser.

Recovery Research is new but

techniques and practices are not.

URTI study in the early 90s

Correlation of stressors and illnesses in the 70s

Running training in the 70s. Triathlon in 80s

Specific modalities like dry needling

“The problem I have assessing an intervention… is that

I can’t know how my injury would have done without

the procedure. If it was going to resolve itself on its

own over those same few weeks, perhaps its greatest

benefit was that it gave me a distraction, new pain to

deal with, temporarily, and the feeling that I’d done

something proactive — while nature ran its course.” -

Jason Silvernal, DPT

Planning for Types of recovery

In-Training recovery – recovery during a workout such as time

between cardiovascular intervals or rest between weight sets to

enable a quick refueling of mostly fast-twitch muscle fibers

Training day recovery – recovery between workouts, matches or

games held on the same day.

Training week recovery – recovery between workouts, matches or

games within the same training week.

Training cycle recovery – planned extended recovery periods

between well planned overload training periods designed to elicit a

supercompensation response that significantly advances the

performance and conditioning level of the exerciser.

Most of our discussion will focus on the latter two.

Linear and Undulating Plans for

recovery

Periodization

Linear periodization - stretched out over a long time-frame increasing effort in

a consistent manner on a weekly, monthly seasonal, annual or quadrennial

basis. Good for athletes with specific seasons and goals.

Non-linear periodization - Increases intensities in an undulating manner

alternating rest and work schemes in shorter cycles. Good for fitness clients

and recreational atheltes whose schedules tend to be affected by life’s random

pattern.

Both have proven to be effective in achieving higher performance levels (Simao,

et al 2012)

Measuring physical response

Baseline fitness assessments

5-10 rep max

30-60 min. Threshold test

Vertical jump

Horizontal leap

Sprint and agility tests

Baseline fitness assessments can be used to measure progress

and performance decreases can indicate a need for

recovery.

Recovery Bioindividuality

Each individual physiology recovers from various workout protocols differently. Sayers and Clarkson found found it took between 5 and 89 days for participants to return to full strength after an intensive weight training program

Gender - Men and women have been found to suffer the same amount of muscle soreness after intensive weight lifting but women have a lower inflammatory response. Women also take longer to return to peak strength, and range of motion. (Flores et al)

Genetic differences have also been found. Some genotypes

have the ability to return to baseline quicker after strenuous eccentric exercise than others. (Venckunas et al 2012)

Measuring homeostasis and

stress response

Resting Heart Rate

HRV

Blood lactate

Subjective Questionnaire

Resting and working heart rate

Resting heart rate: 5-10 beat increase in resting

heart rate indicates a system under stress.

Working heart rate that is higher at a specific

performance output also indicates a system under

stress.

How ya doin honey

Subjective questionnaire that athletes/clients fill out

each week to assess the non-exercise stress they are

undergoing each day/week.

Forces them to understand when

high intensity workouts may not be

optimal.

Accountants in March

Athletes during exams

Santa in December

Blood lactate measurements

Small hand-held monitor

Great for measuring a particular indi

individual immediate and resisual

response to a specific

anaerobic workout.

$500-700 for a unit.

Day to day?

HRV – Heart Rate Variability

Recent tool added to the analysis of stress response.

Measures the time between beats.

Regular intervals indicate a system under stress and dominate in the

Sympathetic Nervous System

Less regular intervals indicate a system in the Parasympathetic recovery

and repair mode.

A balance between the two is sought.

Extremely versatile tool that measures all types of stress responses.

Current case studies

Endurance athletes –

Ironman and Ironliver

Sleep and diet cola

Post op client

Food sensitive colleague

Pregnant client

Personal 50 plus fitness

Powerlifting colleague

Companies – Bioforce, Omegawave, iThlete, Sweetbeat.

Non-Exercise influences of

homeostasis

These factors also need baseline measurements

HPA Axis

Responds to exercise, nutrition, environment,

emotional/mental, sleep and allergen stressors

HPA axis response to stress

Directly or indirectly influences action response

Stress hormones- Cortisol

Neurotransmitters – epinephrine, norepinephrine, histamines, ACh

Inflammatory cyctokines – Interleukins, TNF

Chemokines.

All provide necessary responses to stress can put the body in long

term allostasis. Their job is to return the body to homeostasis.

Same axis as the physical response to exercise.

Same intensity different response

Two similar studies designed to stimulate overtraining

Two weeks of high volume and intensity training – metabolic symptoms of overtraining and had decreased power output, increases in their time trial performance, a decrease in max heart rate, and an increase in ratings of perceived exertion (RPE). (Halson et al, 2002)

21 days under similar training condition eliciting similar metabolic overtraining responses with one exception – there was no decrease in performance markers. (Slivka, et al, 2012)

Second group performed training in a camp experience. First group followed workouts under normal circumstances.

Sleep: The ultimate recovery tool

Critical for biochemical balance in substances

Increased growth hormone

Decreased inflammatory chemicals like cortisol,IL-6 and TNF-a (Dement, 2000).

Increased protein synthesis

Relaxed parasympathetic state.

Improved immune function

Optimal recovery of muscle tissue. (Hausswirth and Mujika, 2013).

Key element in brain tissue repair.

