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The more you train to achieve peak performance, the more you need to maximize your recovery time. Over the last few decades, exercise science has advanced, as has our understanding of how to best recover in order to reach our peak fitness level. Gone are the days when recovery was synonymous with a long nap or a day off. Athletes are trying many techniques to speed up the recovery process.
After overloading muscle tissue with eccentric exercise, symptoms of exercise-induced muscle damage are expected. Symptoms may include reduced muscle strength, decreased range of motion, swelling, increased protein in the blood, and delayed onset muscle soreness.1 These temporary symptoms improve during the recovery period. Stressing the muscles before they are fully recovered might cause muscular injury and decreased performance. When the difference between winning and losing is measured in milliseconds, any recovery method that helps expedite healing is helpful.
Recovery is necessary to help athletes bounce back from training and solidify their fitness gains. Recovery is essential to reduce physical and psychological stress, avoid joint overload, and mitigate fatigue. The recovery process may look different for each person.
Recovery is an essential part of the principle of training, which refers to the systematic and progressive process of improving physical performance through the use of specific training methods. The training principle is based on the idea that the body adapts to the demands placed on it and that by progressively increasing the intensity and volume of training (overloading), an athlete can improve their physical performance. This is different from over-training, which impairs rather than improves performance.2
Recovery is the process of repairing and rebuilding the body following physical exertion. It is an essential part of any training program, as it helps the body adapt to exercise demands and improve performance.
There are several ways in which recovery can improve performance, including:2,3
Several strategies can facilitate recovery in sports, including:
Consuming a balanced diet that includes sufficient amounts of carbohydrates, protein, and healthy fats can help support recovery. Choosing your nutrition wisely will restore muscle and liver glycogen stores, replace fluids and electrolytes lost in sweat, promote faster muscle repair, and support the immune system.
When planning your nutrition for the day, choose a nutrient-dense, whole-food diet high in micronutrients. Also, consider the following:
According to the Dietary Guidelines for Americans 2020-2025, the optimal percentages of macronutrients for adults are:
An endurance athlete would increase their carbohydrate percentage, and a strength athlete may increase their percentage of proteins. According to International Sports Sciences Association (ISSA):
For more detailed information on sports nutrition, read the International Society of Sports Exercise and Nutrition Research and Recommendations.
Other recommendations from the Dietary Guidelines for Americans and ISSA include:4
Sleep is critical to physical, mental, and emotional recovery. Aim for 8 to 10 hours of quality sleep during periods of heavier training. Otherwise, aim for 7 to 9 hours of quality sleep each night.
About one-third of U.S. adults are sleep deprived. Sleep deprivation can increase the risk of obesity, diabetes, cardiovascular disease, high blood pressure, and depression. In one study, athletes who slept less than 8 hours per night for two weeks were 1.7 times more likely to have an injury than athletes who got enough sleep.5 In another study, runners who slept less were slower and felt like they were working harder when compared to runners who got at least 7 hours of sleep.6
Staying hydrated is essential for recovery, as it helps to replace fluids and electrolytes lost during exercise. Endurance athletes are at increased risk of dehydration, but adequate hydration is important for everyone. Water is the most abundant molecule in the body, representing up to 70% of body mass.7
When you don’t exercise, your kidneys adjust urine production to match fluid intake. However, when you exercise, especially in warm, humid environments, sweat production to release the heat generated during metabolism can reach 3-4 liters per hour in some well-trained people. Many athletes do not replace fluids at the same rate as they are lost, leading to dehydration by the end of the event. Experts believe that losing more than 2% of body weight due to dehydration affects performance.8
Changes in body physiology due to dehydration:8
Massage and other soft tissue work, such as foam rolling or stretching, can help to improve circulation and reduce muscle soreness. Percussive devices combine compression and vibration into one device. Research suggests that percussive therapy improves muscle stiffness and is superior to foam rolling and mechanical vibration. Targeted frequency appears to be between 12 Hz and 120 Hz, depth of 0.5 mm to 5 mm, and a treatment duration of 15 seconds up to 30 minutes to achieve the desired clinical goals.9,10
Cold therapy decreases skin and muscle temperature, decreasing metabolism and blood flow to an injury, which reduces swelling and inflammation from tissue damage. Cold therapy also relieves pain, slows nerve impulses transmitting pain signals to the brain, and may reduce delayed onset muscle soreness.
