Week 11: Recovery from Exercise

Question 1

Recovery: Effects on performance

Good recovery practices can allow individuals to:
* Perform greater training ….. and/or intensity and tolerate increased training ….. better
* Maintain (or increase) training ….. throughout training periods and competition
* Potentially delay the onset of ….. during training/competition or reduce their perception of fatigue and effort
* Maintain performance capacity for longer

Answer 1

Volume
Load
Quality
Fatigue

Question 2

Athlete fatigue
* Psychobiological state that encompasses the interaction of …… and …… characteristics
* Associated with an ……. to complete a physical task that was once achievable within a recent time frame
* Usually associated with altered …… of effort
* Also experience feelings of tiredness and/or exhaustion

Answer 2

Psychological & biological
Inability
Perceptions

Question 3

Recovery – Individual response

The actual amount and type of recovery required is individual-specific and depends on several factors:

• Training …… – type and amount of physiological strain induced
• Training status – well-trained typically endure ….. severe functional impairments to given stress
• Age – slower rates of ….. repair and ….. synthesis in older individuals
• Sex – may be slower recovery for …… after strength training, although may be intensity dependent
• Environment – climate, altitude and travel (time zones) alters …… responses and recovery
• Training goals – targeting adaptation (…..) or performance optimisation (taper)

Answer 3

Stress
Less
Cell
Protein
Females
Physiological
Overload

Question 4

Recovery – typical response

We get glycogen ….. as we use it throughout performance and that typically takes around ….. days to be completely replenished. Additionally, we also get exercise induced muscle damage from the ….. muscle contractions and loading and as a result of the ….. stress to various tissues and cells, we get increases in various inflammatory cytokines such as …… 6 and macrophages which spike in the first ….. hours after exercise to assist in the repair of cells and their function promoting adaptation. Muscles soreness peaks after …-…. hours before slowly dissipating over several days and ultimately all of these responses are dependent on those individual factors we discussed but we can use various strategies that can help us in enhance and potentially hasten recovery so we can return to full performance capacity sooner.

Answer 4

Depletion
Three
Repeated
Oxidative
Interlukin
Several
24-36 hours

Question 5

Fundamentals of recovery

• The overall goal of recovery is to restore ….. in many of the bodies physiological systems
• The fundamental components of recovery are …., ….. and ….. (the big 3 rocks)
• After exercise fluids and fuels lost or consumed during exercise must be replaced
• Body ….. and regular cardiovascular function must be restored and damaged tissue must be repaired
• These events should all occur in a ….. manner before the next training session or competitive event occurs

Answer 5

Homeostasis
Fluid, food and sleep
Temperature
Timely

Question 6

Fighting fatigue: acute strategies

During training or competition, the major performance limiters are:
* ……. …….
* …… (primarily occurs as result of …… loss to maintain core body temperature)

By using carbohydrate and fluid replacement as an acute recovery strategy we can potentially:
* Maintain performance ….. during the session (work harder for longer)
* Limit ……. strain induced by exercise, reducing recovery time after the session (eg effect of fluid loss on blood volume, heart rate and blood pressure)

Answer 6

Glycogen depletion
Dehydration
Sweat
Quality
Physiological

Question 7

Carbohydrates: during exercise
* …… ingestion is beneficial during prolonged exercise, especially activities involving high-intensities, for maintaining performance and deferring fatigue
* Provides ….. fuel for muscles and CNS, sparing muscle and liver glycogen
* Maximal glucose absorption rate is ….g/min
* Inclusion of other CHO sources eg fructose can increase total absorption above ….g/min
* However carbohydrate ingestion decreases …… …… rate (rehydration) and cause gastrointestinal distress

Answer 7

Carbohydrate
Exogenous
1g/min
1.5g/min
Gastric emptying

Question 8

Carbohydrates: after exercise
* Restoration of …… and …… glycogen is essential for recovery between training sessions and competitive performances
* Particularly important when athletes required to perform frequently within condensed time period
* Daily carbohydrate intake should match fuel needs to meet training demands to optimise glycogen storage
* Athletes should consume CHO as ….. as practical after exercise to maximise recovery
* Failure to meet additional energy demands of high-intensity and frequency training can lead to cumulative depletion and poor performance

In the graph we can see what happens when carbohydrate needs aren’t met during repeated bouts of training over successive days. In the athletes given insufficient carbohydrates to replace losses there is a cumulative ……. over successive days and this will obviously influence performance. Those with high carbohydrate intake, while overall there was a muscle glycogen deficit compared to before training, those losses where minimised and therefore performance was …… effected. This is particularly relevant when athletes are congested training and so daily carbohydrate intake should match fuel demands of their training. They should be consumed as soon as practical after exposure to maximise their combination of insulin and exercise induced Glut4 uptake into the muscle

