1. What is Hydrotherapy?
2. What are the Benefits of Hydrotherapy?
3. Hydrotherapy for Recovery
4. Hydrotherapy for Rehabilitation
5. Does Hydrotherapy Work?
6. Conclusion

Hydrotherapy, derived from the Greek words “hydro” (water) and “therapeia” (healing), refers to the therapeutic use of water to treat various physical and mental health conditions. Hydrotherapy encompasses a range of treatments, including hydrotherapy massage, hydrotherapy pools, and hydrotherapy exercises, each utilising the properties of water to promote health and well-being.

What is Hydrotherapy?

Hydrotherapy is defined as the external or internal use of water in any form (liquid, steam, or ice) for health purposes such as pain relief, improved circulation, muscle relaxation, improved mobility, reduced stress, improved sleep quality, and fatigue reduction. It involves methods like thermotherapy, cryotherapy, contrast water therapy and thermoneutral therapy (1). Furthermore, aquatic exercise and underwater massage can be used with these methods.

Cryotherapy

Cryotherapy refers to the treatment of injury using extreme cold such as icepacks, or liquid nitrogen, and also includes cold water immersion (CWI) whereby subjects are immersed in cold water < 15 °C. A wide variety of techniques have been used to implement CWI including ice baths, ice bins, and plunge pools (1). More recently, portable ice bathtubs have become a popular and affordable alternative. An immersion duration of between 15-20 minutes has been suggested in research, however, the duration could be as low as 30 seconds due to individual tolerance to cold temperatures (1).

Thermotherapy

Thermotherapy, or hot water immersion (HWI) refers to immersion in warm water > 36 °C to increase core body temperature. This can be implemented using heated baths, spas and pools. An immersion duration of between 10-20 minutes has been suggested in research (1). 

Contrast Water Therapy

Contrast water therapy (CWT) refers to alternating between hot and cold temperatures. For example, an athlete may go from an ice bath to a hot shower. Protocols have varied widely, but often consist of 30-300 seconds at a hot temperature, followed by 30-300 seconds at a cold temperature. This is repeated between 3-7 times and lasts between 4-30 minutes (1).

Thermoneutral Therapy

Thermoneutral therapy is the simplest form of hydrotherapy to apply as temperatures typically range between 16-35°C. Immersion time ranges from between 5 minutes and 6 hours (1).

What are the Benefits of Hydrotherapy?

The benefits of hydrotherapy are multifaceted, encompassing both physical and psychological aspects of health and performance.

Physical Benefits

Reduced Muscle Soreness

CWI, HWI and CWT improved the recovery of maximal isometric squat force compared to a passive recovery group at 24, 48, and 72 hours following an eccentric leg press post-fatigue protocol. The hydrostatic pressure caused by water immersion is believed to displace fluids from the periphery to the central cavity. This causes physiological changes including increased substrate transport, cardiac output and a reduction in peripheral resistance. These changes may increase the removal of waste products, possibly enhancing recovery from exercise-induced muscle soreness. However, only CWI and contrast water therapy enhanced the recovery of squat jump power and post-exercise swelling. This demonstrates that water temperature also appears to affect recovery using hydrotherapy (2).

Improved Strength

Foley et al. (2003) investigated the effects of a 6-week intervention comprising three 30-minute thermoneutral water or gym-based training sessions per week on the strength and function of osteoarthritis patients (3). The same progressive loading strategy was utilised for both water and gym-based interventions. Both interventions successfully improved the physical function and strength of participants, however, gym-based sessions were more effective in improving the muscular strength of the quadriceps. Increased muscle strength around affected joints can improve shock absorption capacity and joint stability. Water resistance can therefore improve physical function and muscular strength without the load associated with land-based weight-bearing physical activity. 

Injury Rehabilitation

Mixed-level athletes suffering from femoroacetabular impingement underwent a hip arthroscopy as they were unable to perform their sport due to debilitating pain and restricted range of movement. Following surgery, the athletes were allocated to a control group comprised of land-based exercises or a hydrotherapy group including thermoneutral water and land-based exercises. The same progression principles and exercises were employed, regardless of group. The hydrotherapy group returned to play at 15 weeks, while the control group took 22.3 weeks, demonstrating an improved return. Furthermore, the athletes’ hip-specific scores and patient satisfaction scores improved considerably, suggesting that hydrotherapy is beneficial in post-operative injury rehabilitation (4).

Pain Relief

A 6-week intervention of one 30-minute thermoneutral hydrotherapy exercise session demonstrated a greater improvement in the Numeric Pain Rating  Scale ( NRPS) when compared with land-based exercises of the same volume and frequency. The hydrotherapy group demonstrated the maximum response compared to the land-based group. However, both interventions elicited a greater improvement in pain compared to the control group. This demonstrates that hydrotherapy offers a non-invasive, drug-free treatment option that can reduce pain and improve quality of life. The reduction in gravitational force allows for easier movement and pain reduction during exercise and therapy sessions (5).

Psychological Benefits

Reduced Anxiety 

Benfield et al. (2001) reviewed the use of hydrotherapy to decrease anxiety and pain during labour. The mean water temperature of the studies was 36 °C, however, temperature varied from 32-42°C (6). After bathing for 15 minutes the anxiety scores of all women in the hydrotherapy group decreased, whereas only 43 % reported a decrease in the control group. Furthermore, the hydrotherapy group demonstrated a mean decrease in anxiety, whereas the control group increased. This anxiety reduction is believed to increase relaxation, which is particularly beneficial during the physiological and psychological effects of labour. Therefore, during labour, immersion in warm water is hypothesised to decrease the production of stress-related hormones such as cortisol, whilst increasing the release of endorphins, which are natural mood enhancers.

Improved Sleep Quality

Patients with fibromyalgia completed a 2-month intervention consisting of 2 x 60-minute hydrotherapy sessions per week in a 32 °C pool. On completion of the intervention, patients reported an improvement in perceived physical function, work absenteeism, pain intensity, fatigue, morning tiredness, stiffness, anxiety, depression, sleep quality and daytime sleepiness. With regards to sleep quality, the Pittsburgh Quality Sleep Index (PSQI) was used to detect sleep disorders in the month leading up to the study. Prior to the intervention sleep disruption was scored at 39.5. Upon conclusion, 80 % of patients reported an improvement in sleep quality, with a mean reduction to a score of 33. It is stipulated that the physiological effects of hydrotherapy originate from the combination of the physical effects of water (thermal/mechanical) and exercise (7).

Improved General Health

A hot spring balneotherapy intervention was used for 30 minutes, 2-3 times per week for 5 months with 326 participants classified as ‘sub-healthy’ at two separate springs. The balenotherapy group bathed in a head-out immersion bath with naturally warm water (36-42 °C) mineral water. The research concluded that balenotherapy improved a range of factors including mental stress, women’s health problems, sleep quality and general health. Interestingly, despite mental stress being significantly relieved, bad/low mood, worry and irritability were not relieved. Symptoms of head pain, joint pain, leg or foot cramps and blurred vision were significantly relieved in the intervention group. 

Further analysis also revealed that increased bathing time increased relief and participants in the senior group (56-65 years old) had greater relief from insomnia, fatigue or cramps. Women’s health problems including breast pain, dysmenorrhea and irregular menstruation were significantly relieved in the intervention group possibly because of the thermal effects of spring water can regulate metabolism and blood circulation and metaboric acid can regulate the endocrine system (8).

Hydrotherapy for Recovery

Hydrotherapy has been found to improve the recovery of maximal force, power and swelling 24, 48 and 72 hours post-fatigue protocol (2). This could be particularly beneficial for athletes with short turnaround times between competitive fixtures. Examples include international football tournaments, tennis tournaments, basketball and baseball. 

Twelve cyclists completed five consecutive days of cycling consisting of 105 minutes, including 66 maximal sprints. They then completed a 14-minute recovery intervention consisting of either CWI, HWI, CWT or passive recovery. Sprint and time trial performance were enhanced across the five day period following a CWI and CWT recovery when compared with HWI and passive recovery. CWI and CWT appear to improve recovery from high-intensity cycling and therefore allow maintenance of performance across a five day period (9). 

However, a systematic review investigating the use of CWI post-resistance training stated that less muscle growth was achieved compared to no post-exercise immersion (10). Therefore, it should be considered whether recovery or adaptation is the goal post-exercise.

Hydrotherapy Massage

Hydrotherapy massage involves heated water and mechanical pressure provided by jets or manual manipulation to massage the body. This type of therapy is typically performed in specially designed tubs, hydrotherapy pools, whirlpool baths, and hydromassage tables.

WATSU

WATSU is a passive form of hydrotherapy in chest-deep thermoneutral water (35 °C) combining myofascial stretching, joint mobilisation, massage and shiatsu. A therapist stands in the water, supporting the supine patient with their upper body, slowly moving the patient in circular motion sequences. Simultaneously, the therapist uses their hands to stimulate acupuncture points (11).  

In a systematic review, it was reported that WATSU was predominantly used as an intervention for pain, physical function and mental health with chronic conditions such as fibromyalgia, asthma, neurological conditions and geriatric care. The meta-analyses concluded that WATSU had a beneficial effect on acute and chronic pain, however, this was not statistically significant. Similarly, the analysis concluded that WASTU indicated beneficial mental effects but was not statistically significant. Interestingly, WATSU appears to have moderate effects on physical function, linking to lower muscular tone and stiffness, translating to fewer muscle spasms and increased range of motion (12). 

Hydrotherapy for Rehabilitation

Hydrotherapy has been found to accelerate the return to play time of athletes following a hip arthroscopy. It is stipulated that the buoyancy of water reduces the impact on joints and muscles, making it ideal for individuals in the early stages of rehabilitation (4).

Eighteen male professional athletes who incurred a grade I or II acute ankle sprain began thermoneutral hydrotherapy with hydrogen-rich water (HRW) intervention or a standard RICE (rest, ice, compression, elevation) protocol 24 hours post-injury. The HRW group received 6 x 30-minute ankle baths every 4 hours during the intervention period. The RICE group offloaded the injured leg, administering ice packs for 8 x 20 minutes every 3 hours. HRW was equally as effective for reducing joint swelling and pain while regaining range of motion and balance 24 hours post-acute ankle sprain. Therefore, HRW could be applicable to athletes and healthcare professionals requiring an alternative strategy to reduce swelling and pain (13). Further investigation is required to identify the effectiveness of HRW on other upper and lower-limb injuries.

Patients with osteoarthritis of the knee were allocated into a land-based or thermoneutral water-based exercise group for an 18-week period. Both groups completed similar exercises, consisting of gait training and strengthening and stretching the muscles of the lower extremities 3 times per week for 50 minutes per session. A similar progressive volume-loading strategy was also used by both groups. Both land-based and water-based exercises reduced pain and improved function, showing that water-based exercises could be a suitable alternative to land-based exercises (14). 

