Updated: Aug 11, 2021
By Matthew Hearn(APAM, M.Phy, PG. Cert 4. Human Movement Sc, BSc Matthew has completed a Masters in Physiotherapy, where he previously attained a Bachelor of Science (extended Biology Major) and a Postgraduate Certificate in Human Movement Science with a focus on Anatomy and Physiology.
He is the director and lead Physiotherapist at Matthew Hearn Physiotherapy and works with multiple sporting organisations and athletes across state, national and international.
NOTE: there are sport specific recovery protocols at the end of this blog.
There are a multitude of recovery techniques employed post exercise in both elite and general populations . This blog will shed light on the science behind different types of recovery, with a focus on describing the ‘recovery techniques most appropriate for the demands of your sport. Before we talk about recovery techniques it is important to understand a bit of terminology of recovery processes.
Aerobic exercise- this generally refers to endurance exercises that utilise oxygen for the body to generate its energy. These sports/events include- triathlon, marathon, rugby/ football/ Soccer, netball, Hockey, distance swimming etc.
Anaerobic exercise- this includes exercise which is short in duration up to 0-4 minutes, and very high intensity. For this type of exercise, the body utilises what ever energy is already stored in the muscles. These exercises include- 400m, 200m, 100m sprint. Weight lifting/ gym. Cross fit (some wods) , boxing/ MMa etc.
NOTE- as you may notice many sports involve both aerobic with anaerobic aspects or visa versa.
Lactic Acid/ Creatine Kinase (CK)- These are substances within a muscle/ the body which although are not bad for the general bodies processes and are quiet important for day to day life, post exercise they are recognised as indirect measures of muscle damage. Also usually the marker for Delayed onset of Muscle Soreness (DOMS) post exercise.
Vaso constriction- in terms of arteries and veins; Arteries distribute fresh blood to muscles from the heart, Veins return deoxygenated blood (the left over blood after the muscle has used its nutrients and oxygen) back to the heart. Vaso-constriction refers to a process which reduces the diameter of the veins.
Vaso Dilation- refers to the process of opening up the veins.
Let’s get on with it.
WATER IMMERSION- this involves standing in any pool of water following exercise (i.e. lake, ocean, pool)
What it does:
· Creates a hydrostatic (water compression) pressure on the body.
· At approximately 15°, can reduce CK build up in the muscles and enable an Active recovery with less stress to joints.
· Optimal time interval is 1 x 20 minutes in water at or slightly above 15°.
When to Use:
This can be effective between multiple games on the same day with a minimum 4 hour break in between, post aerobic exercise, or even the morning following exercise. As it takes time, may not be able to be completed immediately post exercise or if you have another game very soon after finishing one.
When not to use: at break within a game or immediately prior to a game/ exercise.
COLD WATER IMMERSION (CWI)
This involves immersion up to shoulders in water cooler than 15° which may be a bin/ Bath filled with iced water. Currently there are two different methods for CWI; 1) cycles of 1 minute in the cold water 4° and 1 minute out. Repeated 3-4 times. Or 2) 1 x 10-15 minutes in the cooler water 6-10°. If you have sustained an injury and not only muscle soreness a localised Ice pack would be more beneficial to reduce swelling, blood flow and reduce further damage to the injury site.
What it does:
In addition to water immersion benefits, CWI can further reduce inflammation throughout joints as it reduces bodies core temperature and increases venus return. It also causes vaso constriction. This all helps to reduce the inflammatory markers within the muscles which helps reduce DOMS.
When to use: In aerobic exercise/ sports where contact occurs as the cold effects can help with the inflammation and muscle damage related to impact. Can also be used following long aerobic events if desired.
When not to use: Research has found that following CWI temporarily the body cannot perform at optimal workings for a period of time due to the reduced muscle temperature. Therefore, not ideal when multiple events within short time frame in the same day. Also the resources for cold water therapy is hard for events such as team sports to complete properly following a game, so often players may only get 1 minute each in the cool water. This reduced cycle is not optimal for recovery.
This involves alternating between hot and cold water, optimally this is completed with cold water between 6-15° and hot water > 37°. Research suggests cycles 3-4 minutes in cold then 1 minute in hot. Repeated 4-5 times. As spa’s may be hard to locate immediate post game hot/cold showers can be an alternative.
What it does: Contrast baths are thought to create a muscle pumping action of vasodilation (in hot water), and vaso constriction (in the cold) which inturn causes muscle contraction, increased blood flow and removal of waste products (CK and Lactic Acid) and also said to reduce inflammation. Contrast recovery acts as an active recovery with less physical demands on the body whereby some studies suggest is better and more effective than an active recovery on land.
When to use: immediately post strenuous mixture of aerobic and anaerobic exercise. Or when 2 games in a day with long break between. eg. between a morning and night game. Benefits of contrast also include increased range of movement quicker than CWI.
When not to use: during a game/ prior to a game.
