Published on June 24, 2013
Welcome to the next chapter of “Beyond Training: Mastering Endurance, Health & Life”, in which I'm going to give you 26 top ways to recover from workouts and injuries with lightning speed.
I'll admit it.
I used to be pretty old-school and simple with recovery. A post-workout shake or smoothie. Maybe a little stretching or foam roller. And if things got really bad, a bit of ice massage or a cold bath.
Heck, there's absolutely nothing wrong with simplicity. After all, you can easily get carried away spending so much time playing with new gadgets, toys and recovery tools that you forget about simply enjoying a glass of wine while gazing into the sunset at the end of a long day or a tough run.
But at the same time, I remember back to the days when I shared an office (for three years) with a sports medicine physician. All day long, marathoners, triathletes, cyclists and weekend warriors would come through the medical clinic door complaining of chronic aches, pains and injuries that they'd been fighting for weeks, months and even years. However, with just a few of the simple recovery tips or home recovery gear you'll discover in this chapter, these folks could have easily saved themselves expensive doctor's office visits, surgeries, missed workouts, cancelled races, pain and frustration.
So I would be remiss not to equip you with every possible technique I've studied to keep the body in pristine shape, especially if you're laying down some serious damage by going above and beyond the status of “weekend warrior”. Heck, as I write this chapter I am actually sitting on my couch after a tough bike ride, with an electrostimulation unit called a Compex and a frozen icing application called FrozenPeaz on my knees. This isn't because I'm injured. I simply want my joints to last longer, so I consider this type of recovery hack to just be better living through science.
And in this chapter I’m giving you 26 of my top techniques to recover from your workouts with lightning speed. Sure, I've mentioned some of these gear, food, supplementation and underground recovery techniques before, but never aggregated all of them into one mighty blog post that will have you bouncing back from workouts, races, events and injuries as fast as possible.
The Best Recovery Techniques
So why not jump off the deep end right away and start talking about scary needles, eh?
I'll admit that it may seem inconvenient, odd and a bit excessive to include acupuncture as a convenient or do-able recovery method, but as a coach and athlete, I've found the occasional acupuncture session to be an incredibly useful method for everything from nagging aches and pains to full-blown adrenal fatigue. There's no need to duck down back alleys to find some fringe Chinese medical clinic – and in the USA, you'll find that the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is chock full of licensed acupuncturists operating out of pristine medical clinics.
Acupuncture is relatively painless, and simply involves stimulating certain points on the body using a variety of techniques – with the most common being penetrating the skin with super-fine needles (which are then manipulated manually or by electrical stimulation).
As one of the oldest healing practices in the world, acupuncture has been proven to help in recovery from muscular fatigue(19), recovery from overtraining and adrenal fatigue(39), management of muscle pain (12), and many of the common issues faced by physically active or overtrained people. I've personally used an acupuncturist to fix IT band friction syndrome and nagging hip pain. For more on acupuncture, and an interview with the guy I personally use for my acupuncture, you should listen to the podcast episode “Exactly What To Expect If You Try Acupuncture“.
But let's say you have an aversion to needles. Or you don't have time to drive around hunting down an acupuncturist. Later in this chapter, I'll tell you about PEMF, which is a non-invasive optimal alternative to acupuncture. It's been proven in research (17) to work similarly to acupuncture, and may be a good solution if you don't like poky things, or you simply want something similar to acupuncture that you can use in a home setting.
2. Stem Cell Therapy
Yes, I'm sticking to the fringe stuff early in this chapter – and stem cell therapy certainly is another potent recovery method that flies under the radar. Traditional, injectable stem cell therapy would be something you'd reserve as a last-ditch effort to avoid, say, a hip or knee replacement, or as a final attempt to fix a joint before giving up running, lifting, cycling, etc. and taking up foosball as your new sport.
But if you are desperate, stem cells have incredible healing abilities and can be transformed into neurons, muscle, and several different types of connective tissue – allowing for rapid joint “regeneration”. In the US, companies like RecyteCorp are on the cutting edge of developing injectable stem cell treatments to manage everything from regrowing spinal chord cells to erasing cartilage pain.
If stem cells offend your ethical values about how embryos should be used, then there's no need to fret. Contrary to popular belief, stem cells can be harvested from sources other than human embryos, such as body fat and bone marrow (16). Clinics such as the Institute of Regenerative Medicine and Orthopedics actually offer stem cells from these alternate regions for injections into injuries that need to be healed fast, or chronic aches and pains that need a permanent fix. But at this point, an embryonic stem cell injection therapy session is going to require a jaunt to Europe or Asia, where those type of stem cell injections are more common.
But if harvesting and re-injecting your own or somebody else's stem cells doesn't seem like a logistical or financially feasible option for you, there are alternate ways to upregulate your own internal stem call activity. One of my personal physician advisors, Dr. David Minkoff (who has himself completed 40 Ironman triathlons), recently made me aware of the fact that you don't necessarily have to get fancy or expensive injections to take advantage of your body's ability to use stem cells for fast recuperation. In his Lifeworks Wellness Center medical clinic in Florida, he prescribes a supplement called Celergen, which is based on what they call a “biological DNA extraction technology”, which works very similarly to stem cell therapy, without the injections.
Celergen is comprised of a cellular marine complex and peptide collagens – two compounds very popular in the anti-aging community, but componds that can also be used to enhance recovery in active individuals (you'll increasingly find that what is “old news” in the anti-aging community is going to become more and more popular for recovering or injured athletes).
Another cellular compound that also acts similarly to stem cell therapy is marine phytoplankton, a green, gooey liquid that you can suck sublingually from a dropper bottle. The idea behind marine cells is that they contain the proper ratios of amino acids, enzymes, fatty acids, minerals and pigments to allow your body to rapidly generate new stem cells. Reaserch is still a bit scant on phytoplankton, but I currently have a couple bottles in my refrigerator (and they literally do taste what you would imagine liquid algae to taste like).
Cryotherapy is a recovery method I personally use nearly every day (in the form of morning and evening cold showers, and many, many cold soaks in the bathtub or river). In Chapter 4 of this book, you learned all about the advantages of cold thermogenesis, including the multitude of performance benefits derived from frequent exposure to cold temperature such as cold water immersion, cold showers, cold-hot contrast showers, or use of body cooling gear such as the Cool Fat Burner vest or 110% Compression Gear. The benefits of all these forms of “cryotherapy” include enhanced immune system, increased cell longevity, decreased level of inflammatory molecules such interleukin-6, and of course, an incredible tolerance to be able to run outside and do snow angels in your underwear (8).
But what about simply icing a sore muscle or joint?
The application of cold to an injured area is hardly a new concept. The Greek physician Hippocrates wrote about the use of cold therapy to control pain and swelling in the 4th century B.C., and the Roman physician Galen described the use of cold compresses for analgesia following soft tissue injuries in the 1st century A.D.
During the Middle Ages, ice was used for pre-surgical anesthesia, and ice therapy has been extensively used in the athletic training and physical therapy for the treatment of sports injuries for many years. But despite the seeming widespread acceptance of tossing a bag of ice on an injured ankle or aching shoulder, there seems to be a doubting of icing’s efficacy across the internet and in several magazines.
The argument goes something like this: when an injury occurs, your body creates inflammation as a healing response. So if inflammation is the body’s natural way to heal an injury, why would you want to block this inflammatory process with ice?
Furthermore, it is claimed that icing may increase the permeability of lymphatic vessels (tubes which normally help carry excess tissue fluids back into the cardiovascular system). Once this lymphatic permeability increases, there may be risk of a large amounts of fluid backflowing into the injured area, causing more swelling than may have occurred if you didn’t ice in the first place.
There are several studies that are commonly cited in this argument against icing.
The first is “The Use of Cryotherapy in Sports Injuries” (22). But if you look closely at this study, the researchers simply concluded that “cold can inhibit as well as enhance inflammation” . It should be noted that when ligament injuries were induced in pigs, swelling was greater in ice treated limbs. However, in this study (as well as in another study entitled “Cryotherapy Influence on Posttraumatic Limb Edema”) (21) animal subjects were subjected to extended periods of icing up to 1 hour in length. A full hour of icing is a period of time that you’d be hard pressed to find any sports medicine professional recommending.
