Passive Recovery Strategies after Exercise: A Narrative Literature Review of the Current Evidence

Can Manual Lymph Drainage Be Considered as a Passive Recovery Strategy?

CONTEXT

The aim of this study was to investigate the acute effects of Swedish massage and manual lymph drainage (MLD) on performance parameters related to jumping, walking, and blood lactic acid levels after Nordic hamstring exercises.

DESIGN

This study was designed as a controlled crossover study.

METHODS

The study included 16 young trained men. Participants' lactic acid levels, gait-related parameters, and jumping performance were assessed. Assessments were performed at baseline, after Nordic hamstring exercises, and after 3 different passive recovery strategies: resting, Swedish massage, and MLD for 3 weeks.

RESULTS

As a result of the study, it was observed that lactic acid levels after the MLD and massage intervention were significantly lower in both MLD and massage conditions compared with the control condition (P < .05). There was no within- and between-conditions difference in jumping parameters after the MLD and massage interventions (P > .05). Walking speed in the MLD condition was statistically higher following the intervention compared with both before and after exercise (P < .05). Step time in the massage condition was statistically lower after the intervention compared with after Nordic hamstring exercise (P < .05).

CONCLUSIONS

Although MLD and massage interventions have positive effects on lactic acid levels and walking and jumping parameters, they are not superior to each other. MLD can be used as a passive recovery technique after exercise.

The Acute Effects of Cold Water Immersion and Percussive Massage Therapy on Neuromuscular Properties and Muscle Soreness after Exercise in Young Male Soccer Players

Cold water immersion (CWI) and percussive massage therapy (PMT) are commonly used recovery techniques in team sports. In particular, despite its wide use, PMT has been scarcely investigated in the literature, especially regarding neuromuscular measures and in comparison with other techniques. This study aimed to evaluate and compare the acute and short-term effects (24 h) of CWI and PMT on muscle strength, contractile properties, and soreness after exercise. A randomized crossover study was performed on sixteen male soccer players (22 years, 20-27) who participated in three experimental sessions involving a fatiguing protocol consisting of a Yo-Yo Intermittent Endurance Test followed by 3 × 10 squat jumps and a wall sit for 30 s, and 12 min of recovery including CWI (10 °C water), bilateral PMT on the anterior and posterior thigh, or passive resting. Outcomes were assessed immediately after the exercise protocol, after the recovery intervention, and at 24 h. Isometric knee extension (IKE) and flexion (IKF) and tensiomyography (TMG) were assessed. Muscle soreness and fatigue were scored from 0 to 10. PMT increased strength after the treatment (p = 0.004) and at 24 h (p = 0.007), whereas no significant differences were found for the other two recovery modalities. At post-recovery, compared to CON, CWI resulted in a longer TMG contraction time (p = 0.027). No significant differences were found at 24 h. Finally, PMT and CWI enhanced muscle soreness recovery compared to passive rest (F4,60 = 3.095, p = 0.022, pη2 = 0.171). Preliminary results from this study suggest that PMT might improve isometric strength after strenuous exercise, and both PMT and CWI reduce muscle soreness perception, while the effects on TMG parameters remain controversial.

Deloading Practices in Strength and Physique Sports: A Cross-sectional Survey

BACKGROUND

This study explored the deloading practices of competitive strength and physique athletes. A 55-item anonymised web-based survey was distributed to a convenience-based, cross-sectional sample of competitive strength and physique athletes (n = 246; males = 181 [73.6%], females = 65 [26.4%]; age = 29.5 ± 8.6 years) who had 8.2 ± 6.2 years of resistance training and 3.8 ± 3.1 years of competition experience.

RESULTS

All athletes deloaded within training with energy and fatigue management being the main reasons to do so. The typical duration of a deload was 6.4 ± 1.7 days, integrated into the training programme every 5.6 ± 2.3 weeks. Deloading was undertaken using a proactive, pre-planned strategy (or in combination with an autoregulated approach) and undertaken when performance stalled or during periods of increased muscle soreness or joint aches. Athletes reported that training volume would decrease (through a reduction in both repetitions per set and sets per week), but training frequency would remain unchanged during deloads. Additionally, athletes reported that training intensity (load lifted) would decrease, and effort would be reduced (facilitated through an increase in repetitions in reserve). Athletes would generally maintain the same exercise selection during deloading. For athletes that supplemented deloading with additional recovery modalities (n = 118; 48%), the most reported strategies were massage, static stretching and foam rolling.

