Spring is here!
A time for new beginnings and fresh starts.
Use this time to take care of your body. A proper recovery is one way to do this!
Productive, challenging, and efficient training sessions for athletes are important, but we have to make sure that we are also teaching athletes how to take care of themselves through proper recovery. While there are a lot of fun recovery tools out there (cryotherapy, ice baths, stretching, TheraGun, massage, etc), we must not forget about the basics:
Sleep
Fueling yourself with energy-giving nutrition
Hydration
A proper training progression
Stress management
Time for REST (this is NECESSARY for all athletes, particularly youth and adolescents)
These recovery efforts can't be viewed as an annoying inconvenience. Modalities and recovery tools have their time and place in maintenance, but there is no amount of cupping, massage, or ice that will replace the basics. They are necessary for our bodies to function, and not one person is the exception to this!⠀
Check out a recovery checklist developed my Stephen Bird, PhD, CSCS, linked in our bio. Although it lacks important basics like sleep and rest, it may get you off to a good start!
Did you know that MBody You offers recovery services? Check it out on the website here!
1. SLEEP
Important metabolic, immunologic, and restorative processes in our bodies are negatively affected by sleep restriction (not getting enough) and/or sleep disturbances (poor sleep quality or non-restorative sleep). This absolutely can have carryover to the way that your body recovers and performs.
(Bird 2013; Samuels, 2008; Kellmann, 2018)
SLEEP RECOMMENDATIONS:
Increase your sleep time.
7-9 hours is recommended per night. If you’re training harder and/or longer, you will need more sleep on those days. Adolescent athletes under high training loads may need up to 10-12 hours of sleep per night!
A study conducted on the Stanford University men’s varsity basketball team showed that extra sleep (goal of 10 hours per day for 5-7 weeks) enhanced basketball performance, including faster sprint times, improved shooting accuracy, improved alertness and mood, and reduced sleepiness and fatigue
Adopt a regular sleep routine and healthy sleeping habits:
Try making bedtime and waking time relatively the same each day. This will help to promote good sleep quality.
Avoid screen time before bed, including watching television or using a computer, iPhone, or tablet in bed
Napping.
Try to keep naps under 30 minutes. A 30-minute post-lunch nap after partial sleep loss improved 20m sprint performance and alertness and decreased sleepiness.
Stress management
Excessive worry, anxiety, and stress can decrease sleep quality. Try practicing mindfulness, relaxation, goal setting, and imagery before bedtime.
2. HYDRATION
Dehydration can cause a host of problems that you may have never thought about. It plays a role maintaining heart rate, maximum oxygen volume (VO2MAX), and athletic performance (Batista 2020).
Did you know? About 85% of our brain, 80% of our blood, and 70% of our muscles are made up of water! Make your muscles, brain, and body happy by drinking a few extra glasses each day.
Flexibility is not the only thing that a lack of hydration can affect…
Dehydration can cause upper and lower stomach upset in endurance athletes.
Dehydration can negatively affect strength and sport-specific performance
Dehydration can cause lightheadedness and impaired coordination, mood, concentration, and cognition.
Dehydration can cause an increase in body temperature and can potentially lead to a heat stroke when combined with other environmental factors.
So how do we track hydration?
Well, that’s where it gets complicated.
Hydration demands are affected by sport, genetics, activity level, environmental factors, gender, age, and so much more. Hydration practices and strategies should be individualized and specific to each person’s unique needs. This holds especially true with endurance athletes (runners, cyclists, etc)
The more you sweat, the more fluids your body is losing, and the higher your potential is for dehydration.
So...
The more you sweat, the more fluids you should drink
Sport-specific factors (Meyer, et al, 2016):
Athletes in weight class (or aesthetic…dance, gymnastics, cheer) sports
These athletes may decrease body mass prior to competition or for aesthetic purposes by reducing total body water and limiting caloric intake.
Athletes in intermittent high-intensity sports (stop and go like in basketball, soccer, football, ice hockey)…
Due to higher intensity and decreased focus on hydration, young athletes can show higher sweat rates and dehydration levels during competition than during training. Soccer players have shown sweat rates of up to 1.7 liters/hour during games in hot weather. That’s a lot!
