The 7 Best Recovery Activities
If any of your have worked with me in the clinic you all know I get excited and love to nerd out about Recovery Science. Getting into the scientific reasoning of how athletes recovery and implementing strategies for my athletes is something I really love to do.
Much like nutrition however there is a lot of BS out there on how to properly recover. Some of it is from old research, and some of it is from companies wanting to sell you a product. Let me be your guide here what recovery modalities are best to spend your time on. These 7 Activities are research verified and well worth the investment.
1. Sleep
The most powerful recovery tool is Sleep. Yes, sleep; the thing we all do every night is the most crucial component of your recovery. While you are sleeping your body is almost as metabolically active as it is when you are awake. During this time your body is busy:
Reducing systemic inflammation
Repairing muscle tissue via Protein Synthesis
Restocking cells with energy (Glucose and Glycogen)
Cleaning out metabolic waste products in your brain
In fact, your immune system is most active at night. One study had 164 participants get the common cold injected into their nose to see how sleep affected infection rate. The group that slept 5 or fewer hours had a 45% infection rate. In the 7+ hour group only 20% of people ended up getting sick from the cold.
In addition, not getting enough sleep will increase the likelihood of sustaining an injury. Getting only 6 hours of sleep is associated with a 70% increase in injury risk. Even 7 hours of sleep sees a 60% increase in injury risk. Not until you get over 8 hours does injury risk drop dramatically.
Practical Application: Make sure to schedule 7-9 hours of sleep per night.
2. Active Recovery
Active Recovery is when an athlete performs light activity post-workout or in-between events to accelerate their return. This has been accepted as a great way to accelerate your recovery.
The key to efficiently bouncing back from a tough workout or competition is blood flow. Blood flow will shuttle metabolic by-product away from muscles and bring repair cells in to fix the injured tissue. There is no better way to improve blood flow than exercise.
A Systematic Review of 26 articles determined that active recovery interventions lasting 6-10 minutes consistently improved performance. In addition, a study examining the recovery of football players and canoeists showed that 20 minutes of active recovery targeting the fatigued muscle group was most effective at returning muscle power, strength, and endurance. Active recovery has also consistently outperformed passive recovery modalities (massage, compression, cold tub, etc.).
Practical Application: Perform a 10-20 minute workout targeting sore musculature the day after a tough workout. You will bounce back faster and stronger.
3. Saunas
While sitting in a sauna your heart rate is going to increase to try to dissipate the heat. The blood flow is redistributed from the core to the skin to facilitate sweating. This is similar to the physiologic response we get during cardiovascular exercise. In addition, a five-fold increase in growth hormone has been associated with sauna use. Both of these factors, increasing heart rate and growth hormone, are great for recovery.
Another study examined the benefits of sauna use post-work in relation to run endurance. Athletes sat in a sauna for 30 minutes post-workout 2 times per week for 3 weeks. This resulted in a 32% increase in the athletes’ ability to run to exhaustion. The benefit was theorized to stem from the saunas ability to trigger a mild form of cardio. This provided an extra training stimulus to the program in a passive fashion.
Now not everyone has a sauna, and that includes me. So, what is a good alternative? A good alternative could be a hot bath. It will raise the core body temperature while allowing you to relax. Stay in about 30 minutes adding more hot water as needed. This is what I have done and I typically feel great the next day.
Practical Application: 30 minute Sauna Session or Hot Bath the day of or after a workout.
4. Massage
Massage has benefits for pain, anxiety, stress, and recovery. Playing on the same denominator as #2 and #3 on this list, massage can increase local blood flow.
One study showed that a 5 minute massage using an Effleurage stroke improved localized blood flow. Now, we do not know exactly why this happens. The leading theory is that the soft compression causes our bodies to release Nitric Oxide which dilates the blood vessels. Either way, we do not have to fully understand the science to take advantage of this.
The important note in the study was that a light stroke was used. Deep tissue massage may actually impede recovery. When deep tissue massage is applied the muscle tissue can actually be broken down. This is beneficial when a muscle is tight, but not when it has already been broken down from a workout. A light stroke will not damage the muscle any further; instead, it will increase circulation to get out the metabolic debris and bring in repair cells.
Practical Application: Schedule a massage the day after a tough workout, just make sure to request light pressure.
5. Blood Flow Restriction (BFR)
Blood flow restriction training may be new to some of you. It is a tool I have found very useful for rehabbing and training my athletes, and also has recovery applications. With BFR the blood flow is restricted for the muscle in use, but not totally. This restriction allows the athlete to get a great workout while using light weights. This is perfect for post-operative, and injured athletes.
For recovery however, 100% of the blood is restricted while the athlete relaxes for 5 minutes. Upon releasing the pressure the blood vessels dilate (via a release of Nitric Oxide) and blood rushes in. This process is then repeated 3-5x. In addition, research has shown an increase in IGF-1 and Growth Hormone in the targeted regions.
