Recovery
Recovery in sport has become a vital component in athletes of any ability. Bishop et al.(2008) research implied that athletes spend a much greater proportion of their time recovering than they do training. Kellmann,(2010) states that effective recovery from intense training loads often faced by elite athletes can often determine sporting success or failure.
This review will concentrate on just one element to aid recovery, as there are too many to delve into without diluting the evidence. Recovery takes many forms, including nutrition, massage and cold-water immersion (CWI). Recovery is categorised into three sub-sections: immediate recovery between exertions, training recovery between sets and recovery between workouts, which is the focus of this blog as it contains the most diverse forms of recovery.
The major complaint between training experienced between elite and novice athletes is delayed onset of muscle soreness (DOMS) (Cheung et al., 2003). There has been extensive research on this subject. The accepted consensus is that the recovery from DOMS takes up to 72 hours. This is supported by Hill et al. (2014) meta-analysis research. This is most commonly brought about through unaccustomed eccentric muscle action or heavy loading of the muscles, this leads to a disturbance in the connective and/or contractile tissues (Cheung et al., 2003). Lewis et al.(2012) report that this process is a result of combination of mechanisms and not just a singular mechanism.
Areas that this affects is researched by Vila-Chã et al.(2012) who show that DOMS impairs force output up to 24 hours following exercise. Strategically, most elite athletes will train on consecutive days or have multiple workouts in a day.
As stated, earlier there are various methods to combat recovery, however, this review focuses the attention on CWI. CWI derives from the broader term cryotherapy. The term cryotherapy is a nondescript term, like ‘oxygen-therapy’. Cryotherapy is a type of proven medical treatment, in which CWI is included.
This recovery strategy is widely utilised among athletes of all levels in hot and normal environments in an attempt to ameliorate factors associated with exercise. (Dunne et al., 2013; Peiffer et al., 2008). Machado et al.(2016) paper states that the most effective approach remains unclear. Despite the extensive use of this strategy the research highlights that there is no one significantly successful CWI protocol to use, despite its widespread use, generally. Investigations have suggested that physiological changes are temperature dependant (White & Wells, 2013), causing alterations in the body (Wilcock et al., 2006). Critically, other studies claim the magnitude of these mechanisms depends on the intensity of the cold and how it affects the body (García-Manso et al., 2011). Chesterton et al.(2002) research reiterates response discrepancy due to alterations in the application of CWI. These differences result in positive effects in muscle blood flow reduction (Wilcock et al., 2006), which is reinforced by McGorm et al.(2015). Similar analysis was shown in nerve conduction velocity (NCV) (Algafly & George, 2007), again supported by McGorm et al .(2015).
Performance studies, conducted by researchers as early as the 1960’s examined the influence of CWI on performance recovery from sustained handgrip exercises (Clarke, 1963). Amid this early, research the literature inclines towards the aspect of performance, with less focus on physiological factors until recently.
Having already discussed some research into physiological adaptations of CWI, the next step is to review the performance research. (Brophy-Williams et al., 2011) indicate that there is a significant improvement in the next day Yoyo Intermittent Recovery Test (YRT) on immediate CWI. Similarly, this study also demonstrates that delayed CWI, has some significant, however, the time frame of the delay is 3 hours, this compared to the control group may have a benefit for exercise performance. These results are consistent with other research that employed a delayed aspect to the testing such as Lum et al., (2010). Reinforcing the factor of immediate immersion for aiding benefits to performance is research conducted by Ingram et al.(2009) and Vaile et al. (2011). Further supporting evidence in post-exercise CWI comes from Yamane et al.(2006), whose results attenuated increases in endurance and maximal strength, as well as endurance time, plus VO2. More recent research (Fröhlich et al., 2014) also reported that regular cold water immersion attenuated gains in strength.
Critically, this review may appear in principal to show a strong argument in supporting the use of CWI. Nevertheless, there is a body of evidence that refutes the positive effects of CWI, with the evidence that CWI induces nothing more than a ‘placebo effect’ (Broatch et al., 2014). The authors concluded that the placebo trial was just as effective as the CWI trial, which gives some food for thought for the current widespread use of CWI.
Further studies emphasizing the contrast, Halson et al.(2008) found no decrease in performance when they used CWI in their trial of 39 day cycling training block. Versey et al.(2013) has published an article with practical recommendations, which summarised a research in CWI along with Contrast Water Therapy. This research reports by Coffey et al.(2004); Hamlin, (2007); Howatson et al.(2009), that these authors advocate no significant effects from the intervention of CWI. One final thought for consideration is evidence, which expresses the theory that CWI has negative effects on the advances which training produces by the nature of reducing the acute satellite cell response to strength training (Roberts et al., 2015; Yamane et al.,2015). This is strengthened from earlier research by Takagi et al.(2011). However, the participants’ were rats, which showed a significantly smaller regeneration of muscle fibres, compared to not receiving treatment
The review of the literature shows whilst there is strong evidence to indicate that post-exercise CWI may enhance both short and longer-term recovery, the precise factors responsible for such improvements are unclear, with numerous mechanisms proposed. There is an equally strong support for no effects on recovery from exercise. Additional research into CWI is still required to truly understand its effects in a range of situations. As mentioned, a large amount of performance-based research exists; so future research should focus more on understanding the physiological aspects of CWI. Additionally, a dose-response relationship is yet to be determined.
References:
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