Wednesday, April 15, 2009

Serious Recovery for Serious Athletes

"Ignoring regeneration techniques can have an adverse influence on supercompensation. In fact, without adequate regeneration, it will be non-existent"
- Tudor Bompa

It’s been a little while since my last blog post. I’ve been jet-setting across the U.S. from a training camp in Tucson to a vacation trip in San Francisco. Somewhere along the way the calendar ticked over one more click to initiate the start of my 33rd year on this Earth. As my own age advances, one aspect of my training is beginning to become more important – Recovery.

My hunch is that this attention is going to need to become ever more vigilant as I approach my 40’s. Gordo has certainly seemed to pay more mind to recovery over recent years and he is not alone. I was fortunate to have the opportunity to chat a little with Greg Bennett at Gordo’s 40th birthday party. Of course (like most of you would, I’m sure) I did my very best to segue, as quickly as possible, from pleasantries and commonalities (primarily related to our motherland) to the ‘secrets’ of his training. Unsurprisingly, as Greg will more than happily point out, while there is some very intelligent planning, there are few secrets, just executing a very good plan over a very long period of time.

If there were any ‘secrets’ or ‘short cuts’ that seemed to keep cropping up in the conversation, they were not directly related to training but instead to that oft skipped over chapter in the training books – Recovery.

If there is one lasting impression that you get from Greg, it is that of a professional athlete – in every sense of the word. He points out that while he may only be training 3 or 4 hours a day, he is an athlete 24/7. I would go so far as to suggest that it is this attitude that has contributed to his athletic longevity and performance level that he has built over many years. A key component of this professionalism for serious athletes is active recovery.

As my brother from another mother (and father :-), Josh, pointed out to me , while lip service is paid to the benefits of active recovery in the various training texts, serious practical instructions as to ‘what to do’ and ‘when to do it’ is lacking. In this blog I want to point out some of the things that have been shown to work to hasten recovery and when and how to do them in the context of your training plan.

First a quick primer on fatigue and recovery:

Generally speaking, fatigue in long duration endurance sports is the result of energy depletion. This energy depletion takes several forms. To name a few:

- Metabolic: Running out of hepatic glycogen, blood glucose, intramuscular glycogen or (possibly) intramuscular lipids.

- Structural: Muscular damage that decreases contractile ability and elasticity of the muscle

- Neural/Central Fatigue: Depletion of dopamine and an increase in tryptophan (the ‘sleepy’ amino acid), depletion of electrolytes that slow neuromuscular firing.

- Neuroendocrine: Recent research has focused on reduced catecholamine uptake or production following long term stress that may adversely affect energy liberation and neuromuscular drive.

In any of these situations there is both a limiting amount of good stuff (an energy medium) coupled with accumulating bad stuff (waste products) that must be set right before the athlete is ready to go again.

Thus, a good portion of recovery is about getting good stuff (glycogen, oxygen, lipids, anabolic hormones) into the muscle and getting bad stuff (lactic acid, muscular waste, catabolic hormones) out of the muscle.

Now, the anatomical superhighway to our muscles is blood. To a large extent, specifically blood plasma. Plasma carries a lot of the good stuff into the muscle and all of the bad stuff out. Thus, one of the things that can slow recovery down is if your plasma is not where it should be. Two things that can dramatically affect how much plasma you have in your blood:

1. Dehydration
2. Increase in intramuscular fluid during exercise.

Mission critical is rehydrating. Fluid intake after key sessions should begin immediately and not finish until bodyweight reaches pre-session values.

Mission #2 is decreasing intramuscular fluid:
During exercise we lose fluid volume from the blood due as fluid is pushed into the muscles from the increased arterial pressure gradient that comes with exercise. In other words, our capillaries ‘leak’ fluid into our muscle. So, first step in recovery is to get blood volume back to where it should be as quickly as possible, via rehydration and normalizing the intramuscular pressure gradient, i.e. decreasing muscular swelling. While swelling may not be obvious (like it is following more serious injury), any blood that is not circulating through your circulatory system is ultimately slowing the process of recovery.