A study demonstrated this by taking 16 athletes and separating them into 2 groups. One group got BFR, while the other got a SHAM treatment (very low pressure BFR) after a leg workout. The outcome was that the BFR group showed less soreness, and their quad strength bounced back faster. One caveat was that the elite trained athletes had less of a benefit. The researchers speculated that this might be due to them having such good blood flow already, and because of that BFR was not as effective.
In the end BFR can be a great recovery tool for the recreational athlete, but elite level athletes may not see the same return. Maybe research will find more on this in the future.
Practical Application: Perform 3-5 rounds of passive BFR the day of or after a workout targeting the sore extremities.
6. Compression
Most of you have probably seen people sitting around with these bulky compression sleeves on their legs and wondered, does that actually work? The device was originally invented to help people with Peripheral Vascular Disease. The goal was to improve the blood flow of their lower extremities, and they were successful!
As it turns out, they are also a great way to improve your recovery. Research shows that pneumatic compression causes a release of nitric oxide, thus improving our blood flow. This effect is seen not only at the site of compression, but throughout the body.
In addition, the compression can reduce muscle soreness in about 15 minutes. This was shown in a study looking at 24 Olympians. There was also an acute increase in muscle flexibility post-compression. It accomplishes all of this by mimicking the pumping action of our muscles that increase venous return 3-6 fold.
So, if you have the chance to utilize this type of modality take advantage!
Practical Application: Perform 15 minutes of compression therapy post-workout or the day after for improved recovery.
7. Neuromuscular Electric Stimulation (NMES)
Neuromuscular Electric Stimulation (NMES) has bee around for decades. There are even stories of Bruce Lee using this back in the 70s to try and improve his performance. Unlike many other modalities, this one has stood the test of time.
NMES works by sending electric signals into your muscle and causing it to contract. The involuntary contraction can be used to improve muscle strength and recovery. An increase in Nitric Oxide has been observed in animal models. And remember Nitric Oxide increases blood flow, therefore improving muscle repair.
One study examined how athletes bounced back from workouts when NMES is used. Participants underwent a heavy leg day targeting the quads. The right leg then got 1 hour of NMES, and the left did not. The right leg had less soreness and was measured as stronger than the left the next day. Part 2 of the study had the athletes run hills to cause quad soreness. Again the right leg got 1 hour of NMES, and the left got nothing. The day after, athletes reported less soreness in the right leg when compared the left.
Based on these findings NMES is a great way to bounce back from a tough workout or competition. And the best part is that it is passive. You can sit down and watch Netflix while gaining all the recovery benefits.
Practical Application: Perform up to 1 hour of NMES targeting sore muscles post-workout.
All of these methods bring something to the table, but do not feel like you're missing out if you are not regularly performing most of them (except sleep). Just giving yourself a day off and doing true Passive Recovery is okay, and still beneficial. I do it all the time. If you are the type of person who always wants to be doing something, then all of these are solid options on your path to getting stronger, faster, and better.
References:
1. Aschwanden, C. (2020). Good to go: What the athlete in all of us can learn from the strange science of recovery. W.W. Norton & Company.
2. Walker, M. P. (2018). Why we sleep: The new science of sleep and dreams. Penguin Books.
3. Ortiz, R. O., Sinclair Elder, A. J., Elder, C. L., & Dawes, J. J. (2019). A systematic review on the effectiveness of active recovery interventions on athletic performance of professional-, collegiate-, and competitive-level adult athletes. Journal of Strength and Conditioning Research, 33(8), 2275–2287. https://doi.org/10.1519/jsc.0000000000002589
4. Mika, A., Oleksy, Ł., Kielnar, R., Wodka-Natkaniec, E., Twardowska, M., Kamiński, K., & Małek, Z. (2016). Comparison of two different modes of Active recovery on Muscles performance after fatiguing exercise in MOUNTAIN Canoeist and football players. PLOS ONE, 11(10). https://doi.org/10.1371/journal.pone.0164216
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9. Page, W., Swan, R., & Patterson, S. D. (2017). The effect of intermittent lower limb occlusion on recovery following exercise-induced muscle damage: A randomized controlled trial. Journal of Science and Medicine in Sport, 20(8), 729–733. https://doi.org/10.1016/j.jsams.2016.11.015
10. Bowman, E. N., Elshaar, R., Milligan, H., Jue, G., Mohr, K., Brown, P., Watanabe, D. M., & Limpisvasti, O. (2019). Proximal, distal, and contralateral effects of blood flow restriction training on the lower extremities: A randomized controlled trial. Sports Health: A Multidisciplinary Approach, 11(2), 149–156. https://doi.org/10.1177/1941738118821929
11. Sands, W. A., McNeal, J. R., Murray, S. R., & Stone, M. H. (2015). Dynamic compression enhances pressure-to-pain threshold in elite athlete recovery. Journal of Strength and Conditioning Research, 29(5), 1263–1272. https://doi.org/10.1519/jsc.0000000000000412
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