Several years ago a team of Japanese researchers put a dozen college-aged men on exercise bicycles for four to six weeks of training. Following each workout, the research subjects stuck one limb in an ice bath at temperatures ranging from 5 degrees C to 10 degrees C (41 degrees F to 50 degrees F). The other limb stayed at room temperature, allowing everyone to serve as his or her own control.
The goal was to find out how much ice baths contributed to building fitness. The results were eye-opening.
For decades, post-workout ice baths have been a rite of passage for high school and college athletes. The theory was that if ice works for sprained ankles, it should also speed recovery from hard workouts, since these too involve tissue damage.
That, at least, is what most coaches have long believed. Interestingly, there has been some scientific difficulty in proving it works, though nobody really doubted that faster recovery was beneficial. After all, the sooner you recover, the sooner you can do another hard workout, and that has to be better, right?
The first chink in the armor of this longstanding wisdom involved ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs). All the way back in 2002, a study in the American Journal of Physiology-Endocrinology and Metabolism found that ibuprofen (and acetaminophen) inhibited protein synthesis in muscles after high-intensity exercise. Another study in the May 2006 issue of Medicine and Science in Sports and Exercise carried this a step further by finding that ibuprofen inhibited muscle strengthening in exercising rats.
But that just shifted the coaching emphasis more strongly toward natural techniques: Don't take NSAIDs for recovery, the rule became. Use ice.
But that's not what the Japanese team, led by Motoi Yamane of Chukyo University, found. Instead, they discovered that at the end of training, the non-ice-bathed limbs had gained more strength, more circulation and more endurance than their ice-bathed counterparts. Even VO2 max (as measured in single-leg tests) had gone up more in the non-ice-bathed legs. The conclusion: Ice baths are counterproductive. "[They] retard rather than support the desired improvement of muscular performance," the scientists wrote in a 2005 online edition of the European Journal of Applied Physiology.
How has this and related research affected practice among athletes? For one, Nike's Oregon Project athletes no longer do routine ice baths, says Steve Magness, who assists Alberto Salazar as coach and scientific advisor for the group.
The new approach, Magness says, is based on the realization that training is designed to stimulate molecular biological "signaling pathways" for fitness adaptations. In other words, hard workouts are intentionally designed to produce micro-damage to muscles. That damage induces repair processes that leave the muscle slightly stronger than it was before the workout.
That's not new: It's just the old tear-down-to-build-back-up process long known to bodybuilders and athletes of all stripes. What's new is the realization that inflammation is one of Magness' "signaling pathways"--and probably an important one. You could think of it as your muscles' biochemical call for help. Ouch, we're damaged, they're more or less telling the rest of the body. Come help us repair.
That's a bit anthropomorphic, but it's less of a mouthful than the way Yamane's article put it, which spoke in terms of the effect on neutrophils (a type of white blood cell which has been called the body's first-responder to inflammation-producing damage), satellite cells (a type of stem cells that can merge into damaged muscle cells and make them stronger), and a host of other factors that might be involved in muscle strengthening.
"So it makes sense that if we're doing all this muscle training, and getting this damage and inflammatory response, [that] if we knocked it out right afterward with icing, anti-inflammatories or what have you, that we're decreasing the stimulus the body gets, and it's not going to adapt as much as it would if we just left it alone," Magness says.Brad Aiken, medical director for rehabilitation at Baptist Hospital, Miami, I Fla., agrees. "Anything that interferes with the natural physiology would likely interfere with the expected outcome [of] larger, stronger muscles," he says. "Muscle fibers require a certain amount of time for these changes to occur."
What this means, Magness says, is that ice baths, compression tights, NSAIDs and any other recovery aids should be used sparingly.
"You balance when you need recovery and when you don't," he says. Thus, during periods of the year when training is the most important thing, what matters is getting the biggest training boost you can from each workout. Whether you bounce back in time to do another hard workout two days later or three days later "doesn't really matter in terms of the big picture," he says.
But if you're sore and a major race is looming--or if you're a high school or college athlete racing every week--priorities shift. Now, Magness says, the goal isn't to get stronger. "We're just trying to sharpen up, maintain, and feel fresh and good for races. That's when you take an ice bath. You don't care if you lose a bit of training stimulus because the goal is to feel good on race day."
Magness doesn't even recommend ice baths as follow-ups to races, except for marathons, which he views as having more in common with sprained ankles than with ordinary training. "I would say that a marathon would be looked at as a traumatic injury," he laughs. "The amount of damage is extremely high." But for shorter races, he thinks the ice/no-ice decision again turns on whether your primary goal is to get stronger, or to feel good for the next race. "Early season," he says, "I probably wouldn't do it. But later in the year, if you're racing every week, yeah, you should probably use it. With our athletes, we don't use ice baths or anything like that until it's time to go."
