A presentation on recovery modalities and available research for support through 2013.

1. Recovery: The most
important and
misunderstood workout

2. October 12 – 15, 2017
Recovery: The Most Important and
Misunderstood Workout
Charlie Hoolihan
Pelican Athletic Club Director of Training
NASM – PES, CES
CSCS

3. October 12 – 15, 2017
Agenda
• The Role of Recovery in
Performance
• Physiology of Stress
• Evidence-based recovery
modalities
• Recovery strategies

4. October 12 – 15, 2017
A Humble Offering
“When the human body is concerned, we
are dealing with a system that is so complex
with so many interrelated variables, we can
do nothing but be humble about our beliefs
and recommendations.”
• Chris Beardsley

5. October 12 – 15, 2017
Individual variance
Every BODY is different.
At least 1 out of 3 in well-designed research
respond differently. 1 in 5 respond poorly.

6. October 12 – 15, 2017
Exercise can prevent and cause illness and injury.
It can keep you out of and put you into a hospital.
• Immuno-enhancing. Immunosuppressive
• Marathon finishers have elevated troponin levels akin to heart attack
victims.
• Iowa Strength and Conditioning staff put 13 members of their team into the
hospital w myoglobin numbers approaching kidney failure. 100 backsquats
@ 50% max followed by a similar upper body workout.
• Oregon this past off-season.

7. October 12 – 15, 2017
Conundrum
• Does our personal knowledge
database have more information
on how to put our athletes/clients
in a hospital?
• Do our athlete’s clients have
more desire to be injured than
healthy?
• Is the culture of HIIT
overwhelming sensible training.
• What is the measure of a
successful workout/training plan.

8. October 12 – 15, 2017
Homeostasis and Allostasis
Workouts have to challenge homeostasis – the internal balance of
all the physiological processes at the chemical, molecular and
tissue levels. These challenges create a state of Allostasis

9. October 12 – 15, 2017
Allostasic reactions
Exercise stressors alert the body that more strength, speed and
cardiovascular fitness are needed to survive in a new and
challenging environment
• Damaged muscle contractile tissue
• loss of strength
• decreased speed and oxygen delivery.
• Inflammation and immune system hormones and
chemicals begin circulating in order
to help minimize and repair the damage.
• Swelling and muscle soreness complete process.
After all this good stuff is done, the body is said to be in
state of allostasis – or a disrupted, out of balanced internal state of
physiological processes
(Flores et al, 2011)

10. October 12 – 15, 2017
Increased vulnerability
• High Intensity cardiovascular training beyond 20-40 min.
• Long cardio sessions exceeding 60-90 minutes
• Heavy eccentric resistance training loads
– Running uptempo and sprinting

11. October 12 – 15, 2017
Disrupted and out of balance!
But it’s good
for me, right!?

12. October 12 – 15, 2017
Non-Exercise influences of
homeostasis

13. HPA Axis
Responds to exercise, nutrition, environment,
emotional/mental, sleep, allergen stressors, lions and tigers
and bears

14. HPA axis response to
stress
Directly or indirectly influences action response
• Stress hormones- Cortisol
• Neurotransmitters – epinephrine, norepinephrine,
histamines, ACh
• Inflammatory cyctokines – Interleukins, TNF
• Chemokines.
All provide necessary responses to stress can put the body in
long term allostasis. Their job is to return the body to
homeostasis.
Same axis as the physical response to exercise.

15. October 12 – 15, 2017
Recovery and restoration
• Planned recovery is designed to minimize the
accumulation of the byproducts of physical stressors
from workouts as well as similar byproducts from
mental, emotional and environmental stressors that
are also affecting the exerciser.

16. October 12 – 15, 2017
Recovery Research is new but
techniques and practices are not.
• URTI and athlete study in the early 90s
• Correlation of stressors and illnesses in the
70s
• Running training in the 70s. Triathlon in 80s
• Recovery strategies and modalities are just
now getting enough research to be able to
put together reviews.
Massage, sauna and cold plunges, herbal
“rejuvenators”, acupuncture have been
around for centuries.