In addition, in the first study cited above, it was demonstrated that permeability of the lymph vessels indeed increases with ice application, but that within 25 minutes after icing, the permeability of the lymph vessels returned to pretreatment levels. Finally, it was simply ice used in both these studies – with no compression (pressure) or elevation (two other injury protocols that are highly recommended in sports medicine). The majority of studies that combine ice with compression and elevation do not show the same permeability increase or resultant swelling with cold treatment. This is because compression from pressure placed upon an injured area reduces swelling by increasing the pressure at the interstitial space, which equalizes the osmotic pressure within the vasculature and preventing fluid from leaking out of the vessels.
Another study commonly cited in the argument against icing is the 2008 study “Is Ice Right? Does Cryotherapy Improve Outcome for Acute Soft Tissue Injury?” (5). This was basically a literature review of ten studies. Of these ten studies, there were six trials in humans, but four of them were thrown out because of poor research. The additional two human studies were split, with one of them supporting cooling, while another lacked statistical significance to show icing’s efficacy. Four animal studies in this review showed reductions in swelling from ice application. The final two pieces of literature cited were systematic reviews, one of which was inconclusive and the other suggesting that ice may hasten return to participation. None of these results justify tossing your ice bags into the trash bag, but again simply suggest that icing by itself may not work in some cases.
Finally, a more recent 2010 study was performed at the Neuroinflammation Research Centre at the Cleveland Clinic in Ohio, and was instantly heralded across the press as conclusively revealing that “putting ice on injuries can slow healing” (40). But laughably, a closer look at this study reveals that no ice or cold treatments were used at all. Researchers simply studied two groups of mice: one group that was genetically altered so they could not form an inflammatory response to injury, and a second group that was normal.
The researchers then injected the mice with barium chloride to induce muscle injury, and found that the mice who were genetically altered to not form an inflammatory response to injury did not repair their damaged muscle. So this research simply demonstrated that the complete absence of inflammation will shut down the muscle healing response – but did not investigate the effect of ice at all!
So the important question is this: does ice – or any of form of cryotherapy or cold thermogenesis – indeed completely shut down inflammation, and thus decrease the rate of soft tissue repair by suppressing your body’s natural healing response?
To answer that question, you have to look at reactions associated with the body's natural healing response. Take swelling, for example.
Ice does not in fact reduce normal swelling significantly. That’s what pressure and elevation are more effective for. But ice can prevent excessive swelling from occurring for a long period of time after the initial injury occurs (31). While swelling allows important healing components such as white blood cells and other chemicals involved in the healing process to migrate into damaged tissues through increased vascular permeability, and also physically protects an injured area through decreasing it’s potential range of motion, there is no physiological reason to allow swelling to freely progress for hours or days after an injury occurs.
In fact, prevention of excessive swelling is important because fluid that has escaped into the tissues from excessive swelling can create a low oxygen (hypoxic) environment that can lead to additional tissue damage and delay healing. In addition, swelling can cause distention in joint capsules and other tissues, and excitation of nervous system components called mechanoreceptors – which can increase pain. Ice simply causes vasoconstriction (shrinks blood vessels) around the vasculature surrounding an injury.
But the benefits of icing don’t stop with the ability to control excessive swelling.
The cold temperature of ice can slow down nerve conduction velocity and shut down the activation of your muscle spindles, making it a highly effective pain reliever and muscle relaxant. If a muscle is in less pain and is more relaxed, then mobilization and movement become a reality, and a return to functional training status can occur much more quickly, which can limit muscle atrophy or loss of fitness.
Ice also reduced metabolic activity in the tissues that are iced, making them better able to resist the damaging effects of loss of oxygen from inflammatory swelling pressure (2). In other words, lower tissue temperatures from icing means less oxygen is required by those muscles to sustain their integrity.
Finally, as you learned earlier, ice causes vasoconstriction, or shrinking of blood vessels. But unless you’re in extreme conditions where you must shuttle blood to your brain and vital organs to survive, your body will avoid tissue death by not allowing the body part you’re icing to cool excessively. Through a process called “reactive vasodilation” (also known as the Hunting reflex or Lewis reflex), your vessels create a negative pressure in the capillary system, which causes a pumping of inflammatory and metabolic byproducts out of an injured area, while allowing additional healing components such as macrophages and white blood cells to mobilize into the area. When combined with pressure and elevation, this “pumping” action of ice can be an extremely effective rehabilitation tool (and you can observe this in nature by simply jumping into a cold lake for about 20 minutes and watching your skin slowly turn red as reactive vasodilation occurs).
So while there are certainly other fancier recovery modalities in this chapter, the simple fact is that ice is inexpensive, readily available, and easy to apply.
To get the full benefits, ice therapy can (and should) be initiated as soon as possible after the onset of the injury, for a duration of 20 to 30 minutes, using frozen ice cups, ice baths, crushed ice, frozen vegetables in a plastic bag, or one of my latest finds, a convenient pack of FrozenPeaz. Just be careful not to leave any chemical based frozen packs on the skin for too long, unless you want to give yourself frostbite.
Ultimately, my take on cryotherapy for recovery for active people is to just use cold thermogenesis (such as daily cold showers or cold soaks), and then if you get injured, turn to traditional icing therapy combined with pressure and elevation. Cool? I thought so.
Prolotherapy fits into the same category as stem cell therapy – something to consider when you need to “take out the big guns” on a joint or muscle injury that just won't go away.
Think of prolotherapy as “spot-welding” for an ache or pain. It is the precise injection of a solution into the areas where tendons and ligaments attach to bone, or into places where cartilage is worn or damaged (28). When you (or more specifically, a licensed medical practitioner) inject a prolotherapy solution – which can be anything from hyperosmolar dextrose (basically glorified sugar water) to glycerine, lidocaine, or even cod liver oil extract – you create a localized, controlled inflammatory process that stimulates the body’s own repair mechanisms to heal the damaged tissue.
Specifically, the inflammation from prolotherapy injection leads to the creation of collagen, the protein that makes up ligaments, tendons and cartilage (14). This causes targeted repair to occur at the exact site of an injury, and can be especially useful in areas of poor blood supply, such as cartilage or ligaments.
Dr. David Minkoff, who I mentioned earlier, is a huge fan of prolotherapy, and prolotherapy clinics such as his Lifeworks Wellness Center are becoming more common. You can check out The American Osteopathic Association of Prolotherapy Integrative Pain Management to find a licensed practitioner near you.
It may not be the sexiest of methods, but the simple act of deloading is an extremely underrated recovery “technique”.
A deload week is just a fancy word for an easy recovery week, and in the training plans that I write, I typically add a deload week every 4-8 weeks, depending on the volume of an athlete, the age of an individual (the older you are, the more deload weeks your hormones, joints and ligaments need) and the training time of year (typically I use fewer deloads during a race season, since an easy taper week leading up to a race is technically a deload). As you've already learned, exercise is just like any injury, wound, illness, or other stressor, and it's during the recovery period that you grow stronger (25). This is the whole concept behind the supercompensation you learned about in the previous chapter. So when used properly, a deload week doesn't just leave you with the same fitness you had when you left off training, but can actually improve your fitness to levels greater than prior to the deload.
But a deload week doesn't mean you cease all activity and take things into bon-bon eating, couch-loung mode. In most cases, I recommend continued use of mobility work, yoga, easy “injury prevention” style workouts, skills and drills to work on efficiency and economy or learning new exercises and movements, along with a general reduction in weights, sets, and reps, and a few aerobic, fasted workouts (the fasting for reasons you'll discover later in this chapter). Since it takes up to three weeks of inactivity for muscular atrophy, you don't need to worry about significant strength loss during a deload week, and one study actually found that deloading for up to three weeks doesn't cause loss of even an ounce of strength or power.
The Best Recovery Gear
6. Vibration Platform
One of the underground training techniques you already discovered in the chapter on building endurance is Whole Body Vibration (WBV) therapy, which involves standing or moving on a vibration platform.
But a vibration platform (such as the simple, no-frills Bulletproof Vibe, pictured right) has been shown to not only increase strength, power and speed, but to also result in a hormonal, immune system and anti-inflammatory response that can speed recovery (26).