Knee and hip implants with telemetric data transmission were used to measure the joint contact forces of twelve elderly participants completing thermoneutral aquatic and land-based exercises. In chest-high water, the buoyant force led to decreases of 65-68 % in body weight. Specifically, a reduction of 58 % was identified in the hip and 62 % in the knee during a one-legged stance. Furthermore, both higher movement velocity and increased water resistance led to an increase in joint forces. This indicates that aquatic exercises can be used for effective muscle activation. Furthermore, these joint forces and muscle activation can be manipulated through exercise selection, movement velocity and utilising additional resistive devices, proving a useful tool in rehabilitation (15).

Hydrotherapy Exercises

Hydrotherapy exercises, performed in water, help improve strength, flexibility, and balance. They are a viable option for individuals recovering from sprains, fractures, or post-surgical intervention. 

Throughout pregnancy, hydrotherapy exercises have also been found to help control heart rate and blood glucose levels, prevent excessive weight gain, and improve balance and mobility. These exercises can be adapted to suit individuals at different stages of recovery, rehabilitation or pregnancy (16). 

Walking or Jogging

Water walking or jogging is particularly beneficial for individuals recovering from lower limb injuries or surgeries. Additionally, it is an excellent method of reintroducing locomotion without the cost associated with equipment such as anti-gravity treadmills (14).

Water Squats

Water squats are performed by standing in the water at different depths, dependent upon the stage of rehabilitation. This exercise targets the lower body muscles and aims to improve strength and stability. The buoyancy of the water reduces the load on the lower limbs, making it easier for individuals with pain or injuries to perform (15).

Aqua Aerobics 

Aqua aerobics involves aerobic exercises performed in water, including jumping jacks, high knees, leg kicks, treading water and arm circles. These exercises can enhance cardiovascular fitness, strength and balance. Aqua aerobics is suitable for individuals of all fitness levels and ages (17,18).

Does Hydrotherapy Work?

There is still some speculation about the use of hydrotherapy for physical and psychological purposes. Furthermore, the method of hydrotherapy (thermotherapy, cryotherapy, contrast water therapy) applied will change the effect it has on an individual.

Cold Water Immersion (CWI)

CWI  has commonly been used to aid post-exercise recovery. A review including 27 studies measured the effects of various cryotherapy on delayed onset muscle soreness (DOMS). Analysis revealed that CWI significantly improves DOMS at 24, 48 and 96 hours post-exercise. It should be noted that CWI reduced DOMS more than cold air and ice packs. Furthermore, male participants responded better than female participants up to 48 hours (19). 

Thermotherapy

Despite its use in a physiotherapy setting, there is less research-based evidence to support thermotherapy. A review by Versey et al. (2013)  found that thermotherapy is unlikely to have a significant positive effect on the recovery of performance (20). However, studies have suggested there are a variety of psychological benefits to thermotherapy.

In labour, the anxiety of all women in hydrotherapy decreased, whereas only 43 % reported a decrease in the control group (6). A hot spring balneotherapy intervention improved a range of factors including mental stress, women’s health problems, sleep quality and general health (8).

Contrast Water Therapy

A review by Higgins et al. including 23 articles investigated the recovery effects of contrast water therapy with well-trained team sport athletes (21). Contrast water therapy did not enhance recovery of perceived muscle soreness 24 hours post-exercise; however, it appeared to reduce the detrimental effects of team sport on countermovement jump performance 24 hours post-exercise but had no additional benefit 48 hours post (21).

Thermoneutral Therapy

Hydrotherapy exercises completed in thermoneutral water have been used with individuals recovering from injury, surgical intervention or patients diagnosed with chronic conditions such as fibromyalgia (3). 

Although water-based exercise has been found to improve both physical function and strength, however, gym-based interventions have been more effective at improving the strength of osteoarthritis patients (3). Silva (2008) also found that hydrotherapy improved physical function and reduced pain similar to land-based exercises (14). Athletes recovering from femoroacetabular (hip) impingement returned to play at 15 weeks following a hydrotherapy intervention, while the control group took 22.3 weeks, demonstrating a significantly improved return to sport (4).

Patients with fibromyalgia reported an improvement in perceived physical function, work absenteeism, pain intensity, fatigue, morning tiredness, stiffness, anxiety, depression, sleep quality and daytime sleepiness (7).

Conclusion

Hydrotherapy offers a range of benefits, from physical and psychological improvements to aiding in recovery and rehabilitation. The method of hydrotherapy intervention seems to elicit different responses, therefore the individual’s goal should be considered before selecting a specific method. The therapeutic properties of water make it a versatile treatment option for various conditions. Whether used in clinical settings, sports facilities, or at home, evidence suggests hydrotherapy can enhance health and well-being. As research continues to investigate its efficacy, hydrotherapy remains a valuable tool in the arsenal of modern therapeutic practices.

The post Hydrotherapy appeared first on Science for Sport.

1. Introduction
2. What is a massage gun? 
3. Do massage guns work? 
4. Benefits of using a massage gun
5. Side effects of using a massage gun
6. Can you use it every day? 
7. How to use a massage gun?
8. Which massage gun to purchase?
9. Conclusion

Introduction

Vibration and pressure therapy has been used for health benefits for a considerable amount of time (1), in a variety of forms, with the idea of using a device to apply such targeted methods first came to prominence in the 1950s (2).  Since then, a greater variety of tools have been produced to apply a variety of pressure to musculature, notably the foam roller (3),  and with ever-increasing commonality, the massage gun.

What is a massage gun?

A massage gun is a handheld, portable device that resembles a power drill and comes with a range of attachments.  When applied (and through the attachments), the massage gun applies pressure to the target area, thought to promote blood flow, reduce myofascial restriction and tension, alleviate pain and break up trigger points (4).

Do massage guns work? 

baY-balance test calculatorResearch into the effects of massage guns typically centres around performance and recovery (5).  The use of massage guns did lead to an increase of range of motion (ROM) (6) and flexibility (7), however, they appear to be less effective when improving strength is the goal, with massage guns actually resulting in a decrease in jump height (8).  Massage guns appear ineffective in improving strength, balance, acceleration, agility, and explosive activities (5).

Vibration therapy as a whole-body tool does show promise for attenuating muscle soreness (13), although as the title suggests, this was based on whole-body massage rather than targeted to the level of a massage gun. However,  including massage guns as part of a structured warm-up was suggested to reduce perceived muscle soreness as well as increase range of motion, with no negative impact on muscle activation and force output (9).

Side effects of using a massage gun

Massage guns do not come without their potential side effects, typically as a result of overuse in terms of frequency or intensity. Indeed, one case study highlighted a case of rhabdomyolysis (the breakdown of muscle tissue, potentially releasing harmful chemicals into the bloodstream) following the use of massage guns (10), muscle oedema (12) and other potentially adverse effects from massage therapy in general (11). 

Can you use it every day?

Information on when to use a massage gun has not been widely investigated, but there may be different ideas based on the goal at that time (5).  For recovery, evidence points to greater than 2 minutes per muscle group at low frequencies, whilst for range of motion improvements, brief application at higher frequencies may be more beneficial and it is recommended to avoid massage gun therapy before strength activities due to potentially negative effects on performance (5).  

It may be tempting, especially if the massage gun delivers pain relief to an affected area, to rely on it or use it for longer than needed.  However, spending more time on an area may become detrimental and have negative effects, especially those greater than 30 minutes (5).

How to use a massage gun

It is suggested that a massage gun should be used with “gentle pressure, using the ball-tip attachment, moving dynamically” over affected areas (5), so essentially not pressing too hard, and constantly moving over areas where the user may feel tightness.  It’s important to let the massage gun do the work as opposed to pressing harder with the hope that “more is better” to avoid bruising and unnecessary tissue damage. Bony areas (knees, ankles, etc.) should be avoided, with a focus on the musculature around those joints, just like a massage professional or physical therapist would.

What is the best massage gun?

There are a huge number of different brands of massage gun.  Whilst they all perform the same basic role, there is a range of prices, number of accessories, speeds, battery life, and even decibel level.  Below are a selection of massage guns available on Amazon:

For the Pros

Theragun is perhaps the most well-known, with the elite model coming with 5 attachments, an LED screen and customisable speeds costing USD 399.  The Theragun has an impressive range of features and users can pair it with the accompanying application to get step-by-step routines for individual needs.

The weekend warrior

The Hyperice Hypervolt Go 2 offers 3 speeds, is lightweight and super quiet.  At USD 129.99 it offers significant performance and a 3-hour battery life, more than enough for numerous uses before recharging.   As the partner with a number of professional sports teams and leagues, the Hyperice certainly has pedigree and with the ability to purchase more massage heads, gives the ability to tailor the massage gun to what works best for the individual.

The occasional user

For those looking into massage guns for the first time, it may be prudent to look at a model such as the Arboleaf Massage Gun which offers 6-10 hours of battery life, 8 massage heads and 20 speed levels in addition to low noise for USD 64.99.  

Conclusion

Massage guns are, like a number of health and exercise tools throughout the years, currently trending.  So, is it worth purchasing one? As ever, it is case by case! Level of athletic performance, current injury status, training age, schedule, stage of season or goals may all have an impact on whether to purchase and ultimately use a massage gun.  Including one as a small part of an overall regimen, depending on outcome goals may prove useful.

The post Massage Guns appeared first on Science for Sport.

Some people swear that cold showers can deliver myriad health benefits, from keeping chronic disease at bay to clearer thinking, improved circulation and general wellness improvements. But what does the science have to say about them?

By Dr. Tom Brownlee
Last updated: February 29th, 2024
9 min read

Cold showers: Are they worth the pain?

NOTE: This article refers to cold water exposure. If you are currently experiencing any medical issues, we recommend you speak to your physician before attempting.
Early in September last year, I found myself standing on a beach in County Mayo in the west of Ireland. The air temperature was about 18°C (64°F), which is a little too chilly for the pair of swimming shorts I was wearing. I was being told by my other half’s parents (also wearing swimming gear) that “you get used to the cold quite quickly!”. We were going for a swim. The water temperature was about 15°C (59°F) – so much for a summer’s worth of warming up!
As a physiologist, I know we lose body temperature much more quickly in water than air of the same temperature. Was I excited for what awaited me? No. Was I feeling peer-pressured and at risk of being shown up? You bet!
So, in we got. They do this every day, and marched in as if they were striding into a luxury spa. I tried my best to keep pace but it was tough, especially as certain body parts became submerged. What then followed was a satisfaction curve that followed somewhat of an arc, with a flat top. Ten minutes of hyperventilating and questioning my life choices, 10 minutes of enjoyment coupled with ‘oh, it’s actually quite nice!’ and 10 minutes coming back down the arc as I felt the life being sapped from me. When we got out and (finally) warmed up, there was general agreement that it was in fact enjoyable.

I subsequently went in each day I was there, and it did indeed get easier. But it was after the first dip when someone said: “I’m sure it’s supposed to be really good for you … isn’t it?!”. There was talk of all sorts of miracle cures following these cold plunges, from keeping chronic disease at bay to clearer thinking, improved circulation and general wellness improvements. Also, there was a talk of a mystery man named Wim Hof.

So, is there any basis for these claims and who is this fella they call the Ice Man? Let’s find out.

Are cold showers good for you?

This article will consider the purported claims of cold water exposure and also how these statements stack up against the scientific literature.