Answer 8

Muscle & liver
Soon
Depletion
Less

Question 9

Recommended carbohydrate intake during intake

Brief (<45 mins)

Sustained high-intensity (45-75 mins)

Endurance & HI intermittent (1-2.5hrs)

Ultra endurance (>2.5hrs)

Answer 9

Brief: not required

Sustained high-int: small amounts, glucose mouth rinse

Endurance & high intermittent: 30-60g/h

Ultra-endurance: up to 90g/h

Question 10

Recommended carbohydrate intake after exercise

Refuelling between sessions (<8 recovery)

Answer 10

1.0-1.2g/kg/h for first 4 hours, then normal intake

Question 11

Recommended carbohydrate daily needs

Low (light/skill based)

Moderate (~1hr day)

Endurance (1-3 hr day)

Extreme volume (4-5hrs day)

Answer 11

Low: 3-5g/kg/day
Moderate: 5-7g/kg/day
Endurance: 6-10 g/kg/day
Extreme volume: 8-12g/kg/day

Question 12

When insufficient carbohydrate available during recovery, adding ….. can enhance …. storage

Answer 12

Protein (both)

Question 13

The addition of protein to carbohydrate recovery drinks and meals stimulates …… release which increases uptake and accelerates muscle ……. repletion. This is an effective strategy for improving replenishment and optimising post exercise glycogen replacement because it has been shown to result in rates of muscle glycogen synthesis similar to those with the intake of larger amounts of …… and may be particularly useful when carbohydrate availability is limited in the acute recovery window.

Answer 13

Insulin
Glycogen
Carbohydrate

Question 14

Protein after exercise

Muscle damage results in a complex cascade of physiological responses to repair fibres through process of muscle protein synthesis

Ingestion of protein (esp with carbohydrates) increases the ….. response (MPS) improving muscle repair and hypertrophy

Answer 14

Anabolic

Question 15

Hydration: during exercise
* Limiting fluid losses can help reduce …… in performance
* But should not try to replace all losses! Drinking to thirst/ad libitum advised
* Trained able to tolerate dehydration better than those with lower training status
* Electrolytes (esp …..) can be added to drinks to increase water …..
* Carbohydrates may also be added for prolonged and high-intensity sessions to replace glycogen

Answer 15

Decrement
Sodium
Absorption

Question 16

Hydration: after exercise
* Athletes should monitor changes in body ….. from pre to post exercise to assess dehydration level, and to evaluate the effectiveness of any hydration strategy, especially in hot conditions
* A loss of 1kg is approximately equal to ….L of fluid lost (also substrate oxidation)
* Since fluid losses continue during the recovery period via continued sweating (-30-60 mins) and urine losses, athletes need to rehydrate with more than a ….:1 ratio of fluid losses
* When rehydrating, typically require ~…..% of body mass changes replaced if water only, and …..% if electrolyte drink over …-…. hours after exercise to restore fluid balance
* Inclusion of electrolytes (and carbohydrates) advised in event of moderate to large fluid loss (eg >1.5L) to increase fluid absorption and prevent electrolyte dilution/losses (eg hyponatraemia)
* …… (esp chocolate) is an effective rehydration drink due to its nutritional profile of ……+, …… and …….

Answer 16

Mass
1L
1:1
150%
120%
2-4 hrs
Milk
Na+, protein & carbohydrates

Question 17

Sleep & recovery
* Sleep is essential for the brain and body to repair, recover and rejuvenate
* Athletic performance is reduced by low sleep quality and duration, affecting mental and physical health
* Sleep loss impairs ……, memory consolidation and mental well-being
* Poor sleep disrupts cell repair and growth, impairs glucose metabolism and immune response
* Elite athletes particularly susceptible to inadequate sleep and poor sleep quality
* Need to develop good sleep routines to maximise recovery and performance
* The evidence is clear that athletic performance is reduced by a …. … …. …. ….. …..

Answer 17

Cognition
A night or more of poor sleep

Question 18

Routines
* Set intense training before …..pm: avoid needs for large food/fluid intake close to bed time
* Eat and drink correctly: avoid big late meals and fluid intake, caffeine in afternoon, alcohol
* Keep a regular sleep schedule: regular bed and wake times, early afternoon naps (….. mins) for lost sleep
* Create a relaxing bedtime routine: limit device time, take a hot shower/bath
* Make your bedtime sleep friendly: keep room dark, cool, quiet; a comfortable bed reserved for sleep
* Manage anxiety and stress: meditation, breathing exercises, seek medical advice
* Utilise basic techniques to get back to sleep: remain in bed, aim to relax, avoid looking at phone (….. light emitted triggers hormonal response which causes alertness and wakefulness)
* Cold water immersion: decreased core temperature, reduced soreness