Since there is an element of friction when you are standing on a vibration platform, you need to be careful in the early stages of healing for any ankle, knee or hip injuries that may be aggravated by the “rubbing” of ligaments on bone from friction (such as IT band friction syndrome). I actually experimented with vibration for recovery within hours after I had sustained a knee injury from stepping the wrong way during a trail run, and unfortunately found that the vibration left me reeling in pain for several hours, which probably slowed recovery.
But in the later stages of healing, and for any injured body parts not aggravated by vibration (e.g. if it hurts, don't do it), a simple WBV platform can be a handy investment and training/recovery tool to keep in your home gym, garage or office. You can simply stand on one for a few minutes in the morning or evening, or implement it into your actual workout routine (such as balance, yoga, lifting, etc.).
Studies have shown that when you wear compression gear during a hard workout, your performance in subsequent workouts may be better than if you hadn’t worn the compression gear – possibly because the increased blood flow from compression helps to restore muscle glycogen levels and to clear metabolic waste. When you wear compression, there may also be less muscle damage from tissue “bouncing up and down” while you exercise. If you sleep, rest or travel wearing compression gear, you’ll find that the improved support and blood flow leaves you less stiff and sore.
Although I find compression gear a bit annoying and time-consuming to wear during a workout or race, I personally use compression socks or compression tights while using my standing workstation, and also sleep in compression gear after particularly tough workout days. I've even experimented with compression shirts to enhance posture and upper body blood flow and recovery (29).
2XU, Skins, and Underarmour are among the leading compression gear manufacturers – but a company called 110% Play Harder gear has actually implemented the ability to place recovery enhancing ice packs into compression tights and leggings, which is an important consideration, since you just learned that combining compression with ice can limit the amount of fluid leaking out of the lymph vessels.
And if you have a couple thousand dollars to spare or like to own nice things, there is a device called a “GameReady“, which can achieve a similar level of compression with icy cold water, but gives the added benefit of a pumping action similar to RecoveryPump boots or a Normatec device.
Although there is relative lack of research on the therapeutic use of magnets to help in reduction of pain or speed of recovery, there have been some promising studies on the use of magnets to improve nervous tissue regeneration and wound healing. The proposed mechanism of action via which magnets might improve recovery include increased blood flow, changes in the migration of calcium ions, alteration of pH balance, changes in hormone production, and an alteration of enzyme activity (20).
For example, if a magnetic field is strong enough to attract or repel ions such as sodium and chloride in the blood, these ions may eventually encounter the walls of the blood vessels, move more rapidly, and cause an increase in tissue temperature or an increase in blood flow.
Companies such as Nikken, MagnaPower and BodyGlove make thin, light and flexible magnets that can be wrapped around body parts or easily applied with adhesive, and then used while you are sleeping, exercising or at the office. I must admit that aside from occasional experimentation with small adhesive magnets and magnetic wraps for tennis elbow and a sore knee, magnets have not been a huge part of my personal recovery routine, but many folks swear by slapping them on an injured joint, or wrapping sore muscles with a magnetic wrap – and I'm not going to argue with as much anecdotal evidence as I've seen.
If you’ve been to an Ironman triathlon recently, or watched the Olympics, you may have observed several athletes with brightly colored strips of tape on their shoulders, hips, knees or lower legs. Manufacturers of this tape, such as Rocktape and Spidertape, claim that unlike traditional athletic tape, kinesiotape increases fluid drainage through special channels formed in the skin, and may alter joint motion through the elastic tension applied to the tape (3). It supposedly lifts the skin away from the muscle, which is supposed to increase blood flow and lymph drainage.
I've seen little quality evidence to support the use of kinesiotape over other types of traditional taping in the management or prevention of injuries, but one advantage of this type of tape is that it is more flexible and easier to apply than the average roll of athletic tape from the pharmacy. If you find that kinesiotape works for you, the best explanation is probably not any mechanical influence the tape has on joint motion, but rather, a tactile stimulation of the skin that may make you more aware of how you’re moving a body part or slightly override some pain sensations.
Similar to magnets, kinesiotape is one of those recovery tools that simply requires you to use yourself as a N=1 test to see if you notice a difference. In my opinion, one of the handier uses of kinesiotape is for postural cuing for something like time trialing on a bicycle (see pictured right).
10. Foam Roller
As you learned in the chapter on mobility, deep-tissue massage and trigger-point therapy are the only true ways to remove knots from your muscles, and having a good foam roller handy keeps you from having to schedule a massage appointment after every workout. As you learned, if you stretch after a workout, it will only make knots in your muscles tighter (in the same way that if you tie a knot in a rubber band and pull both ends of the rubber band, the knot will only get tighter).
So save your stretching for after deep-tissue and mobility work with a foam roller (or lacrosse ball, tennis ball, golf ball, etc.), which will actually encourage release of the muscle knots. This means your idealy workout recovery order should ideally be: foam rolling to exercise, back to foam rolling, and finishing with stretching.
Or, if you're like me and don't have oodles of time to foam roll before and after a workout, you can just have 1 or 2 days during the week during which you make sweet love to a foam roller for 10-20 minutes. I recommend a very firm roller equipped with ridges that can dig into muscle tissue (and I am a big fan of the Rumble Roller for that).
11. Massage Stick
The problem with a foam roller is that it doesn’t fit too well into a carry-on, suitcase or even a gym bag. This is where portable deep-tissue massage devices such as the MuscleTrac, Myorope, Tiger Tail or other massage “stick” come in handy.
While it’s difficult to get as deep with these devices as you can when shoving your entire body weight over a foam roller, they can do the trick for body parts where you have can get good leverage with a stick, such as your calves, forearms, neck or hips. I also discuss these more comprehensively in the chapter on mobility, but only really use them when I'm traveling.
12. Electrostimulation (EMS)
You've already learned about EMS in the chapter on underground training methods, and while EMS devices such as the Compex Sport Elite, can be effectively used to build strength, they can also be used to keep a muscle fit when you are rehabbing from an injury – such as doing an electrostimulation strength set for your quads if you’ve injured your feet and can’t do lower body exercise, or for your pecs if you've injured your shoulders and can't press or do push-ups. EMS increase blood flow to the area of damaged muscle tissue. You simply place the electrodes over the area that need enhanced blood flow, and the electrical current causes a muscle contraction that results in heat and blood flow.
I've found that for any sore muscles, there is almost nothing that beats electostimulation combined with pressure, and ice. This icy e-stim treat is actually pretty simple to do. You just place the electrodes around the muscle area for which you want to control pain or speed healing, wrap an ice pack like FrozenPeaz around those electrodes, then flip the electrostimulation on for 20-30 minutes.
By the way, accuracy of electrode placement is crucial, so make sure you know your anatomy. Most EMS devices come with some kind of placement instructions.
13. Cold Laser
More common in Europe than in the States, but growing in popularity everywhere among physical therapists and alternative medical practitioners is low-level laser therapy (LLLT), also know as cold laser. This is a medical treatment that uses lasers or light-emitting diodes to reduce pain related to inflammation. It has been proven to be effective for tendinitis, arthritis, and both acute and chronic pain, and it can lower levels of pain producing chemicals such as prostaglandins and interleukin while decreasing oxidative stress from free radicals, bruises, swelling, and bleeding (10).
While a good cold laser device costs several thousand dollars and is typically only available at physical therapy or alternative medical clinics, you can achieve some benefit with a $100-500 home handheld “wand” that acts similarly – and you simply hold or move the wand slightly over the area of damaged tissue for 5-20 minutes.
I have one of these wands in my office and will occasionally use it when a muscle feels a little tight or constricted after a tough workout day, basically just “shining” it on a joint while I'm talking on the phone or teaching an online workshop. Companies such as Vetrolase.com and Coldlasertherapy.us make such devices. Just be careful not to shine the laser into your eyes (and it's probably not a good idea to expose your crotch to a laser either). Alternatively, you can achieve a similar warming and blood-flow effect through the use of infrared wraps or infrared saunas (see below).
