Monday, April 29, 2013

"Squeezing" the Most Out of Your Recovery

Recovery from vigorous workout sessions has become an important aspect in achieving optimal performance.  Athletic performance hinges nearly as much on proper recovery as proper training methods.  Heavy training inevitably results in tissue damage, soft tissue inflammation, and waste byproducts (typically referred to as edema). For effective recovery, tissue inflammation and edema must be removed to allow tissues to rebuild.  While we are slowly accepting that more training may not be necessarily better, we are also learning with heavy training, there are methods and techniques available to help us maximize potential for recovery.  This is achieved through moving and minimizing inflammation making our trek toward personal athletic performance excellence easier.

Recently, compression technology has gained popularity as means of enhancing recovery. There are several methods of compression available to athletes and all work to assist the body in minimizing the effects of heavy training. Common methods available to athletes are compressive garments and mechanical compressive devices. Both have their benefits.  Picking the appropriate method hinges on many factors.

Compression Recovery Theories
The theory behind compression technology is often misunderstood.  Without being overly scientific, to be effective, compression must surround the body part at a high enough level to affect fluid movement between tissues and blood vessels, ultimately ending with fluids being moved through tissues and into the lymphatic system for removal. With most compression devices, compression is graded with the distal portion of the device (furthest away from the heart) applying more pressure than the proximal portion of the device (closest to the heart).  The lymph system runs in this same direction, and the graded pressure promotes movement of fluids in the appropriate direction. 

Clinically, the use of compressive devices has been associated with creating pressures correlated to diastolic blood pressure (approximately 80 mmHg in a normal person).  However, arterial capillary pressures are approximately 30mmHg, and any pressures that exceed this theoretically should promote fluid re-absorption and movement of the lymph.  Squeezing of the lymph channels and increasing the hydrostatic pressure of the tissues can be accomplished with as little as 40-50 mmHg and will force fluids and edema through blood vessels promoting removal as well.  The importance of active movement of the body part, muscular contractions, and elimination of the effects of gravity in conjunction with compression enhances the fluid removal effects even greater (and are explained in a previous blog).  Understanding these pressure numbers is important when choosing your method of compression.

Mechanical Compression Devices.
Normatec MVP Sequential Compression
Mechanical compression devices have been utilized by sports medicine experts in professional, collegiate, and elite athletics for many years.  Mechanical compression devices are typically filled with air, cold fluids, or gels. Device pressures can be adjusted according to the desired effects.  These devices come with appliances for application on the upper and lower extremity.  Some devices apply uniform compression throughout the device while others have separate chambers capable of filling with pressures of varying levels.  One of the most popular compression devices is the Normatec MVP Pro (shown here). This device is utilized by top-level athletes and sports medicine professionals due to it's unique ability to alter pressure changes throughout the device and to perform a sequential filling and emptying of different areas of the device creating a massaging effect from distal to proximal.  Combined with elevation and taking advantage of the great effect of gravity, this device has quickly become a modality of choice for top sports medicine professionals and endurance sports teams for recovery and edema removal.  NormaTec has recently introduced a more affordable unit called the MVP Pro which contains the protocols used for recovery and is more affordable.  In the coming year, this will be a product that many age-groupers purchase to help their efforts.  Other products are entering the market in a lower price range (BioCompression Systems, Jobst, and Recovery Pump), but the adjustability and capabilities of these products is unknown at the time of writing of this blog.  The negative aspect of these machines are the cost.  However, many sports medicine clinics and clubs are purchasing sequential compression units and are becoming more readily available to the everyday athlete. Empirical evidence on the effectiveness of these products is very high.

Compression Garments
Another popular trend has been the application of compression garments before, during, or after competition.  Research on the application of these devices is sparse.  Considering the pressure numbers needed to achieve the desired results, it is a "buyer beware" market.  Before purchasing compression garments, it is wise to find out the pressure numbers provided by the garment.  Reputable manufacturers will have these numbers available to the consumer. Make sure to purchase compression garments that will provide the minimum pressures needed to have a desired effect.

Don't Overlook the Obvious
Exercise and movement of body parts promotes fluid movement and exchange.  Though compression garments might not provide enough pressure to cause a fluid shift independently, use of compression garments in conjunction with light exercise during recovery may have a positive effect.  Certainly, the use of compression garments in conjunction with elevation will provide good results.  Elevating the limbs is the most overlooked, yet likely one of the most effective tools available in recovery.  So, after your next strenuous workout, don't be afraid to cool down, stretch, shower, and then spend some quality time relaxing and recovering with your feet elevated.  Adding one of the devices above will simply enhance what mother nature wants us to do to recover.

Future blogs will report on other methods used to improve chances of training healthy and enhancing recovery.

Until next time, train safe and train smart!

1 comment:

  1. Is this enough compression to see a benefit? Thanks.

    Skins is medical grade gradient compression which means that are product is tightest at the extremities and decreases as you move closer to the heart. For example, our tights are tightest at the ankle and less so as you move up to the hip. I have provided the compression levels below.

    Ankles: 20 +/- 3 mmHg
    Calves: 18 +/- 3 mmHg
    Lower Thigh: 15 +/- 2.5 mmHg
    Upper Thigh: 9 +/- 2 mmHg