Getting Better at Recovery

A growing body of research is shedding more light on the importance of resting after exercise—providing vital clues on measuring and enhancing the recovery process. These insights are welcome news to personal trainers and coaches who see the consequences of overtraining and inadequate recovery every day.

This column discusses some of the latest research on assessing and managing recovery and advises on tactics that may help your clients recover from exercise.

Resting/Recovering: The Basics

Fatigue and recovery are integral components of exercise. Fatigue can be defined as a reversible decline in one or more biological systems. Traditionally, fatigue is considered either central (emanating from the brain and nervous system) or peripheral (happening at the neuromuscular junction and in the exercising muscle) (Sands et al. 2016).

Summarizing many definitions, Sands and colleagues describe recovery as a physiological repair process that overcomes the effects of fatigue and re-establishes the exerciser’s ability to meet and/or exceed a previous performance. Recovery includes the processes of growth and physiological adaptation.

Using Blood Biomarkers to Assess Recovery

In years past, recovery research measured strength, peak power output and athletes’ subjective estimates of how they felt after a workout, but all those measures were inherently limited because they did not assess the biological forces at work in a recovering exerciser. Lately, recovery research has taken an exciting new turn—quantifying key biomarkers of inflammation and muscle damage in the blood along a “time course” after exercise.

Blood biomarkers provide the most accurate indications of the body’s recovery state after activity ends (Bessa et al. 2016) . The challenge is that scientists are only just beginning to identify the time course from its beginning (when biomarkers first appear) through the end of the course (when recovery has cleared those biomarkers from the blood). Bessa and colleagues were one of the first research teams to explore this time-course method of assessing recovery.

The researchers worked with 19 top-level amateur male cyclists (aged 28 ± 2.5 years; 179 ± 6.4 pounds; VO₂peak = 61.2 ± 1.7 ml O₂/kg/min, which is a superior level) who performed 6 sets of deep squats at 85% of their one-repetition maximum, alternating with 6 sets of bench presses performed at 85% of their 1-RM. Immediately after the strength workout, they cycled for 1 hour at 85% of their VO₂peak. The researchers collected blood biomarker samples immediately before and then 3, 6, 12, 48 and 72 hours after the exercise protocol.

This pioneering descriptive study measured biomarkers of muscle damage (creatine kinase and lactate dehydrogenase), inflammation (leukocytes, lymphocytes and neutrophils) and oxidative stress (proinflammatory and anti-inflammatory cytokines). The results point to fascinating possibilities for athletic teams: When future research identifies optimum protocols, teams will be able to easily assess athletes’ exercise intensity and recovery status over the course of a season. Eventually, assessment protocols could be developed to allow athletes in all types of aerobic, anaerobic and combined (aerobic–anaerobic) sports to track their recovery biomarkers.

Practical Ways to Improve Recovery

A good night’s sleep is one of the best paths to effective recovery, but researchers say almost anything that enhances circulation should help (Sands et al. 2016). Indeed, three of the most popular recovery-improvement methods address circulation: Compression garments, self-
myofascial release and cold-water immersion. Here’s a look at how well they work:

Compression Garments

Compression garments (CGs) apply pressure to parts of the lower and upper body, with options including short sleeves, sleeveless, full-cover long sleeves, shorts, long shorts and full-length pants. Sakadjian (2015) reports that wearing CGs during and after a workout (for 12–48 hours for best results) has been associated with small to moderate improvements in muscle soreness, muscle swelling, proprioception, sensory feedback, blood flow in exercising muscles and perceived exertion.

Research has not determined an optimal level of compression. The industry standard for estimating compression is measured in millimeters of mercury (mm Hg), and pressure is ranked from low (15 mm Hg) to mild (15–21 mm Hg) to moderate (25–32 mm Hg). The pressure in a medical-grade compression garment (for specific clinical conditions) is usually higher than 30 mm Hg. Sakadjian observes that CGs may provide minor physiological gains in performance and recovery, and there is no evidence that CGs are detrimental.

Self-Myofascial Release (Foam Rolling)

Self-myofascial release (SMR), using a foam roller or roller massager, has become a popular way to enhance mobility, flexibility and recovery. Although the literature on the effects and reliability of SMR is still emerging, evidence suggests it may be an effective method for enhancing joint range of motion without harming exercise performance (Cheatham et al. 2015.

Cheatham et al. also reviewed research hypothesizing that SMR improves recovery by reducing swelling in the target areas, enhancing blood flow to the exercising muscle and removing metabolic byproducts of exercise. The researchers caution that studies provide no consensus on optimal SMR techniques.

Cold-Water Immersion and Cryotherapy

Cold-water immersion is an easy, affordable and common strategy for enhancing recovery. In their review article, White and Wells (2013) say that reducing tissue temperature alters blood flow, cell swelling, metabolic reactions and neural conductance speed during recovery from high-intensity exercise. The researchers suggest these physiological changes may likely improve recovery from exercise, but they note that the long-term effects of chronic cold-water immersion have not been spelled out.

White and Wells also suggest trying other forms of cryotherapy (extreme cold), including ice or cold gel packs, ice massage, or any other local or general application of cold. An optimal target temperature for cold-water immersion or other cryotherapies has yet to be identified.

Getting It Together With Recovery

Recovery research is moving in fascinating directions—especially with the study of blood biomarkers for muscle damage and inflammation—though practical applications lie in the future. When it comes to day-to-day exercises, however, trainers and coaches may find that all of the recovery tactics discussed above can help their clients recover and potentially avert overtraining injuries. Given that research doesn’t generally point to a “best dose” for most of these techniques, personal trainers may want to introduce them progressively, just as they do with their exercise programs.