Acquatic athletes, like swimmers, water polo players, and synchronized swimming…
Since sweat is not noticeable in water, many young aquatic athletes are not aware they are sweating during training and thus do not drink enough fluid.
Environmental (Meyer, et al, 2016):
Warmer weather may increase sweat rates (and reduce hydration) while cooler weather may decrease sweat rates.
Thick sports uniforms and heavy protective equipment that cover a large portion of the skin may increase sweat.
Gender (Meyer, et al, 2016):
Most studies examining the effects of dehydration are studied on males.
Little to no studies account for menstrual status in females, despite the fact that hormones, fluid retention, and plasma volume may affect hydration status.
Hydration recommendations:
Young athletes should drink adequate fluids before, during, and after practice, performance, or competition.
Caffeine and fluids high in sugar should be minimized or even discouraged.
Coaches should…
Make sure that water and/or sports drinks must be readily available
Encourage young athletes should bring their own water bottles
Provide frequent fluid breaks (at least every 15 min)
One study provided an educational invention program to youth athletes. It included a lecture on the benefits of and how to maintain optimal hydration, education on the urine color chart, and improved water accessibility during training, dining, and rest. Those who were educated on proper hydration showed an improvement in clinical hydration status. (Kavouras et al, 2011)
3. NUTRITION
Fuel your body to recover. Recovery can be affected by:
Not consuming enough calories
Not consuming enough nutrients
The quality of food and amount of processed food that you are eating.
Some athletes, particularly those in aesthetic sports like dance and gymnastics, do not realize that they are not taking in enough calories. This can actually lead to a cascade of events that can put you at a higher risk of bone stress injury or a chronic, overuse injury! Although it is outside of a PT's scope to give individual recommendations, I love to educate on how diet and lifestyle affect your pain, recovery, and injuries.
The Female Athlete Triad consists of • Intentional OR unintentional disordered eating
• Low bone mineral density (like osteoporosis) • Menstrual dysfunction
A more broad term, Relative Energy Deficiency Syndrome, is “an energy deficiency relative to the balance between dietary energy intake and the energy expenditure required to support homoeostasis, health and the activities of daily living, growth and sporting activities” (Williams 2019).
Low Energy Availability, which can occur by under-eating or overtraining, may put you at a higher risk of stress injuries. Conditions such as Female Athlete Triad and Relative Energy Deficiency-Syndrome are common in adolescent athletes who may not be realizing that they are consuming too few calories to sustain their body's necessary functions.
Additionally, making sure that you are consuming enough fruits and vegetables is extremely important to keep you healthy and injury free. If you don’t consume enough plant foods, it may lead to...
Inadequate supply of vitamins phytochemical, and minerals
Excessive oxidative stress, which may
Decrease your ability to recover
Decrease immunity
Increase susceptibility to injury (Williams 2019)
The CDC recommends that...
Adult women consume > 1½ cups of fruit and 2½ cups of vegetables daily
Adult men consume > 2 cups of fruit and 3½ cups of vegetables daily
Athletes may need an upwards of 13 servings! (Disclaimer: I am not a registered dietician. Contact a RD for your specific dietary needs).
While eating fruits and vegetables is the best way to fuel your body with vitamins and nutrients, supplementing with encapsulated fruits and vegetables may be beneficial. It has been shown that daily consumption of encapsulated fruits and veggies increases the amount of antioxidant vitamins in your blood, reduced oxidative stress, and reduced inflammatory markers in athletes (Lamprecht 2013). This has completely changed my life, as I am on the road ALL. THE. TIME. and have trouble getting all of my veggies in on travel days.
Health Made Simple, a company that partners with Juice Plus+ has a ton of free resources on how to incorporate more veggies into your diet. Get started with this video for dancers.
Check out the plant gummies, capsules, shake powder, and bars here.
Has 2020 made you want to be self-sustaining and want to grow your own greens?!
Want to be able to make a salad from the fruit of your own labor?
Check out the tower gardens here.
