Saturday, June 28, 2008

Restoration and Regeneration

Restoration and Regeneration as Essential Components within Training ProgramsFrom http://www.swimmingcoach.org/articles/9712/article5.htm
By Angie Calder, B.A., M.A. (Hons), B. Appl. Sci. Sp.
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Recovery sessions are rarely incorporated into sports specific training programs, except in Eastern Bloc countries. Yet the benefits of structured recovery periods are well documented both in terms of improved performances and decreased injury rates. Coaches and athletes alike need to be more aware of the importance of restoration and regeneration following heavy workloads, and of how to use the modalities available to facilitate recovery.


Feigley, 1984, Yessis 1986, Crampton and Fox, 1988, Kulpers and Kelzer, 1988. Some of the above can be experienced following heavy and intense workloads even though a classic overtrained state has not been reached.


The desire to provide peak physical and psychological performances during competition necessitates rigorous preparation involving intense and stressful training. Adaptations to heavy workloads are dependent upon the athlete’s physical and emotional ability to cope with increased work volumes and intensities. The overload threshold required for optimal improvement without the corresponding problems associated with overtraining is difficult for coaches to gauge. Individual athletes within the same sport can respond differently to the same training loads and preliminary symptoms warning of imminent overtraining are elusive. However, once that state has been reached there are several distinctive physical and psychological markers evident (Table 1).


Unfortunately the effects of overtraining can negate months of hard work and detract from the athletes’ full potential. In many situations overtraining leads to ‘staleness", then ‘burnout’ or injury, or both. These require lengthy and often expensive rehabilitatory process for athletes, team and coach. To overcome this problem many Eastern Bloc countries sustain maximal workloads and intensities with minimal detrimental effects by structuring recovery sessions within training regimens (Kopysov et al. 1982; Matusezewski, 1985). The range and scheduling of recovery modalities is extensive and tailored to suit the requirements of individual athletes and their respective sports (Zalesky, 1982). The systematic inclusion of recovery sessions reduces overtraining problems and injuries and also appears to significantly increase performance by enabling the athlete to cope with greater workloads (Talyshev, 1980; Birukov and Pogosyan, 1983; Zhang et al, 1987).


RECOVERY: RESTORATION, REGENERATION AND REHABILITATION

Recovery is a generic term used specifically with reference to the restoration of parameters in either or both physiological and psychological states that have been excessively stressed or altered during a particular activity. These states contain variables or markers which can be measured objectively (Yessis, 1982:38).


Restoration refers to returning physiological markers to normal levels whereas regeneration refers to the recovery of psychological traits particularly associated with mood states. Rehabilitation refers to recovery from injury or illnesses which are often the result of overtraining. Physiological and psychological recovery are both equally important and excessively stressed athletes may exhibit symptoms or signs indicative of overtraining, in both states (Table 1). Some of the signs and symptoms shown in Table 1 can be experienced following heavy and intense workloads even though a classic overtrained state has not been reached.


RECOVERY METHODS

Recovery methods fall into four major categories:
(1) Work/rest ratios, including light active recovery
(2) Nutrition
(3) Physical Therapy
(4) Psycho-Regulatory Training (PRT)


Restoration and regenerative programs followed by Eastern Bloc countries employ all of these procedures in varying proportions depending on training workloads, the demands of the sport, and the individual needs of the athlete (Sports (eds) 1986: Fox, 1986:9). Zalessky, also notes that the type and amount of restoration employed depends on the extent of the athlete’s state of fatigue (1984:53).


WORK/REST RATIOS

Work/rest ratios vary both within and between work sessions. Successful schedules for specific sports are well documented from the West as well as the Soviet Bloc. The body requires recuperative time to allow for adaptive processes to occur and promote anabolic activity such as strength gains. Consequently rest periods need to be programmed into training schedules, but these vary depending on the requirements of the sport and intensity of the workload.
For example, prescribed rest days for jumpers and throwers differ despite the fact that both are explosive anaerobic sports (Bakarinov and Zalessky, 1982).


Although most track and field athletes have one passive rest day per week, workloads vary both within daily sessions and between training phases. For example, the training volumes and intensity between the preparatory phase and the competitive phase differ. A high compensatory effect is achieved in the preparatory period via three consecutive weeks of increasing workloads, followed by a fourth week with significantly lighter training.


