By: Dr. Scott A. Weiss
(Completed within the first 2 hrs. post exercise)
Aerobic Exercise, Compression, Elevation, Physical Agents, Massage, Stretching, Sleep, Food, Hydration, Electrolytes.
- Aerobic exercise – After strenuous exercise, light aerobic exercise at 20-30% VO2 MAX has long been known to aid in recovery by working as a pumping and flushing mechanism for the body’s circulatory system. Simply pedaling a bike, jumping on the elliptical or a going for a walk at a lower intensity aids in a speedier recovery. Pushing fluids back to central circulation and preventing the build-up of excess by-products of metabolism in the muscle helps prevent a “Muscle Hangover”. If you follow your heart rate (HR) through training as most do, keep your HR at 30-40% of your maximum heart rate (MHR) for 10-15 minutes post-exercise. One of the easiest ways to find your maximum heart rate is by using the formula 220-Age. For a 44 year old man, he would have a MHR of 176. By adding this simple variable to your training program will be prove to be paramount to your recovery program.
- Compression – For several years now, athletes have been reaping the advantages of mechanical compression once only thought to be used for patients with medical dysfunction. Compression Garments and Compression Devices are used for cardiac patients and patients with lymphedema. They help push venous, deoxygenated blood and stagnant lymph back to central circulation. These days, some of the more popular, adapted versions seen in the sports community use pneumatic pressure and sometimes ice water to push fluid back to the core. Some of the more popular brands albeit expensive are systems like the Normatech ?, Gameready?, and Sportspump?. They are widely used in sports medicine / recovery facilities all over the world. There are a host of other companies selling compression garments which are a cheaper option. They are made from tight, high tech elastic cloth that one can wear on different parts of the body. Athletes take advantages of everything from socks and arm sleeves to full lower body tights. They are similar to stockings/stockinet which keep fluids out of the limbs by providing constant pressure on the limbs preventing pooling in that region of the body. Recent research has reported that compression garments not only improve recovery but can increase power and enhance athletic performance by enhancing lactate removal. The compression sleeves worn around a joint has also been known to reduce muscle and tendon oscillation/vibrations, one of the key causes of soreness. If you have never experimented with compression, you will realize it is a terrific, proactive tactic to promote faster recovery.
- Elevation – Using gravity to work with you is always a great option. It’ simple, cheap and ideal after exercise. Elevating the legs for 20 minutes after a workout or run helps prevent pooling of blood in the lower extremities. When I was working with Olympic marathoners and triathletes I observed the entire team laying on the floor with their legs up on a wall within minutes of finishing their run. The whole team performed this position. While in this position, the athletes would use Progressive Muscle Relaxation Exercises (PMRE). With PMRE, the athlete simply squeezes the muscle of the feet, calves, legs, and core all the way up to the fists and face. Starting from the feet and working your way up to the head is considered one full set and we prescribe performing this 3-5 full sets of PMRE. Contracting and relaxing the muscles helps gravity by further pushing metabolic byproducts, lymph fluid and water out of the working muscle. The main goal is to clean those working muscles out after a workout and prevent the stasis of fluid.
- Physical Agents – There are a multitude of methods employing physical agents into the recovery equation. The top three methods we enforce at both Fifth Avenue and Arista Physical Therapy and Wellness are Ice baths, Contrast Methods, and Epson Salt Baths. Epson Salt is made up of Magnesium Sulfate which can be absorbed into your body through the skin. Concomitantly, fluids are also pulled out of the body through reverse osmosis to decrease fluid retention and swelling. Magnesium is an important mineral in that it helps keep enzyme activity regular in your body while Sulfate is vital for the formation of joint proteins. Recommendations for these soaks are 1-2 times per week for about 15-20 minutes each soak. Epson salt baths are ideal within 2 hrs. post exercise. Ice baths on the other hand are used as soon as possible post exercise. We talked about some of the other recovery methods aiding in flushing the muscles from the pooling effect. Here, ice vaso constricts the arterioles so in that none to minimal pooling takes place. Ice baths basically try to stop the pooling effect from developing in the first place. For this to happen the ice bath need to be set to 55° F and the duration of the ice baths should be about 15-20 minutes. Contrast Baths or showers are done with two tanks or two showers, preferably baths. Alternating hot and cold water stimulates the lymph vessels to virtually dilate and constrict which essentially pushes and moves stationary fluid out of that area. Full body immersion up to the neck in both hot and cold tubs provide the best effect. Yes, I saidFULL IMMERSION. The cold tank should be set at 50-60° F and the hot tank set at 102-106°F. The frequency of immersion is 3:1, hot: cold respectively. So we usually have patients and athletes stay in the hot tank for 3 minutes and 1 minute in the cold tank. This is considered one set and it is optimal to perform this 3-5 sets. Not only are contrast baths amazing for recovery but they specifically exercises one of your smallest blood tributaries in the body, the arterioles. The opening and closing of these arterioles literally gives them a work out and ones that may have been previously closed may open from the great velocity and force of blood flow.
- Massage / Myo-Fascial Release (MFR) – Massage is one of the oldest forms of treatment around. It dates back to 700 BC and the manual effects of massage helps blood flow, lymph flow, decreases muscle tension, reduces stress and improves overall psychological relaxation. If you are and avid exerciser, consider finding a regular “Go-To” massage therapist (LMT) or physical therapist (PT) you trust. Trying to coordinate your massage after your workouts are optimal and anyone very active should have some regular bodywork weekly. Either relaxing with a spa massage, sports massage or performing self-massage techniques all work and are acceptable. Foam rolling, using “The Stick”?, acupressure using a tennis ball, or even using the corner of two walls are some of the MFR skills that will benefit the recovery process. Most people often benefit greatly from massage but in some cases it may leave you sore for a day or so depending how aggressive it is. Make sure to periodize your massages into your complete schedule because the worst thing is to show up to a practice, race or competition all-ready banged up, sore and moving slow. I know I have been guilty of this from time to time.