14. Far Infrared
Far infrared light is comprised of radiant heat waves, very similar to the type of heat waves we get from direct sunlight, or from the cold laser therapy I described above. Radiant heat is simply a form of energy that heats objects directly through a process called conversion, without having to heat the air in between. Exposure of the body to infrared light sources has been shown to raise white blood cell count and enhance immunity, but can also heat tissue and increase blood flow to injured or recovering muscles (15).
In an infrared sauna, ceramic or metallic elements are used to emit energy that, unlike a regular sauna or steamroom, penetrates the skin and heats from the inside as well as on the outside of the skin. This helps the heat reach deeper tissues in the body. One drawback to most home infrared saunas is that they can produce a significant amount of potentially stress electromagnetic fields (EMF), which you'll learn more about in the lifestyle section of this book. So an alternative is a type of infrared sauna that uses infrared heat lamps. These actually produce “near infrared” energy, which penetrates the body even deeper than far infrared, without producing any detectable EMF.
Similar to cold laser, you can also easily find handheld infrared wands, but fancier infrared devices are becoming more common. For example, I personally know several athletes who swear by the use of sleeping or resting on a Far Infrared Mat, such as the Biomat. A Biomat mattress will set you back several thousand dollars, but beats the pants off a grounding or earthing mat, for reasons you'll learn about in just a moment.
Every night, I sleep with a PEMF device placed under my mattress, and I can take the same device and apply it to areas where tissue or bone needs enhanced healing. PEMF is definitely something you can feel almost immediately when you begin using it for anything from sleep enhancement to injury management.
PEMF uses electrical energy to direct a series of magnetic pulses through injured tissue, and each magnetic pulse induces a tiny electrical signal that stimulates cellular repair by upregulating a tissue repair protein called “heat shock protein” and also by increasing the uptake of oxygen and nutrients into tissue. Tons of studies have shown PEMF to be effective in healing soft-tissue wounds, lowering inflammation, decreasing pain and increasing range-of-motion (33). By stimulating ATP production through a process called myosin phosphorylation, PEMF can also decrease the amount of time it takes to replenish energy stores post-workout. PEMF may also accelerate bone growth repair, which can come in handy if you find yourself dealing with a stress fracture or recovering from a bike accident or fall.
There are several PEMF devices that are widely available for consumer use, and I personally use a small doughnut-shaped device called an Earthpulse. Similar to cold laser or far infrared wands, PEMF can simply be placed and held or moved slightly for 10-30 minutes over an area of damaged tissue or healing bone. Interestingly, the magnetic signal released by a PEMF device is very similar to that released by a “grounding” or “earthing” mat, which have been used for over a decade by professional cycling teams in the Tour de France to enhance both sleep and recovery. But unlike these mats, a PEMF device does not plug into the grounding outlet in your home – so it actually exposes you to less electrical “pollution” compared to a grounding or earthing mat (for more on the electrical pollution issue with grounding or earthing mats, listen to this podcast).
Hanging upside down like a bat may not seem like a stress-relieving or relaxing activity, but I personally hang from an inversion table in my garage for about 5-10 minutes several times per week, especially after a long bike ride or run, and the “drainage” effect is amazing. Heavy, swollen feet and legs almost instantly become lighter and less swollen – and the inversion effect even works nicely after a long day of standing workstation use. Inversion has been shown to assist with lymph fluid circulation, back pain, blood flow and circulation, and spinal or hip mis-alignment from high impact workouts (24).
If you don't want to purchase a new inversion table, you can usually find good deals on inversion tables on sites like eBay or Craigslist (usually sold by people who bought them as a cure-all and realized that hanging in a gravity-defying upside-down position is not quite as relaxing as they thought).
Of course, you don't have to have an inversion table to invert. For example, if you go for a long run, you can follow the simple rule of elevating your legs above your head by propping yourself up against a wall – and keep those legs elevated for at least 1 minute for every mile you've run. Another option would be any popular yoga inversion moves, such as plow pose, supported shoulder stand, supported head stand or, if you dare, the feathered peacock pose (Google it).
The Best Recovery Nutrition
While the majority of post-workout sports nutrition recommendations tell you to shove carbohydrates and protein down your gullet as soon as possible after you finish a workout (which has merit in some cases, as you'll learn in this book's section on nutrition), there is actually quite a bit of evidence that fasting can also have a recovery effect. In a study on cyclists, three weeks of overnight-fasted workouts increased post-workout recovery capability, while maintaining lean muscle mass, lower body fat and maintaining performance (11). Another study on endurance athletes suggested that fasted training may more quickly activate muscle protein translation, especially compared to athletes who had ate carbohydrates before training (36).
There is also benefits to fasting for weight training. A 2009 study found that subjects who lifted weights in a fasted state had a greater anabolic response to a post-workout meal (7). In this case, levels of p70s6 kinase, a muscle protein synthesis signaling mechanism that acts as indicator of muscle growth, doubled in the fasted vs. the fed group. Martin Berkhan, a big proponent of fasting and author at LeanGains.com, has a good take on the possible mechanism behind fasted training adaptations:
“Another way to think of it is that by providing nutrients to the body, exercise is experienced by the body as less of a stressor compared to fasted-state training. No need to adapt or compensate when all is provided for you. A similar phenomenon can be seen with antioxidant intake, where recent studies show that ingesting antioxidants from supplements weakens the body's own response to deal with free radicals created by training. We are making it easy for the body and that may be a suboptimal way to train.”
I personally use fasting in two ways:
1) a daily overnight fast of 13-15 hours, from 8-9pm-ish in the evening to 9-11am-ish in the morning, leaving me with a 9-11 hour daily “feeding window”;
A word of warning: I've found from my experience in wellness and nutrition consulting that for extremely lean individuals with low essential body fat stores, people prone to eating disorders, and women who deal with adrenal fatigue or hormonal imbalances, the risks and stresses of fasting outweigh any benefits.
18. Anti-Inflammatory Diet
It is especially important for injured or recovering athletes to avoid inflammatory foods. One huge pet peeve of mine is to see an athlete “pulling out all the stops” to fix a hip, knee, shoulder or low back injury, or fighting constant joint soreness – all while eating huge whole wheat bread sandwiches, drinking sugary sports drinks, and consuming multiple cups of coffee every morning.
The aforementioned foods can all aggravate inflammation, so trying to fix an injury without fixing your nutrition is synonymous to spraying a firehose full of water on a roaring fire on one side of your house, while dumping gasoline on the other side of your house.
So what can make a food inflammatory? There are at least two dozen factors that affect a food’s inflammatory potential, including the amounts and proportion of various fatty acids, the amount of antioxidants and other nutrients, and a food’s glycemic impact, or effect on blood sugar levels (32).
But when it comes to choosing anti-inflammatory foods, things are not exactly clearcut. Some foods have a combination of inflammation-producing and inflammation-reducing factors. An orange, for example, contains antioxidants that can fight inflammation, but also contains natural sugars that can have a mild inflammatory effect. Beef is another good example. A nice cut of steak contains mildly inflammatory saturated fats, but also has a high amount of anti-inflammatory monounsaturated fats.
A good way to cut through the confusion is InflammationFactor.com, an excellent website that actually gives an “Inflammation Factor” (IF) for food. The IF Rating system allows you to take a quick glance at whether a specific food is going an inflammatory or anti-inflammatory effect, and to determine the inflammatory potential of entire meals or recipes, you can simply total up the IF Ratings of the individual foods.
Some convenient anti-inflammatory foods include:
-Pineapple – pineapple is rich in a proteolytic enzyme called bromelain, which produces substances that help fight pain and inflammation.
-Blue, red and purple colored fruits and vegetables – all of which contain antioxidant flavonoids that limit inflammation, stop tissue breakdown, improve circulation and promote a strong collagen matrix. This includes pomegranates eggplant, berries or tart cherry juice.
-Ginger – two studies from the University of Georgia show that 2 grams of ginger per day helps fight inflammation and reduce exercise-induced muscle pain, and this can easily be consumed by boiling chunks of ginger, juicing ginger, or tossing ginger into a smoothie.
Other foods with very high IF ratings include garlic, peppers, parsley, dark leafy greens, onions, salmon, avocado and apple cider vinegar. There is a free Superhuman Food Pyramid on my website that is categorized into Eat, Moderate, and Avoid categories, and for a proper anti-inflammatory food intake, especially if you're injured or trying to optimize recovery, you'd only want to choose foods in the “Eat” category.
