Most Recovery Methods Cut Very Little Ice

Standing at the top of the stairs wondering how I will get to the bottom in one piece …… sideways, walking backwards and the piggy back from my wife have all been ruled out. Molly believes the solution is obvious and shows me how to slide down on my bum. “It is the only option” she shouts up from downstairs. So at 33 years of age I’m sliding down the stairs on my bum to the laughs of a 4 year old. But now I have to try negotiating a busy Sunday of “playing” with legs that are sore and as stiff as scaffolding poles. But this story is well known to runners and athletes of all levels, no matter how long you’ve been running delayed onset muscle soreness (DOMS) is a common occurrence (Armstrong, 1984). The symptoms can range from simple muscle tenderness to severe incapacitating pain but what is the best way to recover from a hard run and prevent DOMS? Athletes, both recreational and elite, swear by personalised recovery routines varying from – ice baths and compression garments to foam rolling and massage. The ability to recover is important because training isn’t just about one run on a single given day.  It’s about consistency and logging enough miles each week to promote the adaptation of the muscles and cardiovascular system and ultimately improvement.

ICE BATHS …..Whats the point?

I first came across ice baths while I was playing rugby in the early 2000s. It was the “fix all”. If you were injured you were sent for an ice bath, if you were in bad form – an ice bath would sort it! After training they were compulsory for every player without exception. But I hated them. Having spent the previous hour and a half of a cold, wet and windy Tuesday evening in January maintaining the blood flow to my extremities, I was never eager to jump into ice chilled water. Why would you do that to yourself? But others did, and were even enthusiastic about it, competing to see how long they could last in the freezing water! It almost became a measure of your commitment to the cause. Ice water immersion quickly grew in popularity and became common practice amongst athletes in various sports. The level of investment by sporting clubs in providing ice bath facilities varied from borrowing a wheelie bin and filling it with ice water to be used by 30 or so people, to purpose built amenities. Despite this continuing to be a practice among some athletes, even elite ones, it is not an evidence-based recommendation and studies performed thus far have been small or inconclusive. In fact, some findings even  suggest the practice may cause muscle soreness the day after (Barnett, 2006; Lateef, 2010; Torres et al., 2012; Crystal et al., 2013) Cold-water immersion may have no benefit in promoting recovery but there is some evidence that suggests that athletes feel better after an ice bath, which is likely why they are so popular. So if you enjoy ice baths go ahead and keep doing them, but in the name of science, I’ll give them a miss!

The next fashionable method of recovery I encountered during my rugby career was compression garments. This gear looks great on the bodies of elite athletes but is less forgiving of the more robustly built athlete like myself.  People believed the claims of the manufacturer, so much so that sales of compression gear almost doubled between 2008 – 2010. Now in fairness to the producers of the skin tight gear  there are a small number of studies that suggest a slightly positive effect of lower-body compression after high intensity or long duration exercise (MacRae et al., 2011).  The Australian Institute of Sport presented preliminary results of research into the effectiveness of compression garments at the American College of sports Medicine conference in May of this year with their main finding being “Belief in the efficacy of compression socks appears to further enhance performance benefits.” So the benefits of compression gear may depend on the frequency and intensity with which you run. If you train only a few times a week, and have 1 -2 days recovery between sessions, then your body will adequately recover on its own without the assistance of compression.

After the recent half marathon in Tullamore I availed of the post run free massage, kindly provided by chartered physios, directly after the race. I had never done this before, and in honesty I did so only because the plinth was free, it was pouring rain outside and I felt like lying down. The use of massage in reducing post activity muscle soreness is weakly supported by research. Post-exercise massage can produce minor reductions in a markers of inflammation and  may improve the metabolite profiles in DOMS (Zainuddin et al., 2005; Urakawa et al., 2015). Unfortunately massages are rarely free, but all is not lost, you can always use the foam roller, which too has been shown to reduce DOMS (Pearcey et al., 2015).

Preventing or recovering from DOMS may be as simple as getting up and moving. As counterintuitive as it may seem completing light exercise whilst recovering from a harder session may be the most promising means to alleviate the pain and soreness. This method of active recovery is my choice in trying to speed up my recovery – a light jog or gentle swim (Cheung et al., 2003). Runners will tend to try all methods and stick to the method they believe to work, and if they really believe it works it probably will! However in reviewing the literature the overwhelming body of evidence suggests that the best method of avoiding and recovering from DOMS may be much more simple than building ice bath or purchasing expensive compression gear and equipment.   It may be as simple as adopting a well periodized training plan allowing a progressive increase in training load combined with plenty of rest with proper sleep and nutrition. But trying to explain the benefits of a Sunday afternoon nap to a 4 year old who just wants you to join her on the trampoline is easier said than done!

References

Armstrong RB. (1984). Mechanisms of exercise-induced delayed onset muscular soreness: a brief review. Med Sci Sports Exerc 16, 529-538.

Barnett A. (2006). Using recovery modalities between training sessions in elite athletes: does it help? Sports Med 36, 781-796.

Cheung K, Hume P & Maxwell L. (2003). Delayed onset muscle soreness : treatment strategies and performance factors. Sports Med 33, 145-164.

Crystal NJ, Townson DH, Cook SB & LaRoche DP. (2013). Effect of cryotherapy on muscle recovery and inflammation following a bout of damaging exercise. Eur J Appl Physiol 113, 2577-2586.

Lateef F. (2010). Post exercise ice water immersion: Is it a form of active recovery? J Emerg Trauma Shock 3, 302.

MacRae BA, Cotter JD & Laing RM. (2011). Compression garments and exercise: garment considerations, physiology and performance. Sports Med 41, 815-843.

Pearcey GE, Bradbury-Squires DJ, Kawamoto JE, Drinkwater EJ, Behm DG & Button DC. (2015). Foam rolling for delayed-onset muscle soreness and recovery of dynamic performance measures. J Athl Train 50, 5-13.

Torres R, Ribeiro F, Alberto Duarte J & Cabri JM. (2012). Evidence of the physiotherapeutic interventions used currently after exercise-induced muscle damage: systematic review and meta-analysis. Phys Ther Sport 13, 101-114.

Urakawa S, Takamoto K, Nakamura T, Sakai S, Matsuda T, Taguchi T, Mizumura K, Ono T & Nishijo H. (2015). Manual therapy ameliorates delayed-onset muscle soreness and alters muscle metabolites in rats. Physiol Rep 3.

Zainuddin Z, Newton M, Sacco P & Nosaka K. (2005). Effects of massage on delayed-onset muscle soreness, swelling, and recovery of muscle function. J Athl Train 40, 174-180.