But before we get to that, let’s back up a bit. You may have heard of colleagues, friends or loved ones telling you how they’ve started to kick their day off with a freezing cold shower in the morning and they “feel great” for it. But how has this crept into the public consciousness? In part, it is likely through one of its top advocates Wim Hof, the Ice Man. Hof is described as a Dutch extreme athlete who is noted for his ability to withstand freezing temperatures. He holds, or has held, a number of world records including being embedded in ice for nearly two hours.

Hof states his ability to achieve such feats stems from a combination of breathing technique work (which he likens to controlled hyperventilation), the cold exposure itself (which he recommends you work up to gradually) and meditation (which he does while doing both the breathing exercises and the cold exposure).

We have Hof to thank for this upsurge in this kind of practice, with many Hollywood A-listers citing use of his techniques. This has further driven up interest and participation across all walks of life. You can find his particular method easily online, but we are going to focus mainly on the cold water immersion.

The supposed benefits of cold water immersion are numerous. Physiologically they include:

The psychological benefits are also numerous and include:

It is also worth mentioning that such practice is not without risk to some individuals. Cold water immersion has been found to sometimes make stiff muscles worse, reduce the impact of some training types and also (unsurprisingly perhaps!) increase the risk of hypothermia.

But if even half of the positive claims were true, then it’s safe to say we would all have something to gain from factoring cold water immersion into our lives. However, this is a long, and at times woolly, list (I actually removed a fair few from my original list as they were even woollier!).

But let’s be honest – this is not a particularly pleasurable experience, certainly at first anyway. So, let’s see what evidence is out there to back up what, for many, is likely a pretty uncomfortable lifestyle change.

The cold, hard facts on cold showers

Relatively, there is quite a lot of specific research out there on what is quite a niche topic. A lot of this centres around Hof himself, who has participated in a lot of the research that is referred to below.

MRI scans of Hof’s brain found that when he is carrying out his breathing technique, he is able in a sense to trick his brain into producing a chemical that puts him into a euphoric state at a time when the rest of us would be feeling intense discomfort. The pain we would typically feel is important, as from an evolutionary sense, it lets us know when a situation is undesirable. Subsequently, this lets us know that we should remove ourselves from it – this is certainly how I felt as the water became waist deep in Ireland!
Our bodies, though, can override this, again for evolutionary reasons.  For example, let’s imagine you’re being chased by a gorilla 10 seconds after standing on a nail that goes right through your foot. Normally, the nail would be extremely painful. In this circumstance though, your brain knows it can worry about your foot later – if you’re able to outrun the gorilla! It seems as though Hof’s breathing technique enables him also to override his pain response, without the need for the ape!
So, is it actually the breathing that is leading to the reduced pain and improved psychological state rather than the water itself? Well, it is argued this initial consequence will only help you for the first couple of minutes in the water. As a result of more prolonged exposure, opioids, serotonin, and dopamine (all of our happy chemicals) kick in, a kind of self-fulfilling positive cycle. These chemicals, it seems, are your reward for getting through that initial pain barrier. They then aid your ability to tolerate longer exposure and potentially bring about some of these further benefits.

But what about some of these other benefits that are claimed? Are they too good to be true?
The changes in the brain referred to above not only seem to allow for greater ability to tolerate the cold but also provide additional chemical responses. This is achieved via what has been described as a controlled stress response characterised by activating the sympathetic nervous system. This appears to reduce the innate immune response and, in turn, leads to reduced inflammation which has subsequently been found in more in-depth research also. Though links are yet to be specifically made, this could lead to many positives linked to some of the physical benefits listed above, from enhanced recovery to reduced likelihood of some disease occurrences.

This manipulation of the body’s immune response could also influence the way the body responds to pathogens such as bacteria and viruses. This was trialled with a group who were trained in Hof’s methods and were found to be able to voluntarily activate their immune response and subsequently showed fewer flu-like symptoms.

The chemical response mentioned above is likely the primary reason for the pleasure experienced by many following their cold showers, alongside serotonin and dopamine chemicals, including adrenaline which have also been found to be ramped up after undertaking Hof’s methods. This cocktail would combine to give effects similar to that felt when on a rollercoaster.

Beyond such acute euphoric benefits listed above are also a handful of specific chronic medical conditions. At this time, it seems evidence to substantiate such claims is often unspecific, and it is suggestions based on broader evidence that triggers them. That is not to say they are untrue, and often in science the research can take time to filter through.

Arthritis is one such condition where this is the case. Linking back to the potential to reduce inflammation in someone practicing these techniques, healthy individuals have been found to be able to reduce chronic inflammation using Hof’s methods. This has prompted researchers to suggest that this proof of concept investigation should now be rolled out further to include diseased populations. This is similar for many other chronic illnesses linked to the above proposed benefits.

Is it time to take the plunge?

Perhaps unsurprisingly, it seems Hof’s success in tolerating extreme cold, and the subsequent benefits it might yield, are driven by training the brain rather than specifically the body. Further investigation into whether his tolerance was a result of the brain or body indeed found that control of the brain may be more possible than first realised and that this may lead to many possible positive outcomes.

This leaves some interesting and exciting proposals that we may genuinely be capable of far more than we think if we can safely train our brain over time to deal with such environments. It seems this may then allow us to reap some of the benefits that may in time be shown to be associated with such mind over matter challenges.

Cold showers: Take-home points

Wim Hof is likely the Usain Bolt of the extreme cold temperature world. Can you expect to build superpowers on the same level as his to be able to withstand such extreme extremes? It’s unlikely. Can you train yourself to be better able to tolerate a cold shower in the morning? That seems a little more likely. And will it live up to every claim? Well, probably not. The science certainly isn’t backing them all up just yet. But that’s not to say evidence won’t be gathered over time as further research is conducted.

It’s also useful to keep in mind that some people will absolutely hate to implement these kinds of techniques. To those, I say you shouldn’t be worried if that’s how you feel as you read this. A lot of the psychological and potentially physical benefits associated with the Wim Hof method can be achieved via other mindfulness techniques such as meditation.

It does seem though, that if you’re able to get through the initial period of discomfort, there likely are some benefits for both the body and mind for the breathing technique, cold water immersion and meditation of the Wim Hof method.

My next trip to Ireland is planned for some time just after Christmas, so I’ve plenty of time to prepare. I’ve just looked, and the water temperatures should be down to 10°C (50°F) by then though. Maybe just a shortie wetsuit?

[optin-monster slug=”nhpxak0baeqvjdeila6a”]

Dr. Tom Brownlee

Tom is an assistant professor in applied sports sciences and has worked with elite sports for over 10 years. Previous roles include working as a sports scientist at Liverpool F.C., where he completed his Ph.D., and working across a number of other sports. He is passionate about physiology, coach communication, and high-performance strategy and systems.

Tom graduated with a BSc in 2011 before undertaking an MSc at Loughborough University. He has published 25 academic papers on strength and conditioning, nutrition, and youth development in Sports Medicine, the Journal of Strength & Conditioning Research, and others. Tom also now supervises a number of his own Ph.D. students around the world embedded within sporting organisations.

More content by Tom

The post Cold showers: Is there any scientific rationale? appeared first on Science for Sport.

Long journeys and jet lag are a concern for many athletes, but what exactly is the impact of long flights on performance, and what strategies are available to counteract these effects?

By Dr. Tom Brownlee
Last updated: March 1st, 2024
7 min read

Jet lag: How can athletes minimise its impact?

When I wrote this article, we were sitting in the time between the Olympic and Paralympic Games in Tokyo. Having previously written about the difficulties of the heat during the Games, I thought I’d consider another issue that was brought up frequently over the past few weeks. As with any Olympics — where people have travelled from far and wide — long journeys and jet lag are a concern for many athletes during the build-up to what could be the biggest few days of their life.

Today I’ll examine the impact of long flights and jet lag on performance. I will look at the underpinning science and strategies we might want to use to limit the effect on our next family holiday, business meeting or gold medal race.

Flying: Jet lag vs. travel fatigue

Firstly, we need to differentiate between two potential issues that may be at play when we consider long-haul travel. If we go on a long journey, let’s say a flight from London to Cape Town, this will mean a 12-hour flight crossing one time zone (during British summer time). The result of this would be travel fatigue. We would be tired from the event but would have different experiences from a 12-hour flight east, say from London to Tokyo, where we would pass through eight time zones. This second trip would be more likely to trigger the infamous jet lag that we heard so much about from British, American and many other athletes at the Tokyo Games.

We’ll start with a little explanation of the physiological difference between the two before diving deeper into the details of avoiding them.

What is actually happening to us up in the air?

Way back in 1997, the Godfather of sports chronobiology (the study of biological rhythms), Professor Tom Reilly, acknowledged the difference between travel fatigue and jet lag. He and colleagues summarised that travel fatigue, achieved via long trips (typically within three time zones of your origin), could be tackled with relative ease. They suggested this state was an acute accelerated tiredness and recommended simple amendments to training schedules and short periods of rest to allow individuals to return to normal following such trips.

They went on to acknowledge that once travelers exceeded three time zones,  experiences were much more noticeable, especially when travelling east. The exact reason for this east/west difference isn’t known, but it likely has something to do with the fact that advancing your body clock is trickier to deal with than delaying it. The general reason for our body struggling following time zone differences is that our internal body clocks become out of sync. Our brain gets confused when trying to determine the difference between where we are and where we think we are. This can also be exaggerated by novel issues such as a change in temperature, altitude, humidity, pollution etc., which has certainly been the case in Tokyo.

Beyond these factors, the key variable messing with our internal clocks is light. This is perhaps no surprise, and it is logical that if your body thinks it’s the middle of the day, but it’s pitch black outside, you may find it harder to go to sleep.

But beyond the annoyance experienced by anyone who’s ever had jet lag, from an athletic performance standpoint is it something we should be concerned with?

Jet lag and athletes: What’s the go?

It’s worth a quick glance at the science here to see what the impact of travel fatigue and jet lag might be on athletic performance. If, for example, our brains feel upside down, but we are still able to optimally perform, then maybe this would be less of an issue.

Starting with travel fatigue, it seems there is limited evidence that it might directly impact performance (assessed via counter-movement jump, yoyo test and technical/tactical performance). However, despite the potentially limited impact on physical markers, it was considered to negatively impact perceptual measures such as alertness, motivation, and mood, which would likely be a concern for athletes and coaches.

When we more specifically look at jet lag, it seems that crossing time zones increases resultant fatigue sufficiently such that performance markers including sprint and jump ability are negatively affected. It’s also suggested your chronotype (whether you’re a night owl who naturally likes a late bedtime, or a morning lark who prefers waking up early) may impact how affected you are, with larks appearing to adapt to eastbound travel more quickly.

Key strategies to reduce the impact of jet lag

Having established that, for long trips, especially when crossing multiple time zones, there are likely negative performance consequences, the big question is, what can we do about it? Below we will consider some pre-, during and post-travel strategies to help shake that funk as best we can.

Prior to travel
Firstly, it is important to try to embark on your journey in as fresh a state as possible. So, attempt to get a good night’s sleep leading up to your journey. It has also been recommended it may be useful to begin to adjust your sleep and waking time by one hour each day in the two or three days leading up to travel (especially when flying east). Greater adjustment than this is likely to be disadvantageous, with periods longer than two to three days likely to be too disruptive to an individual’s days before travel.