Compression vests/ pants are designed to create a compression gradient from distal (furthest from the body e.g. ankle) to proximal (closest to the body eg hip). Research is also limited in this area in regards to amount/ gradient of optimal compression, although few studies that have been completed show improved perceived results from the use of wearing these post AFL games.
When to use: immediately following exercise, up to 15 hours’ post. For sports where compression can be used during events e.g. long distance running, cycling, rowing etc. this can be effective also.
When not to use: One study recommends not to warm up with compression if they are not permitted during the event although there is not sufficient data gained to be able to make a clinical call.
This may include a small low intensity 10-15-minute walk or bike ride post exercise.
What it does: increases blood flow to working muscles and helps reduce muscle toxins (CK, Lactic Acid) also creates vaso dilation. This enables increased ROM, although can add stress to joints if completed following high exertion, aerobic activity/ events.
When to use: immediately post exercise (cool down) and again 5-12 hours’ post. Or is effective if you have multiple events in the one day. Active recovery immediately post event is ideal for sub maximal aerobic exertion e.g. hockey, Football, Basketball, swimming, Cross fit, Athletics.
When not to use: maximal exertion events, such as marathon, triathlon (long distance), road run/ Trail run. For these events there may be more effective and less energy demanding recovery techniques see below.
There are multiple types of stretching, static stretching is most common post exercise and also most studied. There is little research that supports increased rate of recovery due to stretching alone, however many anecdotal studies suggest stretching post exercise reduces the sensation of pain and enables increased range of motion around various joints.
As suggested in a review by ASCA 2011 there are no studies which conclude stretching to be detrimental for recovery. Ideal cycle for stretching involves holding each stretch for 30 seconds, and repeating each muscle group 2-3 times.
What it does: increases range of movement around a joint, relaxes tight muscles and reduces muscle spasm.
When to use: can be used throughout exercise as required, and immediately post exercise, and as required ongoing.
When not to use: in the instance of injury e.g. muscle tear/ strain as stretching can create increased damaged to the site of the injury.
OTHER MODALATIES TO AID RECOVERY
MASSAGE: this can be an adjunct to recovery 48 hours post strenuous exercise. Benefits include release of tight muscles, improves range of motion, increases blood flow, eliminated toxins from fatigued muscles. Also by releasing trigger points enables greater portion of the entire muscle to be utilised for the next bout of exercise. Important to note following a massage it can ache following treatment.
When not to use: immediately post injury e.g. corky, strain or muscle tear, caution if on blood thinners advised to seek professional advice for massage.
DRY NEEDLING: is the use of acupuncture needles by a trained professional inserted into tight muscle trigger points. This increases blood flow to the site of the needle once removed but not the surrounding region therefore can be more targeted and specific to enable more effective release of spasm.
Dry needling can also help to improve neuro-muscular motor control and decrease pain sensitivity to a specific region post exercise.
YOUR SPORT, YOUR OPTIMAL RECOVERY
Remember for injuries sprains, strains RICER (Rest, Ice, Compression, Elevation, referral)
No HARM (Heat, alcohol, running, massage 24-48 hours’ post
1) Aerobic exercise to max capacity (once off) - marathon, triathlon, endurance bicycle race, 24-hour trail run/walk.
Immediately post: Contrast bath post event 4:1, followed by stretch, compression garment applied 15 hours. (nutrients/ H2O).
Next Day: water immersion with active recovery, stretch compression
2 days’ post : light jog/ bike ride 10-20 minutes
3-4 days post: massage/ Dry needling
2) Sub max Aerobic exercise contact sport- Australian Football, Soccer, Netball, Basketball, Rugby,
Immediately post: active recovery, stretch static, CWI (which ever method 1 or 2 suits), compression garment (nutrition/ H2o)
Next day: water immersion 15-20 minutes, active recovery, stretch, compression
2 days post: Light jog/ bike ride 10-20mins
3-4 days’ post: massage/ Dry needling ready for next training session.
3) Aerobic non contact- cricket, 3 km swim, 3 sets tennis match, triathlon
Immediately post: water immersion 20 minutes, active recovery, stretch, compression, nutrients/ H2O
Next day: as for immediate with light jog 10 minutes.
2 days’ post: massage/ Dry needling/ heat
4) Multiple Aerobic/ anaerobic events in same day- Cross Fit Games, Basketball tournament, athletics, surf life saving, Rugby 7’s
Immediately post: compression, active recovery, stretch, (depending if greater than 5 hours’ water immersion 15° may be appropriate)
Next day: if contact sport CWI 10-15 minutes, if not water immersion, followed by active recovery, stretch, compression
2 days post: long walk 30 minutes, stretch
3+ days post: Jog, massage, Dry Needling, Heat, stretch, training light drills.
5) Anaerobic exercise- Gym weightlifting, single event 100m sprint- 400m sprint, swimming < 800m, single session cross fit.
Immediate post: nutrients, compression 5 hours +, stretch, 24 hours’ rest prior to another session on same muscle group. Range of movement exercises nil weight.
Next day: massage/ heat if feeling tight.
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