Steve Ingham - Recovery and adaptation

Recovery and adaptation

Dr Steve InghamHead of Physiology, English Institute of Sport, UK

Centres at 250 staff– Loughborough University

– Sportscity, Manchester,

– Sheffield,

– Medicine

– Physiotherapy

– Strength & Conditioning

4000 hours– Gateshead,

– Bisham Abbey,

– Bath University,

– Physiology

– Performance Analysis

– Biomechanics

hours of

– Alexander Stadium/Lilleshall,

– London (Twickenham, Brunel University, Lee Valley)

– Nutrition

– Psychology

– Performance Lifestyle

support per

– Milton KeynesPerformance Lifestyle per

week

83%88% 95%83%88% 95%

84%84%

84%84%

91%

“Are you going to make y g gme go faster?”

“Just tell me if IJust tell me if I am talking crap”

“D ’t i th hi h j !”“Don’t ruin the high-jump!”

Training categorisationTraining categorisation

2009

Blood Lactate VO2 Heart Rate

160

200

6

7

8

9

b/m

in)

e (mM)

ke (l/min)

RaceVO2LT2

80

120

3

4

5

6

eart rate (b

ood lactat

ygen uptak

Pace2

max

0

40

0

1

2

3

HeBl

Oxy

00

14 15 16 17 18 19 20 21 22 23

Running speed (km/hr)

80

90

%)

70

80

volume (%

50

60

training v

30

40

n of total

20

30

Proportio

Sub‐LT2 LT2‐VO2max VO2max‐Race Pace +0

10

P

Sub LT2 LT2 VO2max VO2max Race Pace +

Cycling 70 20 10

Swimming 77 16.4 6.6

Canoeing 60 30 10

hlAthletics 50.7 29.6 19.7

Training category

What are the ‘stresses’ in running?What are the stresses in running?

*my notes only

Comparison between sports of rowing and athletics

315

Injury

Over‐training'

7382

4

0

2

15-17

Forces through single limb onForces through single limb on ground contact x body mass

7-9

3-6

3-52-4

Source: Dr Paul Brice, Biomechanist, English Institute of Sport

Eccentric load• Concentric

(contraction) and eccentric (lengthening ( g gaction)

• ->Eccentric phase involves fewer muscle fib f i ffibres for a given force

• ->Strain on contractile and structural components of thecomponents of the muscle

• ->Micro-trauma

The issues in athletics/runningThe issues in athletics/running

• Key observations

– ‘Over‐training’ cases are rareg

– Problems with injury/tolerance of mechanical loading (soreness) are highloading (soreness) are high

– Use of recovery treatments is high

/ ‘ h d’– 16/27 are ‘attached’ to recovery treatment

– Role of other support disciplines!

Thoughts on adaptationThoughts on adaptation

Some distinctions to be madeSome distinctions to be made

1 Training response vs injury1. Training response vs injury2. Maximum adaptation vs maximum

t i i l dtraining load3. Training vs competition

How do you get fit?How do you get fit?

TrainMechanical (inc neural)/ Mechanical (inc neural)/ mmetabolic stimulusetabolic stimulus

Hormonal, immune Hormonal, immune

Adapt Eat/DrinkBlood flow/ Blood flow/ NutrientsNutrients

,,rresponse esponse

inflammation inflammation breakdownbreakdownp NutrientsNutrients breakdownbreakdown

gene gene transcription transcription growthgrowth

RestNo further No further ttRest stressstress

Jean Baptiste LamarkJean Baptiste Lamark

Fi L I i l hi h h d h li iFirst Law: In every animal which has not passed the limitof its development, a more frequent and continuous useof any organ gradually strengthens develops andof any organ gradually strengthens, develops andenlarges that organ, and gives it a power proportional tothe length of time it has been so used; while thepermanent disuse of any organ imperceptibly weakensand deteriorates it, and progressively diminishes itsf ti l it til it fi ll di “functional capacity, until it finally disappears“.