During the competitive period the lighter training loads extend over two weeks. Alternating training loads between sessions and incorporating active rest periods is designed to produce an undulating ‘wave like’ growth curve. Peaks and troughs correspond to workloads (volume and intensity) and rest.

Daily programs for track and field athletes usually begin with lighter morning sessions which have a preparatory role before the heavier main sessions during the middle of the day. Evening workouts are lighter and designed to restore the functional capabilities of the athlete.


Cross training activities can be used as a form of active rest, especially during the competitive phase. This can help switch the psychological direction of the athlete to rest better from the specialized event and help to restore the functional capabilities of the central nervous system.

NUTRITION
Similarly nutrition and the dietary requirements for sporting events require careful programming. The body requires food not only for energy but also for anabolic and reparative processes. The link between overtraining and a depressed immune state is also an area of recovery being addressed through nutrition (Telford, 1990). A poor or inadequate diet can lead to fatigue, irritability, and sometimes to eating disorders such as anorexia.


Training and competitive diets will vary according to the type of activity being undertaken. Adequate intakes of complex carbohydrates are essential for all athletes, but especially crucial for events lasting over one hour. Carbohydrate loading or ‘super-compensation’ practices are designed to maximize the storage of glycogen and prevent the early onset of fatigue. Rehydration can also prevent fatigue and assist athletes to sustain the intensity of a training session.


All athletes require a well balanced diet containing the essential macronutrients of meat, fish, dairy products, fruit and vegetables, cereals and bread. Protein is especially important for muscle regeneration and the prevention of exercise-related anemia. In particular, athletes involved in anaerobic activities require additional dietary protein to facilitate training adaptation and recovery.


The interplay between the immune system, white cell production, the production of free radicals and those athletes involved in continual heavy oxidative metabolic activities, is complex. Antioxidants such as vitamins E, A and C provide protection against the action of free radicals, and dietary supplementation of these vitamins may assist athletes in maintaining heavy training loads.


Similarly, minerals are important for muscle regeneration. Muscle cell damage can result from strenuous training or alter the balance of sodium, potassium and magnesium within cells leading to chronic fatigue and tiredness. Extra intake of minerals and trace elements may be necessary to assist recovery, but synthetic supplementation may not be as effective as increased dietary sources, due to the reactivity of some elements and metals with other foodstuffs in the gut.
Special attention is required for food intake pre and post training, and during competition, to maximize energy stores, minimize fatigue and to assist with tissue regeneration.


PHYSICAL THERAPY
The most commonly used modalities relate to a wide range of physical therapies available. Water therapies include a variety of spa, float tanks, baths, (contrasting temperatures, ionizing, and aromatic), hydromassage, whirlpools, Sharko showers and floating stream showers. Sauna (dry baths) are frequently used with specific regimens developed for different sports and workloads, and decompression chambers (baromassage) are used in the Soviet Union for extremely fatigued muscles. Eastern European countries also use a wide variety of electrotherapeutic procedures for restoration whereas many of these are largely restricted to rehabilitatory roles in the West. Ultra high frequency modalities, magnetic field generators, interferential and ultra sound are some of those most frequently employed.



MASSAGE

The most common and frequently used restorative modality for both East and West alike is massage. This is relatively inexpensive and can provide for both restorative and regenerative recovery, plus give the individual athlete specific feedback about the physical state of specific body parts.


There are five basic terms describing different massage maneuvers, vibration (shaking), tapotement (percussion), petrisage (kneading), effleurage (stroking) and friction (small range intensive stroking). (Yessis, 1986; Kresge, 1988.)


Sports massage uses different combinations of these techniques and, relative to training times, is regarded by many authors as the most effective means of recovery. Apart from massage sessions for rehabilitative reasons, treatments are administered during three phases:
(a) Within the training phases where massage is given during the work sessions to help accommodate for high training loads and to increase the athlete’s training potential. (Zhang et al. 1987).
(b) Preparatory massage given as part of a warm-up phase, some 15-20 minutes before competition. This can either relax an overstimulated athlete or arouse an apathetic one.
(c) Restorative massage is given in the post-training or post-competitive phase. This procedure is regarded as being at least two or three times more effective for recovery than passive rest. (Birukov and Pogosyan, 1983). These treatments facilitate recovery from the effects of fatigue, the reduction of muscle tension and a lowering of stress levels.