17. October 12 – 15, 2017
Nocebo + Modality = Placebo?
“The problem I have assessing an intervention… is that I can’t
know how my injury would have done without the procedure.
If it was going to resolve itself on its own over those same few
weeks, perhaps its greatest benefit was that it gave me a
distraction, new pain to deal with, temporarily, and the feeling
that I’d done something proactive — while nature ran its
course.” - Jason Silvernal, DPT

18. October 12 – 15, 2017
Science and Recovery
• Evolving science of pain
– Biosocial model
– People with bulging discs who aren’t in pain.
• Practitioners and manufacturers with an
agenda.
• “Big Recovery” Industry

19. October 12 – 15, 2017
Planning for Types of recovery
– In-Training recovery – recovery during a workout time
between cardiovascular intervals or between weight sets to
enable a quick refueling of mostly fast-twitch muscle fibers
– Training day recovery – recovery between workouts,
matches or games held on the same day.
– Training week recovery – recovery between workouts,
matches or games within the same training week.
– Training cycle recovery – planned extended recovery
periods between well planned overload training periods
designed to elicit a supercompensation response that
significantly advances the performance and conditioning
level of the exerciser.
Most of our discussion will focus on the latter two.

20. October 12 – 15, 2017
Linear and Undulating Recovery Plans
Periodization
• Linear periodization - stretched out over a long time-frame increasing
effort in a consistent manner on a weekly, monthly seasonal, annual or
quadrennial basis. Good for athletes with specific seasons and goals.
• Non-linear periodization - Increases intensities in an undulating
manner alternating rest and work schemes in shorter cycles. Good for
fitness clients and recreational athletes whose schedules tend to be
affected by life’s random pattern.
Both have proven to be effective in achieving higher performance levels
(Simao, et al 2012)

21. October 12 – 15, 2017
Recovery and Bioindividuality
• Each individual physiology recovers from various workout
protocols differently. Sayers and Clarkson found found it
took between 5 and 89 days for participants to return to full
strength after an intensive weight training program
• Gender - Men and women have been found to suffer the
same amount of muscle soreness after intensive weight
lifting but women have a lower inflammatory response.
Women also take longer to return to peak strength, and
range of motion. (Flores et al)
• Genetic differences have also been found. Some
genotypes have the ability to return to baseline quicker
after strenuous eccentric exercise than others. (Venckunas
et al 2012)

22. October 12 – 15, 2017
Measuring physical response
Baseline fitness assessments
– 5-10 rep max
– 30-60 min. Threshold test
– Vertical jump
– Horizontal leap
– Sprint and agility tests
Baseline fitness assessments can be used to measure
progress and performance decreases can indicate a need
for recovery.

23. October 12 – 15, 2017
Measuring homeostasis and
stress response
• Resting Heart Rate
• HRV
• Blood lactate
• Subjective Questionnaire

24. Resting and working
heart rate
• Resting heart rate: 5-10 beat increase in
resting heart rate indicates a system under
stress.
• Working heart rate that is higher at a
specific performance output also indicates a
system under stress.

25. How ya doin honey
Subjective questionnaire that athletes/clients fill out
each week to assess the non-exercise stress they
are undergoing each day/week.
• Forces them to understand when increased loads
may not be optimal.
Accountants in March
Athletes during exams
Santa in December

26. October 12 – 15, 2017
Blood lactate measurements
• Small hand-held monitor
• Measures a particular
individual immediate and
residual response to a specific
anaerobic workout.
• $500-700 for a unit.
– Day to day?
– accuracy

27. October 12 – 15, 2017
HRV – Heart Rate Variability
Recent tool added to the analysis of stress response.
– Measures the time between beats.
– Regular intervals indicate a system under stress and dominate
in the Sympathetic Nervous System
– Less regular intervals indicate a system in the Parasympathetic
recovery and repair mode.
– A balance between the two is sought.
– Extremely versatile tool that measures all types of stress
responses.

28. October 12 – 15, 2017
Current HRV case studies
• Endurance athletes –
– Ironman and Ironliver
– Sleep and diet cola
• Post op client
• Food sensitive colleague
• Pregnant client
• Personal 50 plus fitness
• Powerlifting colleague
Companies – Bioforce, Omegawave, iThlete, Sweetbeat.