During travel
Once on the plane, it is recommended travellers attempt to make themselves as comfortable as possible. Many sports science departments are now taking this very seriously. During the Olympics, we saw special pillows on planes to aid rest, which you can even pick up yourself through the Team GB mattress sponsor. Incidentally, it was recently found that business class travel led to better sleep quality and quantity as well as reducing some jet lag effects – something to keep in mind if you’re looking to barter with the boss!
It has also been recommended athletes change their watches to the time at destination upon travel to aid the mindset shift. Sleep should then ideally take place during the ‘new’ night-time. Specifically, in the hour prior to attempting to sleep, it is advised to restrict computer, TV, and phone use. Loose fitting clothing, an emphasis on hydration and refraining from alcohol and caffeine have also been recommended. These interventions are based on evidence that exposure to light and noise can reduce sleep quality – aim to increase comfort and induce the physiological state required for sleep onset without pharmacological aids.

Upon arrival when having travelled west
Once you arrive at your accommodation, it has been suggested a short nap may be useful. This is aimed at suppressing the desire to go to sleep that can creep in when we extend our days by flying west. It is important, though, to keep this nap short (around 20 mins seems a good estimate) and seek some form of activity in the daytime once you’re up and about. This can lead to greater exposure to daylight, which can also aid the reduction of some jet lag symptoms.

You may also feel like going to bed 1 to 2 hours earlier than usual, subsequently waking earlier too. Don’t fret, though – this should pass after spending a few days in your new time zone.

Upon arrival when having travelled east
Things are a little trickier when we’ve flown east. This is because frustratingly, the time you feel most tired coincides with night-time in your origin time-zone, which is far from ideal if you’ve arrived into glorious sunshine at your destination. The key to cracking this and resynchronising your body clock is through manipulation of light after flying eastwards.

This comes through making the most of the positive effects of natural light at the right time. The problem with crossing many time-zones (e.g., six to nine hours) to the east is that a morning arrival worsens this issue. In such instances, the use of light shades on the plane and dark glasses en route to the immediate accommodation can minimise light exposure and allow the traveller to retire to bed until late morning if necessary after arriving. Subsequently, light exposure in the ‘new’ afternoon is beneficial.

It would also be beneficial to avoid training the first few mornings and train in the late afternoon instead.

Dreaming of gold: Take home points to maximise your performance

Generally, athletes, practitioners and us mere mortals are advised to firstly get the basics right when it comes to combatting jet lag.

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Dr. Tom Brownlee

Tom is an assistant professor in applied sports sciences and has worked with elite sports for over 10 years. Previous roles include working as a sports scientist at Liverpool F.C., where he completed his Ph.D., and working across a number of other sports. He is passionate about physiology, coach communication, and high-performance strategy and systems.

Tom graduated with a BSc in 2011 before undertaking an MSc at Loughborough University. He has published 25 academic papers on strength and conditioning, nutrition, and youth development in Sports Medicine, the Journal of Strength & Conditioning Research, and others. Tom also now supervises a number of his own Ph.D. students around the world embedded within sporting organisations.

More content by Tom

References

The post Jet lag: The impact and management of flying on athletic performance appeared first on Science for Sport.

Compression garments are everywhere nowadays, from elite athletes down to the average Joe. But what are they supposed to do, do they work, and should you be using them to improve your recovery?

By Dr. Tom Brownlee
Last updated: February 29th, 2024
9 min read

Compression garments: Crucial recovery aid, or just a fashion trend?

I first started taking sport seriously more than 20 years ago now – that makes me feel very old. Back then, I was a track and field athlete – a triple jumper in fact. I was okay at it, but I definitely took it seriously. I trained three to five times a week, on the track and in the gym, and I wanted to be the best I could be. I was a member of my local team, which had a strong pedigree and provided a good environment for me to improve.

As young sportspeople do, I began to pick up some of the traits of my peers at the club – buying similar spikes to them and also copying some of the other clothing choices they made. This included lycra. I don’t remember really considering this to be unusual, but I think at the time it probably was. Back then, unless you did gymnastics, cycling, track and field or were a keen aerobics participant (a type of group exercise class – ask your mum or dad) lycra wasn’t really all that common. How times have changed…
I’m not going to stray into fashion here and start talking about activewear but now, lycra is a staple in most people’s wardrobes. Whether this is to go to the gym in, to wear under your shorts for rugby training, a full kit for the ‘MAMILs’ amongst us, or those weird sleeve-only things that NBA players wear, there’s a lycra option for your needs! 
Rather than listen to my sartorial musings, we’re going to focus today’s blog on a particular kind of lycra clothing – the compression garment. Added to the list of massage guns and GPS devices, one of the most commonly seen bits of sports technology across social media, where so much advertising is done these days, are compression garments. They are supposed to aid with recovery through squeezing the muscles in a way to rid them of their evils – or something like that. They mainly come in the form of socks, shorts and short- and long-sleeve tops and are worn under your normal gear, or sometimes standalone. They’re sold by pretty much all of the big hitters and are also pretty tight – obviously.

So, let’s consider what is going on here. What are they supposed to do, do they work, should you be using them to improve your recovery and was I ahead of my time as a 15-year-old in full-length lycra trousers all those years ago?!

Fresh as a daisy…

When we exercise, especially when we do something we haven’t done before or we ramp up the challenge, we get sore. This soreness is a sign that our body has done something difficult, and it has to repair in a way that makes it able to cope with it should it experience it again. This principle of overload, when sustained during an exercise program, is what enables us to get fitter, stronger, bigger etc. This soreness usually only lasts a day or two but during that period it’s advised that you don’t work those muscles again at a high intensity.

Depending on your goals, this can be frustrating and not aligned to what is required of you. For most of us, this isn’t a huge issue, as we can take a little extra time between sessions. If you’re a professional though, and you have a soccer match on a Sunday and another on a Tuesday, or a tennis Grand Slam match that occurs over two days, you may not appreciate that soreness much at all! As such, methods to relieve this soreness including massage, foam rolling, ice baths and compression garments have crept into use. Some professional soccer clubs now even have members of staff dedicated to heading up recovery strategies, such is the importance of having the best players firing on all cylinders during key periods of the year.

The science of the squeeze

The theory behind the use of compression garments is that they have two main periods of use – during and, more commonly, after exercise. During exercise, it is thought they aid improved blood flow, therefore providing working muscles with more oxygen. The theory here is that as the blood returning from the lower body is having to work against gravity, squeezing the veins increases that pressure, a bit like how squeezing a hosepipe increases the water pressure – it aids the system in becoming more efficient. This would reduce the perceived difficulty of exercise at a given intensity, which we would all appreciate. It is also thought that the factor of wearing tighter-fitting clothing aids our proprioception, or our ability to know where our body is in space. This might sound a little odd but it is thought this will improve our ability to maintain a correct posture, which can help to make us more efficient.

Following exercise, as we’ve alluded to, compression garments aim to minimise delayed onset muscle soreness (DOMS). This is the specific muscle ache we have the day after a hard session. It is thought this is achieved through some of the same mechanisms as having a massage. It is thought they also increase the temperature of the muscle they are around. This also promotes blood flow and can promote healing.

Lastly, there are some rumblings that compression garments are able to reduce injury risk. This is linked to the fact that by aiding the warming of our muscles, we may be less likely to strain or pull a muscle.

Wouldn’t it be great if all of that were backed by science? Well, let’s see what we can unearth.

Starting off with the claims for use during exercise, it doesn’t seem like we are off to a great start. From the limited evidence out there, typically looking at runners, it doesn’t seem there’s much linking compression garments and improved running performance directly. This is likely because our bodies are already pretty good at what they do. When we exercise, the muscles, as well as propelling us around, are squeezing the blood back to our hearts. As a consequence, the addition of a compression garment doesn’t really add much to this system.

It was also hoped that by stopping our muscles from shaking too much when we hit the ground during running, this too may limit the micro-trauma to the muscle, which is associated with soreness. Sadly, it doesn’t seem like there’s too much to this one either. Also, though some studies have found that wearing tighter garments during exercise does indeed improve our proprioception, this hasn’t translated to better performance. Maybe this could be an advantage for those who are trying to overcome serious technique issues but as is often the case with science, we can’t say that for sure just yet.

So, let’s shift our hopes to recovery, and perhaps more where we think these types of clothing can benefit us. Thankfully, here we’re on slightly more solid ground. It does seem there is a link between the wearing of compression garments and reduced muscle soreness and fatigue. This likely is based on more solid foundations as its history lies in the medical rather than sporting realm. Compression has been used for years to reduce swelling after an operation by pushing pooled fluids and blood away from the specific area. This isn’t enough to improve performance during running, as we’ve said, but can be useful during recovery. Often such research points to weight training though, where there is obviously a huge muscular load. The evidence for improved recovery — measured by an ability to reproduce a performance during a 24-hr recovery phase in cycling and running — is limited. There is also limited evidence to suggest that DOMS duration or intensity is reduced following use of compression garments.

Compression garments for sport: Adaptation vs. recovery

One interesting point to consider when thinking about if you need or want compression garments in your life relates to the very thing they are trying to achieve. Compression garments are attempting to rid the system of the chemicals that make us feel sore and stiff. As we said at the start of this blog though, those chemicals are involved in the process of helping us to adapt. This is obviously less of an issue if we’re between matches at Wimbledon or we’ve got the Olympic 100m final tomorrow, but what if we’re trying to train for a four-hour marathon? Surely then we want those chemicals to help us to get fitter, not to dull them down so that we have a few hours where we aren’t so sore.

And this isn’t just the case of elite athletes versus us normals. Consider warm weather training camps that endurance athletes might do, or soccer or rugby players’ pre-seasons – they are very much aiming to adapt. So, this is quite an important consideration for your use of compression garments in sport. But not only that – this logic also applies to ice baths, foam rolling and massage. Sometimes there may be a balancing act between recovery and allowing adaptation but be mindful of your broader goals before you slap on every bell and whistle in pursuit of being 100% for the next session. If your program is correctly periodised and planned, then you won’t always need, or indeed want that to be the case!
Another thing to consider is the specificity of the products themselves. In many of the studies I’ve referred to in this blog, the investigators do not mention the tightness of the products used. As such, it is hard to know how tight they are supposed to be. Potentially, some studies with no positive findings may simply have not used tight enough garments. Scientists do suggest we’re looking for a Goldilocks effect here – it must be tight enough to increase blood flow but not too tight as to stop it. Frustratingly, it doesn’t seem we’re too sure where that level of tightness sits at the moment though.

Despite all of this, I know that some will be confused by reading this. On the other side of this argument is the case for what is probably the strongest reason for compression garments working – the strength of the placebo effect. Maybe the evidence isn’t strong enough to talk you all into purchasing compression garments. And in fact, a lot of them are pretty expensive. But for others, the slightly limited evidence shown here will be irrelevant, as you know it just “works for me”. I would rephrase that as “feel” it works for you rather than “know”, but there’s no doubting the power of placebo.

