Posts in Sports Performance
Does Foam Rolling Need to Be Painful To Be Effective?
foam-rolling-treatment-pain

Foam rolling has become a popular exercise intervention used to improve sports performance, accelerate recovery from workouts and training, and decrease muscle pain and tightness. Previous research has utilized 2-3 bouts of 60 seconds along major muscle groups in the lower body including the quadriceps, hamstrings, and calves. One component of the exercise prescription which has not been studied included intensity of the foam rolling. Is more better? Does it have to hurt to work? A new study asked these questions.

Grabow and colleagues in the Journal of Strength and Conditioning Research studied the effects of foam rolling intensity on range of motion, strength, and performance (2018). 16 healthy participants completed 3 different foam rolling prescriptions (low intensity (3/10 pain scale), moderate intensity (6/10 pain scale), and high intensity (8/10 pain scale)) with each exercise condition was performed 3 times for 60 seconds. Authors found significant increased of active and passive range of motion after each exercise condition, but these changes were independent of the intensity utilized. Thus, foam rolling does not need to be painful to be effective.

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Do Compression Socks Help With Muscle Recovery?
compression-socks-recovery-soreness

Athletes have always sought remedies and treatments which accelerate their recovery from workouts. Optimal recovery allows for higher training intensities and in turn better performances during their sport of choice. Delayed onset muscle soreness (DOMS) is one of the most common reasons athletes struggle to reach a desired training intensity during a subsequent workout. Successful treatment approaches to reduce DOMS include a post workout cool down, nutrition, hydration, and foam rolling, but more recent attention has been focused on compression garments. These garments including leggings and socks are designed to optimize circulation across exercised muscles. Previous research has found no association between wearing a compression garments and improved performance, but there may be an effect on muscle soreness and recovery.

Heiss and colleagues examined the impact of compression socks on muscle performance, flexibility, circulatory markers, and recovery (JOSPT. 2018). Authors studied healthy young adults as they performed an exercise protocol designed to induce DOMS. Participants performed eccentric calf lowering using a weighted vest (25% of body weight) on an incline plane. They performed 5 sets of 30 reps with 10 seconds of rest between sets. After the exercise session, each participant immediately donned a compression sock on 1 randomized leg and wore the garment for 60 hours after the exercise session while the bare leg served as the control. Authors assessed muscle perfusion using contrast ultrasound and a MRI to assess muscular injury associated with DOMS. No effect of compression socks were found on circulation, flexibility, muscle soreness, calf circumference, or muscular injury. In contrast, authors did find a change in muscle stiffness between the legs depending on sock use.

This study supports our current understanding regarding compression socks. These garments remain an personal choice, but performance and recovery benefits remain inconclusive.

Updates on the Successful Management of Tendon Pain
Photo Credit: Scott, A. CMAJ. 2011. Mead, M. Transl Sports Med. 2018.

Photo Credit: Scott, A. CMAJ. 2011. Mead, M. Transl Sports Med. 2018.

Tendon injuries have previously been diagnosed as tendonitis and were believed to be marked by an inflammatory process in the tissue.  Our current knowledge on these injuries has been improved by a better understanding of the disease process behind tendon pain.  Current research indicates tendon pain (tendinopathies) is caused by an ingrowth of nerve and blood vessels to the injured area of the tendon leading to increased sensitivity with loading.  Further, as our body begins to heal the injured area of the tissue, tendon cells become more disorganized in nature.  Conversely, healthy tendons display high degrees of organization with tendon fibers aligned in parallel along the lines of healthy stress.  Gradual loading of the tendon through exercise promotes remodeling of the injured tissue.  In short, both under and over loading tendons lengthens the recovery process.  

A summary article on the available evidence behind tendon treatments was published in a sports medicine journal recently (Mead, M et al. Transl Sports Med. 2018).  The authors reported on a general trend against the use of injections for tendon pain.  This includes corticosteroid injections which may provide short term relief, but at the risk of further tendon injury or rupture.  Further, the research does not support the use of injections including prolotherapy or PRP at this time.  Conversely, the authors reported Physical Therapy including the use of loaded exercises, including eccentric exercise, should be considered a first line treatment for tendon pain and injury.  

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Hip Thrust Superior to Deadlift for Gluteus Maximus Recruitment
photo credit: J Strength Conditioning Research

photo credit: J Strength Conditioning Research

The gluteus maximus is an essential muscle for daily and recreational activities, but is often found to be weak among patients with musculoskeletal pain.   In our Boulder Physical Therapy practice we frequently find hip weakness among patients with low back, hip, knee, and ankle pain.  Improving gluteus maximus strength improves movement patterns, dynamic alignment, and tolerance for daily or sport activities.  Bridging and deadlifts are commonly utilized exercises designed to train the gluteus maximus, but new research highlights the value of a less utilized exercise.

Andersen and colleagues analyzed the muscle performance of trained weight lifters during three exercises: the hip thrust, deadlift, and hex bar deadlift.  The authors reported the best recruitment of the outer hamstring during the straight bar deadlift, but no differences were noted for the lumbar paraspinals.  Surprisingly, the best gluteus maximus recruitment was found during the hip thrust compared to either the straight or hex bar deadlift.  

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Two Week Block of Sprint Training Improves Distance Running Performance
boulder-sprinting-running-training

The least injured and best performing runners training programs include both strength and sprint training.  These complementary training programs reduce injury risk and improve running performance among trained distance runners.  These programs target a different energy system in the body and have been shown to improve time to exhaustion, running time, and running efficiency compared to runners who do not  utilize strength and sprint training.  A recent study shows even a 2 week block of sprint training can improve distance running times.

Koral and colleagues studied the impact of a 2 week sprint training program on running performance among trained trail runners (J Strength Cond Res. 2018).  Runners were placed through 4-7 bouts of 30 second maximum sprints three times a week for 2 weeks.  Authors tested each runner's performance both before and after the sprint training.  The authors noted improved distance running times, time to exhaustion, peak and mean power after the sprint training block.  This study highlights the value of a short, 2 week, sprint training program on distance running performance. 

Will Cold Water Immersion or an Ice Bath help my recovery?
boulder-physical-therapy

When I first started seeing athletes in the early 2000s we often placed athletes in cold baths in an attempt to both reduce post workout soreness and facilitate recovery.  Since this time we have moved toward more active recovery strategies including aerobic exercise, corrective exercise, static stretching, and foam rolling.  A new study examined the impact of cold water immersion on an athlete's recovery.

Anderson and colleagues placed athletes through 45 minutes of intermittent run training and then provided one of three 12 minute recovery methods: 14 degree C, 5 degree C, or a seated control group (J Strength Conditioning Research, 2018).  The athletes were assessed immediately after exercise through 3 days post exercise.  Peak power output measured on a cycle ergometer was improved in the 5 degree vs. 14 degree or control group 24 hours after exercise.  Conversely, both the control and 5 degree were more effective than the 14 degree C immersion at 48 and 72 hours.  Mean power output on the cycle ergometer was higher in the control vs. either cold water immersion group.  No changes were noted in either lactate or creatine kinase levels.  The authors concluded repeated bouts of exercise are initially impaired following cold water immersion and the treatments should not be used for acute recovery.  Athletes are encourage to choose more active recovery methods. 

No penguins were injured in the writing of this post