- Stretching – Stretching, my favorite piece to the recovery equation is analogous to twisting and wringing out a wet towel. Elongating a muscle literally drains the muscle of its by-products from strenuous exercise. Statically Stretching those working muscles in multiple angles is the chosen form of flexibility after exercise. Holding each stretch for 30-60 seconds performed 3-5 times is our prescription for flexibility. Of course, one can perform Ballistic Stretching here but holding a stretch truly flushes the muscles better than ballistic or more dynamic type stretching. We like to perform more ballistic style flexibility as a warm-up before exercise and save the static stretching for after exercise. Plus we all know that the research states that static stretching before a competition clearly reduces performance. Furthermore, your body temperature is heightened after exercise, most likely giving one the ability to gain flexibility at this point and stretch further. Try to always perform a full body stretch as this will only help balance out all the forces around each joint and help create space in the body.
- Sleep – Everyone has individual needs based on their lifestyle, workouts, and genetic makeup but nothing on this list helps the body recover as much as good, solid rest and sleep. Some say that sleep and rest are just as important as training but it is a fact that you cannot ever really catch up on sleep. Having 7-8 hours a night sleep truly repairs, recovers, rejuvenates and aids in the growth of new tissue in the body, not to mention how amazing sleep is for recharging the immune system. Plan adequate rest into your weekly routine and schedule a “Rest Week” every fourth or fifth week or we recommend to take a “Rest Day” about every tenth day. Manipulate the volume, intensity and duration during rest weeks to unload accumulated fatigue, maintain fitness and sharpen neurologic performance. Aim to have a comprehensive, periodize workout regimen that adequately adds rest to the entire formula. We use the term “Active Rest“, as nothing beats getting to a race or competition feeling fresh!
- Food – There are several foods known to aid in the restoration of the body after intense exercise. We promote replenishing carbohydrates for muscle and glycogen stores, protein to assist in muscle repair as well as Vitamins C, E, B’s, Zinc, a probiotic and the Amino Acid Glutamine for complete recovery. All have all been touted to aid in the protection and support of the immune system and the ability to enhance the speed of recovery. It has been determined that the body’s cells are most receptive to replenishment, particularly glycogen stores, within the first thirty minutes after intense training. It is recommended that about 1g per kilogram of bodyweight of Carbohydrates be consumed post-exercise while.5g per kilogram of bodyweight of Protein be consumed within one hr. of finishing exercise. In essence, 15-60 minutes is the amount of time during which you should start your recovery nutrition routine following training or competition. The amount and ratio of nutrients obviously varies with special populations but specific recommendations should take into account age, gender, body size, physical condition, duration and nature of events, as well as environmental factors such as temperature and altitude. Before making any major change to your diet, make it a point to speak to a physician or nutritionist.
- Hydration – The human body is about 70% water and so is our planet. So it should come as no surprise that water is extremely imperative for every chemical reaction in the human body not just for recovery from exercise. Every cell, tissue and organ in your body needs water to function correctly and we are almost always in a state of constant dehydration. If you just start to get the thirst mechanism then you have been dehydrated for a while already. This is why you need to drink even when you are not thirsty. Sipping fluids over time maximizes fluid retention and is more preferable to drinking large amounts in one sitting. Cold water also goes through your system faster than room temperature. The simplest way to check hydration is to look at your urine. If it is clear to pale yellow you are well hydrated. The darker and more color in your urine, the less hydrated you are. Yes, excess water soluble vitamins are released in the urine and can make your expensive urine colorful as well. Recommendations are to drink 16-20 ounces of fluid two hours before exercise, then 16 ounces immediately after exercise, 4-6 ounces every 15-20 minutes during exercise and finally, for every pound lost through sweat, one should consume 16 oz. of fluid. I am getting thirsty just writing this, cheers, drink up.
- Electrolytes – Electrolytes are minerals that break into small, electrically-charged particles called ions and they can be dissolved in water. Found in blood and cells, electrolytes are essential to physical activity because they regulate bodily fluids and maintain the proper acid/base balance of the body. A few key electrolytes, who may be the most well-known of the cast are Sodium and Chloride. They help maintain normal blood pressure, fluid levels, as well as muscle and nerve function. Some of the supporting cast are just as important. Calcium aids in muscle contraction and the development of strong bones. Magnesium supports over 300 chemical reactions in the body. Potassium and Phosphate are key for nerve transmission, cardiac function and overall pH balance. Electrolytes simply supply the proper, balanced milieu for optimal recovery to take place. They help set the stage for all reactions.
About Fifth Avenue
Fifth Avenue Physical Therapy and Wellness was created at the onset of the new millennium in order to bridge the gap between strength and conditioning and rehabilitation. We have 2 clinics in New York (Grand Central & The Hamptons) and provide care to everyone at a level that Olympic athletes receive. The services we offer are physical therapy, acupuncture, yoga, massage and more.
If you’re looking to build yourself up as an athlete, why not take personal training from us? Where better to train than a place that has built up professional athletes to the highest degree.
If you’re in pain and need help or looking for a service we can provide for you and you’re in New York, then please contact us on 212-529-5700. Or you can fill in your details on our contact page and we will get back to you.