Means of mitigating swelling are well known:
• Rest
• Ice
• Compression
• Elevation

The latter 3, in particular can also be used in recovery. A fourth modality that is particularly useful is hydrotherapy, i.e. submersion in water. The hydrostatic pressure of the water weight can greatly assist in normalizing the intramuscular pressure gradient and get blood fluid back where it should be. Combining this with modality #2, we get the best of 2 worlds in every athletes favorite recovery tool – the ice bath :-)

For those with access to the appropriate facilities, e.g. cold pool + hot tub, an alternative, marginally better protocol is a contrast bath, i.e. alternating hot and cold submersion. This adds using alternating vasodilation and vasoconstriction as a pumping method to assist the hydrostatic pressure in ‘pumping’ the blood back into the central cavity of the athlete. There is good research support to the efficacy of both cryotherapy (ice baths) and contrast baths (French et al., 2008, Kuligowski et al. 1998, Burke et al., 2001,2003)

Compression (via compression garments) is a new increasingly popular recovery therapy that has received mixed research reviews. It seems to have good support in attenuating muscle soreness but the jury is still out on performance benefits for endurance athletes(Pro-Ali et al, 2007, Gill et al. 2006; Against – French et al. 2008). My opinion is that compression therapy makes good intuitive sense as a recovery aid (esp when coupled with elevation), however less so than those modes that utilize thermodynamic means to hasten the process. Sorry, in my mind and the literature, the ice baths win out.

So, that’s step #1, clean up the super highway. Step #2 is fill the delivery trucks with the good stuff. Namely:

• Carbohydrate
• Minerals
• Protein/BCAA’s
• Oxygen
• Anabolic Hormones

The most important recovery strategy bar none is rapid restoration of the body’s glycogen stores via quick carbohydrate replacement after exercise. Numerous studies have shown a maximal glycogen resynthesis rate of ~45g/hr by consuming 0.8-1.2g/kg/hr in small meals every 15-30mins for the first 3 hours after exercise (Van Loon et al., 2000, Burke, 1996)

Additionally, protein synthesis is enhanced when it is taken close to exercise (Rasmussen, 2000). It appears there is an optimal quantity of essential amino acids (Glutamine, Phenylalanine, Isoleucine, Leucine, Lysine, Valine), that leads to the highest rate of amino acid uptake without compromising glycogen resynthesis. This appears to be in the vicinity of 6-20g/hr of EAA’s for the first 3hrs after exercise. Amino Acid uptake, like glycogen uptake, is elevated by ~3.5x the normal rate at this time (Borsheim et al, 2001).

Oxygen is an interesting one. In the grand scheme of things it is best enhanced by getting blood volume back to normal. However, additional techniques such as supplemental O2 and hyperbaria have been shown to be advantageous under certain conditions, notably high altitude training. Under most endurance training conditions oxygen saturation is not limiting, however, if SpO2 is compromised, the time required to fill the EPOC can be decreased with these strategies.

Finally, and probably most important, is the impact of stress hormones on recovery. In order for growth to occur, whether it be actual growth of muscle in the form of hypertrophy or growth of muscle structures that are advantageous to endurance performance such as mitochondria, a pre-requisite is that the muscle is ‘primed’ for growth via the growth hormones HGH and IGF-1. These hormones are particularly enhanced during sleep and particularly suppressed during periods of stress, whether physiological or psychological. For this reason, both naps and sport psychology strategies that promote arousal control can play a valuable, often overlooked, part in recovery.

So, putting the above together, what would a serious athlete do after a key training session (TSS>~150)?

1. Perform a 15 minute cooldown at a very low intensity (<60% max HR)
2. Have sports drink mixed to 75-90g of Carbohydrate and 10-20g or protein at the ready.
3. Finish your session at the health club and head for the deep end of the cold pool (or prep an ice-bath if at home). Continue to sip sports drink for 20-30min while ‘flopping’ around in the pool.
4. If not excessively sore, do 2-3 cycles of alternating 2mins in the pool w/8mins in the hot tub.
5. Get changed, put compression garments on and head home, continuing to sip sports drink
6. Drink a smoothie when you get home containing 40g CHO/10g EAAs
7. Do 20mins of self massage, 20mins of supine yoga and 20mins of meditation/progressive relaxation, incorporating inverted/semi-inverted postures (see Gordo’s post workout stretch routine in Going Long for a good starting point).
8. Eat a snack of 75-90g of CHO and 20g of Protein with a high water content and mix of sugars (e.g. fruit plus yogurt)
9. Take a 1-2hr nap with legs elevated and compression gear on.
10. Eat another snack of 75-90g of CHO and 20g of Protein with a lower glycemic index (mainly fruit & veg) and some healthy fats.
3-4hrs (including nap). Ideally completed by 4pm.