Maybe I’ll rewrite this in a few years with some more robust studies and we can be more sure one way or the other. For now though it seems that psychological benefits are likely near the top of the list for mechanisms behind any successes linked to compression garments.

Take-home points

It is a shame there isn’t a tighter case to make for the use of compression garments. Having said that, it certainly isn’t the worst sports technology evidence I’ve ever considered. It seems that use during exercise is not as well backed up as it is during post-exercise. It seems that through impacting blood flow, there are positive outcomes in helping people to feel less sore following certain types of exercise. Now you just need to consider whether you actually want to blunt some of these markers of overreaching or whether you’d rather put up with them to benefit from the associated adaptation.

As with so much of sports science, I’m afraid this is a bit of an ‘it depends’ situation. But hopefully now you’re a little clearer on what compression garments are supposed to do, and how close they might be to achieving that.

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Dr. Tom Brownlee

Tom is an assistant professor in applied sports sciences and has worked with elite sports for over 10 years. Previous roles include working as a sports scientist at Liverpool F.C., where he completed his Ph.D., and working across a number of other sports. He is passionate about physiology, coach communication, and high-performance strategy and systems.

Tom graduated with a BSc in 2011 before undertaking an MSc at Loughborough University. He has published 25 academic papers on strength and conditioning, nutrition, and youth development in Sports Medicine, the Journal of Strength & Conditioning Research, and others. Tom also now supervises a number of his own Ph.D. students around the world embedded within sporting organisations.

More content by Tom

The post Compression garments: Do they actually work? appeared first on Science for Sport.

There is good evidence that meditation can play a role in helping athletes achieve a better state of mind when they’re competing, and this translates well across a variety of sports.

By Dr. Tom Brownlee
Last updated: March 1st, 2024
8 min read

Sports meditation: Yes, no, maybe or sometimes?

Sports stars can be a strange bunch. I suppose it’s fair to say that anyone who is at the top of their industry can behave a little differently to the rest of us (Bezos, Elon and Zuck, I’m looking at you). Sports stars are certainly no different to this rule and whether it’s superstitions around what they eat before they compete, a persona they adopt when they cross the white line, or a desire to be super hyped (Conor McGregor) or calm (Kimi Räikkönen) before they compete, most will have practices they adopt to help them feel ready.

In recent years one of the best pole vaulters in the world has been Yelena Isinbayeva. Between rounds she would lay quietly with a towel over her head with commentators joking she was having a nap. If you’re a ‘get as hyped up as possible’ person you would probably see that and think that she couldn’t be successful, but she was. With two Olympic golds and seventeen World Records, I’m certainly not going to argue with her.

Isinbayeva isn’t the only individual to adopt such tactics either. In tennis we often see players with towels over their heads as they sit quietly between games. Often this includes top players, and their successes suggest that we don’t all need to be shouting and screaming to achieve at the sharp end. Who really knows what’s going on in their heads while the towel is on but with the rise of the use of sports psychologists, it’s not a big stretch to think that some kind of self-talk, focusing and meditation may be happening.

As I mention psychologists it’s time for a disclaimer: I am not one – at all! I am a physiologist. But I’m a physiologist who is interested in helping athletes to maximise their performances. And as such I’m interested in the potential physiological impact of psychological techniques such as meditation. So, let’s learn together and see what the supposed benefits of meditation are, how they affect us physiologically and whether there’s a place for them in our own practice.

First things first – what is meditation?

You probably have an idea for yourself but first of all, what are we actually talking about when we refer to meditation? Historically, I think when people hear the word they will think of mystics sitting cross legged searching for enlightenment. There is likely good reason for this, with evidence of meditation stretching as far back as around 3500 years! More recently we might think of lycra-clad Californian guys and girls searching for their own inner peace between chai lattes.

The actual definition of meditation is quite broad though, being described as a practice of focusing the mind on a particular thought or activity to achieve mental clarity and/or emotional calm. The actual techniques used to practise this are quite varied, but we’ll get to that later.

Benefits of meditation

So, we’ve said that meditation is supposed to help us achieve calm, clarity and a relaxed state. It has also more specifically been shown to lower stress and decrease anxiety, which obviously might be useful in sport. It has also actually been suggested to be able to alter the physical structure of the brain, which I find particularly amazing. This is supposed to be achieved via potentially being able to increase the mass of the corpus callosum and hippocampus, which are responsible for the communication of information between the left and right sides of the brain. They are also important in forming and recalling memories and controlling our emotions. If this is the case, then meditation might be able to help with solving problems, learning skills, and making decisions, which would be very useful for many sportspeople.

Meditation in an athletic setting

So, as always, let’s look into the research to see whether some of these big claims are true. Is meditating going to make us better at our sports? Perhaps it depends on our sport of choice. More stress-based sports such as golf might benefit more from a calmer mind, as those athletes consider and execute shots, compared to the more chaotic goings on of a rugby field. This might be where our meditation style should be considered. Focused attention meditation (FAM) requires the individual to focus on a specific action or object, such as their breathing. This can help to eliminate distractions and aid skills like sinking a crucial putt. The other type of meditation we’ll consider is open monitoring meditation (OMM). This is much more suited to more open sports as it allows focus on all internal and external input before decisions can be made. This type of meditation weakens the focus on the task, as there is so much else going on, but can be more appropriate in these more open type sports.

But does meditation actually work? Well, the evidence in closed sports (sports performed in a stable or largely predictable environmental setting, such as archery, golf, or field events like throwing the javelin) is pretty strong. Following an extended period of integrating meditation into normal training, golfers have been found to improve their performance across a season. It is thought this happens by identifying the right things to focus on.

This may not be surprising though given the kind of sport it is and the benefits of remaining calm, relaxed and focused on the task. The good news is that in a soccer task where meditation was used twice a week for six weeks, shooting performance improved here too. The exact mechanism of these performance benefits are uncertain though it likely shows how meditation can play a part in the toolkit of improved sports performance.

Another potential mechanism behind the successes of meditation is the ability to achieve a state of ‘flow’. Flow is that feeling where you’re ‘in the zone’ and not needing to think about the task at hand. You’ve likely heard sportspeople talk about it in interviews after exceptional performances, though often you and even them don’t know that it’s happened: “Yeah, to be honest I can’t really remember too much of the match!”; “That final set was all a bit of a blur!”; “Looking back on the race now I couldn’t even really tell you that much about it!”. This would be flow. It can manifest as a loss of concept of time, reduction in self-consciousness, a focus on the present and a sense of effortlessness in your endeavours. If only we could bottle it! But it seems meditation can help us find it easier to achieve. This is also backed up by the research and linked to decreases in pessimism.

This sadly isn’t something we can likely tap into in one session though. It seems that at least three weeks seems to be around the point where performance benefits begin to manifest. This isn’t to say there will be no performance benefits at all or no other kind of benefits. Here we come back to two themes that seem to be a running trend in sports science topics – ‘it’s individual’ and ‘the placebo effect’. We need to remember that scientific studies use what we call a sample. This means that maybe 10, 20 or 50 individuals are used in a study to allow the outcomes to be expressed as if they are likely for the whole population. That is why the average response across the whole sample is reported. Some people will respond better, some worse. The bigger the sample the better, as it’s more representative of the population as a whole. You might be one of the good responders and it might only take a week for you to benefit from meditation. On the other hand, you might be a bad responder and it might be longer before you feel a benefit.

The other ever present is the potential for the placebo effect to impact our performance – the placebo effect is real too, there is no doubt about it. If you feel you’re getting a benefit from a practice then you are! And you should keep doing it. If that’s the case for meditation for you then great. At least you can do it for free! Meditative techniques such as focusing on your breathing will also certainly have an effect on your state of calm. This might not directly help you to sink the championship-winning free throw, but it certainly won’t hurt.

Meditation techniques

So, if we think this might be something we’d like to trial, how do we actually go about doing it? If you want some help, there are plenty of apps out there that can help to lead you through it but really it doesn’t have to be too complicated. If you want to keep it simple then you can sit somewhere quiet (you don’t need to be cross-legged!) and concentrate on your breathing. The reason behind using your breathing as an anchor is that thinking of nothing (which is often what people think of as the aim of meditation) is very hard! In fact, even focusing on your breathing is hard. So perhaps start with just three minutes and gradually build it up towards the 20 minute mark.

It’s also recommended by many to do it first thing in the morning – pre-emails, pre-coffee, pre-teeth brushing. This allows you to hopefully focus before your brain starts being pulled all over the place! There are many meditation techniques, and I would advise you perhaps to trial a few to see what you feel most comfortable with.

Take-home points on sports meditation

It feels a lot of my blogs aren’t able to provide strong evidence to back up the use of the technology or practice we’re discussing. It seems today though that we are on sturdier ground – there is good evidence that meditation can play a role in helping athletes achieve a better state of mind when they’re competing. This translates well across a variety of sport types to lead to improved performance. Will it work for everyone? Of course not – not much does, but I would certainly recommend giving it a go. Just keep in mind you likely need a decent level of commitment to it as potentially you’ll feel little benefit initially.

But for a technique that can be practised very cheaply, with low time commitments and no physical effort, what are the downsides? Perhaps there’s a reason it’s been around for thousands of years!

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Dr. Tom Brownlee

Tom is an assistant professor in applied sports sciences and has worked with elite sports for over 10 years. Previous roles include working as a sports scientist at Liverpool F.C., where he completed his Ph.D., and working across a number of other sports. He is passionate about physiology, coach communication, and high-performance strategy and systems.

Tom graduated with a BSc in 2011 before undertaking an MSc at Loughborough University. He has published 25 academic papers on strength and conditioning, nutrition, and youth development in Sports Medicine, the Journal of Strength & Conditioning Research, and others. Tom also now supervises a number of his own Ph.D. students around the world embedded within sporting organisations.

More content by Tom

The post Sports meditation: Can it make a difference to your performance? appeared first on Science for Sport.

Yoga provides many recovery benefits from both physiological and psychological stress, which can correlate to improved athletic performance.

By Will Ambler
Last updated: March 1st, 2024
3 min read

• Some stress is required for athletes to achieve their optimum performance, but it’s a balancing act – too little stress and athletes become bored but if stress becomes too high, they can experience anxiety.
• Yoga provides many recovery benefits from both physiological and psychological stress which correlates to improved athletic performance.
• Athletes should complete two 30-minute yoga sessions per week to maximise their recovery.

Yoga for recovery: Why you should ponder it as an option

Stress is often perceived as inherently bad for athletic performance. It has been cited to be one of the main contributors to feelings of anxiety, depression, and even physiological  issues like cardiovascular disease. Despite technological and medical advancements, stress can be difficult to recognise, manage, and can negatively impact performance.

Despite the negative impact of stress, Yerkes and Dodson (1908) explained not all stress is bad. In fact, some stress is required for athletes to achieve their optimum performance. Commonly referred to as the inverted-U theory of stress, the researchers’ work dictates that performance increases with physiological or mental arousal, but only to a point. Too little stress and athletes become bored, but if stress becomes too high, then the very same athletes can experience acute anxiety or unhappiness, says a leading performance coach.