4. LOAD MANAGEMENT
BE STRATEGIC WHEN INCREASINGTRAINING LOAD. When you increase your training level, increase your rest and recovery.
The general rule of thumb is to increase activity by 20-30% per week. Exceeding this ratio may put you in the "DANGER ZONE" (Blanch 2016).
Sounds easy, but it can be quite difficult to calculate, especially if you are a multi-sport athlete or your are a performing artist, where your schedule and dance/event styles are different each week. This is where a professional comes in! You should feel comfortable reaching out to your local physical therapist, trainer, or doctor for specifics on how to ease back in.
A couple of ways that you can track your increase in activity:
Rate of Perceived Exertion (RPE)/Intensity
Duration
Repetitions of impact
Some apps may help
Ideally, use a combination of these
DID YOU KNOW?
MBody You offers return-to-sport services! Finished with your rehab program but need guidance with returning to the sport(s) you love? Email marybeth@mbodyyou.com or schedule a complementary phone call for more information.
5. STRESS MANAGEMENT
In addition to finding the appropriate healthcare provider to help with stress-management strategies, physical therapy can help with some of the side effects of stress by teaching you breathing exercises, performing manual therapy techniques or dry needling, and providing exercise prescription and guidance on becoming more physically active
Having a history of negative stressors and stress response has shown to have a mild predictive relationship with injury (Ivarsson 2017). Stress can cause attentional changes, like general distraction, increased self consciousness, and narrowed attention, which may interfere with an athlete’s performance. It can also lead to increased muscle tension and coordination difficulties (Herring).
Specifically to dancers, studies have found that stress was related to the amount of time a dancer was injured (Mainwaring 1993) and that a stress intervention program has been shown to reduce the amount of time that dancers were injured (Young-Eun Noh 2007).
6. RECOVERY TOOLS
Generally, if it makes you feel better, use it. Evidence is extremely variable in supporting or denying the effectiveness of recovery tools.
Some of the literature has shown:
Using post-exercises recovery measures can accelerate the reduction of blood lactate concentration and creatine kinase concentration, which may help the body quickly return to a pre-exercise state (Gu 2021).
Perceived fatigue can be effectively managed using compression techniques, such as compression garments, massage, or water immersion (Dupuy 2011) (Perez, 2019)
Reductions in muscle soreness, inflammation, and pain may allow for improved sleep quality. Two of the most commonly used recovery strategies for recovery are cold water immersion and compression garments. (Bird 2013)
Massage may lead to improvements in flexibility and delayed onset muscle soreness (DOMS) (Davis 2020).
Cryotherapy (ice/cooling measures) may reduce symptoms of Delayed Onset Muscle Soreness (DOMS) up to 96 hours post-activity. Cold water immersion (like an ice bath) were the most affective type of cryotherapy. In this review, the best parameters are temperature between 41-55* F. For 10-24 min (Hohenauer 2015)
Additionally, static stretching is a cheap and easy way to potentially help your muscles recover.
Remember, MBody You offers recovery services! Check it out on the website here.
Mary Beth Foreman, PT, DPT, is a mobile and telehealth physical therapist in Louisiana and Ohio. She is a board-certified specialist in orthopedic physical therapist and has extensive experience treating youth athletes, cheerleaders, gymnasts, and recreational, pre-professional, professional, and competitive dancers. To contact Mary Beth, email marybeth@mbodyyou.com. MBody You offers complementary phone consultations and is now accepting both mobile and telehealth patients. At this time, she is only licensed in Ohio and Louisiana, but is expanding virtual services soon.References:
Bird, S. Sleep, Recovery, and Athletic Performance. (2013). Strength and Conditioning Journal. 35(5); 43-47. doi: 10.1519/SSC.0b013e3182a62e2f Samuels, C. Sleep, Recovery, and Performance: The New Frontier in High-Performance Athletics. (2008). Neurologic Clinics: 26(1); 169-180, doi: https://doi.org/10.1016/j.ncl.2007.11.012.
Kellmann, M., et al. Recovery and Performance in Sport: Consensus Statement. International Journal of Sports Physiology and Performance. 13(2); 240-245. Doi: https://doi.org/10.1123/ijspp.2017-0759
Meyer, Flavia, et al. Fluid Balance, Hydration and Athletic Performance. CRC Press/Taylor & Francis Group, 2016.