29. Same intensity different response
Two similar studies designed to stimulate overtraining
• Two weeks of high volume and intensity training – metabolic symptoms
of overtraining and had decreased power output, increases in their time
trial performance, a decrease in max heart rate, and an increase in
ratings of perceived exertion (RPE). (Halson et al, 2002)
• 21 days under similar training condition eliciting similar metabolic
overtraining responses with one exception – there was no decrease in
performance markers. (Slivka, et al, 2012)
Second group performed training in a camp experience. First group
followed workouts under normal circumstances.

30. The Big Four
Sleep
Nutrition
Planning and Periodization
Active Recovery

31. October 12 – 15, 2017
Sleep: The ultimate recovery tool
• Critical for biochemical balance in substances
– Increased growth hormone
– Decreased inflammatory chemicals like cortisol,
IL-6 and TNF-a (Dement, 2000).
• Increased protein synthesis
• Relaxed parasympathetic state.
• Improved immune function
• Optimal recovery of muscle tissue. (Hausswirth and
Mujika, 2013).
• Key element in brain tissue repair.
– Brain’s waste removal system kicks into high
gear during sleep pumping cerebral spinal fluid
(CSF) through the brain’s tissue, flushing waste
back into the circulatory system where it
eventually makes its way to the general blood
circulation system and, ultimately, the liver.
(ScienceBlog, 2013)

32. October 12 – 15, 2017

33. October 12 – 15, 2017
Nutrition
• Carbohydrates and fats – fuel the process
• Proteins – build the muscle
• Vegetables and fruits – anti-inflammatories
and alkaline
– Acidosis – attenuated by alkaline
substances like sodium bicarbonate
– Bad nutrition can make matters worse

34. October 12 – 15, 2017
Diets, Macros and Broscience
• Research is all over the map.
• Everybody responds to
macronutrients and
micronutrients in a bioindividual
manner.
• There are minimal absolutes that
can be determined from specific
percentages of macronutrients to
the amount of water we should
consume.
• This also includes previous
sacred lambs like fasted cardio
and anabolic windows.
• Athletic/wellness goals change
everything as well.
• What makes you feel good and
move better
.

35. October 12 – 15, 2017
Diets, Macros and Broscience II
• Diets designed to lose weight are stressful to the system.
Especially diets that exclude a macronutrient and diets that
are conducted during exercise.
– Dieters need recovery from dieting.
• Food sensitivities exist and stress the system but are not
researched real well because they are non-lethal.
– Wheat, sugar, dairy, peanuts, soy,
corn etc.
• Nutrigenomics – there is compelling
evidence indicating genotypes specific
to optimal macro/micronutrient utilization.
APOE2-3-4 and metabolizing energy
substrates

36. October 12 – 15, 2017
Best diet for optimal recovery
• Real food with balanced macronutrients applicable to
your goals. Vegetables and protein are good.
• Gives you long term energy to accomplish your goals.
• Helps maintain healthy weight relative to your goals.
• It takes time and effort to figure it out but it’s possible

37. October 12 – 15, 2017
Exercise intensity and active
recovery
Active recovery has been well researched and is seen as an
optimal recovery technique. Most research into newer
modalities compare outcomes to active recovery
– Between matches/events or in incorporated into
periodization schedule
– Speeds healing process via increased circulation of
healing hormones and chemicals.
– Low intensity is the key. 50-60 % of maximal efforts
– Reduced eccentric loading – cycling, swimming,
rowing and stair climbing

38. Neuromuscular Electric Stimulation (NMES)
• An active recovery/strengthening technique providing a muscle
stimulus without additional stress on joints or the central nervous
system. It is theorized that the non-impact contractile stimuli from a
source outside of the CNS enables enough neuromuscular activity
to provide strength gains in a specific muscle group and also
increase circulatory presses to speed recovery (Lee 2011 and
Hansen 2012)
• NMES has been shown to increase quadriceps and latissimus dorsi
strength, increase lactate clearance and decrease DOMS*.
(Laughman et al, 1983; Girould, 2012; Neric et al, 2009 and Blum et
al, 2011).

