3 Recovery Methods to Question
The recovery side of exercise is chuck full of bad advise and false claims. From infrared pajamas claiming to improve blood circulation and sleep efficiency to adjustments claiming to improve spinal alignment, there is a lot to watch out for. In the last post we went over 7 modalities that are worth your time. The following methods are not dangerous, and some of you may even enjoy them, but they do have questionable research behind them.
And just to preface, I am not married to my beliefs. In the future there may be research that shows benefits for the listed methods. At that time I will gladly eat my words and adopt them in practice, but for now I think there are better options out there.
Let us jump in and see what they do, and do not bring to the table.
1. Cupping
Nothing has done more for the popularity of cupping than Michael Phelps’ dominant 2016 Olympics with cupping marks on his back. After his appearance Google registered an increase of 2,100% in cupping related searches. With that this old school Chinese Medicine technique found new life here in the West.
Cupping’s reasoning is based off of 2 models; The Biomechanical Model, and The Circulation Theory.
The Biomechanical Model states that by pulling the superficial tissue away from the muscle the fascia stretches. Fascia is a connective tissue that wraps around most structures in our body. I always thought of it like the white stuff on the inside of an orange. Stretching this improves mobility and therefore can help with movement limitations that impair performance, in theory. This notion is challenged in the research.
One study aimed to see if cupping could improve hamstring length. It had 25 people split into 3 groups. One group received cupping on their hamstrings, one group received a sham technique that mimicked cupping, and the other group got no treatment. All 25 individuals had their hamstring length measures on Day 1. The first 2 groups got 2 treatment sessions and had their hamstring length measured after each treatment. They found that the cupping did not improve muscle length at all.
The bruises you get when cupping are from the bursting of capillary beds in the skin. The Circulation Theory states that by doing this it forces the body to undergo a process called angiogenesis. Angiogensis is when the body regrows blood vessels. These new blood vessels are viewed as better than the old ones for some reason. The theory does not state why, and that is the giant hole in this theory. Why are the new vessels better? There did not seem to be a problem with the old ones. Until this can be answered this theory seems far fetched. Also remember that improving blood circulation is the key to recovery, and breaking the blood vessels is very counterproductive to that.
The one area cupping seems to get some credibility in is pain control. Studies have found that cupping can reduce pain for people dealing with low back and neck pain. Although, cupping did not add any additional benefit to existing treatments. This means that if you are getting a massage for pain, adding cupping does not further reduce pain. In addition, cupping underperforms when compared to more active activities like exercise.
So there you have it, the controversial area in which cupping likes to operate. I myself have used cupping at times to improve scar mobility for post-operative patients and have found some benefit. I do however believe that the benefits of cupping have been massively overstated. If you enjoy this practice there is no reason to stop, but keep in mind the benefits may be limited.
2. Voodoo Floss
Voodoo Floss entered my life when I first got into CrossFit. This product is marketed to help improve mobility and reduce post-workout soreness. You can find it on popular websites like Rogue Fitness, and it is heavily marketed by Ready State Founder Kelly Starrett.
There are 2 theories behind Voodoo Flossing. One states that by tightly wrapping the floss around a body part it will partially cut off the blood flow, similar to Blood Flow Restriction Training. Upon releasing the pressure the body will rebound and increase blood flow to the region. We know this is true for blood flow restriction training, but there is no evidence this is true for VooDoo Floss. No research to date has measured this event as nothing measures how much blood flow the floss actually restricts. In addition, research shows that the floss does not reduce muscle soreness or improve recovery times. As of now this is a piggy back claim with no backing.
The other theory states that by going through movements with the floss applied creates better fascial mobility. Fascia again being that connective tissue that wraps around structures in our body. This is a theoretical benefit. Studies show that performing stretching with and without the floss applied yield the same results. So is it the floss that is helping the mobility, or the exercise? Sounds unequivocally like it's the exercise, which we know without a doubt improves mobility.
Based on the evidence at hand my recommendation would be to save your money and not purchase VooDoo Floss.
3 Cryotherapy
Social media is filled with athletes and fitness enthusiast plunging themselves into cold baths. The posts will state that this practice improves recovery, boosts performance, heals injuries and creates mental toughness. While sitting in an ice bath is undoubtably miserable and mentally taxing, let's explore what the literature says.
One study examined the effects of doing a cold plunge on strength gains from resistance training. Athletes were split into 2 groups. Group 1 worked out, and then immediately immersed themselves in an ice bath. Group 2 performed active recovery right after lifting. Athletes followed this routine for 12 weeks. After 12 weeks both groups showed strength gains, but Group 2 showed significantly more improvements in baseline strength.
Why did this happen? When you workout you damage the targeted muscle tissue. This damage triggers an inflammatory response. Now this inflammatory response is beneficial as it will repair the damaged muscle. Not only does it repair the muscle tissue, it also helps the muscle adapt into a stronger state. If this response is stunted, the adaption does not reach its full potential.
Cold water immersion is not all bad. Research shows that it significantly reduces post-exercise soreness, and improves performance in the short term. This is likely due to the blunting of the inflammatory response. Therefore if you are taking part in a multi-day event it may be helpful to ice within an hour of the first event. This will reduce the inflammatory response and give you a better chance to perform the next day.
So it seems like using ice baths comes down to the athletes goal. If your goal is to improve muscle strength, ice baths will hold you back. If you are competing in a multi-day event, ice will help you perform at your best for a short duration.
References
1. Falsone, S. (2018). Bridging the Gap from Rehab to Performance. On Target Publications.
2. Almeida Silva, H. J., Barbosa, G. M., Scattone Silva, R., Saragiotto, B. T., Oliveira, J. M., Pinheiro, Y. T., Lins, C. A., & de Souza, M. C. (2021). Dry cupping therapy is not superior to sham cupping to improve clinical outcomes in people with non-specific chronic low back pain: A randomised trial. Journal of Physiotherapy, 67(2), 132–139. https://doi.org/10.1016/j.jphys.2021.02.013
3. Kim, S., Lee, S.-H., Kim, M.-R., Kim, E.-J., Hwang, D.-S., Lee, J., Shin, J.-S., Ha, I.-H., & Lee, Y. J. (2018). Is cupping therapy effective in patients with Neck Pain? A systematic review and meta-analysis. BMJ Open, 8(11). https://doi.org/10.1136/bmjopen-2017-021070
4. Effect of Cupping Therapy on Range of Motion, Pain Threshold, and Muscle Activity of the Hamstring Muscle Compared to Passive Stretching
5. M;, K. A. M. R. N. (n.d.). Effects of tissue flossing on the healthy and impaired musculoskeletal system: A scoping review. Frontiers in physiology. Retrieved September 18, 2022, from https://pubmed.ncbi.nlm.nih.gov/34093228/
6. Roberts, Llion A., Truls Raastad, James F. Markworth, Vandre C. Figueiredo, Ingrid M. Egner, Anthony Shield, David Cameron-Smith, Jeff S. Coombes, and Jonathan M. Peake. Post-exercise cold water immersion attenuates acute anabolic signalling and long-term adaptations in muscle to strength training The Journal of Physiology 593, no. 18 (August 2015): 4285–4301. https://doi.org/10.1113/jp270570.
7. Higgins, Trevor R., David A. Greene, and Michael K. Baker. Effects of Cold Water Immersion and Contrast Water Therapy for Recovery From Team Sport: A Systematic Review and Meta-analysis Journal of Strength and Conditioning Research 31, no. 5 (May 2017): 1443–60. https://doi.org/10.1519/jsc.0000000000001559.
