by Nora Gilman, MS, LAT, ATC
New Studies suggest that active recovery is more beneficial than complete rest.
Active recovery is a new area of exploration in the athletic world. A recent meta-analysis (compilation of numerous qualifying studies) compared the benefits of contrast water therapy as a recovery option vs. complete rest after exercise. The research trials measured outcomes such as muscle soreness and muscle strength loss at various time intervals after muscle damage-inducing tasks. The goal was to determine if participating in active recovery is worth the effort, or if laying around at home on rest days just as beneficial?
The trials suggest muscle soreness, muscle damage, strength, and power all appear to recover more quickly after contrast water therapy compared to no intervention or rest.
Contract water therapy on muscle soreness
Muscle soreness, otherwise known as DOMS (delayed-onset muscle soreness), results in temporary muscle discomfort, reduced production in muscle force, joint stiffness or immobility, and reduced athletic performance. You may notice soreness from your activity peaks within 24-48 hours, subsiding after 5-7 days. Healthy athletes were examined at various time points: less than 6 hours, 24 hours, 48 hours, 72 hours, and 96 hours after exercise induced muscle damage exercise and concluded significantly less muscle soreness in comparison to complete rest, especially within 24 hours after activity. Measuring muscle soreness comes with criticism. Muscle soreness is generally measured subjectively on a visual-analog scale (VAS), which you might be familiar with if you’ve ever gone to the doctor. VAS have subjects rate their symptoms on a scale of 1 to 10.
More objectively, we can measure the inflammatory markers that DOMS cause in the muscle and blood stream, such as creatine-kinase (CK). CK rises when muscle is damaged, and muscle damage leads to muscle soreness. There was no difference in CK levels between contrast therapy groups and rest groups less than 6 hours post-activity, but CK levels were significantly lower in contrast therapy groups at 48 and 72 hour follow ups. Overall, perception of pain from muscle damage and actual muscle damage were significantly less during peak muscle soreness time frames in contrast water therapy groups. This has great implications for athletes with back-to-back competitions.
Contract water therapy on muscle performance
Pooled data showed that contrast water therapy significantly reduced muscle strength loss at each follow-up time in comparison to passive recovery. The ‘pumping’ mechanism of contrast therapy is responsible for this affect. The alternating warm-immersion followed by cold-immersion increases limb blood flow thanks to vasodilation and vasoconstriction of peripheral blood vessels. This mechanism is proposed to increase lactate clearance, decrease edema (inflammation), reduce muscle cell damage, and increase blood flow. This has great implications for athletes experiencing chronic reduction in muscle function, such as fatigue or an injury.
While we're at it, active recovery surpasses ice tub submersion, alone.
The most relevant finding in the pooled data is the benefits utilizing a combination of recovery modalities vs. a single intervention. When subjects utilized multiple active recovery interventions (such as compression and contrast water therapy), it was superior to just stretching, for instance. Ice tub submersion/ice application, alone, is the most popular choice for most athletes. For athletes, take advantage of the potential cumulative effects of a recovery package consisting of a number of different treatment approaches. This will delay soreness and increase muscle function the most.
Reference: Bieuzen F, Bleakley CM, Costello JT (2013) Contrast Water Therapy and Exercise Induced Muscle Damage: A Systematic Review and Meta-Analysis. PLoS ONE 8(4): e62356. https://doi.org/10.1371/journal.pone.0062356