Answer 18

6pm
30 mins
Blue

Question 19

Nutrition & recovery summary
* Carbohydrates are beneficial during prolonged and high-intensity exercise to maintain performance
* After exercise, carbohydrates should be consumed as soon as possible after exercise to restore muscle and liver …… stores and maximise recovery
* …… can be consumed with carbohydrates to increase glycogen resynthesis rate, and to aid muscle protein synthesis for repair of muscle damage after exercise and hypertrophy
* Fluids should be consumed ad libitum/to thirst during exercise to replace some (but not all) losses
* Addition of …… increases fluid absorption and carbohydrates can be added during prolonged and high-intensity exercise but be mindful of reduced gastric emptying and possible gut discomfort
* After exercise, fluid should be replaced with ……% body mass losses if water, and …..% if sports drink, consumed over 2-4 hours, avoiding ingestion of large volumes in short periods of time
* Milk is effective for rehydration and protein synthesis due to its nutritional profile (Na+, CHO, protein)
* Small amount of alcohol (<….%) not detrimental to rehydration but high quantity and percent can be

Answer 19

Glycogen
Protein
Electrolytes
150%
120%
<2%

Question 20

11.03 - Hydrotherapy
* Water immersion creates …… pressure, improving venous return, central blood volume and …..-…… volume
* Recovery benefits of hydrotherapy may include:
- Reduced inflammation, swelling and soreness
- Improved metabolite clearance from muscle
- Increased ……. nervous activity
- Improved sleep onset or quality
* However some negative effects are possible, when used after certain types of exercise or improper protocols used

Answer 20

Hydrostatic
End-diastolic volume
Parasympathetic

Question 21

Water immersion strategies
* Four main hydrotherapy strategies exist:
- ….. water (CWI <….. degrees) *Most common
- ……. (TNI, …..-36 degrees)
- ….. water (HWI >….. degrees)
- …… (CWT, alternating cold and hot water)
* Passive or active recovery may be performed with complete or partial immersion of the body
* ….. is the most common hydrotherapy method used after exercise to elicit various physiological responses to aid recovery

Answer 21

Cold <15
Thermoneutral 20-36
Hot >36
Contrast
CWI

Question 22

Cold water immersion – effects on recovery
* CWI reduces perceptions of fatigue & DOMS, …..-….. degree water for ….-…..mins being most effective for reducing muscle soreness
* Contrast therapy is effective for DOMS but unclear if beneficial for perceived fatigue
* Cold water also reduces markers of muscle damage (…..) and inflammation (…..-….)
* Effectiveness may be specific to the type of exercise performed and ….. dose
* Tolerability of cold water may affect individual’s ability to achieve sufficient dose and benefit

Answer 22

10-15 degrees
10-15 mins
CK
IL-6
CWI

Question 23

The results from a meta-analysis of cold water immersion – effect on muscle damage markers and soreness. We can see that there is a strong beneficial effect of cold water immersion reducing muscle damage markers after high intensity exercise, the results are equivocal after ……. exercise. This indicates that cold water immersion can help reduce ……. muscle damage that occurs are the exercise bout, likely caused by inflammatory cytokines. Muscle soreness is reduced by ….. ….. ….. after both types of exercise although the effect is stronger after ….. intensity exercise.

Answer 23

Eccentric
Secondary
CWI
High

Question 24

Cold water immersion effect on recovery

Average sprint ….. maintained over successive days with post-exercise CWI, CWT

Average ….. power maintained over successive days with post-exercise CWI, CWT

Core temperature significantly lower with post-recovery ….. than CWT, passive

Answer 24

Power
TT
CWI

Question 25

Cold water-immersion: Practical recommendations
* Hydrotherapy can be useful for improving recovery from exercise by reducing ……, ……. & …….
* Benefits arise from ……. pressure exerted by water on body to increase central blood volume/venous return as well as temperature effects on physiological responses
* Cold water immersion provides greatest benefits; however contrast water therapy may be suitable for those with lower tolerance for required immersion time and temperature
* Best practice protocol:
- Full body (shoulder-level) immersion preferable, waist level OK
- 10-15 minute immersion time
- 10-15 degree water temperature – can adjust within range to suit athletes’ tolerance, increase compliance
- Immersion may be continuous if tolerable, or intermittent with ….-minute immersions and ….-minute rest or 1:1 contrast between cold and hot (…..-….. degrees)

Answer 25

Soreness, muscle damage and inflammation
Hydrostatic
5 minute immersion w/2 minute rest
38-40 degrees

Question 26

Cold-water immersion: how cold is too cold?
* Anecdotally, ice baths are suggested to have positive physical and mental health effects
* Limited evidence to support these claims & exposure to extreme cold water <…..-….. degrees, can result in adverse outcomes
* Likelihood of cardiac arrhythmia >……% in young, fit individuals with breath-holding during extreme CWI due to autonomic conflict
* Sudden cold water immersion can result in ….. problems, with risk higher for those with co-morbidities (esp when unaware)
* Non-freezing cold injury to peripheral vasculature (feet, hands) also possible, resulting in circulatory issues
* Extreme cold-water exposure can result in cardiac arrhythmia and superficial peripheral vascular damage