“Stress and recovery need to be strategically implemented to elicit increases in athletic performance … where lots of coaches struggle today is that they do not emphasise the importance of recovery, or lack the recovery modalities to accurately address both physical and mental stress,” said Paige Schober, assistant athletic performance coach at the University of California, during her Science for Sport Presentation titled ‘Recovery Yoga for High Performing Athletes’.

Athletes commonly experience the following, if stressed:
Physical stress

• Muscle damage
• Fatigue
• Sleep disturbances
• Testosterone imbalances

Psychological stress

• Burnout
• Staleness
• Depression
• Mental health issues

How yoga can mitigate stress

There is a high correlation between the variables studied in physiological and psychological stress accumulation and the benefits of yoga, Schober said.

“If done correctly, yoga can play a key role in maintaining and improving the physical and mental health of athletes whilst also developing athletic performance through improved recovery,” said Schober.

Yoga helps by improving an athlete’s mindfulness, breathing, movement, relaxation response, and psychological resilience. Schober explained that together, this leads to favourable on- and off-field performance improvements including but not limited to:
Physiological benefits of yoga

• Decreased soreness
• Increased pain tolerance
• Improved sleep
• Increased immune function

Psychological benefits of yoga

• Decreased self-reported stress
• Increased energy
• Increased self-reported recovery
• Decreased depression levels

Yoga prescription for athletes

Schober outlined some best practises for how to prescribe yoga effectively for athletes:

• Athletes should complete two 30-minute yoga sessions per week to maximise their recovery.
• An additional 60-minute session is recommended if the athlete’s time schedule accommodates.
• Teach a prolonged exhale technique to take control of breathing during yoga practice.
• With reference to movements, start with a simple, accessible posture to target mobility and flexibility needs.
• Allow your athletes to become more resilient by progressively challenging and overloading through different yoga examples.
• The greatest influencer for athlete buy-in is word of mouth from other athletes who have attended, so be sure to share testimonials from similar other athletes.

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Will Ambler

More content by Will

The post Recovery yoga: how it can help athletes manage stress and improve performance appeared first on Science for Sport.

DOMS is the soreness we get in our muscles caused by micro-traumas, and the chemical processes associated with going above and beyond. But is it dangerous, and how can you avoid or minimise it?

By Dr. Tom Brownlee
Last updated: March 1st, 2024
9 min read

Delayed onset muscle soreness (DOMS): A brief introduction

We all know the feeling. For me, it’s when I attempt to reintroduce squatting into my program. For a lot of the soccer players I’ve worked with over the years, it was the first day back after their off-season when the grounds are hard and they have to start running again. For you, it might be your first five-a-side soccer session in a while and you have to mark someone who’s a little too quick for you, and you’re running around more than a kid on Christmas morning. I’m talking about muscle soreness. And to get all scientific on you I’m talking delayed onset muscle soreness, or DOMS.

You may have heard the term before, and if not, as I say you’ve almost certainly felt it. As its first initial suggests, typically you don’t feel it during the activity, or even straight after. No. This silent assassin typically strikes while we’re asleep and it’s when we wake up and hobble out of bed the next day that we feel the full effects!
Typically, it presents itself as pretty serious muscle ache localised around an area that you used the previous day, such as the glutes and hamstrings following a squat session. The duration of this soreness can be three or four days even in extreme cases. So, what’s going on here? Are we working too hard, and this is our body’s way of saying that it’s damaged? Or is this a necessary evil to make us stronger and if so, what can we do to reduce its severity and duration? Or shouldn’t we be looking to dampen it at all? That’s a lot of questions. So, let’s find out what’s going on.

For those of us who have ever taken 10 minutes to get down the stairs the day after a tough session, this is for you.

Defining DOMS

As the name suggests, this is a muscular soreness that occurs after a specific event. That event in our case is likely to be a bout of exercise. But physiologically, what’s going on in the muscle, why does it happen and why doesn’t it happen to us every time we train?
Let’s start off with some basic muscle physiology. If we were to look at skeletal muscle under a microscope (as opposed to cardiac or smooth muscle, which aren’t involved in moving our bodies), we would see a chequerboard of cells nicely, neatly arranged. When we move, those cells contract or squeeze together – think about when you flex your biceps muscle. You can see it getting shorter when it contracts – that is the result of those cells contracting. After a period of exercise, that neat, ordered microscope image would look quite different. Now we would see a much messier pattern as the cells have become disrupted and damaged. Here, damaged is the correct word but may sound more serious than we need it to – every time we exercise, ideally we are looking for progressive overload. That is to say that what we’re asking our body to do is ever so slightly beyond our current ability. If we don’t do that when we train, then our body has no reason to adapt and become stronger (in the case of weight training). That’s not to say that every session needs to get harder and harder – rest is still important, and we need to periodise our work on a session-by-session, week-by-week and month-by-month basis.

But back to the microscope. So, after our session we would see that damage, or micro-trauma, as it’s known. And it’s a good thing – it’s bringing da gainz! These micro-traumas aren’t solely responsible for DOMS though – in fact you can have DOMS with no trauma, but generally they do factor into the explanation.

As well as the trauma, another factor that can lead to DOMS is some of the chemical changes in our muscle caused by the exercise bout. We’re not talking about lactic acid here though, which is often accused of being a contributor to DOMS. We won’t go too much further into the science here but we’re talking about an increase in hydrogen ions that occur when we exercise. This metabolic stress plays an important role in our recovery as it leads to inflammation. Inflammation has quite a bad reputation but is also very important in aiding recovery and adaptation. These chemicals and inflammation are picked up by nerve endings that tell our brain that something hurts. Our brain is kind enough to then let us know this! Much like inflammation, DOMS is part of the important cycle of repair and growth and as we’ll discuss later we should consider carefully whether we want to eliminate it or not.

Will any training type lead to DOMS?

To some degree, any training type can elicit DOMS if we do enough of it. Some types of exercise will bring about greater DOMS than others though. Eccentric training is the big culprit here. Eccentric training is where our muscles are lengthening under tension. A good example of this might be if you are at the top of a pull-up position and you lower yourself to the start position as slowly as you can. Here it is still your latissimus dorsi (lats) and biceps taking the majority of the work, but this is being done in a lengthening fashion. Again, think of the shape of your biceps muscle during this effort – it’s becoming longer as you go down but it’s doing a lot of work. This is an eccentric contraction and it’s great at producing micro-trauma and subsequently, DOMS.

To this point, we’ve mainly focused on how resistance training causes DOMS, but that isn’t always the case. You may have also experienced DOMS when you’ve upped your mileage when running or another kind of aerobic activity. This is our clue that really it’s the novelness of an activity, coupled with a relatively high intensity, that causes DOMS rather than specifically its type. In fact, going back to eccentric contractions briefly, when aerobically exercising, you may have experienced bad DOMS from a period of running downhill. This is due to the braking forces going through our legs in each step to stop us gaining too much momentum and cartwheeling off to the bottom.

What to do once you’ve got DOMS

Something I’ve been asked a fair few times is “should I not train again while I have DOMS?”. Keeping in mind we now know this soreness is in part linked to micro-traumas and it is part of a recovery process, then there is certainly logic to this question. Well, DOMS will reduce your ability for the muscle to produce full force, which obviously can lead to reduced abilities when we train. It doesn’t seem to worsen the muscle damage though, so when making your decision to train or not you should consider how important it is that you do so. By this I mean, if you’re a recreational athlete who can take an extra day’s rest before coming back firing on all cylinders, then I would do so. For those who really feel they need to get back to it, or perhaps are into their second (or third!!) day of DOMS, you can do so knowing you won’t be causing further issues.

Is there anything we can do to avoid or reduce DOMS?

Now we have a bit of an understanding as to what is causing DOMS, what are the best ways to avoid it? Well, the easiest way, as you may have guessed, is to ramp up our exercise stimuli more slowly. This allows more time for the body to become familiar with the demands we’re trying to place on it. Sometimes we get a little carried away though, and perhaps remember what we could squat eight weeks ago when we last tried – we might take it down by a little, but likely not enough, and then we’re waddling like Donald and Daffy for a week! 
But let’s imagine that we’ve already got this soreness – what can we do? Foam rolling might help, if you can stand the pain of doing it. It’s something you can do yourself and is relatively cheap.

If you are fortunate enough to be able to utilise massage therapy, then there is some positive suggestion that it can help relieve the pain of DOMS. This may be due to increased blood flow to the area rather than by reducing offending metabolites, but the exact mechanism is unclear. The same cannot be said for cryotherapy though, sadly, which pours (ice) cold water on some of the reasoning around cold-water immersion helping reduce muscular inflammation.

On the whole it seems that although there are a few ways of quickening the process, in the case of speeding up the DOMS timeline, time really is a healer. We just have to let our body work through it in the time it requires.

Should we want to speed up recovery from DOMS?

But as I planted the seed earlier, even with these little tips, do we want to get rid of DOMS? For example, despite cold-water immersion being unlikely to reduce inflammation, many will testify that it makes them feel less sore. But if it’s part of recovery and adaptation, surely that soreness is a good thing, or at least a necessary evil? Well, really that depends why we are training and why we might want to get rid of it. If this is our first session of pre-season and we’re looking to adapt and get fitter for what’s to come, then it stands to reason that perhaps we just need to suck it up and get through it. If we have DOMS from our Olympic 100m quarter-final and we have a semi-final and hopefully final tomorrow, then we probably want to try our best to dampen it down!! Here though we must remember that we are far more likely to experience DOMS when we are unaccustomed to the training stimuli. If you’ve made it to an Olympic quarter-final then I’d hope you’ve got enough work in the tank not to cause DOMS in the first place, but you get the idea! 
It’s also important to keep in mind that having DOMS is not the marker of a successful session. In fact, as you get more in the swing of your training you’ll probably experience it less and less. And that’s a good thing. Although DOMS isn’t to be feared, it is relatively painful and it can impact your ability to train, which can lead to reduced motivation. So, get past it, plan your training accordingly and enjoy.

Take home points

So, there you have it. If you didn’t know the name, you had likely experienced the muscular pain following an increase in training load, especially if it was your first effort for a while. DOMS is the soreness we get in our muscles caused by micro-traumas, and the chemical processes associated with going above and beyond a little too over-zealously. It’ll pass, it isn’t dangerous and if you’re really desperate you can actually still do some training while you have it, though lowering the intensity in the form of a recovery-type session is probably your best bet.

Self-massage such as foam rolling or seeing a massage therapist is likely to make it feel a little bit better, but you can be safe in the knowledge that it’ll pass. It’s all about building things up, and in time you’ll be doing way more than you were able to before, and all without a duck waddle in sight!

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Dr. Tom Brownlee

Tom is an assistant professor in applied sports sciences and has worked with elite sports for over 10 years. Previous roles include working as a sports scientist at Liverpool F.C., where he completed his Ph.D., and working across a number of other sports. He is passionate about physiology, coach communication, and high-performance strategy and systems.

Tom graduated with a BSc in 2011 before undertaking an MSc at Loughborough University. He has published 25 academic papers on strength and conditioning, nutrition, and youth development in Sports Medicine, the Journal of Strength & Conditioning Research, and others. Tom also now supervises a number of his own Ph.D. students around the world embedded within sporting organisations.