Back in the 1940s, during World War II, physicians began routinely giving their surgical patients 1000 mg of vitamin C daily for three days before surgery, followed by 100 mg of daily C during recovery. These docs reported in the British Journal of Surgery that failure of wounds to heal properly decreased by 76 percent, with a three to six-fold increase in wound strength (1).
Russian researchers have showed that surgical patients who supplement with Vitamin C are discharged from the hospital one to two days earlier, compared to individuals who receive no Vitamin C. This is because Vitamin C plays a critical role in collagen formation, and collagen is the primary component of connective tissue.
Vitamin C also works as an antioxidant to limit free-radical damage to tissues, and boosts the growth of fibroblast and chondrocyte cells, which produce connective tissue fibers and cartilage (6). I don't personally supplement with Vitamin C unless I'm injured, and instead simply get adequate daily doses from fruits, vegetables, and whole food antioxidant powders. If you are injured and want to use Vitamin C, do not use synthetic Vitamin C capsules (which can actually increase risk of brain stroke), but instead supplement with a whole foods Vitamin C source.
20. Proteolytic Enzymes
Proteolytic enzymes such as papain, bromelain, trypsin and chymotrypsin promote healing by supporting the production of cytokines, activating immune system proteins such as alpha-2-macroglobulins, breaking down fibrinogen and slowing the clotting mechanism (30). This is another strategy that (similar to vitamin C) can even help heal wounds faster or assist you with bouncing back more quickly from surgery.
My two favorite source of proteolytic enzymes are Wobenzymes or Recoverease. But just like Vitamin C, I really don't go out of my way to use anything other than natural food sources of proteolytic enzymes unless I'm injured or really beat up from a workout or race, and the best foods sources are pineapple, papaya and meat. If you do decide to use a supplement source of proteolytic enzymes, be sure to take them on an empty stomach, since consuming proteolytic enzymes with food simply causes them to digest the proteins in the food, rather than working to break down fibrinogen in your body.
21. Amino Acids
When used in daily doses (preferably during workouts) of 3-10 grams per hour, Branched Chain Amino Acids (BCAA’s) such as leucine, isoleucine and valine can significantly enhance performance, improve physiological markers such as red blood cell count, hemoglobin, hematocrit, serum albumin and fasting glucose, and also decrease inflammatory markers such as creatine phophokinase while enhancing restoration of muscle glycogen. You can easily find BCAA’s in capsule or powder format.
Because they are a more complete source of amino acids, and because they keep your body from “cannibalizing” your own lean muscle tissue during exercise, whole amino acids (also known as essental amino acids or EAA's) are a better option than BCAA's, but are relatively spendy, especially if you're popping them during or after every workout (4). So why are whole amino acids so much more expensive, and what’s the difference between them and other proteins? At the low end of the amino acid spectrum, you'll find whey and soy protein powder – and only 17% of their content is utilized by the body, with 83% leaving your body as nitrogen-based waste. Foods like meat, fish and poultry fare a bit better with 32% being absorbed and 68% being wasted. Eggs are the winners in the food stakes with 48% being utilized with 52% waste.
Compare those numbers to EAA's, which have a massive 99% utilization by the body, with only 1% leaving as waste. EAA's are also absorbed by the body within 23 minutes, compared to several hours for food or powder sources of whole protein (and, for any weight watchers, there is only 0.4 of a calorie per gram/tablet/capsule). The whole amino acids source that I use (and swear by) is Master Amino Pattern. It's completely legal to use EAA's in sporting events, and because they have a potent fatigue-fighting and recovery-enhancing effect, they're one of my top recommended supplements to use for both performance and recovery. I recommend 5-10 grams taken prior to a hard workout or race, and another 5 grams each hour during the event.
22. Fish Oil
While omega-6 fatty acids found in compounds such as vegetable oils and heated seeds, nut and nut butters can produce eicosanoids that are pro-inflammatory (especially when eaten in the quantity that many endurance athletes tend to eat these items), omega-3 fatty acids found in sources such as coldwater fish, algae and fish oil are anti-inflammatory (35)- which is why you'll find them ranked so highly on the InflammationFactor.com website.
Conventional fish oil supplements contain significantly more EPA than DHA (typically a 3:2 EPA:DHA ratio), but mounting research suggests that higher levels of DHA are optimal for recovery and anti-inflammatory, so you preferably need to look for a fish oil with something close to a 1:1 EPA:DHA ratio, and also ensure that it is in a natural trigylceride form and not the cheaper, less well-absorbed ethyl ester form. Preferably, a fish oil should also be packaged with antioxidants such as astaxanthin and Vitamin E to keep the fatty acids from becoming rancid (and to keep your fish oil from doing more harm than good to your joints).
I personally use 4-6 grams per day of a brand of fish oil called “SuperEssentials“, and other good brands include Pharmax, Barleans, Carlson's and Green Pastures.
23. Ferritin & Iron
Research at the Center for Sports Medicine in San Francisco examined 101 female high school runners over the course of a cross-country season, and found that the runners who were injured had average ferritin levels that were about 40% lower than those found in non-injured runners. The runners with the lowest ferritin concentrations had twice as many injuries as the runners with highest ferritin.
Shat the heck does all this have to do with iron?
Simply put, ferritin is your body’s critical iron storage protein.
The idea is that since iron is a key component of hemoglobin, the compound which carries oxygen to muscles and other tissues, it's possible that athletes with low ferritin have decreased oxygen delivery to tissues, become fatigued more easily during workouts and races, and then end up with exhausted muscles that are less able to stabilize and support the knees and ankles which were incidentally the two primary sites of injury in the study above (13).
Furthermore, research in the Medicine and Science in Sports and Exercise journal has suggested that low ferritin might also decrease the rate at which muscles and connective tissues are repaired, allowing minor injuries to mutate into major problems.
Since iron can be toxic, and high stores of iron are even associated with heart disease, I recommend testing both your ferritin and iron levels prior to actually supplementing. I'd also recommend looking into the use of a ferritin pyrophosphate supplement or Floradix (good, non-constipating source of iron boosting compounds) prior to dosing with an actual iron supplement. The two times in my life that I have tested ferritin and found it to be low, I've been able to turn things around by simply using Floradix for 1-2 months.
24. Glucosamine Chondroitin
You learned a bit about glucosamine and chondroitin in the chapter on mobility. Glucosamine is an sugar present in the protective exoskeleton of shellfish, and chondroitin sulfate is a major component of cartilage. Glucosamine and chondroitin are also natural substances produced by your body. Glucosamine stimulates cartilage production in your joints and chondroitin helps to attract water to the tissue, which helps your cartilage stay elastic. Chondroitin may also block the action of enzymes that break down cartilage tissue (34).
For this stuff to be effective at reducing joint pain, you need to look for a supplement that contains the “sulfate” form of glucosamine (glucosamine sulfate). The scientific evidence for this form is stronger than for supplements containing the glucosamine hydrochloride form. In addition, you need to use at least 1500mg of glucosamine sulfate per day, and you usually need to take it for three months or long to notice any improvement in stiffness, pain or mobility.
Myself and the athletes I coach have personally tried many different glucosamine-chondroitin blends and have settled on one called “Capraflex” to be most effective. It’s not an “everyday” supplement per se, but I recommend popping 8-12 capsules per day if you’re injured, or you need to nip nagging joint pain in the bud. In addition to glucosamine-chondroitin, it contains a cocktail of anti-oxidants and anti-inflammatories such as cherry juice, ginger, turmeric, white willow bark, feverfew, valerian, acerola cherry, and lemon powder. Of course, it should go without saying that if you’re vegan or have a shellfish allergy, this supplement wouldn’t be the smartest idea.
Curcumin is the principal compound you find in the popular Indian spice turmeric (which happens to be a member of the anti-inflammatory ginger family). It is a widely recognized herbal anti-inflammatory that has proven in studies to be as effective in reducing inflammation as injectable cortisone. Curcuminoids, which are extracted from turmeric, are the subparticles that make up curcumin, and have been found to be very powerful COX2 inhibitors – without damaging the gut in the same way as something like ibuprofen (18).
