Effects of Various Recovery Strategies on Repeated Bouts of Simulated Intermittent Activity

Comparative evaluation of recovery interventions-individually and in combination-on lactate clearance and physical performance metrics following 3 versus 3 basketball matches

OBJECTIVES

The study evaluates the effects of active recovery, massage therapy, and foam rolling-both individually and combined-on recovery after 3v3 basketball matches, focusing on lactate levels, sprint performance, explosive strength, and agility to identify the most effective recovery strategy.

DESIGN & SETTING

Using a within-within group design with repeated measures, the study recorded data on physiological and physical variables before, immediately after, and at 10- and 15-min post-match, including blood lactate, sprinting ability, explosive strength, and agility.

PARTICIPANTS

Twenty-one male basketball players, aged 18-25 years, were purposively selected from Haridwar district, Uttarakhand. All participants had prior competitive experience, having competed in either the INBL or Red Bull Half Court Tournament.

RESULTS

Post-match lactate levels averaged 10.0 mmol/L, dropping to 4.4 mmol/L by 15-min. Active recovery combined with foam rolling improved lactate clearance and performance metrics more effectively than active recovery alone or with massage therapy, which showed better explosive strength recovery but less efficient lactate clearance.

CONCLUSION

Active recovery with foam rolling was more effective for immediate lactate clearance and agility compared to active recovery with massage therapy, highlighting the need for personalized recovery strategies due to individual variability in responses.

Impact of different doses of cold water immersion (duration and temperature variations) on recovery from acute exercise-induced muscle damage: a network meta-analysis

Objective

This network meta-analysis and systematic review evaluated the recovery impacts of varying cold water immersion (CWI) protocols on acute exercise-induced muscle damage.

Methods

We searched CNKI, PubMed, Cochrane Library, Web of Science, and Embase from January 2000 to September 2024 for randomized controlled trials examining CWI's recovery effects on acute muscle damage. Data extraction, study screening, and risk of bias assessment were conducted independently by two reviewers. Analyses were performed using Stata 16.0.

Results

A total of 55 RCTs were included, with 42 reporting delayed onset muscle soreness (DOMS), 36 reporting jump performance (JUMP), and 30 reporting creatine kinase (CK) levels. Network meta-analysis showed that compared with the control group, MD-MT-CWI: Medium-duration medium-temperature cold water immersion (10-15 min, 11°C-15°C) [SMD = -1.45, 95%CI(-2.13, -0.77), P < 0.01] and MD-LT-CWI: Medium-duration low-temperature cold water immersion (10-15 min, 5°C-10°C) [SMD = -1.12, 95%CI(-1.78, -0.47), P = 0.01] significantly reduced DOMS; MD-LT-CWI (10-15 min, 5°C-10°C) [SMD = 0.48, 95%CI(0.20, 0.77), P = 0.01] and MD-MT-CWI (10-15 min, 11°C-15°C) [SMD = 0.42, 95%CI(0.15, 0.70), P = 0.02] significantly improved JUMP; MD-MT-CWI (10-15 min, 11°C-15°C) [SMD = -0.85, 95%CI(-1.36, -0.35), P = 0.01] and MD-LT-CWI (10-15 min, 5°C-10°C) [SMD = -0.90, 95%CI(-1.46, -0.34), P = 0.02] significantly reduced CK. Cumulative probability ranking showed that MD-LT-CWI (10-15 min, 5°C-10°C) was the most effective for improving JUMP and reducing CK, while MD-MT-CWI (10-15 min, 11°C-15°C) was the most effective for reducing DOMS.

Conclusion

Different dosages of cold water immersion (varying in duration and temperature) had different effects on recovery from acute exercise-induced muscle damage. We found that MD-LT-CWI (10-15 min, 5°C-10°C) was most effective for improving biochemical markers (CK) and neuromuscular recovery, while MD-MT-CWI (10-15 min, 11°C-15°C) was most effective for reducing muscle soreness. In practice, we recommend using MD-LT-CWI (10-15 min, 5°C-10°C) and MD-MT-CWI (10-15 min, 11°C-15°C) to reduce Exercise-induced muscle damage (EIMD). However, due to the limitations of the included studies, further high-quality studies are needed to verify these conclusions.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/, identifier CRD42024602359.

The effect of cold water immersion on the recovery of physical performance revisited: A systematic review with meta-analysis

This review evaluated the effect of CWI on the temporal recovery profile of physical performance, accounting for environmental conditions and prior exercise modality. Sixty-eight studies met the inclusion criteria. Standardised mean differences were calculated for parameters assessed at <1, 1-6, 24, 48, 72 and ≥96 h post-immersion. CWI improved short-term recovery of endurance performance (p = 0.01, 1 h), but impaired sprint (p = 0.03, 1 h) and jump performance (p = 0.04, 6h). CWI improved longer-term recovery of jump performance (p < 0.01-0.02, 24 h and 96 h) and strength (p < 0.01, 24 h), which coincided with decreased creatine kinase (p < 0.01-0.04, 24-72 h), improved muscle soreness (p < 0.01-0.02, 1-72 h) and perceived recovery (p < 0.01, 72 h). CWI improved the recovery of endurance performance following exercise in warm (p < 0.01) and but not in temperate conditions (p = 0.06). CWI improved strength recovery following endurance exercise performed at cool-to-temperate conditions (p = 0.04) and enhanced recovery of sprint performance following resistance exercise (p = 0.04). CWI seems to benefit the acute recovery of endurance performance, and longer-term recovery of muscle strength and power, coinciding with changes in muscle damage markers. This, however, depends on the nature of the preceding exercise.