CONCLUSION

Results from this research might assist strength and physique athletes and coaches to plan their deloading. Future research should empirically investigate the findings from this study to further evaluate the potential utility of deloading in strength and physique sports.

How do women feel cold water swimming affects their menstrual and perimenopausal symptoms?

OBJECTIVE

This study aimed to determine how women felt cold water swimming affected their menstrual and perimenopausal symptoms.

STUDY DESIGN

An online survey that asked women who regularly swim in cold water about their experiences. The survey was advertised for 2 months on social media. Questions related to cold water swimming habits and menstrual and perimenopausal symptoms were analysed.

MAIN OUTCOME MEASURES

Quantitative and qualitative data including; frequency of menstrual and menopause symptoms, the effect of cold water swimming on these symptoms.

RESULTS

1114 women completed the survey. Women reported that cold water swimming reduced their menstrual symptoms, notably psychological symptoms such as anxiety (46.7%), mood swings (37.7%) and irritability (37.6%). Perimenopausal women reported a significant improvement in anxiety (46.9%), mood swings (34.5%), low mood (31.1%) and hot flushes (30.3%). The majority of women with symptoms swam specifically to reduce these symptoms (56.4% for period and 63.3% for perimenopause symptoms). Women said they felt it was the physical and mental effects of the cold water that helped their symptoms. For the free text question, five themes were identified: the calming and mood-boosting effect of the water, companionship and community, period improvements, an improvement in hot flushes and an overall health improvement.

CONCLUSION

Women felt that cold water swimming had a positive overall effect on menstrual and perimenopause symptoms. Studies on other forms of exercise to relieve menstrual and perimenopause symptoms may show similar findings.

Effects of Percussive Massage Treatments on Symptoms Associated with Eccentric Exercise-Induced Muscle Damage

Percussive massage (PM) is an emerging recovery treatment despite the lack of research on its effects post-eccentric exercise (post-EE). This study investigated the effects of PM treatments (immediately, 24, 48, and 72 h post-EE) on the maximal isometric torque (MIT), range of motion (ROM), and an 11-point numerical rating scale (NRS) of soreness of the nondominant arm's biceps brachii from 24-72 h post-EE. Seventeen untrained, college-aged subjects performed 60 eccentric elbow flexion actions with their nondominant arms. Nine received 1 minute of PM, versus eight who rested quietly (control [CON]). In order, NRS, ROM, and MIT (relative to body mass) were collected pre-eccentric exercise (pre-EE) and after treatment (AT) at 24, 48, and 72 h post-EE. NRS was also collected before treatment (BT). Electromyographic (EMG) and mechanomyographic (MMG) amplitudes were collected during the MIT and normalized to pre-EE. There were no interactions for MIT, EMG, or MMG, but there were interactions for ROM and NRS. For ROM, the PM group had higher values than the CON 24-72 h by ~6-8°, a faster return to pre-EE (PM: 48 h, CON: 72 h), and exceeded their pre-EE at 72 h by ~4°. The groups' NRS values did not differ BT 24-72 h; however, the PM group lowered their NRS from BT to AT within every visit by ~1 point per visit, which resulted in them having lower values than the CON from 24-72 h by ~2-3 points. Additionally, the PM group returned their NRS to pre-EE faster than the CON (PM: BT 72 h, CON: never). In conclusion, PM treatments may improve ROM without affecting isometric strength or muscle activation 24-72 h post-EE. Although the PM treatments did not enhance the recovery from delayed onset muscle soreness until 72 h, they consistently provided immediate, temporary relief when used 24-72 h post-EE.

Black holes in compression therapy: A quest for data

OBJECTIVE

Although compression therapy (CT) is considered a crucial conservative treatment in chronic venous disease, strong evidence is missing for many clinical indications. This literature review aims to point out what strong evidence we have for CT and all the clinical scenarios where strong evidence still needs to be included.

METHODS

The research was conducted on MEDLINE with PubMed, Scopus and Web of Science. The time range was set between January 1980 and October 2022. Only articles in English were included.

