Karel PARDAENS, PhD Bloemfontein, 03-10-2009 TRAINING & RECOVERY for elite athletes Illus(trat)ions of the quest to speed up nature Karel PARDAENS, PhD Bloemfontein, 03-10-2009 03-10-2009

TRAINING & RECOVERY PART 1. Recovery: what’s in a name? PART 2. Long-term recovery - periodisation - relative rest periods - absolute rest periods PART 3. Short-term recovery - modalities - sleep PART 4. Concluding remarks: is it possible to expedite a natural process other than with rest? 03-10-2009

Supercompensation: the most fundamental training principle (Busso et al 2002) Training (session or period) Homeostasis Supercompensation EFFORT REST Fatigue Muscle damage Metabolic acidosis Muscle cramps Pain ‘RECOVERY’ 03-10-2009

Supercompensation: the most fundamental training principle (Busso et al 2002) Training Supercompensation ‘RECOVERY’ 03-10-2009

‘Homeostasis’ EFFORT (EXERCISE) REST (RECOVERY) 03-10-2009

Supercompensation: the most fundamental training principle Most fundamental, but most difficult to quantify !! ‘Sport is an art’ Fatigue, pain, muscle soreness, thirst, hunger,… at the end of exercise: - how far do you need to go? - when is the time for another training session? - how much time for tapering-off? - when will the athlete be at its best? 03-10-2009

“Common to everyone, a mystery to science” Fatigue “Common to everyone, a mystery to science” 03-10-2009

Fatigue: what’s in a name? Central vs. peripheral fatigue General vs. local fatigue: - decline of overall performance - decline of a certain system’s function: - cardiorespiratory system - neurological system (peripheral nerves, CNS, ANS) - endocrinological system (hormonal) - metabolic system (substrate availability) - gastrointestinal system (e.g. stomach problems) - musculoskeletal system (muscle damage, soreness,…) 03-10-2009

Muscular ‘fatigue’ Metabolic acidosis Lactate accumulation (Mechanical) muscular damage (CKs) Cytokine production Oxidative stress (reactive oxygen species, ROS) Release of ‘heat-shock proteins’ (HSP) Delayed onset of muscle soreness (DOMS) 03-10-2009

Fatigue & Recovery ‘Recovery’ = much more than ‘recovery from muscular fatigue’! Cfr. all bodily systems Cfr. chronic fatigue syndrome (CFS), overtraining syndrome (OTS): ‘fatigue’ can ‘accumulate’! Distinction (for the purpose of this presentation): → ‘chronic fatigue’ vs. ‘acute fatigue’ → ‘long-term recovery’ vs. ‘short-term recovery’ 03-10-2009

Long-term recovery1 Empirical necessity (cfr. performance declines / ameliorates) cfr. nature, e.g. seasons (relative) rest periods are bio-logical All biological beings are subject to diurnal and circannual variation Impossible to be ‘in shape’ whole year long 03-10-2009

Long-term recovery2 Periodisation = dividing training process into periods & mesocycles - preparation period, competition period, transition period - mesocycles of 2-6 weeks, incl.: (1) a load & rest phase (physical training) (2) a certain training ‘content’ = variation of the training frequency & intensity & time (volume) (F.I.T.) over the year = (relative) rest of (a part of) the body = variation of the physical demand by manipulating: - the (physical) F.I.T.-variables - the technical skills training - the tactical training 03-10-2009

Long-term recovery3 (Fry et al 1992) Note: Overtraining vs. overreaching ! 03-10-2009

Long-term recovery4 Relative rest period = - stress other metabolic systems (e.g. aerobic vs. anaerobic // FT- vs. ST-fibers) (e.g. resistance training for a cyclist) - stress other muscles (e.g. tennis for a soccer player) - other coördination (e.g. MTB for a skater) - less stress on the body (training less & less intensive) (e.g. swimming 3 x/wk instead of 2 x/day) Absolute rest period = no sport activities Mental & physical: ‘recharging batteries’

Long-term recovery5 03-10-2009

Datum of periode

Short-term recovery1 Barnett A, Using recovery modalities between training sessions in elite athletes: does it help?, Sports Med 36: 781-796: 2006 Most studies are based on (almost) untrained subjects ↔ elite athletes ! e.g. ‘repeated-bout effect’: prior training attenuates DOMS, muscle injury (CK), and loss of strength up to 6 (!!) months later “Biochemical, physiological or immunological markers that consistently detect an imbalance between training and recovery resulting in future performance decrements have yet to be indentified” (p.786) Main question = “is any the modalities more effective than rest?” (by enabling to tolerate greater training loads, or by augmenting the performance-enhancing effect of training at a given load?) 03-10-2009

When talking about ‘recovery’… Recovery of performance (clinical) vs. Recovery of underlying parameters (subclinical) e.g. blood lactate, CKs,… 03-10-2009

Short-term recovery2: massage According to studies: - no effect on muscle blood flow - no effect on blood lactate removal - no effect on muscle strength recovery - slight effect on DOMS sensation → risk of overdoing ! May even cause further trauma (upon tissue damage from exercise) Massage sessions may have important mental effects (cfr. e.g. cyclists during TdF) 03-10-2009

Short-term recovery3: active recovery I.e. ‘cool-down’ Well-established effect on blood lactate removal (cfr. ‘lactate shuttle’) HOWEVER: lactate is not a valid indicator of recovery quality ! Might reduce muscle damage (cfr. CKs) No significant effect on performance after 4h May even be detrimental to rapid glycogen resynthesis 03-10-2009