Stress/Adaptation

+ve

nce

+rf

orm

ave

Pe

Time (hours, days)

-v

Time (hours, days)

R t d b t ff tRepeated bout effect

» Presenting the same stimulus to the body again

ce

+

ve

stimulus to the body again » Reduced disturbance in

homeostasis

Per

form

anc

» BUT will probably result in smaller adaptive response

-ve

P

Time (hours days)Time (hours, days)

untrained vs traineduntrained vs. trained

xpre

ssio

n

xpre

ssio

n

Gen

e E

x

Gen

e E

x

FlueckM. (2010) Myocellular limitations of human performance and their modification through genome‐dependent responses at altitude. Exp Physiol. 95(3):451‐62

Diminishing returnsDiminishing returns

Perry et al (2010). Repeated transient mRNA bursts precede increases in transcriptional and mitochondrial proteins during training in human skeletal muscle. J Physiol. 1;588 4795‐810

Strength changes vs stimulusStrength changes vs stimulus

90

100*

nce

+ve

70

80

90

N.m

)

Per

form

an

50

60

70

MVC (

WARM

-ve

40

50

Pre Day 1 Day 2 Day 3 Day 4 Day 7

WARM

CON

Time (hours, days)Time

Ingham et al (2010) Effect of a concentric warm-up exercise on eccentrically induced soreness and loss of function of the elbow flexor muscles. J Sports Sci. 2010 Nov;28(13):1377-82.

Recovery treatmentsRecovery treatments

Progress?Progress?

2002‐5 2012

Ice bathsC t l CWI Ice baths6

8

ss (1‐10) Control CWI

2

4

ved sorenes

0

Pre 0 1 24 48 168Perceiv

3 5

2.5

3

3.5

Nm.kg‐1)

10 15° C1.5

2

tric force (

10-15° C water 10-15 mins

1

Pre 24 48 168Isomet

Time (hours)

Bailey et al, 2007 Influence of cold-water immersion on indices of muscle damage following prolonged intermittent shuttle running. J Sports Sci.Sep;25(11):1163-70.

Magnetic Resonance Imaging12 sets of 5 repetitions – plantar flexionp pT2 relaxation time as marker of intra muscular water

Control

Cold water immersion 15 mins at 5 degCold water immersion 15 mins at 5 deg

Yanagisawa et al (2003) Evaluations of cooling exercised muscle with MR imaging and 31P MR spectroscopy. Med Sci Sports Exerc. 2003 Sep;35(9):1517-23.

Meta analysis of CWIMeta‐analysis of CWI

CWI has a moderate effect in alleviating CWI has a moderate effect in alleviating soreness from exercise in generalsoreness from exercise in general

CWI;CWI;

CK effluxCK efflux ‐‐ reducedreducedCWI is highly effective in alleviating CWI is highly effective in alleviating soreness after high intensity exercise soreness after high intensity exercise

CK efflux CK efflux ‐‐ reducedreducedMuscle strength Muscle strength –– little effectlittle effectMuscle power Muscle power –– helps recovery helps recovery

Soreness

Leeder et al (2011) Cold water immersion and recovery from strenuous exercise: a meta-analysis. Br J Sports Med. 22

“Ice-baths help me to run the day after a hard session”

Do workout

hFeel sore

Recovery therapy must work

Unable to complete next

session

Able to complete next workout

Do next workoutFeel less sore

Use recovery therapy

Long term adaptation?g p

14

16

(%)

Cooled Control

†

†

8

10

12

e ch

ang

e †

†

2

4

6

erce

nta

ge

-2

0

2Pe

-4

Perfomance trial VO2max VT Femoral artery diameterdiameter

Test parameter

Yamane et al., 2006 Post-exercise leg and forearm flexor muscle cooling in humans attenuates endurance and resistance training effects on muscle performance and on circulatory adaptation. Eur J Appl Physiol. 2006 Mar;96(5):572-80. Epub 2005 Dec 22.

IbuprofenIbuprofenMaximal over‐the‐counter

dMeasured skeletal muscle

i h i 24hdose

• (IBU 1200mg.day, ACET (4000mg day)

protein synthesis 24hours after damaging exercise via ‘Fractional Synthesis Rate(4000mg.day)

• Double‐blind placebo controlled

Fractional Synthesis Rate (FSR).

controlled

• 10‐14 sets of 10 eccentric reps at 120% of concentricreps at 120% of concentric max of knee extensors

Blocking COX‐2 pathway, reduces inflammation and

soreness.

Trappe et al.,m (2002) Effect of ibuprofen and acetaminophen on postexercise muscle protein synthesis. Am J Physiol Endocrinol Metab. 2002 Mar;282(3):E551-6.