To enhance the anti-inflammatory effect, curcumin can be combined with boswellia, which is an herb that can also inhibit COX2 the body, but operates by a slightly different mechanism than curcuminoids. I highly recommend the supplement Phenocane as a quality source for the one-two combo of curcumin and boswellia. Phenocane works very well in conjunction with Capraflex and for that reason, this Injury Pack is my “go-to” pain management cocktail for an beat-up athlete.
You’ve probably heard of an Epsom salts bath for decreasing muscle soreness, enhancing relaxation, and displacing many of the calcium ions that can accumulate in muscle tissue during workouts. This is because Epsom salts deliver magnesium sulfate, which is the active compound that actually causes the effects listed above. However, concentrated magnesium chloride is even more effective than Epsom salts.
So why does pure magnesium work so well for recovery?
As you read this, you have about two ounces of magnesium circulating through your body – mostly in muscle and bone tissue. This mineral is essential for more than 300 reactions in your body, including nerve and cardiac function, muscle contraction and relaxation, protein formation, and perhaps most importantly for the exercising individual, synthesis of ATP-based energy (23). A magnesium deficiency can result in muscle cramping, excessive soreness, inadequate force production, disrupted recovery and sleep, immune system depression, and even potentially fatal heart arrhythmias during intense exercise.
Multiple studies have shown magnesium to be effective for buffering lactic acid, enhancing peak oxygen uptake and total work output, reducing heart rate and carbon dioxide production during hard exercise, and improving cardiovascular efficiency. In addition, supplementation with magnesium can elevate testosterone levels and muscle strength up to 30 percent.
While seeds, nuts, grains and vegetables are good dietary sources of magnesium, active people who include these foods in their diet can still be deficient in magnesium. This is due to a combination of mineral loss through perspiration and accelerated mineral turnover due to high activity levels.
Unfortunately, simply using an oral magnesium supplement may not fully replace this deficiency, as oral magnesium in the amount needed for an athlete is not easily absorbed and at high doses creates diarrhea. So while the use of oral magnesium (such as magnesium citrate powder) is certainly helpful from a supplementation standpoint, a far better way to deliver targeted doses of magnesium is through the use of topical (also known as transdermal) magnesium.
The delivery of drugs transdermally (through the skin) is a practice used in medicine to avoid the risk or inconvenience of intravenous therapy, to lower loss of absorption as a drug passes through the gastrointestinal tract, to lower metabolism of the drug by the liver, and to provide a more targeted application (such as a topical non-steroidal anti-inflammatory drug delivery via patch vs. swallowing a pill). This same practice can easily be used to deliver high doses of precisely targeted magnesium to your muscles pre or post-workout for enhancing performance and recovery. Since topical magnesium also bypasses digestion, higher doses of this key mineral can be delivered.
There are multiple ways to take advantage of transdermal magnesium delivery. For example, you’ve probably heard of an Epsom salts bath for decreasing muscle soreness. Epsom salts actually deliver magnesium sulfate, which can help with post-workout recovery. However, magnesium chloride is even more effective than Epsom salts, and you can actually dissolve one to three pounds of pure magnesium chloride flakes or crystals in a bath for an extremely relaxing and soreness relieving soak. A bath will deliver about 500mg of magnesium. Alternatively, after a long run or ride, you can soak your feet in a magnesium chloride footbath.
Topical magnesium chloride is available for use via a spray application (or via an even more potent and pampered lotion application), and I personally use 8-10 sprays or a large dab of magnesium lotion on my shoulders, arms and legs prior to a race or hard workout, and do the same post workout. In most cases, 10 sprays will deliver approximately 100mg of magnesium. You’ll want to make sure your skin is dry, and that you lightly rub in the magnesium after spraying. Some people may find that topical magnesium spray causes a tingling or slightly annoying burning sensation. This is normal, and usually subsides with use.
If you use sports massage therapy, you can give magnesium chloride spray or oil to your massage therapist for use during your session. A magnesium sports massage can assist with the body’s natural recovery process and speed up healing from a workout or injury, as well as help prevent future injuries from sore and stiff muscles. Finally, if you have a strain or sprain, topical magnesium can be used to improve circulation or decrease pain – simply spray the magnesium on a sore area and rub it in.
It’s important to keep track of exactly how much magnesium you’re taking in via a combination of oral and topical use, since anything above 500-1000mg can cause loose stool or gastrointestinal discomfort. So if you're using oral magnesium, make sure you're keeping track of total magnesium “exposure”, unless you want a lot of toilet time.
What About NSAIDs for Injury or Recovery?
So if you're injured or excessively sore, why not simply take non-steroidal anti-inflammatory drugs (NSAID’s), such as ibuprofen or advil?
Unfortunately, when you take a NSAID’s, you prevent your body from manufacturing prostaglandins, which are natural substances are involved in mechanisms such as protecting your stomach lining, regulating blood pressure, and calling in inflammation to an area that has been injured (which can result in pain, redness, swelling and discomfort as that natural inflammatory process takes place).
Because prostaglandins serve functions in addition to simply causing inflammation, NSAID’s can cause stomach upset or gastrointestinal bleeding, and while the risk of stomach irritation or bleeding certainly increases with long-term use of NSAID’s, many exercising individuals simply pop these pills every now and again – for example, to reduce post or pre-workout soreness, or to be able to “push through pain” to complete a competition.
Although studies published since 2005 have investigated the safety of NSAID’s before exercise, a recent entitled “Aggravation of Exercise-Induced Intestinal Injury by Ibuprofen in Athletes” was pretty upsetting (37). In this study, nine healthy and trained men were studied on 4 different occasions: 1) taking a standard dose of 400 mg ibuprofen twice prior to a bike workout. 2) cycling without the ibuprofen; 3) taking 400 mg ibuprofen twice at rest and finally 4) resting without ibuprofen intake.
In each case, researchers measured small intestinal damage through monitoring plasma intestinal fatty acid binding protein (I-FABP). They also measured urinary excretion of special sugar probes, which can determine the amount of gastrointestinal permeability – a sign that the gut is becoming “leaky”.
While both ibuprofen consumption and working out both resulted in increased I-FABP levels (reflecting small intestinal injury), levels were higher after cycling with ibuprofen than after cycling without ibuprofen. In addition, gut permeability (“leakiness”) also increased, especially after cycling with ibuprofen – which reflected a loss of gut barrier integrity. In addition, the amount of intestinal injury from ibuprofen and gut barrier dysfunction were extremely well correlated. Based on this study, it can be concluded that exercise slightly aggravates your small intestine, and ibuprofen turns this into a significantly risky issue.
I can’t sum it up any better than the researchers who concluded that “NSAID consumption by athletes is not harmless and should be discouraged”.
So what about the popular practice of taking NSAID's before a long event like an Ironman or a marathon to “mask the pain”?
It turns out this has also been researched.
One study found that taking 400 mg ibuprofen four hours before exercise reduced the sorness, but didn’t actually prevent muscle cell injury – which is concerning, since this means that the ibuprofen may mask pain, but at the same time, can lead to increased risk of injury as you push through muscle damage. In this study, researchers measured creatine kinase (CK), which is a protein that muscle cells release when they are injured (9).
Other studies have found that NSAID use during long events, such as a marathon or triathlon, actually decreases kidney function, which can lead to very dangerous issues during exercise, including a decreased ability to properly regulate your sodium and electrolyte status and your hydration levels (27). This becomes especially dangerous in the heat, in which there already a great amount of stress on the kidneys, and this extra stress may create a high risk of long term kidney damage or kidney failure. One of most eye-opening studies on ibuprofen use during exercise occurred in research performed during the Western States trail running race, which is a popular and grueling 100 mile race (38).
In this study, runners were split into three groups: a group with no ibuprofen intake, a group taking 600 mg of ibuprofen one day before and on race day, and a group taking 1200 mg of ibuprofen one day before and on race day (having a group that was actually taking more ibuprofen allows researchers to see if there is a “dose response”, meaning whether a more pronounced effect is seen if more ibuprofen is given). This study found that both of the ibuprofen groups have significantly higher levels of marks for severe muscle damage, including C-reactive protein, plasma cytokine and macrophage inflammatory protein, and this effect increased with higher amounts of ibuprofen intake.