The timing and frequency of restorative treatments is dependent on the type of activity, intensity and individual athlete (Kopysov et al, 1982). When heavy workloads are undertaken most authorities recommend restorative massage 2-6 hours following the completion of training (Yessis, 1982). Frequency of treatments varies from 1-2 per week to three times per day. This variability relates to the sport undertaken, intensity of the recovery program and the availability of a masseur.


The duration of each treatment also varies according to the amount of body surface to be massaged. Whole body or general massage requires more time than a localized treatment concentrating on a specific area or body part. Some authors also adjust treatment times according to the athlete’s weight (Matusezewski, 1985). Whole body massage lasts from 40-90 minutes while localized procedures range from 10-30 minutes. The general restorative effects of massage have been summarized by Ylinen and Cash (1988).


Although a few studies have considered the psychological effects of massage, the physiological benefits have been examined in more detail (Wakim 1981). The mechanical effects of massage have often been considered in relation to physiological responses.


The squeezing, stroking, compressive and pushing components of manual manipulation facilitate drainage of venous blood and lymph. Venous and lymph back-flow is inhibited by valves, consequently altered vascular pressure due to massage facilitates blood flow. Lymph vessels are affected in the same way.


Mobilization of tissues occurs as they are moved on one another. Manipulations cause slight stretch thus maintaining elasticity and regaining mobility where tissues have adhered within themselves or to adjacent tissues. This mobilizing effect is enhanced by improved blood supply which causes increased warmth of the body part.


Massage as part of a warm-up regimen facilitates preparation for the sporting event but is not as effective alone as a combined active warm-up with stretching and some massage. Massage is also an effective adjunct for assisting flexibility, but it should not replace stretching schedules programmed for warming up or recovery.


In the Eastern Bloc and Asian nations, accupressure and acupuncture complement massage as a recovery modality. Accupressure and acupuncture are concerned with balancing energy fields via specific points located on 14 meridians which pass through the body. Acupuncture points have a lower cutaneous electrical resistance than adjacent areas and these can be measured and evaluated. Stimulation of specific points are claimed to influence oxygen uptake, respiration, the immune system and biochemical activities including the uptake of glucose, phosphocreatine, cholinesterase, hydroxytryptamine and acetylcholine (Wong 1983).

PSYCHO-REGULATORY TRAINING

(PRT)Psycho-Regulatory Training refers to a number of processes generally used to aid an athlete’s emotional and psychological state following stress. Relaxation techniques, autogenic training, breathing exercises, musical and light influences, psycho-regulatory training, relaxation massage and flotation are the most frequently used modalities.


Although passive rest is an important component of recovery, the time spent during passive rest can be used to incorporate one of several PRT procedures. Meditation trains the athlete to develop the amplitude and regularity of alpha brain waves in order to produce relaxation. In turn this generates an integrated reflex mediated by the CNS which works in opposition to the flight or fight response. Meditation results in a hypometabolic state, with lowered BP, HR and decreased blood flow, indicating a calming of the sympathetic NS. This can be used to counter the stress of training or competition which can cause over arousal of the sympathetic NS (Wallace and Benson 1972).


Progressive muscle relaxation (PMR) and positive cognitive intervention are both components of psycho-regulatory training. PMR is a somatic relaxation treatment which uses both active and passive components of attention. The consequent reduction in muscle tension improves the athlete’s reaction profile and when used in the daily training program can lead to significant improvement in training and competitive abilities (Litschka-Schimpf et al. 1988).
Relaxation massages and flotation assists with muscle relaxation and result in lower HR, BP and improved mood states. These modalities are often used once or twice a week each (Yessis 1986). Modalities such as PMR, PRT, meditation and the use of music can be used daily in conjunction with training sessions.


GENERAL CONSIDERATIONS

The four major recovery areas offer a great deal of scope for designing a recovery regimen specific to the physiological and psychological needs of each athlete. Not withstanding this fact, these recovery sessions should be regarded as additional to the proper normal training procedures involved within each session. An appropriate warm-up and cool-down regimen should include locomotor activity and stretching routines suited to the preparatory or recovery section of the session.


All athletes should be encouraged to stretch in a warm environment wherever possible. Spas, saunas and showers are ideal places to stretch and self massage can be used by athletes. A regular sleeping pattern and sound diet are also essential components of a well balanced training program. For an athlete to maintain demanding workloads without either a loss of performance or increasing the risk of injury, a structured recovery program within the training regimen is essential.