More content by Tom

The post Delayed onset muscle soreness (DOMS): What is it, and how can it be minimised? appeared first on Science for Sport.

In episode 83 of the Science for Sport podcast, one of the world’s leading sport performance scientists reveals the truth behind one of the most used recovery methods: ice and cold water exposure.

By Matt Solomon
Last updated: March 1st, 2024
2 min read

Ice baths and cold water recovery: Are they worth the pain?

Recovery from sport is absolutely crucial if you or your athletes want to perform optimally. Unfortunately, there are a plethora of useless contraptions on the market designed to relieve you of your money, and ultimately prevent you from recovering fully before your next big game.

In episode 83 of the Science for Sport podcast, Dr. Robin Thorpe, sport performance scientist and coach, gives you the truth behind one of the world’s most used recovery methods: cold and warm water exposure.

Have you ever sat in an ice bath, freezing your family jewels off, wondering why you even bother with this nonsense? I have, and frankly, I still had massive muscle aches the next day. If this sounds familiar there is some good news: ice baths do actually work. The bad news is, it probably didn’t need to be that cold!
Never again waste time shivering yourself into icy submission – instead heed the advice of Thorpe, who provides the exact knowledge you need to recover fully before your next big game.

Thorpe frames the conversation by suggesting there are a range of complicated methods and gizmos which the literature doesn’t support.

“When you look at the literature, a lot of these interventions and tools have been used for years and years and years. From a physiological perspective, they actually don’t do a lot,” Thorpe said.

How long and how cold do you have to go?

In fact, the former Manchester United sport scientist points out the majority of these interventions probably only provide a placebo effect.

“The main thing it seems to be is there’s a perception of improved recovery, which we know could be attributed to athlete belief effects or the placebo phenomenon.”
So what does work? Well, Thorpe’s research includes in-depth investigations into how athletes can recover faster using hot or cold baths. These methods are backed by science.

“There’s decent literature that suggests the optimal dose-response from cold water, across the research, is going to be around 10 to 12 minutes,” Thorpe said.

Ok, so you have to endure at least 10 minutes of cold to enhance the recovery process, but just how cold does it need to be?
“I think 10 to 12 minutes between eight and 12 degrees Celsius is going to be, I think, a good starting point for anyone working with athletes or for athletes themselves,” Thorpe said.

This sounds pretty attainable, right? Well, according to the good doctor, you can bin off all the icy goodness, and instead you could just fill your bath from the cold tap.

“People historically have been going out and buying absolutely tons of ice at a supermarket, they could just get a pretty decent ratio by just running the cold tap,” Thorpe said.

What about warm water before training?

So there you have it, those super chilled ice baths which turn you into a human penguin might have been missing the mark, you could have just gotten away with a 10-minute dip using the cold tap.

Thorpe goes on to discuss great details on how to use warm water before training, and how he used cold and warm water immersion in an English Premier League setting. So if you need to take your recovery game up a notch, just hit the link below!
You can download the podcast on any of the big hosting services, including Apple Podcasts and Spotify, or just use this link: https://scienceforsport.fireside.fm/83
Don’t forget to hit the subscribe button and be sure to give us a review and rating too!

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Matt Solomon

Matt is a strength and conditioning coach at Team NL (Dutch Olympic Team). He was also the Lead Academy Sports Scientist/Strength and Conditioning coach at Al Shabab Al Arabi FC. For Science for Sport, Matt works as the group manager for the Coaches Club and is the host of the Science for Sport Podcast.

More content by Matt

The post Cold water recovery: does it actually work (and what about heat)? appeared first on Science for Sport.

Due to the busy lifestyle that many athletes live, sleep and sport don’t always go together, but it is crucial for recovery and performance. Here’s how sleep can be a difference-maker for your performance.

By Matt Tometz
Last updated: March 1st, 2024
11 min read

Sleep – why is it so important?

“It doesn’t matter how tired I get, because if I can’t get amped up for game day, then I shouldn’t be playing anyways.”

The main premise of sport is to achieve a high level of performance to give the best odds of winning. Within that pursuit of high performance, training and competition requires fatigue accumulation and breaking down the body to adapt to becoming bigger, faster and stronger. Sleep is central to this process, as it’s fundamental to both short and long-term recovery (19).

However, due to the busy lifestyle that many athletes live, sleep and sport doesn’t always go together, resulting in insufficient sleep duration and quality. Inconsistent schedules including practice, lifting, travel and games, late nights and early mornings, and also psychological and physiological stress, can all add up to impact an athlete’s sleep.

Despite some of these inevitable factors, sleep is a must for recovery and performance. Sleep is when the body not only repairs itself from hard training and competition but also grows to be better prepared for the next opportunity to perform. In a study done over 21 months with middle school and high school athletes, 65 % were chronically not getting enough sleep (17). Additionally, within elite sports, insomnia symptoms are highly prevalent (8). As one of the common sleep disorders, insomnia is defined as difficulty falling and staying asleep, which leads to a lack of restorative sleep and impaired daytime functioning (1). Lastly, it is also known that collegiate athletes fail to get restorative sleep(14).

Sleep difficulties go beyond just performance, as acute and chronic sleep disturbances could negatively affect immune function and emotional well-being (19). The insufficient sleep quantity and quality of athletes justifies encouraging and opening the discussion about sleep-optimising interventions (20). Off the court or pitch, sleep could be a difference-maker in reaching that next level of performance.

What sleep does

Between sleep and performance, recovery is foundational to the fitness-fatigue model of training. Fatigue is accumulated during training, and sleep aids in recovery to turn it into fitness to increase performance. Sleep is one of the fundamental opportunities an athlete has to recover from training and improve performance. Sleep is not simply just the absence of being awake, but a state of special brain functioning and activity with mechanisms that affect the entire body (11). The circadian rhythm is an internal clock of the body that controls all biological rhythms of the body (19), including sleep.

Exercise timing: Does it really matter if you work out in the morning, afternoon or night?

Of the four stages of sleep, slow wave and rapid eye movement (REM) are the most important. Slow-wave sleep is when growth hormone is produced and the body recovers, while REM sleep is primarily for the brain and memory consolidation (19). Within one night of sleep, the body goes back and forth between these stages, both recovering from the prior day’s efforts and preparing for the upcoming day (5). However, when sleep deprivation occurs, slow-wave sleep will be prioritised, with REM sleep returning after slow-wave sleep has been recuperated (19). For example, sleep-dependent motor sequence learning depends on that night’s sleep (19), meaning sleep deprivation will cause the cognitive benefits of sleep to suffer first.

‘Good sleep’ can be evaluated by these categories: subjective satisfaction, adequate duration, alertness during waking hours, high efficiency, and appropriate timing (3). Understanding why sleep is important and how to evaluate if an athlete is achieving good sleep or not leads to identifying potential sleep deprivation. Although there is a lack of consistency with sleep recommendations, greater than eight hours has been used as a general guideline for sufficient sleep (17). Sleep can benefit an athlete’s health and well-being, mood, and cognitive performance on top of physical performance (14, 15).

Sleep deprivation – it’s more harmful than you think

Although the objectiveness of how much sleep and the effectiveness of sleep is yet to be officially determined, in this context of athletes and sport, sleep deprivation can be described as the lack of sleep quantity and quality required to recover from sport and perform at a high level.

Now that we understand how sleep aids in the recovery process, it’s easy to see how sleep deprivation can be detrimental to physiological growth and repair (19). However, it is important to note there is a difference between acute (one night) and chronic (5+ days) sleep deprivation. Acute sleep deprivation yields consequences related to mood, cognition, performance, emotions, and behaviour, while chronic sleep deprivation can lead to long-term health problems such as cardiovascular disease, weight-related issues, cancer, and risk of mortality (7).

Sleep problems can include long sleep latency (taking too long to fall asleep), waking up during sleep, short sleep duration, and lack of sleep quality (13). These issues can arise from the increased time demands of athletes pushing other responsibilities to later in the day, which reduces sleep duration. For example, morning training sessions limit the opportunity for sleep and lead to increased pre-training fatigue levels (18). Additionally, the stress (both physical and psychological) and pressure to achieve high performance may cause sleep problems. This doesn’t mean athletes should not train in the morning, neglect outside responsibilities, or have lower expectations, it just means these factors need to be considered when planning out training and daily life.

These lifestyle factors can turn into a vicious cycle of not receiving enough sleep due to early practice, a midday nap affecting later sleep latency, bedtime being pushed back due to increased time demands of practice/games, the inability to stay asleep because of the pressure to perform, all combining to alter the athlete’s circadian rhythm and biological systems required for sleep. When this is accumulated over the course of a month, a semester, a school year, and so on, athletes can experience decreased performance and an increased risk of injury.

Can sleep deprivation lead to higher injury risks?

One of the biggest issues surrounding sleep deprivation is injury risk. Although injury risk is hard to predict and we need to keep in mind correlation is not causation, some studies have started to describe this relationship. It has been shown that both acute stress and coping ability contribute to injury risk (16). A risk factor for adolescents includes the amount of sleep they get per night (17), and adolescents with chronic lack of sleep are more likely to suffer sports injuries than those who sleep well; however, the acute effects of poor sleep are not yet determined (7). Lastly, logically, it can be deduced that when sleep-deprived athletes are in a poorer physical condition and possess less neuromuscular coordination when performing the skills of a sport (7), they could be more prone to injury.

Not only can early identification of fatigue-related performance decrements aid injury reduction efforts (10), but these can also be addressed firsthand by sleep-related issue identification. Valid and reliable questionnaires exist that identify athletes who could benefit from sleep-related interventions (2).

How to sleep better … and what about napping?

Sleep hygiene is a term used to describe the behavioural and environmental factors that promote healthy sleep (13). This is often neglected due to all the other responsibilities of athletes including academic, athletic, and social demands (14). However, it is important to know why sleep is important and the factors that affect it, so good sleep hygiene and sleep habits can be made (16, 19). Similar to how performance can be trained, sleep training is conditioning the body for better sleep.

Action can be taken to improve both an athlete’s sleep duration and sleep quality. There is a three-step approach to improving sleep. Firstly,  understanding the value of improved sleep and why it’s important, then gaining information on the best sleep practices, and finally, removing any sleep barriers that may be present (14).

Here are some of the best rules of thumb to improve sleep (13):

1. The closer to bedtime caffeine is consumed, the more likely it is to negatively affect sleep.
2. The more pre-sleep arousal an athlete has, the more likely it is to negatively affect sleep.
3. The more irregular the athlete’s sleep schedule is, the more likely it is to negatively affect sleep.

Turning these into action can include: not consuming caffeine after noon, adopting stress-management techniques to reduce stress and arousal before bedtime, and keeping both bedtime and waking time as consistent as possible. For example, an athlete can adopt a bedtime routine, read a book to relax, write down their schedule for the upcoming day, etc. to ease the mind before trying to fall asleep.