39. Thermotherapy
• Cooling garments - Numerous studies show the
advantage of pre-cooling before an endurance
event with a vest or jacket containing
compartments into which ice packs can be
stored. Pre-cooled subjects show lower core
temperatures, lower heart rates and greater
power output at the end of a specific workout. .
(Hausswirth and Mujika, 2013)
• Heat therapy’s benefits tend to be during the
next day or days after an intensive effort and
mainly due to its ability to reduce DOMS.
Additionally, its reduction of perceived pain and
increased muscle pliability and length make it a
good partner to manual therapy techniques. .
(Hausswirth and Mujika, 2013)
• Research is currently muddled and it looks like
individual response, dosage, time, type of issue
etc are going to come into play

40. Ice is not as good as we thought!

41. The end of RICE(as we know it)
• Josh Stone, Gabe Mierken, Gary Reinl
– Using ice stops or slows the inflammatory process which is
the first step towards remodeling and repair of muscles.
– Contributes to the accumulation of microphages and IGF1
which is a mediator of GH
– Active recovery evidence refutes the rest part of RICE
– Tissue loading through exercise and mechanical means
helps stimulate gene transcription and collagen formation
– Ice does provide pain relief but cost/benefits must be
weighed.
– The efficacy reported may be a result of water immersion
and a modified compressive effect.
– Edwin Moses ice baths.

42. But then again….
There is some positive evidence we
shouldn’t throw the baby out with the ice
water but it may come down to several
factors.
• Acute or Chronic issue.
• Timing of dosage after a homeostatic
disturbance.
• Duration of dosage.
• Temperature.

43. October 12 – 15, 2017
Manual Therapy
Manual Therapy. Good stuff but not enough evidence yet
• It would be expected that manual therapy in the form of massage or self-
myofascial release would have reams of research in support of removing
exercise waste byproducts but not yet. At present it appears to be mainly
efficacious in the relief of DOMS. Because of this, most research points
towards the psychological effects of this recovery technique.
(Hausswirth and Mujika, 2013)
• Longer time to fatigue, lower rate of perceived exertion, perceived
recovery and overall performance attributed to the increased sense of
well being. This does not invalidate the use of manual therapy as the
reduction of DOMS and concurrent increased of range of motion that
some studies indicate occur do indicate it assists in recovering to a ready
state (MacDonald, 2014) (Grieve, et al, 2013)
• Semantics
• Self Manual Therapy vs Self Myofascial Release

44. Foam rolling Review
Chris Beardsley - SCR
• 12 of 15 studies reported
significant increases in
flexibility rest reported no
effects.
• Self-myofascial release
therefore appears to
increase flexibility acutely
up to 10 minutes post-
treatment.
• Six studies found no
adverse effects on athletic
performance. One study
even found a benefit in
contrast to static stretching.
• 3 of 4 studies reported that
SMR reduces sensations of
DOMS (measured in various
ways).
• 3 of 5 reported that self-
myofascial release leads to
increased flexibility over
long-term periods of time

45. October 12 – 15, 2017
Compression Garments

46. October 12 – 15, 2017
Compressed Circulation

47. October 12 – 15, 2017
Compression research Born, et al
Effects wearing compression garments during exercise
• small effect for shortduration, sprints (10–60 m)
• vertical-jump height
• extending time to exhaustion (3–60 min events).
Post exercise
• small to moderate effect sizes were observed in recovery of maximal
strength and power, especially vertical-jump exercise
• reductions in muscle swelling and perceived muscle pain
• blood lactate removal
• increases in body temperature.
These results suggest that the application of compression clothing may
assist athletic performance and recovery in given situations with
consideration of the effects magnitude and practical relevance.

48. October 12 – 15, 2017
Couple other new thoughts
• Anti-oxidents and anti-inflammatories
– Can disrupt the healing process similar to ice
by suppressing a natural response.
– Can cut down on Gainz bro!
• Sometimes stress is helpful in healing
• It depends…..

49. October 12 – 15, 2017
Perspective
Is there a life at stake?
Is there a lot of money at stake?
When is your next state or national championships?

50. October 12 – 15, 2017
Recovery: The Most Important and
Misunderstood Workout
Charlie Hoolihan
EMAIL:Charlie@thepac.com
WEBSITE: www.thepac.com
PHONE: 985-966-9594 (text)
Facebook, Slideshare and Instagram

51. October 12 – 15, 2017
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52. October 12 – 15, 2017
References
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