Science Summary: Injuries and Recovery (Cardio or Weights Part 8)

This post is a continuation on my series through Alex Hutchinson’s Which Comes First, Cardio or Weights? All of the following questions are taken from this book and the answers are paraphrased from the authors words with my interpretations and thoughts added in.

Ouch, I think I sprained something.  How long should I stay off it?

Short Answer:  RICE (Rest, Ice, Compress, Elevate) has been the go to advice for treating injuries for decades.  Recent research suggests that MICE (Move instead of Rest) may be more appropriate once the acute injury phase has passed and scar tissue has developed.

Long Answer:  A team of Brazilian researchers recently published an article in Histology and Histopathology that found faster recovery rates in rates if movement to injured areas was reintroduced during the healing process rather than entirely restricted.  The main reason for this was that the moving rats experienced less muscle atrophy and developed less fibrotic scar tissue.  In practice however, this may be riskier than resting the injured area.  Shawn Thistle of the Canadian Memorial Chiropractic College recommends a progression of simple movements, load bearing movement, and then finally functional movement through the healing process instead of the traditional rest to functional movement.

Will a post-exercise ice bath help me recover more quickly?

Short Answer:  Anecdotal evidence suggests ice baths do speed recovery, but there has yet to be a study demonstrating this is more than a placebo.

Long Answer:  There have been several studies into the effects of post exercise ice baths as treatment to help speed muscle repair.  The three such studies that Hutchinson is aware of have been questionable in their experimental procedure and failed to find scientific proof for actual recovery though two did report their participants feeling better after treatment.  The main critique of these three studies is they all used very short treatment durations (from 1-2.5 minutes) which may be part of their ineffectiveness.

Will a heat pack or hot bath soothe my aching body?

Short Answer:  It has the potential to.

Long Answer:  A literature review published in 2010 found that heating packs have the potential to reduce lower back pain by an average of 17% as compared to control groups.  Heat does increase blood so applying warmth to freshly injured areas may increase swelling and pain.  Heat treatment can be used in place of a warm up and has been shown to increase flexibility in a 2005 study published in the Archives of Physical Medicine and Rehabilitation.

Will massage help me avoid soreness and recover more quickly from workouts?

Short Answer:  It helps for rabbits so it should hep for humans!

Long Answer:  While DOMs is still not entirely understood, many of the popular arguments for the benefits of massage have been proven false.  That being said, researchers are able to accurately gauge muscle effectiveness.  In a Ohio State University study, researchers sedated rabbits and stimulated their muscles in a way that would mimic a workout.  They then simulated a 30 minute Swedish massage on on group of the rabbits and let the other group recover naturally.  They found the massaged group recovered over four times faster than the control group.  These effects were less pronounced when applied the day after exercise as opposed to the day of.  While we can’t say how this will translate to humans, it does support the benefits of massages.

Should I take pain killers for post-workout soreness?

Short Answer:  In the appropriate circumstances, yes.

Long Answer:  Research done by chemist John Vance found that consistent use of NSAID painkillers reduced recovery rates while reducing inflammation and pain.  What this means is that heavy pain killer usage will reduce the effectiveness of any exercise you may do.  It is best to limit consumption and save painkillers for when you really need them in cases such as sprains or strains.

How long does it take to recover after a marathon or other long, intense effort?

Short Answer:  Pain should fade within a week but it might take longer for strength to recover.

Long Answer:  For more information on post-workout pain see my post on DOMs here.  Recovering from fatigue is another story altogether though.  A team of Dutch researchers did a study in 2007 that found even after perceived fatigue had faded, athletes still did not perform as well as they had before an endurance event.  This decrease in performance lasted over a week and was linked to neuromuscular (nervous system) limitations rather than muscular limitations.

Can “platelet-rich plasma” cure my tennis elbow or Achilles tendon?

Short Answer:  Science has yet to be proven but placebo effects do exist.

Long Answer:  Platelet-rich plasma (PRP) is a relatively new treatment.  The theory is that healing can be sped up in limited blood flow areas such as tendons by drawing blood from other areas of the body, filtering out the parts that promote healing (the platelets), and injecting the blood back into the injured area,  So far current clinical trials have found that both PRP treatment and invasive placebo treatments have encouraged a more rapid recovery than no treatment at all.  A Dutch study of 100 participants found that PRP increases healing rates by 50% as compared to the placebo treatment but this is yet to be confirmed by other studies.

How can I reduce my risk of stress fractures?

Short Answer:  Get stronger and reduce repetitive impacts.

Long Answer:  Stress fractures are created by the accumulation of repetitive microfractures which are developed by impacts over time.  If these microfractures a created faster than they are allowed to heal they form a stress fracture.  Researchers at Iowa State University found that reducing stride length effectively reduced overall impact experienced which translates into less microfractures.  A University of Minnesota study found that stress fracture likelihood was inversely proportional to muscle development as the muscles prevent microfractures from forming.

Should I exercise when I’m sick?

Short Answer: Use the “neck check,” if symptoms are above the neck (coughing, sore throat, headaches) then get out there.  If it’s more serious, get some rest.

Long Answer: In a series of studies done in the 90’s by Thomas Weidner at Ball State University, research showed that the common cold did not reduce athletic performance and, more importantly, exercise did not reduce recovery rates.

Will having a few drinks affect my workout the next day?

Short Answer:  If “a few” is less than a six pack, you’re probably good to go.

Long Answer:  Researcher in New Zealand published a study in which participants completed a set of leg exercises then consumed either orange juice or vodka and orange juice following the workout.  They found that “moderate drinking” resulted in about 2x more loss of strength over the next three days.  In this study though, “moderate drinking” was equivalent to a 6 pack of beer for a 200 pound male in 90 minutes or less.  A followup study where alcohol was controlled to half of the “moderate” amount found no difference in recovery rates between groups.