Cold immersion is a technique made popular through the work of Wim Hof, a Dutch physiologist, and explorer. Wim Hof uses a combination of breathwork and intermittent cold exposure to adjust internal physiology. Cold immersion constricts blood vessels. When blood vessels constrict and then dilate, a pumping action occurs in the tissue. In one study, participants who performed breathing exercises, meditated, and were immersed in ice-cold water had better immune function than the control group.11
Further research is needed to determine the optimal cold water immersion technique and its safety.12 A 2017 review suggested that cold water immersion improves neuromuscular performance for 24 hours, but the benefits do not extend past this period. They recommended that cold water immersion include two exposures of 10°C for 5 minutes each, and athletes should sit in ambient temperature for 2 minutes between exposures.13 Multiple other studies support this finding and suggest that ideal temperatures are between 11°C and 15°C for 11 to 15 minutes to reduce DOMS and enhance recovery.14
Hyperbaric oxygen chambers are used to help with tissue healing. Initially, hyperbaric oxygen therapy (HBOT) was used to treat decompression sickness when scuba divers ascended too quickly. HBOT chambers increase atmospheric pressure to increase the volume of oxygen absorbed by tissues. The pressures used in HBOT are typically 2–3 times atmospheric pressure. HBOT uses 100% oxygen at increased pressures to deliver oxygen directly to body tissues instead of relying on the lungs and circulatory system to deliver it.15
HBOT is used to improve immune function and reduce inflammation and swelling. Increased oxygen causes blood vessels to constrict, which reduces swelling and inflammation. Over longer treatment periods, HBOT increases neovascularization and neo-angiogenesis (new blood vessels and increased blood flow). It is often used to treat wounds that are not healing well.15
Potential side effects from HBOT include barotrauma to the ears and sinuses from increased pressure and oxygen toxicity. Barotrauma can also occur in the lungs or in unfilled dental cavities. Oxygen toxicity is due to breathing increased concentrations of oxygen at increased pressures. In oxygen toxicity, an excessive number of free radicals are generated, which can cause nerve damage.15
More research is needed to determine whether HBOT treats musculoskeletal injuries or DOMS effectively. Clinicians should monitor athletes post-treatment for signs of central nervous system or lung toxicity and barotrauma.9
Neuromuscular electrical stimulation devices are composed of a power source, a stimulator, and electrodes. E-stim usually uses a pulsed waveform that can be adjusted for both amplitude and duration. The electrodes are placed on the skin to activate muscle fibers to generate a contraction. NMES units are also used to treat muscle spasms.9
Whole-body electrical stimulation can cause rhabdomyolysis, a serious condition due to the breakdown of muscle tissue. Germany and Israel are the only two countries that have instituted guidelines on the use of whole-body stimulation, including recommending use only by trained individuals, with adequate hydration before and after application and monitoring for rhabdomyolysis.16
The clinical application of neuromuscular electrical stimulation lacks consistent evidence to recommend it.9
Recovery equipment
Using equipment such as compression garments or recovery boots can help to improve circulation, reduce swelling, enhance metabolic waste removal, and reduce muscle soreness. A review of 40 studies suggested that:17
The research supporting these recovery methods is inconclusive and probably varies by person and sport.
Several principles of recovery are important to consider when developing a recovery plan:
Other important principles of recovery include the importance of proper nutrition, adequate sleep, and the use of techniques such as massage and foam rolling to improve circulation and reduce muscle soreness. Finding a recovery routine that works best for an individual athlete is important, as different strategies may work better for different people. It is also important to listen to the body and allow for adequate rest and recovery time to optimize performance.
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Disclaimer
While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.