Repeated sprint performance pre-post recovery and 3 week gain

10 24h post training relative to pre-training ControlSkinz

% gain on repeat sprints (mean)

6

8 ColdD25mgD50mg

a a

2

4 b a a a a a a a

2

0

-4

-2

Week 1 Week 2 Week 3 % gains from 3Week training

-6 block

By week 2 only cold and D50mg (x2By week 2 only cold and D50mg (x2 p.dp.d) were) wereAt the end of a short training block cold and

a: p<0.05; b: p<0.1

By week 2 only cold and D50mg (x2 By week 2 only cold and D50mg (x2 p.dp.d) were) wereHaving significant recovery effectsHaving significant recovery effects

training block cold andD50mg lessened gains

Data courtesy of Christian Cook

“Ice-baths help me to run the day after a hard session”

“Am I just doing more training to get the same

effect”

Do workout

h

Do workout specific to individual needs

Feel soreRecovery therapy

must work Feel soreFeel less sore

Unable to complete next

session

Able to complete next workout

Unable to completnext session

Do next workout

Do next workoutFeel less sore Adjust expectations for training

Use recovery therapy

Adjust next sessionfor training

following hard sessions

Periodising recovery treatments

Adaptation more important, recovery less important i id / ti l h–i.e. mid season/national champs

• Active recovery

• Contrast bathing

Yes

Yesg

• Deep water exercise

• Compression garments

Yes

× No (may impair adaptation)

• Ice baths

• NSAID

• Massage



For other reasons• Massage

• Stretching

- For other reasons

- For other reasons

Recovery more important adaptation lessRecovery more important, adaptation less important –i.e. World Champs, later races

• Active recovery YesActive recovery

• Contrast bathing

• Deep water exercise

es

Yes

Yes

• Compression garments

• Ice baths

NSAID

Yes

Yes

× No unless medical• NSAID

• Massage

• Stretching

× No unless medical

- For other reasons

- For other reasonsStretching

Finish race What? Why

Recovery Plan

After your transitionthrough media and within 5 i

Recovery drink, e.g. REGO 100g with 750 ml of water

Rapid replenishment of muscle fuel stores Enhanced muscle recovery andmins Enhanced muscle recovery and repairEnhanced hormonal profile and immune function

Sort your self out then go Active recovery walk of 10 Improved metabolic clearancey gstraight for a …

ymins Enhanced immune response

Improved readiness for the next session

OPTIONAL depending upon Massage or treatment Depends upon planOPTIONAL depending upon your therapy plan (needs to be consistent with previous competitions)

Massage or treatment Depends upon plan

Then either Contrast bathing Contrast bathing/showers; 15 mins (3 mins warm; 1 min cold x 5) finish on cold,

Improved metabolic clearanceReduced inflammatory response

OR Ice bath, 10 mins at 10°C water

Reduced muscle damageReduced soreness

Before you leave the warm‐ Compression socks on Improved blood flow preventing pooling in lower limbsup track… pooling in lower limbsReduced soreness and damage

If you have time when you get back to your room…

Elevate legs for 20 to 30 mins

Reduced blood poolingReduced inflammation

Is it better to Is it better to warm down warm down or sit down?or sit down?

1204

6

8

10

12

14

16

tag

e ch

ang

e (%

) Control

Cooled

100

max) -4

-2

0

2

4

Perfomance t i l

VO2max VT Femoral t

Per

cen

t

60

80

te (% of m

Passive

trial artery diameterTest parameter

40

ood lactat Massage

Run

Bike

20

Blo e

0

5 10 15 20 25 30

Time post (min)

Post‐exercise response to interval or all‐out

0 s

0 s

0 s

0 s

p

30

4 mins

4 mins

4 mins

30

30

30

3 fold

svs

120vs

8Pre Post

5

A.U.)

Pre Post

4

6

1 α

mRNA

2

3

4

RNA / RP2 (A

0

2PGC1

0

1

2

VEG

F mR

Int Cont Int Cont

Taylor et al., (current study ). Interval and all‐out continuous exercise activates PGC1 a and VEGF signaling in trained athletes

Gibala, et al (2009). Brief intense interval exercise activates AMPK and p38 MAPK signaling and increases the expression of PGC‐1a in human skeletal muscle. J. Appl. Physiol. 106: 929–934.

