I’m not sure why, but I’ve recently received a rapid influx of questions regarding optimal “recovery”. Concerns over recovery at this time of the year are a little confusing, considering we’re in the middle of the off-season. (I’ll explain why later.) So, I decided to inquire further.

From what I got out of conversations with other strength & conditioning coaches, the trending topic of 2015 has been the usage of the latest and greatest recovery modalities (e.g., the MarcPro, compression units, IASTM, etc.) I’ve compiled a few sporadic and random thoughts on the subject that I hope will eventually spark some dialogue with a farther reaching audience, so feel free to comment and discuss. I will be attempting to add to this document based off of further conversations, ideas, and questions (so check back every once in a while).

Understanding the intervention is key

Recovery: Specificity Matters

When people talk to me about “recovery”, the biggest question I always ask them is:

What are you trying to recover?

As with almost everything, identifying what you are trying to accomplish as an end goal should be at the forefront when developing a plan. And, considering its complexity and adaptive capabilities, this concept couldn’t be more important than when we’re dealing with the human body.

When it comes to recovering from training or competition, determining what needs to be recovered will dictate what methods you choose to employ. Are you trying to recover fatigue or function? Are you trying to recover metabolically or psychologically? Centrally or peripherally? Like training, different recovery goals require different recovery strategies.

Are you monitoring the effects of what you are introducing to the athlete? If you aren’t capturing data on fatigue and physical/mental readiness, how do you know your recovery intervention is working? How do you know that introducing passive modalities like the MarcPro are objectively making a difference? What are your outcome measures?

If you aren’t monitoring to begin with, you don’t have a baseline, and you are completely lost.

And if your monitoring system is only subjective—that is, if your only green light benchmark is when a player tells you, “I feel good”—well, you are only slightly less lost.

If you are monitoring objective measures of recovery with, at the very least, some relevant indices and questionnaires (which can be cheap and, yet, still effective) AND analyzing that information THEN you can decide what recovery interventions may in fact be working. This is where minimum effective dose becomes an extremely valuable concept. We are all limited by certain resources; and don’t have thousands of dollars for equipment, or multiple hours a day to train high school players. More is not always better. Why spend the $$$ on a gadget when I’ve discovered that sleep is the limiting factor? How do I know that adding a GameReady on top of several other strategies is making a positive change?

When I see someone using 4-5 different recovery interventions, and usually new products, I automatically assume that they cannot be objectively measuring their efficacy to warrant their inclusion. Shotgun approaches usually indicate a lack of understanding of principles and outcome measures.

It makes me cringe when I see coaches feel the need to purchase expensive equipment when they aren’t even attempting to measure how an athlete is sleeping.

Periodizing Recovery: Don’t Rob Yourself of Adaptation

In my opinion, there should be a big difference between how we approach “recovery” during the competitive season compared to the off-season. Recovering from a start or a relief appearance in the middle of August is a different goal than recovering from throwing session in early January. The goals are different and, thus, the philosophy towards recovery should be too.

Let me explain. The off-season is a time for adaptation. We place a stimulus on the body—a stressor to signal change—and then provide the necessary conditions to adapt to it. I think the word “recover” is misguided in this sense. Why would we want to impede on/undermine the body’s ability to adapt to a stressor by applying an external aid? Playing around too much with the normal physiology of recovery creates an interference effect. Sometimes we just need to let biology do it’s thing.

A good example of this is the fixation on “controlling” inflammation after a workout. Think of how many recovery interventions are based on the premise of reducing inflammation: ice, NSAIDs, antioxidant supplements, etc. Yet, the adaptation process requires inflammation. It is a necessary condition, not some devil to be completely avoided at all costs. After an acute injury do we need to employ anti-inflammation measures? Yes. Do we need to create an all out war against inflammation post-workout? I’m not willing to say yes.

The off-season is a fantastic time to improve an athlete’s ability to recover from physically- and or mentally-demanding workloads (a little something called, “work capacity”). Yet, for some reason the anti-pole-running movement has swung the pendulum so far in the opposite direction that we’ve dismissed the most scientifically-grounded means for improving recovery: aerobic fitness.

Improving mitochondrial and capillary density and therefore oxidative capacity, via aerobic-based exercise comes with a host of benefits not limited to enhancing wasted removal, improving nutrient delivery, and restoring parasympathetic tone. Research isn’t iffy on this subject.

Now, if we understand the importance of oxidative capacity then modalities in the off-season seem even sillier, no? If we want our pitchers to recover more quickly during the season—between pitches, between innings and between appearances—wouldn’t we want to provide them with the biological tools to do so? (Doug Kechijian and Pat Davidson wrote a couple of fantastic blog posts on the subject of oxidative fitness and baseball here and here, and Eric Cressey recently published a very practical piece on the topic here.)

Robbing our athletes of the opportunity to learn the skill of recovery is counterproductive. Yes, recovery is a skill. A skill—just like any other—that needs to be trained for a more robust and resilient biological system. Consider, for a moment, what might happen if during the season those athletes you train don’t have access to all of the free tools you provide them during the off-season? How might their body deal with recovery at that point?