NOTE: ‘regeneration training’ <Niveau> <Sporttak> <Discipline> <Module> <Vak> NOTE: ‘regeneration training’ Bodybuilders: “feeder workouts” (Croskery 1995) Very light AND very short training sessions may promote recovery from heavy training sessions → cfr. hormonal response to exercise e.g. walking day after a marathon 03-10-2009

Short-term recovery4: cryotherapy I.e. cold water immersion Might be appropriate after activities that cause some level of traumatic injury e.g. team contact sports or martial arts However: only analgesic effect, no effect on DOMS Most recent research: “probably negative effects on training adaptation” (suppression of supercompensation) (Busso 2003) 03-10-2009

Short-term recovery5: contrast T° water immersion i.e. alternating immersion in warm-to-hot and cold water Might enhance post-match CK clearance (study in rugby) However: mechanism=??? Popular but probably no effect on performance after 4h 03-10-2009

Short-term recovery6: hyperbaric oxygen therapy i.e. exposure to whole-body pressure >1 atmosphere while breathing 100% oxygen Might increase rate of recovery from soft tissue injury by several mechanisms However: no (consistent) results both with regard to tissue injury markers and to performance measures Additional barriers: - cost of equipment & qualified personnel - risk of oxygen toxicity 03-10-2009

Short-term recovery7: NSAID NSAID = non-steroidal anti-inflammatory drugs Inhibiting cyclo-oxygenase (COX) , enzyme involved in synthesis of prostaglandins, modulators of inflammation Bio-logical role of inflammation in muscle repair !!!!!!! Use of NSAIDs over extended periods might have detrimental effect on adaptation to training !! 03-10-2009

Short-term recovery8: compression garments 3 varieties: 1) for prevention/treatment of deep vein thrombosis 2) sleeves worn over limbs/joints to provide support or reduce swelling 3) elastic tights and tops worn as exercise clothing Very popular Mechanisms: - recovery blood lactate removal - less increase in plasma CK - decreased perceived soreness - reduced swelling - faster recovery of force production However: no evidence of improved recovery on performance to date! (cfr. also Duffield et al 2008 & 2009, Davies et al 2009) 03-10-2009

Short-term recovery9: stretching Possible functions: 1) increase ROM around joints: + (by various modes of stretching) (Mahieu et al 2007) 2) performance-enhancing effect: +/- (dependent on mode of exercise & stretching) (e.g. Kokkonen et al 2007: +) 3) injury prevention: ?/+ (Woods et al 2007: +) 4) facilitating recovery: ?/- Possible mechanism: dispersion of oedema? may not be a desirable goal! also no preventative effect on DOMS (Herbert & de Noronha 2007) Conclusion: no apparent short- or long-term benefit from stretching as a recovery modality 03-10-2009

NOTE: muscle cramps & fasciculations I.e. unvoluntary contractions of (part of) the muscle Fasciculations: may be a sign of recovery In those times: muscles more prone to cramps Muscle cramps: - associated with (physical) fatigue - additional influence of: - training status - caffeine - Mg2+ - mental stress - sleep Balance stress/recovery ! → AND: both stress and recovery: determined by body and mind TRAINING = continuous search for an optimal equilibrium 03-10-2009

Short-term recovery10: electromyostimulation involves transmission of electrical impulses via surface electrodes to peripherally stimulated motor neurons eliciting muscular contractions Mechanism: increased blood flow → ‘muscle pump effect’ → enhance tissue repair Few studies: no improvement of recovery process 03-10-2009

Short-term recovery11: sleep Most explicit mode of rest Better than e.g. shopping ! “A good athlete is a lazy one” Better than e.g. watching TV? Cfr. neurogenesis during sleep Practice of elite/professional athletes (whether or not on training camp): - napping during afternoon - extensive nighttime sleep (cfr. study in Belgian female elite runners) 03-10-2009

Short-term recovery12: rehydration & glycogen resynthesis If appropriate volume & sodium content → fluid balance & plasma volume can be restored <4 hrs Unlikely that currently used recovery modalities would compromise rehydration Rapid glycogen resynthesis: especially important if >1 training sessions/day ! CHO stores can be restored <24 hrs ↔ between sessions 1.2 g/kg/hr at regular intervals up to 5 hrs post-exercise ! 03-10-2009

NOTE: antioxidant supplementation <Niveau> <Sporttak> <Discipline> <Module> <Vak> NOTE: antioxidant supplementation Unaccostumed (eccentric) exercise → inflammatory response → ROS (free radical production) → oxidative stress upon tissue → secondary damage NB: exact nature of relationship between ROS production, exercise-induced muscle damage (EIMD) & soreness is unclear “Vitamin C & E (as well as HMB & proteins) before & after exercise appears to provide a prophylactic effect in reducing EIMD” (Howatson & van Someren 2008) “Effects are only exhibited when nutritional status is deficient. There are no convincing effects of supplementation in well-trained athletes.” (Margaritis & Rousseau 2008) 03-10-2009

To conclude…1 The most effective recovery ‘method’ is: 1) eating NSAIDs like candy 2) sleeping 10 hrs a day 3) a relative rest period 4) a massage by a beautiful masseuse 5) chatting on Facebook 6) going on holiday for 3 weeks without sports equipment Long-term vs. short-term recovery; rest/recovery = much more than sleep 03-10-2009

To conclude…2 You know that recovery is complete when: 1) muscle cramps disappear 2) the interest in training arises 3) blood lactate levels fall to zero 4) fasciculations appear 5) the coach says so 6) DOMS no longer exists Recovery = much more than lactate removal and/or getting rid of muscular fatigue; recovery/supercompensation is difficult to quantify: it is the art of training ! 03-10-2009