Recovery Options Post-Exercise

Cold-Water Immersion Therapy

 Cold-water immersion therapy has been around for recovery purposes for a very long time. What exactly does cold water immersion do and does it work?

We have a few studies that have investigated this recovery modality and have found some interesting findings. There are studies that have found it to be beneficial not only for Delayed Onset Muscle Soreness (DOMS) but also improve muscular power. Moore et al, (2022) investigated to find what the effects of cold-water immersion compared with other recovery modalities on athletic performance are. The other included modalities in this study were contrast-water therapy, warm water immersion, massage and air-cryotherapy.

They found most performance outcomes favoured cold water immersion. However, few of these results were statistically significant. An interesting finding was that there was a dose-response effect where cold-water immersion at lower temperatures and for shorter duration positively improved muscular power recovery 24 hours post exercise. Air cryotherapy was found to be superior to cold water immersion therapy immediately 1 hour post exercise and for recovering muscle strength.

What is important to note though is that cold water immersion is found to be detrimental to muscle strength and muscle hypertrophy adaptations post-resistance exercise. (Malta et al, 2021). It is shown that the regular use of cold-water immersion decreases strength parameters of a one repetition maximum, maximal isometric strength, ballistic effort performance and strength endurance. However, aerobic exercise performance was not affected in a detrimental way.

Summary of Cold-water Immersion Therapy

It can be extremely beneficial for recovery purposes post high intensity exercise. It can improve recovery and the perceived feeling of DOMS. This can be beneficial to those in competitive seasons of sport where recovery is key to train and play the next week. However, cold-water immersion therapy does have detriments to hypertrophy (muscle growth) and strength. This must be known and therefore planned through training programs on when to plunge in cold water and when maybe to find an alternative to recovery. The other and probably the most important factor to take into consideration is determining if it works for you. If you as an individual get great benefit from cold-water immersion, then go for it! There is some research and anecdotal evidence out there that shows cold-water immersion can positively improve mood and stress. Having improved and controlled stress levels is golden for many reasons. Pain is heavily influenced via the stress response and high stress can lead to poor sleep.

If cold-water immersion therapy improves your stress levels, mood, and sleep, then it very well can also improve pain and overall quality of life. If you want to try it yourself, then buying a plunge pool from Life Labs is my recommendation.

References

Malta, E. S., Dutra, Y. M., Broatch, J. R., Bishop, D. J., & Zagatto, A. M. (2021). The effects of regular cold-water immersion use on training-induced changes in strength and endurance performance: a systematic review with meta-analysis. Sports Medicine, 51, 161-174.

Moore, E., Fuller, J. T., Bellenger, C. R., Saunders, S., Halson, S. L., Broatch, J. R., & Buckley, J. D. (2022). Effects of Cold-Water Immersion Compared with Other Recovery Modalities on Athletic Performance Following Acute Strenuous Exercise in Physically Active Participants: A Systematic Review, Meta-Analysis, and Meta-Regression. Sports Medicine, 1-19.

 Infrared Saunas

The heat of the infrared sauna can be quite popular after big sessions of different varieties. They certainly promote relaxation, and I can personally vouch for its use improving my sleep. But I am one guy with an opinion, so what does the research say?

Firstly, infrared saunas radiate heat and it is believed that this radiated infrared heat can penetrate human tissue deeper than other heat modalities. A research study by Ahokas et al, (2022) investigated a single use infrared sauna session post resistance exercise, and its effects on muscle soreness, neuromuscular performance and sleep quality. Their results were that one infrared sauna session improved muscular power recovery in the lower legs and reduced muscle soreness. However, it resulted in raised cortisol hormone (stress hormone) levels in the short term and did not improve sleep duration/quality. The increased stress hormone level is most likely due to an increased heart rate via the induced stress of the heating environment. It is important to remember that this is short term and has no detrimental effects to overall perceived stress levels. Although sleep quality effects were not shown to change, the perceived recovery from sleep was higher in individuals post infrared sauna use.

Regular sauna use has great effects on the cardiovascular system. A higher quality study investigated to find if it improves overall cardiovascular function. Their research investigated sauna baths, which probably have reduced effects compared to infrared saunas. Even though reduced, the results were positive! They found that regular use of sauna baths promotes vasodilation (blood vessels widen) which reduced peripheral vascular resistance. What this means is that blood pressure is reduced, and overall blood flow is improved. The results of this study found that overall cardiac output was improved, therefore the work the heart needs to do to perfuse organs/ body tissues is reduced.

