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Wednesday, 27 June 2012

Top 10 applications: No. 5 - Adapting the recovery position

I would not be so zealous on this blog (or generally) if it were not for some strong and persistent persuasive tutelage from my first two mentors. Colin Clegg was my A Level biology lecturer at college and to his name are some of the most erudite and authoritative basic texts on biology and exercise physiology for the A-level student. He was also an incredible endurance athlete/nut and long-time training partner of the legendary Gordon Pirie. The second mentor is Peter Keen, coach to Chris Boardman, instigator of the cycling revolution and architect of the Mission 2012 ‘no compromise’ approach to high performance sport. Both illuminated me with their insight, explanation and thinking. The former inspired me to learn, the latter showed me what I wanted to be. However, it was their constant reminders, references, anecdotes, metaphors and damned insistence of the importance of stress-recovery-adaptation cycle that has stuck fast in my brain, as the principle I refer to most in applied sports physiology. I thank them.
Jean Baptiste Lamarck the 19th century French evolutionary biologist, much scorned for his principle of acquired characteristics, put it as well as any;
“In every animal which has not passed the limit of its development, a more frequent and continuous use of any organ gradually strengthens, develops and enlarges that organ, and gives it a power proportional to the length of time it has been so used; while the permanent disuse of any organ imperceptibly weakens and deteriorates it, and progressively diminishes its functional capacity, until it finally disappears“.

Egg sucking time - the stress, recovery, adaptation response to exercise. For performance you could replace 'physiological systems' of which an integer or subset could be used.

A wave of studies in the early 2000s examining cold water immersion, compression , anti-oxidant supplementationingestion of non-steroidal anti-inflammatory drugs, are to be applauded. They showed that during the days after intense exercise, such as repeated sprinting, markers of performance and muscle damage were attenuated by the treatment. So, by intervening after exercise with a recovery method the participants and therefore athletes could return to normal quicker and with less disruption to their performance. Sounds good, doesn't it? Since then there have been some further studies that have supported these biochemical, subjective and performance markers with some nice observations by way of an MRI of actual odematous response around the exercising muscle following recovery treatment (for a good overview See Glyn Howatson and Ken van Someren's review). Sounds even better, eh? There is a clear application of this understanding to eventualities whereby recovery in a short time frame is of paramount performance, such as between matches in football say Wednesday to Saturday, or in competition scenarios where an athlete could have a round in the morning and semi-final the following evening (The sights and sounds (ooh aargh, grit teeth) of ice baths is now not just inherently familiar to the popular of athlete methods, but it is also worn as a badge of just how ‘hard’ athletes are!) The acute priority then is to minimise the disruption to homeostatic function – get back to where you were before your performance - as quickly as possible. Great, a nice application, wouldn’t you say? As I say I applaud this research.
BUT, what I do not applaud (in a quaintly British stoicism – 'I withhold my applause') is the over-interpretation, short-termism and blind application of these acute studies to long-term chronic adaptation of physiological capabilities. Here is why I think it ignores the first principles understanding of stress-adaptation. The physiological systems are suppressed after long or intense exercise – this makes sense as nobody feels fitter straight after a marathon. The various recovery modalities have the potential to reduce the nadir of physiological suppression before which time the regeneration processes return the body back to normal. The post-exercise chain of events will include some or all of the following – metabolic and mechanical disruption and disturbance > provision of blood flow and nutrients > aggregation of immune bodies to remove and further breakdown damaged tissues > immune bodies secrete inflammatory agents such as prostaglandins that create secondary swelling and dysfunction > overall leading to mechanical, metabolic immune and inflammatory processes converge on specific cell signalling proteins* to stimulate transcription and thus accumulation of new proteins. In simple terms, the body says ‘if you are going to do that exercise again, I will put new systems in place so that we don’t suffer as much’. If the cascade of events post-exercise is interrupted, even suppressed, then the key question is whether the same zenith of adaptation is still realised. It would appear not. A series of studies since the pivotal Yamane 2006 paper, looking at cryotherapy, non-steroidal anti-inflammatories and anti-oxidant supplementation   have shown that administration of the recovery treatment can reduce the cell-signalling and/or impair adaptation to a training intervention. So if adaptation is blunted – should you use such recovery treatments when the goal is long term adaptation, such as it is for Olympic athletes, off-season phases, long periods (greater than 4 days) between matches? Well the evidence would say that it is highly questionable.
I think applied sports science and therapy got thoroughly carried away in the mid 2000’s with a flurry of advice promoting recovery methods willy-nilly without due consideration to the adaptive goal. Application of a treatment such as ice-baths that in turn provides an anaesthesis to the working muscles, probably dampens the crucial feedback about tightness, soreness, aches and pains that should be used to manage the expectations for the next sessions. There is a chain of thought that would question whether over-recovering some systems such as muscle (high blood flow) disproportionately from say that of bone and connective tissue (low blood flow) has a possible course toward the over-loading bone and connective tissue to the point of failure. For many cases our very own Jonathan Leeder (@joffyleeder – worth a follow by the way) and resident recovery expert in his comprehensive meta-analysis shows that some treatments may be simply a strong placebo.
Hayley Tullett (World bronze medallist in 1500m in Paris in 2003) pinned this topic very well, when her piercingly insightful interrogation of ice-baths followed this reasoning, “Last year I didn’t do ice baths, this year I did. Now I am doing 10% more mileage, I am feeling fresher after my hard sessions and more able to go harder the next day. But if I look at my training diary for the last 4 months and compare it to last years comparable sessions I am not going any faster. So am I just doing more to get the same effect? Aaargh – you might have something there Hayley. This is all a bit ‘no pain, no gain’, so if shortcuts are to be taken, then don’t expect to know the full journey next time! Perhaps more appropriately, Conor Taylor puts it nicely, “If adaptation is to occur, the stimulus must resonate”.
Finish this off with a no nonsense message about putting this into context will you Leeder? “All you need to know is that inadequate recovery is the fault of inadequate basics (sleep, eat and rest) and poorly periodised programmes”. The implication from Hayley and Jonathan’s points is so grandly simple, if you are feeling too sore from your session, do less in your next one and remember to adjust the next session accordingly. Adjust the programme, individualise it and be sensitive to the delicate but potent signs and symptoms of recovery.

Alternative views for managing the stress of training

Recovery takes the number 5 spot in my top 10 applications of sports physiology, not for the over-interpretation and the mass prophylactic administration of ‘recovery modalities’ in an attempt to mask poor programming, but for its positioning of recovery at the centre of adaptation discussion,
*such as PGC1α – not to be confused, as I recently heard PGCE1α which I think is the kinase that allows you to teach!


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