TRAINING & RECOVERY for elite athletes Illus(trat)ions of the quest to speed up nature

1. TRAINING & RECOVERYfor elite athletesIllus(trat)ions of the quest to speed up nature Karel PARDAENS, PhD Bloemfontein, 03-10-2009

2. 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?

3. REST EFFORT Supercompensation: the most fundamental training principle (Busso et al 2002) Training (session or period) Homeostasis Supercompensation FatigueMuscle damageMetabolic acidosisMuscle crampsPain ‘RECOVERY’

4. Supercompensation: the most fundamental training principle (Busso et al 2002) Training Supercompensation ‘RECOVERY’

5. ‘Homeostasis’ REST (RECOVERY) EFFORT (EXERCISE)

6. 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?

7. Fatigue “Common to everyone, a mystery to science”

8. Fatigue: what’s in a name? • Central vs. peripheral fatigue • General vs. local fatigue:- decline of overallperformance- 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,…)

9. 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)

10. 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’

11. 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

12. 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

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

14. 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’

15. Long-term recovery5

17. 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?)

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

19. 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 DOMSsensation → 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)

20. 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 performanceafter 4h • May even be detrimental to rapid glycogen resynthesis

21. <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 exercisee.g. walking day after a marathon

22. Short-term recovery4: cryotherapy • I.e. cold water immersion • Might be appropriate after activities that cause some level of traumatic injurye.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)

23. 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

24. 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

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

26. Short-term recovery8: compression garments • 3 varieties:1) for prevention/treatment of deep vein thrombosis2) sleeves worn over limbs/joints to provide support or reduce swelling3) 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)

27. 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

28. 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 -additionalinfluence of: - training status - caffeine - Mg2+ - mental stress - sleep • Balance stress/recovery !→ AND: both stress and recovery: determined by body and mind • TRAINING = continuoussearch for an optimal equilibrium

29. 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

30. 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)

31. 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 !

32. <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)

33. To conclude…1 • The most effective recovery ‘method’ is:1) eating NSAIDs like candy2) sleeping 10 hrs a day3) a relative rest period4) a massage by a beautiful masseuse5) chatting on Facebook6) going on holiday for 3 weeks without sports equipment

34. To conclude…2 • You know that recovery is complete when:1) muscle cramps disappear2) the interest in training arises3) blood lactate levels fall to zero4) fasciculations appear5) the coach says so6) DOMS no longer exists