Ironically, race time, post-workout soreness and rating of perceived exertion was not affected by taking ibuprofen – which means that A) ibuprofen did not help at all and B) ibuprofen caused significantly greater inflammation and muscle damage compared to not using them at all.
So as you can see, the use of NSAID's isn't really a case of “jury's out”.
Just don't use them. Period. With so many other healthy NSAID alternatives available, this seems to be a no-brainer.
In the previous chapter, “25 To Know With Laser-Like Accuracy If Your Body Is Truly Recovered And Ready To Train“, I gave you everything you need to know to be able to quantify how well a specific recovery technique is working for you. Many of those recovery tools are also self-biofeedback devices that train you to change your heart rhythm pattern to facilitate a state of coherence and enter “the zone.”
Take the emWave2, for example. When you use the emWave2 a few minutes a day, it can teach you how to transform feelings of anger, anxiety or frustration into peace and clarity. This may sound a bit airy-fairy, but it actually can work to control stress and enhance recovery, and since biofeedback has been shown in research to also lower cortisol levels, this can be a valuable recovery tracking and recovery enhancing tool. If you want to use biofeedback to track your recovery, I encourage you to go back and read the previous chapter, and get something like an emWave2, a Zensorium Tinke, or a Bioforce, Omegawave, or SweetBeat heart rate variability tracking system.
Of course, if you really need to take things to the next level from a biofeedback standpoint, you can try neurofeedback, which is also known as Brainwave Biofeedback, EEG Biofeedback, Neurobiofeedback or Neurotherapy. This is an extremely powerful, yet non-invasive method of strengthening and regulating the central nervous system, as well as mediating psychological and neurological stress. There are over 30 years of scientifically published research on neurofeedback, including controlled outcome studies demonstrating its effectiveness.
In a neurofeedback session, sensors (electrodes) are attached to your scalp, and then brainwaves are displayed on one computer which a neurofeedback practitioner monitors – while on a second computer the same brainwaves are displayed in an interactive “game ” format, similar to Pac-Man or Space Race. You then “play” the game by controlling your stress, thoughts and attention. This process serves to condition your brain and nervous system into a more relaxed way of functioning. Neurofeedback training is usually done two or three times weekly, with training time lasting 30 minutes.
For more information on neurofeedback, links to research, and a database of practitioners, I'd recommend you check out the website of my friend Nora Gedgaudas, who is a nutrition and brain expert, author, and neurofeedback practitioner.
What About Adrenal Fatigue?
As we near the wrap-up the top ways to enhance recovery, I need to point out that in the case of adrenal fatigue, there are some additional protocols that need to be considered.
For example, a very “beat up” triathlete recently showed me the results of his saliva testing for hormones.
Nearly all of his hormones were rock-bottom low. Even cortisol was low. Cortisol is the stress-release hormone we churn out when exercising and living, and when that drops low, it's a real warning sign that you're so beat up that your adrenal glands simply can't keep up with your extreme endurance lifestyle anymore. And when your body is so beat up that damage has gone way beyond simple muscle fiber tearing and joint impact and has progressed to hormonal depletion, then recovery becomes a much different story.
So in a situation of adrenal fatigue, what did I recommend to this triathlete to “take care of his body” and bounce back from overtraining and adrenal fatigue?
1. Eat a ton of lots of extremely nutrient dense foods. Some of my favorite nutrient dense foods (which you'll learn more about in the nutrition section of this book) include:
-Eggs, with the yolk
Conveniently, as you've probably guessed, many of these foods also have a high inflammation-factor rating.
2. Get rid of items that tend to aggravate the adrenal glands and make fatigue worse. This includes:
-Banana, dried figs, raisins, dates, oranges, grapefruit (high potassium fruits).
-Fruit and juice in the morning.
-Refined flour products such as pasta,white rice, bread, pastry and baked goods.
-High amounts of fructose from honey, syrups, and soft drinks, as well as dried fruits and concentrated fruit juice.
-Adrenal stimulants such as coffee,tea,black tea,hot chocolate, alcohol, colas, and chocolates.
-Heated oils and fats, especially vegetable oils.
-Rushed and hectic meals.
3. No caloric depletion, fasted workouts or intermittent fasting and going “hungry” during workouts. Instead, eat a big breakfast with lots of proteins and fats, and keep your energy levels topped off during the day. Definitely don't try to lose weight or control body fat, which can be stressful to your body during a state of overtraining or adrenal fatigue.
4. Do 2-4 weeks of easy, aerobic workouts only (no hard intervals or “monster training sessions), along with some kind of yoga, meditation, or very relaxing movement each morning. Basically, you need to do deload weeks until you're fully recovered (unless you really dig yourself into an under-recovery, overtraining hole, in which case you may need to “deload” for months, and sometimes over a year).
5. Consider using the following adrenal supporting supplements:
-High dose vitamin D/K complex 35IU/Vitamin D per pound of body weight and huge amounts of morning sun exposure to ensure that you produce the necessary building blocks to restore hormones.
-2,000 to 5,000 milligrams of a whole foods Vitamin C source each day (or basically, as much vitamin C as you can take until you get lose bowels). Your adrenal glands are one of the #1 storage sources of Vitamin C in your body, and to become severely depleted in Vitamin C in a case of adrenal fatigue.
-4-6g per day of a good fish oil that contains vitamin E with mixed tocopherols (I recommend SuperEssentials) to reduce inflammation and restore the health of the nervous system.
-A B-complex supplement that is high in B6 and pantothenic acid, both of which tend to be severely depleted during adrenal fatigue (I recommend Lifeshotz for this).
–Red ginseng at approximately 6g/day, which stimulates the body to begin producing cortisol again.
–Licorice root extract at 200-400 mg, which reduces the half-life of cortisol and allows it to be broken down at a slower rate by the body.
All of these methods can help tremendously with adrenal fatigue, but in truth, fully recovering from adrenal fatigue typically requires very careful and precise attention to recovery status, heart rate variability, hormones and inflammatory markers, and if you are overtrained or adrenally fatigued, I would highly recommend you be especially cautious trying to completely manage this condition yourself. Most athletes attempting to recover from adrenal fatigue get much better results working with a coach, wellness consultant or medical practitioner to help dig themselves out of an overtraining hole.
If simultaneously implementing all these recovery tools seems overboard (or insane) to you, then you're right.
After all, you don’t necessarily need to do everything that I just described if all you’ve done is enjoy a nice easy Saturday morning bike ride, or even a “typical” week of training. But if you find yourself injured with an important race around the corner, or really beat up from a tough series of workouts, or at a training camp, or doing a big “deload” week, you may actually want to consider pulling out as many stops as possible, and truly geeking out on recovery so that your body is 100% repaired.
However, perhaps your head is spinning about exactly how to take all this information about vibration, electricity, lasers and proteo-what'd-he-say-again? and actually apply it into your own personal recovery plan without feeling as though you're either…
A) spending all your precious time fretting over repairing your body and not enjoying training, or;
B) exposing your body to a constant state of under-recovery.
In other words, what would a typical recovery day, week or month look like if you were uninjured and just trying to maximize the results of your training? Or injured and trying to heal your body and bounce back as fast as possible? Or overtrained and in a state of adrenal fatigue? Or in those last few precious weeks leading up to a race? Or in the throes of healing your body from something like an Ironman or a marathon?
Programming these recovery techniques properly can take some serious forethought and scientific application, and the good news is that in the final version of this book, I'll be walking you through exactly how to design and implement your own personal recovery plan based on what you've just learned – in the same way that I'm including full training plans based on the underground training techniques you learned about in earlier chapters.
In other words, if you're concerned about how to string all this training and recovery material together into a viable and effective program that doesn't leave you gasping for air during a race because you spent too much time hanging from an inversion table or electrocuting yourself, then don't worry – I will be including that information for you in the beautiful, hard copy, final edition of this book, as well as in the Kindle version.
In the meantime, leave your questions, comments and feedback about how to recover from your workouts below, and feel free to also leave your writing criticisms as edits, as I realize this was a monster chapter that could be prone to some of my notorious editing issues. And of course, thanks for reading and giving your body the knowledge it needs to get better every day.