Maximum adaptation is the focus not

Physiology of Performance

maximum training

Physiology of Performance

Potential for energy turnoverMinimising energy expenditure in performance

Aerobic AnaerobicPreparednessTactical method

Ergogenic

Physical

Anthropometric

Economy

Lactate Th h ld

VO2max Anaerobic Capacity

PowerEnergy expend

PacingThreshold Capacityexpend

DraftingMinimal distance covered

Fast-startEven pace

CHO drinkBicarb/citrate

CaffeinePost-

CHO/BCAA d i k

Optimal body mass

Body compFat oxidation -

Carnitine

Max lactate steady state

reps

Peripheral uptake

Volume/wkCHO intake

Central deliveryV 2

PlyometricsExplosive starts

Sprint mechanics

20-90s reps1-2 sessions/wk

CHO intake/ protein

High resistance reps

High Intensity

drink vVo2max repsLung fitness

AltitudeHb

Ferritin storesBlood volume

Tissue

MileageHill reps

Mech/S&CGlut/Ham

CaffeineCreatine

Resistance training

Hormonal response

BCAA

Bi-carbβ-alanine

warm-up

Post – 15 min cool down

Ice bath

Tissue hydration

Immune function

strengthDrills

Core stabilityCompression

stockingsFat oxidation

BCAA

Athl t P fil J 2002Athlete Profile – June 2002• International 5

Mean ± SD

Range

June 2002• International 5

years

• CommonwealthEconomy (ml.kg-1.km.hr-1)

226Commonwealth champion

• Plateauing in LT (km.hr-1) 16

gphysiology and performance

VO2max (ml.kg-1.min-1)

70 • Coach questions focussed on use f

speed VO2max(km.hr-1)

19.4of recovery treatments

Training intensity profile:g y pMale 1500m runner

50

60

ume Pre

Post

30

40

aining vol

20

30

of total tra

(%)

0

10

portion o

<80 80 to 90 90 to 100 100 to 110 110 to 120 120 to 130

Pro

% of VO2max

Ingham, S.A., Fudge, B.W. and Pringle, J.S. (2012) The Change In Training Distribution, Physiological Profile And Performance For A Male International 1500m Runner. IJSPP. 7(2):193-5.

15

10

15

%)

Year 1 Year 2

5

10h

ang

e (%

0

5

enta

ge

c

5

0

VO2max vLT vVO2 max RE

Per

ce

-5 VO2max vLT vVO2 max RE

The change (%) in physiological measures for year 1 and year 2 (mean of Nov, Mar, Sept) compared with Sept T0 and Sept T1, respectively. NB RE, negative change =

RE improvement ).


Pre-support

Yr2

Yr

1

Figure 3. The change in 1500m performance speed during competitive races prior tophysiological support and during year 1 and 2.


Training intensity profile:g y pMale 1500m runner

50

60

ume Pre

Post

30

40

aining vol

20

30

of total tra

(%)

0

10

portion o

<80 80 to 90 90 to 100 100 to 110 110 to 120 120 to 130

Pro

% of VO2max


OverviewOverview • Running is different to most other linear energetic sports

due to the neuro‐muscular pattern

• Injury rate is high, probably due to high eccentric loading

• Recovery treatments are popular

• Recovery treatments are not encouraged out ofRecovery treatments are not encouraged out of competition (this has taken 8 years to change)

• Recovery treatments are used in competitionRecovery treatments are used in competition

• Focus is returning to understanding and intervening with training first before recovery treatment is consideredtraining first before recovery treatment is considered

www eis2win co uk/skills4performancewww.eis2win.co.uk/skills4performance

Nigel WalkerNigel Walker

Ken van SomerenKen van Someren

Ferguson occlusiong

800 800

400

600

400

600

200

400

200

0

Bout 1 Bout 2 Bout 3 Bout 4

0

0‐30 30‐60 60‐90 90‐120

30

me Male

25

ng volum

Female

15

20

tal traini

(%)

10

on of tot (

5

Proporti

0

LT LTP vVO2maxTraining intensity

1920 Physiologists at recent l i

15n

Golds

11Olympics

11 y = 2.56x ‐ 9.2dals wo

Linear (Golds)

9y 2.56x 9.2R² = 0.99910

old m

ed

7

8

5

Go

Top the medal table = 24All 302 golds = 122

1

0

4All 302 golds = 122 0 golds = 3.5

3 4 5 6 7 8 9 10 11 12

No. of Physiologists at OlympicsI f d iInfra‐structure and investment

How do your athletes actually train?

tyg

inte

nsi

Tra

inin

Time (a microcycle)

• Poor association between intensity prescribed and performed (r=0 2‐0 6)and performed (r 0.2 0.6)

Stewart AM, Hopkins WG. (1997) Swimmers' compliance with training prescription. Med Sci Sports Exerc. 29(10):1389-92.Hewson DJ, Hopkins WG (1996) Specificity of training and its relation to the performance of distance runners. Int J Sports Med. 17(3):199-204.

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Steve Ingham - Recovery and adaptation