A Few Notes on Popular Recovery Modalities

I thought I would outline a few thoughts on some recovery strategies that are gaining popularity in baseball, as well as the sports performance industry at large. These are just a few initial thoughts—I will try to add to this list as new research emerges.

Electrical Muscle Stimulation

Recovery strategies such as EMS are not a necessary requirement to “recover” from training. Various claims made by the manufacturers of these units, such as lymphatic drainage and improved blood flow, aren’t backed up very well in the literature. Go ahead and check out Professor Nicola Maffiuletti’s lecture on EMS for recovery below.

I highly recommend watching the entire video, but for those of you who don’t have time, here are some of the major take-aways:

• If you want to improve blood flow, voluntary contractions are better than EMS because you are able to contract more muscle voluntarily. Recruitment via EMS—even at a very high VAS (visual analogue score)—can only recruit around 15% of the muscle cross-sectional area. And of that 15%, it’s mostly superficial fibers. In order to increase muscle fiber recruitment, you would have to increase the intensity by improving an individual’s tolerance via persistent exposure. However, according to Maffiuletti, excessive intensities can actually create fatigue:

“If you increase the intensity, and have the low percentage superficial fibers creating high forces, you are creating fatigue that is 5 times faster than a voluntary contraction.”

• There have been many case reports of muscular dysfunction as a result of overusing EMS units. (In theory, this makes sense.)

• Lactate removal is faster with active recovery than it is with EMS. (Although, I will admit that lactate isn’t necessarily the best indicator of fatigue.)

• EMS is as effective as both passive and active recovery for restoring neuromuscular function.

• Compared to passive or active recovery, EMS is unlikely beneficial for physiological recovery. However, it may potentially be beneficial for psychological recovery.

Foam Rolling & “Smashing”

To suggest that foam rolling—i.e. “smashing” (ugh), “torture tools” (smh), etc.—are equivalent to manual therapy for “recovery” and/or “myofascial release” is unfair. Semantics on the term “myofascial release” aside, there is a difference between what can be accomplished with your hands (as well as the clinical rationale for what you’re doing) and having a partner jamming a lacrosse ball into your first rib (or brachial plexus—whichever you prefer, apparently). It comes down to specificity. Specificity in palpation and it’s guidance in the intervention plan and outcome are important. This argument could span multiple blog posts, so I am not going to go into it, but every intervention requires a sound rationale.

This is not to say that foam rolling does not provide benefits. Here’s a good article summarizing the literature. The Cliff Notes version:

Foam rolling may potentially…

• Improve arterial stiffness and vascular endothelial function.

• Reduce cortisol levels post-exercise.

• Increase parasympathetic activity (high frequency HRV), and reduce sympathetic activity (low frequency HRV).

So, if it’s good for recovery (which seems to be the case) and we’re using it post-exercise, why would you include it before training? I struggled to answer this question, before I finally realized that a proper warm-up doesn’t necessitate it. (Charlie Weingroff wrote a good piece on motor control and the warm-up here, which provides some valuable insight into why foam rolling is probably not a necessary focus before training.)

Voodoo Floss Bands & Compression Garments

I do think Voodoo bands so have some merit for getting a grip on the skin, adding compression to tissues, and self-mobilizing hard-to-get-at areas like tibial rotation. But I’m also concerned by the potentially poor application of it. It might seem cool to blanch the fingers, but I can assure you that neurovascular problems like neuropraxia are not cool. We cannot underestimate people’s stupidity. Moreover, I am not so sure that I buy the argument of relative sliding of tissues via compression. (You’re compressing the entire “compartment”…)

And as per usual…

There is nothing that frustrates me more than an unqualified person declaring they perform MANUAL THERAPY because they are using a butter knife to induce excessive petechiae on a person’s lats after throwing. Manual therapy isn’t just using a tool; whether that’s a stim unit, your hands or a lacrosse ball. Manual therapy involves a clinical decision-making process that is developed through years of studying, clinical experience and passing licensing exams. It’s not something that comes from Amazon.

Aquatic therapy, tempo circuits, and just plain old breathing do not get nearly the love they deserve.

And, I need to say it again because it drives me bananas: sleep is important. Building healthy sleeping habits, including preventing the exposure to blue light (read: scrolling through your Twitter feed) a few hours before nighty night time is essential. All the recovery gadgets in the world aren’t doing anything if you can’t sleep, and sleep well.

Practical Takeaways

• Keep it simple: breathing, active recovery (can be used to improve aerobic capacity), improving sleep habits and nutrition are all backed by the literature.
• Do not rob your athlete from acquiring the skill of recovery.
• Modalities such as MarcPro, GameReady, and Normatec may all provide psychological value, but I’m struggling to find research on the physiological evidence for their usage. (If you have some, please point me in the right direction!)
• Start asking yourself: how do I know this is working? Measurement is a basic tenant of science, and good training—and shouldn’t be excluded when validating recovery strategies. A shotgun approach is not the answer.

Any questions, or points of contention? Let’s start discussing below!

Dr. Stephen Osterer