Following this, relax with family and friends for a few hours, eat a hearty dinner w/an additional 100g of CHO (assuming you took in 400 during breakfast + workout & 200-300 during recovery) and 40-80g of protein.

Then finish the evening with a hot bath, hot tub or sauna (if you have the means ) as a further impetus for Growth Hormone release, before retiring prior to 10:30pm.

For most working athletes, such a routine will be limited to a post workout routine on their biggest training day of the week (for a professional athlete like Greg Bennett, such a routine will be ‘the norm’). However, this frequency does not discount it’s usefulness. Many super-busy working athletes go day to day, week to week without recovery, changing from their running gear to their business suit, slamming a coffee after their long ride to keep up with family obligations. Under these conditions, stress hormones are always prevelant, the body never adapts to the training and growth (on many fronts) is compromised. If not given, the body will take recovery in the form of frequent illness or burnout irrespective of training load. If the athlete allows it to get to this point, fitness has already been sacrificed. There is much to be gained for all levels of athlete, in all life roles, by simply resolving to devote one day per week purely to training and recovery (sharpening the saw), while paying as much attention as possible to fitting in recovery means wherever possible through the rest of their busy week.

Train (and Rest) Smart,



Josh said...

Wow, that was exactly what I was looking for. Thanks so much.

Now to apply it.

Coldone said...
This comment has been removed by a blog administrator.
Lawrence L. Creswell, M.D. said...

Useful, practical advice!

AB@OZ said...

Thanks Alan,

another super post, worth waiting for. Great to finally see a condensed explanation on why various recovery strategies are used.
Now, can you give us a proven method on that 'how' to get ongoing full spousal approval, please. ;)

Thanks again

Alan Couzens said...

Thanks All.

Spousal approval is definitely beyond the scope of my practice and represents a far greater mystery than any question pertaining to exercise phys :-)

Let me know if you come up with any answers on this one :-)


Kurt P. said...

Great Alan. I call it the "3C's of recovery" (calories, cold, compression), now I need to add an E maybe!

Alan Couzens said...

Thanks Kurt,

Could probably add a P too for protein but CCCP doesn't have the same ring to it (and has some socialist undertones :-)



ace said...

This is really well thought out and well presented. I've been giving more and more thought on how to maximize training gains and came to the conclusion that more training was not going to be as effective as becoming more adept at recovery and fueling.

Your post puts some very clear parameters on some ideas that I was moving toward but not exactly sure what implementing them would look like. Great post.

Train (and recover) well!

Alan Couzens said...

Thanks Ace,

Yep. A common experience with a lot of my guys who start bumping up against the time/energy ceiling. It's hard to buy more time but there are means to buy more energy.

Keep improving!!


-Brandon said...

150TSS is a big workout, but that seems like a big CHO load overall, something on the order of almost 800 grams. Does it change if the 150TSS is broken up in 2 sessions or depending on the weight of the athlete?

Just wondering as I've been trying to optimize CHO intake/timing recently, and seem to be quite a bit below that estimate even on days with a pretty solid training load...sometimes 1 but generally 2 sessions.

Alan Couzens said...

Hey Brandon,

Great questions.

The actual CHO cost of a 150TSS workout does depend on the size of the athlete, but probably depends more upon the nature of the workout. I guess I'm a little biased by my Ironman sample in this regard. I tend to think more in terms of Zn 3 key workouts. So, more along the line of 400g of CHO. If there was a good amount of threshold or supra-threshold work in there, it could be more along the lines of 600g. Much more than that isn't really feasible, even for very elite athletes.

2 a day sessions will typically enable a marginally greater training load due to the greater stimulus for glycogen resynthesis following each workout.


AC said...

Alan - great post - just catching up on my reading - quiet Friday afternoon :) It is classic as I actually migrated to MOST of those a few years ago when loads went up - granted - I only really focus on it when I do something BIG but it works...I will send you some Recover Gear - one of my training partners started it - like an ice bath but easier for compliance - great info as always!!!

Alan Couzens said...

Hey Shawn,

Icebaths have a low rate of compliance? Say it ain't so, Joe :-)

Any donations to the "keep AC's bod in working order" cause are much appreciated.