Brain’s waste removal system kicks into high gear during sleep pumping cerebral spinal fluid (CSF) through the brain’s tissue, flushing waste back into the circulatory system where it eventually makes its way to the general blood circulation system and, ultimately, the liver. (ScienceBlog, 2013)

Nutrition

Carbohydrates and fats – fuel the process

Proteins – build the muscle

Vegetables and fruits – anti-inflammatories and

alkaline

Acidosis – attenuated by alkaline substances like

sodium bicarbonate

Diets, Macros and Broscience

Research is all over the map.

Everybody responds to macronutrients and micronutrients in a bioindividual manner.

There are minimal absolutes that can be determined from specific percentages of macronutrients to the amount of water we should consume.

This also includes previous sacred lambs like fasted cardio and anabolic windows.

Athletic/wellness goals change everything as well

.

Diets, Macros and Brocience II

Diets designed to lose weight are stressful to the system.

Especially diets that exclude a macronutrient and diets that

are conducted during exercise.

Dieters need recovery from dieting.

Food sensitivities exist and stress the system but are not

researched real well because they are non-lethal.

Wheat, sugar, dairy, peanuts, soy,

corn etc.

Nutrigenomics – there is compelling

evidence indicating genotypes specific to

optimal macro/micronutrient utilization.

Best diet for optimal recovery

Real food with balanced macronutrients applicable to

your goals. Vegetables and protein are good.

Gives you long term energy to accomplish your goals.

Helps maintain healthy weight relative to your goals.

It takes time and effort to figure it out but it’s possible

Exercise intensity and active

recovery

Active recovery has been well researched and is seen

as an optimal recovery technique.

Between matches/events or in incorporated into

periodization schedule

Speeds healing process via increased circulation of

healing hormones and chemicals.

Low intensity is the key. 50-60 % of maximal efforts

Reduced eccentric loading – cycling, swimming,

rowing and stair climbing

Neuromuscular Electric Stimulation (NMES)

An active recovery/strengthening technique providing a muscle stimulus without additional stress on joints or the central nervous system. It is theorized that the non-impact contractile stimuli from a source outside of the CNS enables enough neuromuscular activity to provide strength gains in a specific muscle group and also increase circulatory presses to speed recovery (Lee 2011 and Hansen 2012)

NMES has been shown to increase quadriceps and latissimus dorsistrength, increase lactate clearance and decrease DOMS*. (Laughmanet al, 1983; Girould, 2012; Neric et al, 2009 and Blum et al, 2011).

Thermotherapy

Cooling garments - Numerous studies show the advantage of pre-cooling before an endurance event with a vest or jacket containing compartments into which ice packs can be stored. Pre-cooled subjects show lower core temperatures, lower heart rates and greater power output at the end of a specific workout. . (Hausswirth and Mujika, 2013)

Heat therapy’s benefits tend to be during the next day or days after an intensive effort and mainly due to its ability to reduce DOMS. Additionally, its reduction of perceived pain and increased muscle pliability and length make it a good partner to manual therapy techniques. . (Hausswirth and Mujika, 2013)

Ice is not as good as we

thought!

The end of RICE

Josh Stone, Gabe Mierken, Gary Reinl

Using ice stops or slows the inflammatory process which is the first step towards remodeling and repair of muscles.

Contributes to the accumulation of microphages and IGF1 which is a mediator of GH

Active recovery evidence refutes the rest part of RICE

Tissue loading through exercise and mechanical means helps stimulate gene transcription and collagen formation

Ice does provide pain relief but cost/benefits must be weighed.

The efficacy reported may be a result of water immersion and a modified compressive effect. Edwin Moses ice baths

Manual Therapy

Manual Therapy. Good stuff but not enough evidence yet

It would be expected that manual therapy in the form of

massage or self-myofascial release would have reams of research in support of removing exercise waste byproducts but

not yet. At present it appears to be mainly efficacious in the relief of DOMS. Because of this, most research points towards

the psychological effects of this recovery technique. (Hausswirth and Mujika, 2013)

Longer time to fatigue, lower rate of perceived exertion,

perceived recovery and overall performance attributed to the

increased sense of well being. This does not invalidate the use of manual therapy as the reduction of DOMS and concurrent

increased of range of motion that some studies indicate occur do indicate it assists in recovering to a ready state

(MacDonald, 2014) (Grieve, et al, 2013)

Compression Garments

The venous activity is stimulated by muscle contraction which moves the blood towards the heart at greater speeds. Research has been mixed with one study indicating knee high lower leg compression stockings improved lactate clearance in cross country runners but also increased running time over a previously tested distance. (Rider, 2013). This suggests a post exercise benefit rather than one for performance.

Other studies have been as unequivocal ranking compression garments as a tool behind other techniques like active recovery or cold water immersion. There is also much debate regarding the amount of pressure and treatment length of time that may be effective or contraindicative. A recent review found studies with ranges of 10 to 30 mmHg in pressure. (Sperlich, 2013).

Probably too new to have enough research to

And venous activity is probably

better served with a full suit

Couple other new thoughts

Anti-oxidents and anti-inflammatories

Can disrupt the healing process similar to ice by

suppressing a natural response.

Sometimes stress is helpful in healing

And finally – Perspective.

Is there a life at stake? Is there a lot of money at stake?

When is your next state or national championships?

My contacts

Charlie@thepac.com

Charliehoolihan@gmail.com

985-966-9594

FB – Charlie Hoolihan