Kavouras, S. A., et al. Educational Intervention on Water Intake Improves Hydration Status and Enhances Exercise Performance in Athletic Youth. Scandinavian Journal of Medicine & Science in Sports, vol. 22, no. 5, 2011, pp. 684-689., doi:10.1111/j.1600-0838.2011.01296.x.
Batista, Mara C.C., and Marcos A.P. Dos Santos. Impact of Hydration on Exercise Performance and Physiological Responses. Current Nutrition & Food Science, vol. 16, no. 9, 2020, pp. 1346-1352., doi:10.2174/1573401316666200309113907.
Williams, N., Koltun, Kristen, Strock, N, & De Souza, M. (2019).Female athlete triad and relative energy deficiency in sport:A focus on scientific rigor.Exercise and Sport Sciences Reviews.DOI:10.1249/JES.0000000000000200
Lamprecht, M. (2013). Supplementation with mixed fruit and vegetable concentrates in relation to athlete’s health and performance: Scientific insight and practical relevance. Nutritional Interventions and Athlete’s Health. Med Sport Sci Basel, Karger, vol 59, pp 70-8
Blanch P, Gabbett TJ. Has the athlete trained enough to return to play safely? The acute:chronic workload ratio permits clinicians to quantify a player's risk of subsequent injury British Journal of Sports Medicine 2016;50:471-475
Dupuy, O., et al. An Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review With Meta-Analysis. Front. Physiol, 2018 | https://doi.org/10.3389/fphys.2018.00403
Gu P, et al. Effects of post-exercise recovery methods on exercise-induced hormones and blood fatigue factors: a systematic review and meta-analysis. Annals of Palliative Medicine. 2021; 10(1):184-193. DOI: 10.21037/apm-20-2409.
Pérez-Soriano P, García-Roig Á, Sanchis-Sanchis R, Aparicio I. Influence of compression sportswear on recovery and performance: A systematic review. Journal of Industrial Textiles. 2019;48(9):1505-1524. doi:10.1177/1528083718764912
Davis HL, Alabed S, Chico TJA Effect of sports massage on performance and recovery: a systematic review and meta-analysis BMJ Open Sport & Exercise Medicine 2020;6:e000614. doi: 10.1136/bmjsem-2019-000614
Hohenauer E, Taeymans J, Baeyens JP, Clarys P, Clijsen R (2015) The Effect of Post-Exercise Cryotherapy on Recovery Characteristics: A Systematic Review and Meta-Analysis. PLOS ONE 10(9): e0139028. https://doi.org/10.1371/journal.pone.0139028
Wiewelhove T., et al. (2019). A Meta-Analysis of the Effects of Foam Rolling on Performance and Recovery. Frontiers in Physiology. 2019; 10: 1-15. Doi: 10.3389/fphys.2019.00376
Ivarsson, A, Johnson, U, Andersen, M, Tranaeus, U, Stenling, A, Lindwall, M. (2017). Psychosocial factors and sport injuries: meta-analysis for prediction and prevention. Journal of Sports Med, 47(2): 353-365. doi: 10.1007/s40279-016-0578-x
Herring, S, Boyajian-O’Neill, L, Coppel, D, Daniels, J, Gould, D, Grana W, Hong, E, Indelicato, P, Jaffe, R, Joy, E, Kibler, W, Lowe, W, Putukian, M. Psychological issues related to injury in athletes and the team physician: A consensus statement. https://www.sportsmed.org/AOSSMIMIS/ members/downloads/education/ConsensusStatements/PsychologicalIssues.pdf
Mainwaring, LM, Kerr, G and Krasnow, D. (1993). Psychological correlates of dance injuries. Medical Problems of Performing Artists, 8, 3–6.
Young-Eun Noh, Tony Morris & Mark B. Andersen (2007) Psychological Intervention Programs for Reduction of Injury in Ballet Dancers, Research in Sports Medicine, 15(1), 13-32, DOI: 10.1080/15438620600987064
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