RESULTS

The main problem with CT is the low scientific quality of many studies on compression. Consequently, we have robust data on the effectiveness of CT only for advanced venous insufficiency (C3-C6), deep vein thrombosis and lymphedema. We have data on the efficacy of compression for venous symptoms control and in sports recovery, but the low quality of studies cannot result in a strong recommendation. For compression in postvenous procedures, superficial venous thrombosis, thromboprophylaxis, post-thrombotic syndrome prevention and treatment, and sports performance, we have either no data or very debated data not allowing any recommendation.

CONCLUSIONS

We need high-level scientific studies to assess if CT can be effective or definitely ineffective in the clinical indications where we still have a paucity of or contrasting data.

The swimming habits of women who cold water swim

BACKGROUND

Cold water swimming is growing in popularity, especially among women. We have previously reported that women felt that cold water swimming helps with their menstrual and menopause symptoms. But little is known about the habits of women who cold water swim.

OBJECTIVES

To determine the habits of women who cold water swim.

DESIGN

This was a mixed-methods study.

METHODS

An online survey asked women who cold water swim about their experience of swimming and how this affected their menstrual and menopause symptoms. The survey was advertised for 2 months on social media, with a focus on advertising in cold water swimming Facebook groups. In this article, only the questions on the women's swimming habits were analyzed.

RESULTS

The analysis of 1114 women, mainly from the United Kingdom, revealed that most had been swimming for 1-5 years (79.5%). Most swim in the sea (64.4%), and only 15.5% swim alone. The majority (89.0%) swim all year around, swimming for mainly 30-60 min in the summer and 5-15 min in the winter. The women mostly swim wearing swimming costumes (skins) throughout the year. The majority of the free-text responses showed women found mental and physical benefits from cold water swimming.

CONCLUSION

It was not surprising to learn that women swim for longer in the summer than the winter, but hearing how they feel cold water swimming helps their physical and mental health is important. With the limitations on access and safety of many wild swimming sites in the United Kingdom, it is time to ensure that cold water swimming is safer and more supported.

Acute Effects of Percussive Massage Therapy on Thoracolumbar Fascia Thickness and Ultrasound Echo Intensity in Healthy Male Individuals: A Randomized Controlled Trial

Percussive massage therapy (PT) has been widely used by therapists and the fitness population to treat myofascial-related conditions. However, there is no evidence to confirm the effects of PT on the fascia. This study aimed to investigate the effects of PT on thoracolumbar fascia (TLF) morphology and other related outcomes.

METHODS

Sixty-six healthy males participated and were randomly allocated into a percussive massage group (PT group) and a control group. The PT group received 15 min of back percussion massage, while the control group rested prone lying in the same environment for 15 min. Thoracolumbar fascia (TLF) thickness and echo intensity, perceived stiffness, lumbar flexibility, and skin temperature were measured in both groups before and immediately after the intervention.

RESULT

TLF thickness and lumbar flexibility did not change when compared in the two groups. However, the echo intensity (left side, difference -3.36, 95% CI -5.1 to -1.6; right side, difference -4.39, 95% CI -6.1 to -2.7) and perceived stiffness (difference, -1.18, 95% CI -1.84 to -0.52) in the TLF region were significantly lower in the PT group than in the control group and were accompanied by increased skin temperature (difference 0.29, 95% CI 0.11 to 0.48).

CONCLUSION

We suggest that a 15 min PT with 30 Hz on the back region could reduce TLF echo intensity and perceived stiffness and increase skin temperature in healthy men individual.

Analysis of Recovery Methods' Efficacy Applied up to 72 Hours Postmatch in Professional Football: A Systematic Review With Graded Recommendations

BACKGROUND

Sleep, nutrition, active recovery, cold-water immersion, and massage were recently reported as the most used postmatch recovery methods in professional football. However, the recommendations concerning the effect of these methods remain unclear.

PURPOSE

To systematically review the literature regarding the effectiveness of the most common recovery methods applied to male and female football players (or other team sports) 72 hours postmatches and to provide graded recommendations for their use.

METHODS

A systematic search of the literature was performed, and the level of evidence of randomized and nonrandomized studies was classified as 1 or 2, respectively, with additional ++, +, and - classification according to the quality of the study and risk of bias. Graded recommendations were provided regarding the effectiveness of recovery methods for physical, physiological, and perceptive variables.