1. Hill J, Howatson G, van Someren K, Leeder J, Pedlar C. Compression garments and recovery from exercise-induced muscle damage: a meta-analysis. Br J Sports Med. Sep 2014;48(18):1340-6. doi:10.1136/bjsports-2013-092456
2. Bishop PA, Jones E, Woods AK. Recovery from training: a brief review: brief review. J Strength Cond Res. May 2008;22(3):1015-24. doi:10.1519/JSC.0b013e31816eb518
3. Chennaoui M, Vanneau T, Trignol A, et al. How does sleep help recovery from exercise-induced muscle injuries? J Sci Med Sport. Oct 2021;24(10):982-987. doi:10.1016/j.jsams.2021.05.007
4. Kerksick CM, Wilborn CD, Roberts MD, et al. ISSN exercise & sports nutrition review update: research & recommendations. Journal of the International Society of Sports Nutrition. 2018/08/01 2018;15(1):38. doi:10.1186/s12970-018-0242-y
5. Milewski MD, Skaggs DL, Bishop GA, et al. Chronic lack of sleep is associated with increased sports injuries in adolescent athletes. J Pediatr Orthop. Mar 2014;34(2):129-33. doi:10.1097/bpo.0000000000000151
6. Huang K, Ihm J. Sleep and Injury Risk. Curr Sports Med Rep. Jun 1 2021;20(6):286-290. doi:10.1249/jsr.0000000000000849
7. Institute of Medicine (US) Committee on Military Nutrition Research. Marriott B, ed. Nutritional Needs in Hot Environments: Applications for Military Personnel in Field Operations. National Academies Press 1993. https://www.ncbi.nlm.nih.gov/books/NBK236237/
8. James LJ, Mears SA. Does dehydration really impair endurance performance? Recent methodological advances helping to clarify an old question. DGatorade Sports Science Institute. 2021;
9. Cullen ML, Casazza GA, Davis BA. Passive Recovery Strategies after Exercise: A Narrative Literature Review of the Current Evidence. Curr Sports Med Rep. Jul 1 2021;20(7):351-358. doi:10.1249/jsr.0000000000000859
10. Lu X, Wang Y, Lu J, et al. Does vibration benefit delayed-onset muscle soreness?: a meta-analysis and systematic review. J Int Med Res. Jan 2019;47(1):3-18. doi:10.1177/0300060518814999
11. Kox M, van Eijk LT, Zwaag J, et al. Voluntary activation of the sympathetic nervous system and attenuation of the innate immune response in humans. Proc Natl Acad Sci U S A. May 20 2014;111(20):7379-84. doi:10.1073/pnas.1322174111
12. Bleakley C, McDonough S, Gardner E, Baxter GD, Hopkins JT, Davison GW. Cold-water immersion (cryotherapy) for preventing and treating muscle soreness after exercise. Cochrane Database of Systematic Reviews. 2012;doi:10.1002/14651858.cd008262.pub2
13. Higgins TR, Greene DA, Baker MK. Effects of Cold Water Immersion and Contrast Water Therapy for Recovery From Team Sport: A Systematic Review and Meta-analysis. J Strength Cond Res. May 2017;31(5):1443-1460. doi:10.1519/jsc.0000000000001559
14. Machado AF, Ferreira PH, Micheletti JK, et al. Can Water Temperature and Immersion Time Influence the Effect of Cold Water Immersion on Muscle Soreness? A Systematic Review and Meta-Analysis. Sports Med. Apr 2016;46(4):503-14. doi:10.1007/s40279-015-0431-7
15.Moghadam N, Hieda M, Ramey L, Levine BD, Guilliod R. Hyperbaric Oxygen Therapy in Sports Musculoskeletal Injuries. Medicine & Science in Sports & Exercise. 2020;52(6)
16. Stöllberger C, Finsterer J. Side effects of and contraindications for whole-body electro-myo-stimulation: a viewpoint. BMJ Open Sport Exerc Med. 2019;5(1):e000619. doi:10.1136/bmjsem-2019-000619
17. Pérez-Soriano P, García-Roig Á, Sanchis-Sanchis R, Aparicio I. Influence of compression sportswear on recovery and performance: A systematic review. Journal of Industrial Textiles. 2019;48(9):1505-1524. doi:10.1177/1528083718764912