Links To Previous Chapters of “Beyond Training: Mastering Endurance, Health & Life”
Part 1 – Introduction
-Preface: Are Endurance Sports Unhealthy?
Part 2 – Training
–Chapter 4: Underground Training Tactics For Enhancing Endurance – Part 1
–Chapter 4: Underground Training Tactics For Enhancing Endurance – Part 2
–Chapter 5: The 5 Essential Elements of An Endurance Training Program That Most Athletes Neglect – Part 1: Strength
–Chapter 5: The 5 Essential Elements of An Endurance Training Program That Most Athletes Neglect – Part 2: Power & Speed
–Chapter 5: The 5 Essential Elements of An Endurance Training Program That Most Athletes Neglect – Part 3: Mobility
–Chapter 5: The 5 Essential Elements of An Endurance Training Program That Most Athletes Neglect – Part 4: Balance
Part 3 – Recovery
1. Antoon AY, Donovan DK. Burn Injuries. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Textbook of Pediatrics. Philadelphia, Pa: W.B. Saunders Company; 2000:287-294.
2. Bleakley, C. (2004). The use of ice in the treatment of acute soft-tissue injury. The American Journal of Sports Medicine, 32(1), 251-61.
3. Briem, K. (2011). Effects of kinesio tape compared with nonelastic sports tape and the untaped ankle during a sudden inversion perturbation in male athletes. Journal of Orthopaedic and Sports Physical Therapy, 41(5), 328-37.
4. Brooks, G. (1987). Amino acid and protein metabolism during exercise and recovery. Med Sci Sports Exerc, 19(5), 150-6.
5. Collins, N. (2008). Is ice right? does cryotherapy improve outcome for acute soft tissue injury?. Emergency Medical Journal, 25(2), 65-8.
6. Cook NR, Albert CM, Gaziano JM, Zaharris E, MacFadyen J, Danielson E, Buring JE, Manson JE. A randomized factorial trial of vitamins C and E and beta carotene in the secondary prevention of cardiovascular events in women: results from the Women's Antioxidant Cardiovascular Study. Arch Intern Med. 2007;167(15):1610-8.
7. Deldicque, L. (2012). Increased p70s6k phosphorylation during intake of a protein–carbohydrate drink following resistance exercise in the fasted state. European Journal of Applied Physiology, 108(4), 791-800.
8. Diong, J. (2013). Cold water immersion (cryotherapy) for preventing muscle soreness after exercise. British Journal of Sports Medicine, April(25), [EPub]
9. Donnelly, A. (1990). Effects of ibuprofen on exercise-induced muscle soreness and indices of muscle damage. Br J Sports Med, 24(3), 191-5.
10. Dorit Avni, Sara Levkovitz, Lidya Maltz, and Uri Oron. Photomedicine and Laser Surgery. June 2005, 23(3): 273-277.
11. Ferguson, L. (2009). Effects of caloric restriction and overnight fasting on cycling endurance performance. Journal of Strength and Conditioning Research, 23(2), 560-70.
12. Furlan, A. (2008). Acupuncture and dry-needling for low back pain. The Cochran Collaboration, (4), 1-137.
13. Gleeson, M. (2013). Nutritional support to maintain proper immune status during intense training. Nestle Nutr Inst Workshop Ser., (75), 85-97.
14. Hackett GS. Ligament and tendon relaxation treated by prolotherapy, 3rd ed. Springfield, Ill: Charles C. Thomas, 1958
15. Hausswirth, C. (2011). Effects of whole-body cryotherapy vs. far-infrared vs. passive modalities on recovery from exercise-induced muscle damage in highly-trained runners . PLoS ONE, 6(12), e27749.
16. Huntsman, H. (2013). Mesenchymal stem cells contribute to vascular growth in skeletal muscle in response to eccentric exercise. American Journal of Physiology, 304(1), H72-81.
17. Kim, S. (2012). Comparison of 2 methods of non-invasive treatment between transcutaneous electrical stimulation and pulsed electromagnetic field stimulation as replacement of invasive manual acupuncture. Acupuncture and electro-theraputics research, 37(4), 247-61.
18. Lee, Y. (2013). Antinociceptive curcuminoid, kms4034, effects on inflammatory and neuropathic pain likely via modulating trpv1 in mice. Br J Anaesth., May(29),
19. Lin, Z. (2009). Effects of acupuncture stimulation on recovery ability of male elite basketball athletes. The American Journal of Chinese Medicine, 37(3), 471-81.
20. McKay, J. (2006). The effects of magnetic field exposure on blood flow and blood vessels in the microvasculature. Bioelectromagnetics, 28(2), 81-98.
21. McMaster, W. (1980). Cryotherapy influence on posttraumatic limb edema. Clinical and Orthopedic Related Research, Jul-Aug(150), 283-7.
22. Meeusen, R. (1986). The use of cryotherapy in sports injuries. Sports Medicine, 3(6), 398-414.
23. Nielsen, F. (2006). Update on the relationship between magnesium and exercise. Magnes Res., 19(3), 180-9.
24. Nosse, L: Inverted Spinal Traction. Arch Phys Med Rehab 59: 367-370, Aug 78
25. Perini, R. (2003). Heart rate variability and autonomic activity at rest and during exercise in various physiological conditions. European Journal of Applied Physiology , 90(3-4), 317-325.
26. Prisby, R. (2008). Effects of whole body vibration on the skeleton and other organ systems in man and animal models: What we know and what we need to know. Ageing Research Reviews, 7(4), 319-29.
27. Rahnama, N. (2005). The isolated and combined effects of selected physical activity and ibuprofen on delayed-onset muscle soreness. The Journal Of Sports Science, 23(8), 843-50.
28. Schwartz, R. (1991). Prolotherapy: A literature review and retrospective study. The Journal of Neurological and Orthopadic Medicine and Surgery,, 12(3)
29. Sear, J. (2010). The effects of whole-body compression garments on prolonged high-intensity intermittent exercise. Journal of Strength and Conditioning Research, 24(7), 1901-1910.
30. Sinclair, R. (1994). Types of chronic wounds: Indications for enzymatic débridement. (1st ed., pp. 7-21). Springer Berlin Heidelberg. Retrieved from http://link.springer.com/chapter/10.1007/978-3-642-78891-8_2
31. Smith, T. (1993). New skeletal muscle model for the longitudinal study of alterations in microcirculation following contusion and cryotherapy. Microsurgery, 14(8), 487-93.
32. Spano, M. (2012, November 23). Anti-inflammatory foods help you recover faster. Retrieved from http://www.bodybuilding.com/fun/how-anti-inflammatory-foods-helps-you-recover-faster.html
33. Tabrah, F. (1998). Clinical report on long-term bone density after short-term emf application. Bioelectromagnetics, 19(2), 75-78.
34. Taniguchi, S. (2012). Long-term oral administration of glucosamine or chondroitin sulfate reduces destruction of cartilage and up-regulation of mmp-3 mrna in a model of spontaneous osteoarthritis in hartley guinea pigs. J Orthop Res., 30(5), 673-8.
35. Tomasdottir, V. (2013). Dietary fish oil reduces the acute inflammatory response and enhances resolution of antigen-induced peritonitis. J Nutr Biochem., S0955-2863(13), 76.
36. Van Proeyen, K. (2011). Training in the fasted state facilitates re-activation of eef2 activity during recovery from endurance exercise. European Journal of Applied Physiology, 111(7), 1297-1305 .
37. Van Wijck, K. (2012). Aggravation of exercise-induced intestinal injury by ibuprofen in athletes. Med Sci Sports Exerc., 44(12), 2257-62.
38. Wharam, P. (2006). Nsaid use increases the risk of developing hyponatremia during an ironman triathlon. Med Sci Sports Exerc., 38(4), 618-22.
39. Zheng, L. (2009, April). Acupuncture and adrenal gland functions. Retrieved from http://www.acupuncture.com/newsletters/m_apr10/acupuncture adrenal glands.htm
40. Zhou L, et al. Macrophages recruited via CCR2 produce insulin-like growth factor-1 to repair acute skeletal muscle injury. Federation of American Societies for Experimental Biology, Nov 2010.