Specifically, he says, "We'll use ice baths in the preliminaries of the 5K at the Olympic trials" (and presumably also for other events with preliminary heats). But the rest of the time, his group lets nature take its course, even after major tune-up races such as Stanford or Mt. SAC. "We have used this theory for the past year and a half or so," he adds.
Elite coach Brad Hudson, author of Run Faster from the 5K to the Marathon: How to Be Your Own Best Coach, agrees. "My feeling is that athletes only use [ice baths] when they're severely tired and severely beaten up," he says. But his reasons are slightly different from Magness'. He thinks that if you use ice baths too often, they simply don't work. Your body adjusts to the process and nothing much seems to happen. "Athletes don't seem to recover [any faster]," he says.
Self-coached Ryan Hall agrees. "I'm not a scientist," he says, "but I have experimented with ice baths, contrast baths, and not taking baths at all. What I have experienced is that I don't really notice feeling any different when I take them and when I don't, so I haven't been taking them lately, as it is not a fun part of the job, anyway." But, he adds, the same theories probably don't apply to at least one other recovery technique. "I would think massage fits into a different category than ice baths," he says. "I see massage more as working out muscular adhesions and tightness."
South African distance runner Hendrick Ramaala, winner of the 2004 New York City Marathon, concurs. "I am not a fan of ice baths," he says. "Hot tubs and compression socks don't do it for me either. I prefer stretching, massages, and most importantly, resting between sessions to allow the body to recover. I believe it is important to listen to your body and do as it asks. If you are tired from a session or have sore muscles, then you need to take it easy in training and rest until the body tells you it has recovered. Athletes must not be slaves to their training programs."
Some athletes, however, still find value in their recovery-speeding techniques. Take U.S. 5,000m record-holder Molly Huddle. As a self-described Type A athlete, she doesn't like sitting back waiting for nature to take its course, even if it might be the theoretically best thing to do. "That 'doing nothing' can be hard," she says, noting that taking an ice bath or pulling on compression tights "makes me feel like I am being proactive with recovery.
"Personally," she adds, "I will probably keep ice-bathing despite the studies, because in the end, whether it's psychological or physical, it makes me feel slightly better."ACUTE INJURIES
Whatever you decide to do following hard workouts, that sprained ankle still needs ice, many experts say.
"There's a difference between muscle recovery from exercise and recovery from major trauma or surgery," says rehabilitation specialist Brad Aiken. "In the latter, bleeding, inflammation and excessive swelling can lead to secondary damage and can delay healing."
But this doesn't mean you should ice, ice, ice, indefinitely. "Once you're past the initial stage of injury (usually about two to five days), acute swelling is no longer occurring, and cold can actually slow the blood flow needed for healing," Aiken adds.
And here, too, there are studies showing that inflammation is a signal calling for healing help from the rest of the body, and that shutting it off may delay the process. "The idea is similar [to that regarding workout recovery] in that inflammation is a natural process," says Steve Magness. "There's a reason your body goes through it. It is not necessarily a bad thing."
Wharton's Simple Solutions No.1
PLANTAR FASCIITIS
The name may sound mysterious, the experience isn't. Millions of people undergo any number of the following on a daily basis: a pain in their heel the moment their foot hits the ground in the morning; tenderness in the heel and arch area; pain in the heel or arch area after taking the first few steps following a long period of sitting; discomfort and throbbing in the heel and arch area after long periods of standing.
WHAT IT IS
Plantar fasciitis is painful inflammation of the heel and bottom surface of the foot. It is generally caused by overstretching of the fibrous tissue (fascia) that connects the heel to the forefoot.
Breaking the injury cycle requires an overall approach, examining critical elements such as postural alignment, biomechanics, musculoskeletal balance, correct footwear and training.
In addition to working on larger corrections in your posture, stride, strength and flexibility, here are a few specific tools to help you get on your road to recovery:
RESET IT
Bend the knee of your exercising leg. Place your hands under your metatarsal heads and toes. Flex your top arch and toes toward you. Move until your natural end range of motion. Gently assist with your hand as you continue to move. Return to start position. Exhale as you flex your toes and arch toward you. Inhale as you return to start position. Repeat for two sets of 8-10 repetitions.
STABILIZE IT
Assume the same starting position as your "reset" exercise--bending the knee of your exercising leg. Place your hands under your metatarsal heads and toes. Extend your toes and top arch toward the ground. Resist with a gentle pressure with your hand resting on the top of your foot. Exhale as you move. Inhale as you return to start position. Repeat for two sets of 8-10 repetitions. Increase resistance with your hand as you get stronger and your body adapts and adjusts to the exercise.
RELEASE IT
While seated, cross your affected leg over your opposite thigh or bend your knee. Using your thumb or fingers start applying a very gentle pressure between the inside of your heel and inside anklebone. Because your fascia may already be inflamed, go slowly, allowing your thumb or fingers to be taken into the distorted tissue. You can use a muscle salve or a more adhesive substance for a better grip. Take the time to allow the micro bundles of your facial fibers to unwind at their own pace.
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