Answer 26

10-15
>30%
Cardiovascular

Question 27

Hydrotherapy – summary
* CWI can be adjusted to target specific physiological outcomes – shorter durations for reducing thermal strain, longer durations for reducing symptoms of exercise-induced muscle damage
* Consider the athlete’s needs when prescribing CWI – can be useful for improving recovery during congested training/competition phases but may impair some beneficial adaptative processes
* May not be suitable prior to …… efforts (eg sprint) due to impact on muscle temperature and nerve conduction velocity – always test athlete response prior to competition!
* CWI impairs adaptation to ……. training, so chronic use should be avoided
* …… characteristics will affect thermal response to immersion (fat mass insulative, small = high surface area to body mass), so adjust protocol as required to ensure appropriate dose and tolerability

Answer 27

Maximal
Resistance
Physical

Question 28

Recovery practices: stretching
* Passive, active, static, dynamic and ballistic stretching mechanically stimulates anatomical structures and ….. and ….. signals
* Various forms of stretching are used in attempts to minimise muscle soreness, improve …… and restore ….. capacity after exercise
* These suggested benefits of stretching are not supported by research evidence
* Some modest benefits may be achieved when stretching is used in combination with other recovery strategies, such as massage

Answer 28

Inhibitory & excitatory
ROM
Functional

Question 29

Recovery practices: massage
* Massage has been suggested to improve ROM, …… & mood as well as decrease neuromuscular excitation and soreness
* Massage can be performed manually or mechanically using foam rollers and pneumatic compression or percussive devices
* Post-exercise massage is effective at reducing DOMS and markers of muscle damage and inflammation
* Massage can assist in reducing perceptions of fatigue and restoring force capacity

Answer 29

Circulation

Question 30

Recovery practices: compression garments
* Compression clothing has been used to enhance recovery - improved circulation, reduced swelling and ……. clearance
* Research suggests compression garments reduce DOMS, perception of soreness & improving performance recovery
* Recent meta-analysis shows improved post-exercise recovery of strength and power as well as clear improvements for endurance athletes
* High-pressure compression garments are more effective at inducing physiological benefits than lower quality garments

Answer 30

Metabolite

Question 31

Recovery practices: whole body cryotherapy
* Use of cryotherapy chambers to apply extremely cold gas (-…..- -….. degrees) over the body has gained popularity as a recovery practice
* Theoretical basis is to reduce ….. and …… temperature to slow ….. conduction, stimulate muscle relaxation and decrease inflammation
* Evidence supports its use for reducing ……, however studies equivocal regarding change in …… …… & …….
* Limited benefits for performance (strength), and unclear whether it as effective as cold-water immersion so doubts about value given cost

Answer 31

-30 to -140 degrees
Skin & muscle temperature
Nerve conduction
DOMS
Muscle damage and inflammation

Question 32

Other recovery methods

Water jet massage
* Reduce ……. of muscle damage following 5 consecutive days, improved ….. …… …..
* Only one study available and unclear if jet massage more beneficial than warm-water immersion only

Acupuncture/acupressure
* Anecdotally relieves muscle tension and helps the athlete relax
* No reliable scientific studies completed

Hyperbaric oxygen therapy
* Theoretically increases …… (02) content for delivery to muscles, aiding recovery
* Limited scientific evidence of benefit, or if increased 02 in blood able to diffuse into tissue

Meditation
* Increase …… (rest and digest) nervous activity
* May aid reduction in stress, anxiety, improve sleep onset

Recovery practices: support evidence
* Several meta-analyses have assessed the effectiveness of various recovery methods for improving recovery from exercise
* What 3 strategies appear to have a positive effect on markers of muscle damage (creatine kinase)
* Unclear of limited evidence available to support use of various recovery methods for reducing inflammatory markers such as interleukin-6 and c-reactive protein

Answer 32

Markers
Vertical jump performance
Haemoglobin
Parasympathetic
Massage, compression garments and hydrotherapy

Question 33

Practical recommendations
* Best strategy is to prioritise big rocks – …., …. & …..
* Then use several ……. recovery practices over hours and days after exercise based on athlete preference and availability
* Trial different strategies in …..-risk training phase prior to use in competition to assess tolerability & perceived effectiveness for athlete
* Despite lack of evidence for effectiveness if an athlete thinks a practice is useful and it doesn’t harm recovery or performance, maybe its worth using – embrace the power of placebo!

The recovery jar: get the big rocks first then use additional practices to fill in the recovery gaps

Answer 33

Fluid, food and sleep
Additional
Low