REFERENCES
Bahrinov Yu. and Zalessky M. (1982) ‘Restoration in thrower, Soviet Sports Review, Vol.17, pp. 162-164. (translated from Legkaya Atletika, Vol 6, pp. 12-13, 1981). /


Birukov A.A, and Pogosyan M.M. (1983) ‘Special means of restoration of work capacity of wrestlers in the periods between competitive bouts, (Condensed), Teorlya I Praktika Fizicheskoi Kultury, Vol. 8, pp 21-24. /


Bompa, T. (1987) "Periodisation as a key element of training, Sports Coach, April-June, 20-23. /
Crampton J. and Fox J. (1987) ‘Regeneration vs burnout. Prevention is better than cure, Sports Coach, Vol. 1 0, No. 4, pp. 7-1 0. /


Feigley D.A. (1984) ‘Psychological burnout in high-level athletes, The Physician and Sportsmedicine, Vol. 12, No. 10, pp. 109-119. /


Fleck S.J. (1988) ‘Signs and symptoms of overtraining in the anaerobic sport of Judo, in Overtraining and Recovery, Australian Coaching Council Conference Papers, Canberra, pp. 2.18-2.31. /


Fox J. (1986) ‘The effect of the intentional usage of various forms of regenerative procedures on mood state in Australian athletes, A graduating paper presented to the F.I.T. Research Committee in fulfillment for Graduating, Footscray Institute of Technology, Victoria. /


Kipysov V.S., Poletayev P.A. and Prilepin A.S. (1982) ‘The distribution of training loads and means of restoration in the preparation of weightlifters, Soviet Sports Review, Vol 17, pp. 49-52. (Translated from Tyazhelaya Atletika, Vol. 10, pp. 20-23, 1981). /



Kresge C.A. (1988) ‘Massage and sport, in sports medicine: fitness, training, injuries’, 0. Appenzeller (ed.), 3rd edition, Urbane and Schwarzenberg, Baltimore, pp. 419-431.
Kuipers H. and Keizer H.A. (1988) ‘Overtraining in elite athletes, Sports Medicine, Vol. 6, pp. 79-92 /


Litske-Schimpf G.G., Manz A., Schimpf M., Weib H., Eberspacher and Weicker H. (1988) ‘Influence of different experimental recreational treatments on sympathoadvenergic and metabolic regulation mechanisms in repeated exercises’, lnt. J. Sports.Med. 9:14 6-150. /



Sports (eds) (1986) ‘Regeneration alternatives in high performance spot, Sports Science Periodical on Research and Technology in Sport, Physical Training W-1. (Adapted from Das, "Betreuungs system in Modern Hockleitungssport’ from Deutscher Sportbund: Bundesausschuss Leistungussport). /


Talyshev F. (1980) ‘Recovery’, Soviet Sports Review, Vol.15, No. 3. (Translated from Legkaya Atleitika, Vol 6, pp. 25, 1977.) /



Telford R.D. (1990) ‘Regeneration - a nutritional perspective’, Excel, Vol. 6, No. 2, pp. 25. /


Wakim K.G. (1981) ‘Physiologic effects of massage, in Manipulation, Traction and Massage, J.V. Basmajian (ed), 3rd edition, Williams and Wilkins, Baltimore, pp. 256-269. /


Wallace R, and Benson H. (1972) ‘The physiology of meditation, Scientific American Feb 1 2 5 -1 31. /



Wong B. (1983) Meridan Research Abroad, People Health Publishers, China: 374-408. /


Yessis M. (1982) ‘Restoration: or increasing the ability to do more voluminous and higher intensity workouts, Nat. Strength and Conditioning Journal, June-July, pp. 38-41. /
Yessis M. (1986) ‘Recovery Part One, Sports Science Periodical on Research and Technology in Sport, July 1986, General W-1. /



Ylinen, Jarl and Cash, Mel (1988) ‘Sports massage, Stanley Paul, London. /


Zalessky M. (1982) ‘Restoration for jumpers’, Soviet Sports Review. Vol. 17, pp. 1-6. (Translated from Legkaya Atletika, Vol. 11, 20-23, 1980). / Zalessky M. (1984) ‘Restoration in the sprint and hurdles, Soviet Sports Review, Vol. 17, pp. 105-107. (Translated from Legkaya Atietika, Vol. 4, pp. 6-7, 1981). /


Zhang Z.B., Carter R.M., Minikin B.R. and Telford R.D. (1987) ‘The influence of repeated massage on leg strength, paper held at the Australian Institute of Sport, Canberra.

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