In summary, the use of infrared saunas is proven to be beneficial to overall improving cardiac function and muscle soreness. More higher quality studies should be conducted to see how it improves sleep and overall hormone levels. Like anything to do with recovery, give it a go yourself. The studies showed no negative effects of sauna use and it did improve muscle soreness post exercise.

 References

Ahokas, E. K., Ihalainen, J., Hanstock, H. G., Savolainen, E., & Kyröläinen, H. (2022). A post-exercise infrared sauna session improves recovery of neuromuscular performance and muscle soreness after resistance exercise training. Biology of Sport, 40(3), 681-689.,

Li, Z., Jiang, W., Chen, Y., Wang, G., Yan, F., Zeng, T., & Fan, H. (2021). Acute and short-term efficacy of sauna treatment on cardiovascular function: Ameta-analysis. European Journal of Cardiovascular Nursing, 20(2), 96-105.

Compression Therapy

Wearing compression boots is thought to stimulate and assist blood flow/ venous return and drive out blood lactate levels. A research study found that the use of compression therapy significantly improved blood lactate levels more then passive recovery. However, they did not find there was a difference between the compression therapy and active recovery (Hanson et al, 2013). One research paper investigated and found that the use of compression therapy was effective at decreasing exercise-induced swelling, stiffness and DOMS (Chleboun et al, 1995).

More recent research investigated ultramarathon runners use of compression boots and manual therapy compared to rest alone post race. They completed four daily sessions and found that the use of both treatments was effective at reducing muscle pain and muscular fatigue day one post race. What is important to note here is that this study got these results with a combined approach of manual therapy and compression boots.

In summary, there is evidence that supports the use of compression therapy in aiding recovery. However, the research in this area does need to improve. As I have stated a few times now, give it a try and see if you think it works for you. I personally find they help my DOMS and therefore can improve my ability to train or perform quicker than if I just rested.

 References

Hanson, E., Stetter, K., Li, R., & Thomas, A. (2013). An intermittent pneumatic compression device reduces blood lactate concentrations more effectively than passive recovery after Wingate testing. J Athl Enhanc, 2(3), 18-25.

Chleboun, G. S., Howell, J. N., Baker, H. L., Ballard, T. N., Graham, J. L., Hallman, H. L., ... & Conatser, R. R. (1995). Intermittent pneumatic compression effect on eccentric exercise-induced swelling, stiffness, and strength loss. Archives of physical medicine and rehabilitation, 76, 744-749.

Heapy, A. M., Hoffman, M. D., Verhagen, H. H., Thompson, S. W., Dhamija, P., Sandford, F. J., & Cooper, M. C. (2018). A randomized controlled trial of manual therapy and pneumatic compression for recovery from prolonged running–An extended study. Research in Sports Medicine, 26(3), 354-364.

Sleep

There is so much research on sleep and pain. We know from many studies that sleep is the king for recovery. If we are getting good quality and quantity sleep consistently, then we are pretty much doing the absolute best regarding recovery. The issue with sleep, is getting to sleep and getting the hours in consistently and under a good quality. That is why in all recovery modalities above, I spoke about sleep and if it affects sleep in a positive manner. If it does then those recovery adjuncts can be absolute gold when we look at the bigger picture.

Sleep deprivation is shown to increase pain sensitivity. Research has found that restorative sleep can significantly improve pain sensitivity. Therefore, we must get our sleep in. Not only is it the best for overall recovery of muscle growth post exercise, it reduces pain and reduces injury risk.

More research has found that extending sleep has a superior effect on recovery of athletic performance.

References

 Stroemel-Scheder, C., Kundermann, B., & Lautenbacher, S. (2020). The effects of recovery sleep on pain perception: A systematic review. Neuroscience & Biobehavioral Reviews, 113, 408-425.

 Bonnar, D., Bartel, K., Kakoschke, N., & Lang, C. (2018). Sleep interventions designed to improve athletic performance and recovery: a systematic review of current approaches. Sports medicine, 48, 683-703.