Universal Training Precautions: A Review of Evidence and Recommendations for Prevention of Exercise-Related Injury, Illness, and Death in Warfighters and Athletes

Facing pressure to train for victory, warfighters and athletes encounter numerous health risks that are directly related to their regular physical training. The concept of universal training precautions (UTPs) signifies universal processes designed to prevent unnecessary bodily harm, including injury, illness, and death, during physical training programs. Although no formal guidelines exist for collectively implementing a defined set of UTPs to address a broad scope of exercise-related health risks, recommendations and guidelines have been published relating to preventing sudden death during high school sports and collegiate conditioning sessions. A long list of critical topics must be considered as UTPs, including physical fitness factors, transition-period accommodation, hydration, environmental factors and acclimatization, appropriate recovery, use of medications and dietary supplements, and importantly, leadership. In this article, we outline in detail, with corresponding Strength of Recommendation Taxonomy ratings, what should be considered universal recommendations to minimize the risk of warfighters and athletes coming to harm when participating in group physical activities.

Effects of Cold-Water Immersion Compared with Other Recovery Modalities on Athletic Performance Following Acute Strenuous Exercise in Physically Active Participants: A Systematic Review, Meta-Analysis, and Meta-Regression

BACKGROUND

Studies investigating the effects of common recovery modalities following acute strenuous exercise have reported mixed results.

OBJECTIVES

This systematic review with meta-analysis and meta-regression compared the effects of cold-water immersion (CWI) against other common recovery modalities on recovery of athletic performance, perceptual outcomes, and creatine kinase (CK) following acute strenuous exercise in physically active populations.

STUDY DESIGN

Systematic review, meta-analysis, and meta-regression.

METHODS

The MEDLINE, SPORTDiscus, Scopus, Web of Science, Cochrane Library, EmCare, and Embase databases were searched up until September 2022. Studies were included if they were peer reviewed, published in English, included participants who were involved in sport or deemed physically active, compared CWI with other recovery modalities following an acute bout of strenuous exercise, and included measures of performance, perceptual measures of recovery, or CK.

RESULTS

Twenty-eight studies were meta-analysed. CWI was superior to other recovery methods for recovering from muscle soreness, and similar to other methods for recovery of muscular power and flexibility. CWI was more effective than active recovery, contrast water therapy and warm-water immersion for most recovery outcomes. Air cryotherapy was significantly more effective than CWI for the promotion of recovery of muscular strength and the immediate recovery of muscular power (1-h post-exercise). Meta-regression revealed that water temperature and exposure duration were rarely exposure moderators.

CONCLUSION

CWI is effective for promoting recovery from acute strenuous exercise in physically active populations compared with other common recovery methods.

PROTOCOL REGISTRATION

Open Science Framework: https://doi.org/10.17605/OSF.IO/NGP7C.

Impact of Cold-Water Immersion Compared with Passive Recovery Following a Single Bout of Strenuous Exercise on Athletic Performance in Physically Active Participants: A Systematic Review with Meta-analysis and Meta-regression

Background

Studies investigating the effects of cold-water immersion (CWI) on the recovery of athletic performance, perceptual measures and creatine kinase (CK) have reported mixed results in physically active populations.

Objectives

The purpose of this systematic review was to investigate the effects of CWI on recovery of athletic performance, perceptual measures and CK following an acute bout of exercise in physically active populations.

Study Design

Systematic review with meta-analysis and meta-regression.

Methods

A systematic search was conducted in September 2021 using Medline, SPORTDiscus, Scopus, Web of Science, Cochrane Library, EmCare and Embase databases. Studies were included if they were peer reviewed and published in English, included participants who were involved in sport or deemed physically active, compared CWI with passive recovery methods following an acute bout of strenuous exercise and included athletic performance, athlete perception and CK outcome measures. Studies were divided into two strenuous exercise subgroups: eccentric exercise and high-intensity exercise. Random effects meta-analyses were used to determine standardised mean differences (SMD) with 95% confidence intervals. Meta-regression analyses were completed with water temperature and exposure durations as continuous moderator variables.

Results

Fifty-two studies were included in the meta-analyses. CWI improved the recovery of muscular power 24 h after eccentric exercise (SMD 0.34 [95% CI 0.06–0.62]) and after high-intensity exercise (SMD 0.22 [95% CI 0.004–0.43]), and reduced serum CK (SMD − 0.85 [95% CI − 1.61 to − 0.08]) 24 h after high-intensity exercise. CWI also improved muscle soreness (SMD − 0.89 [95% CI − 1.48 to − 0.29]) and perceived feelings of recovery (SMD 0.66 [95% CI 0.29–1.03]) 24 h after high-intensity exercise. There was no significant influence on the recovery of strength performance following either eccentric or high-intensity exercise. Meta-regression indicated that shorter time and lower temperatures were related to the largest beneficial effects on serum CK (duration and temperature dose effects) and endurance performance (duration dose effects only) after high-intensity exercise.

Conclusion

CWI was an effective recovery tool after high-intensity exercise, with positive outcomes occurring for muscular power, muscle soreness, CK, and perceived recovery 24 h after exercise. However, after eccentric exercise, CWI was only effective for positively influencing muscular power 24 h after exercise. Dose–response relationships emerged for positively influencing endurance performance and reducing serum CK, indicating that shorter durations and lower temperatures may improve the efficacy of CWI if used after high-intensity exercise.

Funding

Emma Moore is supported by a Research Training Program (Domestic) Scholarship from the Australian Commonwealth Department of Education and Training.

Protocol registration

Open Science Framework: 10.17605/OSF.IO/SRB9D.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40279-022-01644-9.