RESULTS

From the 3472 articles identified, 39 met the inclusion criteria for analysis. The studies' levels of evidence varied among methods (sleep: 2+ to 1++; nutrition: 2- to 1+; cold-water immersion: 2- to 1++; active recovery: 2- to 1+; and massage: 1- to 1+). Different graded recommendations were attributed, and none of them favored the effective use of recovery methods for physiological and physical parameters, whereas massage and cold-water immersion were recommended as beneficial for perceptive variables.

CONCLUSIONS

Cold-water immersion and massage can be recommended to recover up to 72 hours postmatch at a perceptive level. However, there is a current need for high-quality research that identifies effective recovery strategies that enhance recovery at the physical and physiological levels.

Effects of Forearm Compression Sleeves on Muscle Hemodynamics and Muscular Strength and Endurance Parameters in Sports Climbing: A Randomized, Controlled Crossover Trial

Purpose: Wearing compression garments is a commonly used intervention in sports to improve performance and facilitate recovery. Some evidence supports the use of forearm compression to improve muscle tissue oxygenation and enhance sports climbing performance. However, evidence is lacking for an effect of compression garments on hand grip strength and specific sports climbing performance. The purpose of this study was to evaluate the immediate effects of forearm compression sleeves on muscular strength and endurance of finger flexor muscles in sports climbers.

Materials and Methods: This randomized crossover study included 24 sports climbers who performed one familiarization trial and three subsequent test trials while wearing compression forearm sleeves (COMP), non-compressive placebo forearm sleeves (PLAC), or no forearm sleeves (CON). Test trials consisted of three performance measurements (intermittent hand grip strength and endurance measurements, finger hang, and lap climbing) at intervals of at least 48 h in a randomized order. Muscle oxygenation during hand grip and finger hang measurements was assessed by near-infrared spectroscopy. The maximum blood lactate level, rate of perceived exertion, and forearm muscle pain were also determined directly after the lap climbing trials.

Results: COMP resulted in higher changes in oxy[heme] and tissue oxygen saturation (StO₂) during the deoxygenation (oxy[heme]: COMP –10.7 ± 5.4, PLAC –6.7 ± 4.3, CON –6.9 ± 5.0 [μmol]; p = 0.014, η_p² = 0.263; StO₂: COMP –4.0 ± 2.2, PLAC –3.0 ± 1.4, CON –2.8 ± 1.8 [%]; p = 0.049, η_p² = 0.194) and reoxygenation (oxy [heme]: COMP 10.2 ± 5.3, PLAC 6.0 ± 4.1, CON 6.3 ± 4.9 [μmol]; p = 0.011, η_p² = 0.274; StO₂: COMP 3.5 ± 1.9, PLAC 2.4 ± 1.2, CON 2.3 ± 1.9 [%]; p = 0.028, η_p² = 0.225) phases of hand grip measurements, whereas total [heme] concentrations were not affected. No differences were detected between the conditions for the parameters of peak force and fatigue index in the hand grip, time to failure and hemodynamics in the finger hang, or performance-related parameters in the lap climbing measurements (p ≤ 0.05).

Conclusions: Forearm compression sleeves did not enhance hand grip strength and endurance, sports climbing performance parameters, physiological responses, or perceptual measures. However, they did result in slightly more pronounced changes of oxy [heme] and StO₂ in the deoxygenation and reoxygenation phases during the hand grip strength and endurance measurements.

Why Percussive Massage Therapy Does Not Improve Recovery after a Water Rescue? A Preliminary Study with Lifeguards

The aim of this study was to analyze the effects of percussive massage therapy (PMT) on lifeguards’ recovery after a water rescue, in comparison with passive recovery. Methods: A quasi-experimental crossover design was conducted to compare passive recovery (PR) and a PMT protocol. A total of 14 volunteer lifeguards performed a simulated 100 m water rescue and perceived fatigue and blood lactate were measured as recovery variables after the rescue and after the 8-min recovery process. Results: There were no differences between PMT and PR in lactate clearance (p > 0.05), finding in both modalities a small but not significant decrease in blood lactate. In perceived fatigue, both methods decreased this variable significantly (p < 0.001), with no significant differences between them (p > 0.05). Conclusions: PMT does not enhance recovery after a water rescue, in comparison with staying passive. Despite PMT appearing to be adequate for recovery in other efforts, it is not recommended for lifeguards’ recovery after a water rescue.