It is also worth noting more time in bed does not necessarily equate to higher sleep quality (4). This means that more goes into achieving effective sleep than simply spending more time in bed; much more goes into sleep hygiene to achieve the right environment both physically and mentally to get high-quality sleep. Factors such as light, body temperature, and noise can affect an athlete’s sleep (19). Reducing the amount of light in the bedroom, lowering the core body temperature and temperature of the room, and eliminating all noise can promote good sleep hygiene. The optimal room temperature has been recommended to be 66-69˚F (19-21˚C) (9). However, it will depend on what temperature the athlete prefers.

Although there is conflicting research on napping, as it could be up to the athlete’s preference, it is important to consider the effects of sleep inertia when napping. Sleep inertia is the continued feelings of sleepiness and grogginess after waking. If an athlete decides to nap, they should give themselves 30 minutes between waking up and their next obligation to mitigate that side effect (15). Additionally, to reduce the potential negative effects of napping, the athlete should also make sure the nap does not affect their habitual sleep schedule at night (15).

Relative to the training and competition calendar, an athlete should be conscious of when they are at the highest risk of injury to prioritise sleep and recovery. Higher injury rates are experienced during pre-season due to the increased workload and longer or multiple practices (12). With this knowledge, athletes can be intelligent about their training load and extra conscious about the amount of sleep they are getting during that period of time. Additionally, in-season training and games come with the increased physical stress of travel and the psychological stress of competition.

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Final thoughts before you turn in for the night…

Sleep is just as important as training and competition because it’s the body’s opportunity to recover and prepare itself to achieve high-performance next time. Sleep deprivation can reduce the gains and progress made from training, reduce performance, and increase the risk of injury. However, the main issue isn’t necessarily acute sleep deprivation but chronic sleep deprivation (7). The factors associated with being an athlete such as increased psychological stress, irregular schedules, and travel often come at the expense of sleep.

Jet lag and travel fatigue: Tips and tricks for athletes

A study performed on a group of athletes which included an intervention of sleep hygiene education showed the athletes returned to their pre-sleep hygiene education habits within a month of the education ending (4). This shows the habitual nature of sleep, and achieving better sleep goes beyond simply understanding the value of it. Sub-optimal sleep is often not an acute issue but a chronic lifestyle issue. All the factors such as daily physical stress, travel, caffeine consumption, pre-bed routines (or lack thereof), pressure to perform, and irregular sleep schedules over years of being an athlete often accumulate into norms and habits that yield insufficient sleep. The factors listed above are neither inherently good nor bad, but it’ll consequently take the same accumulation in the opposite direction to fix the problem. The subconscious lifestyle choices that appear normal to athletes will take just as much intentionality to reverse them.

Athletes can capitalise on this knowledge of the importance of sleep and common sleep deprivation causes by acknowledging the issue, determining what actions can be taken to mitigate those issues and assimilate those changes into their daily lives to become normal. Sleeping better is just about as opposite as it can be from sport: it’s mundane and slow. Making better choices for sleep hygiene is actively taking the crazy out of daily life wherever possible when much is not in an athlete’s control. But maybe that’s the encouraging part, that there are opportunities to sleep better. And sometimes that’s all athletes can do: give themselves the best opportunity to get an awesome night of sleep. Just as athletes can influence their performance on the court or field, they can influence their performance while sleeping.

Matt Tometz

Matt’s speciality is speed development and he has a fascination for sport science – it’s his daily challenge to integrate the art of coaching with the science of data for his athletes of all ages and sports. His other experiences include being a sport scientist at the Division I level, publishing his thesis in the Journal of Strength and Conditioning Research, and creating educational content for coaches and athletes.

More content by Matt

The post Sleep and sport: Deprivation, training and performance appeared first on Science for Sport.

Recovery is important for every athlete, and massage can play a part. But do massage guns actually fast-track recovery?

By Dr. Tom Brownlee
Last updated: March 1st, 2024
1 min read

You see the advertisements everywhere but what actually is a massage gun?

If you’re active on social media, you’ll have seen the adverts. Perhaps one of your favourite athletes sitting, having finished training, with what looks like a robotic hammer pulsing (often in slow motion) into their thighs, calves, or other relevant muscles. The manufacturers of these pieces of equipment are on a real marketing push at the moment to infiltrate our consciousnesses. But what are they, what do they do, and should we be buying them?
Simply, they claim to offer an effect similar to traditional massage. This is achieved through percussive therapy, which is scientific speak for something hitting something else to bring about some kind of healing effect. But as the number of brands offering such devices grows, it’s always worth improving our understanding of the whats, whys and hows.

How to use a massage gun

If you dig into the multiple manufacturers of these products, you’ll find the guns will come in a variety of levels, even within brands. This will often relate to the frequency with which the unit is able to vibrate at, the attachments it comes with and the power reserve in its battery. When you’ve found a unit you’re happy with, you will be advised by the manufacturer to select the most suitable attachment for the area you’d like to massage and set the speed based on the tension or soreness in the muscle.

Next, depending on why you’re using it (e.g., a warm-up, recovery, or something else – we’ll come to this later), you’ll be given a protocol to follow that will cover duration, depth, and which direction you should move the device relative to the direction of the muscle fibres. Typically, to cover all bases, you’re then normally advised to play around with these rules to see what works best for you.

What do massage guns claim to help with?

When you think of massage, typically you think of recovery. With massage guns, this is also a large part of their marketing drive. Manufacturers will refer to the product’s ability to decrease pain and soreness and improve range of motion (ROM), which we would typically link to something that’s desired following exercise. The claims don’t stop there, though, with benefits now cited to include improved function of soft tissue and blood flow, which would be a positive effect proposing use during warm-ups also. There are even recommendations for use during rest periods within a session. This provides a reason to use the product for physical benefits before, during and after exercise.

As well as these more obvious physical benefits, we’re now seeing claims based around mental relaxation and improved sleep. In the world of mindfulness and holistic approaches to training and life, these benefits would be very useful and open up massage gun use beyond simply being a typical massage alternative.

The big question of course is, can these claims be backed up by research? Well, let’s break them down claim by claim to see what we think and whether they might be worth our investment.

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The science behind massage guns

Now that we’ve covered what the kit does and how you use it, the million-dollar question is, do they work?! Before we get to the specifics, you may be interested in having a look at this broader article from a few years ago covering massage generally. Here, we concluded that massage very popular, but maybe wasn’t backed by rigorous research confirming its effectiveness. Would we find the same here?
Good Vibrations
So, what exactly is going on here? We can all likely appreciate that somehow the pressure the gun exerts on the muscle is having an effect in the same way that it might if we have a massage or use other equipment such as a foam roller or massage wand. But the specifics are a little different here, and sadly, the specific research is still quite sparse due to the relative infancy of the technology.

Thankfully, we can zoom out a stage and have a look at some of the research that has been done previously on vibration and vibration therapy (the precursor to massage guns). This may give us an insight before we consider some of the sparse massage gun evidence out there.

As far back as 15 years ago, scientists were interested in the impact of vibration therapy following a period of muscle-damaging exercise. Back then, though, the device was not percussive like the guns, it simply vibrated on the muscle of interest. They found its use led to improved force production, reduced pain, and reduced muscle soreness. The researchers speculated the vibration impacted the neural system, but were not able to comment on why. Later vibration research suggested there may be multiple systems affected by the stimulus, but again were not able to be overly specific.

These theories are referred back to in the more recent massage gun studies that we will look at shortly. They generally expand on the above and state that the more targeted and deeper application of the gun allows greater specificity of the treatment. We’ll now take a look at how these newer results stack up.

Bringing out the big guns
When looking at the other main claim around recovery, decreasing stiffness, it was recently found that the use of a commonly available massage gun does reduce stiffness to the same level as a traditional massage. However, this specific study did not include a control group, so it’s difficult to know whether this stiffness reduction may have occurred anyway. An attribute that could fall into both the recovery and warm-up camp is ROM. It has been found that following a 5-minute massage gun protocol on the calves, ROM can improve by around 18 percent, though the ability to produce force remains unchanged. The authors of this specific study stated that these results were again similar to a traditional massage but could certainly be seen as beneficial.

When it comes to the claim that massage guns are able to improve soft tissue function, this is a little harder to evidence. This is in part due to the fact the claim itself is a little vague and open for interpretation. It seems, though, from the research mentioned above, that performance (e.g., strength/power) is not improved through the use of massage guns in the current study designs. It could be considered, though, that in time, such performance improvements may be seen as a knock-on from the other benefits mentioned (e.g., decreased stiffness).

One mechanism that may be responsible for some of the above benefits could be improved muscle blood flow. To date, there aren’t any specific papers looking at this, though a conference communication (suggesting a paper may be on its way) did provide some findings. When comparing two massage guns, they found both led to increased blood flow to varying degrees. This suggests there may be beneficial use and that this kind of technology could play a role in our recovery strategies.  
More recently, it has also been proposed massage guns may improve how quickly we’re able to get to sleep and the quality of that sleep. This would obviously be a great benefit both physiologically and psychologically. These studies are yet to be published, though, and the proposed mechanisms are currently unclear. Potentially, this may be an additional benefit linked to the general reduced stiffness.

The power of thought
As we wrap up our summary of the literature, it is worth briefly considering the perception side of using a massage gun. If you have used one, much like if you’ve had a massage, you will likely find they feel nice. It’s been found that after receiving a massage, individuals generally feel more relaxed. Now, without trying to undo all of our rigour having looked over the science, it is worth remembering that the power of the mind is very strong. There are lots of things in sport that although have limited evidence, people will swear by and won’t compete or train without. Beyond the evidence listed above, we cannot forget that for some, simply enjoying using one of these bits of kit will be evidence enough.

The bottom line: should you get a massage gun?

So, now we know what they are, what they’re supposed to do and (as well as we can) how well they might work. But the final question is, should you be following in the footsteps of a certain five-time Ballon d’Or winner and his friends and getting one? I would say from what we know there is sufficient evidence to suggest they are likely to offer some physical benefits. Admittedly, the understanding of the underpinning mechanisms is currently relatively low, but that should change in the coming years.

With these physiological benefits coupled with the potential psychological benefits, it is reasonable to say that if the cost is not off-putting, there is no harm in adding one to your arsenal.

Dr. Tom Brownlee

Tom is an assistant professor in applied sports sciences and has worked with elite sports for over 10 years. Previous roles include working as a sports scientist at Liverpool F.C., where he completed his Ph.D., and working across a number of other sports. He is passionate about physiology, coach communication, and high-performance strategy and systems.

Tom graduated with a BSc in 2011 before undertaking an MSc at Loughborough University. He has published 25 academic papers on strength and conditioning, nutrition, and youth development in Sports Medicine, the Journal of Strength & Conditioning Research, and others. Tom also now supervises a number of his own Ph.D. students around the world embedded within sporting organisations.

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Concussions in sport are a huge issue. Here’s how you can kick-start the recovery process after a head knock.

By Niall Seewang
Last updated: February 29th, 2024
2 min read

Concussion recovery is complex, but exercise can help

Low-intensity aerobic exercise can kick-start your recovery

Early initiation of low-intensity aerobic exercise is recommended for athletes who have suffered a concussion, a leading strength and conditioning coach and physiotherapist says.

Brooke Nairn, a strength and conditioning coach and physiotherapist based in Ireland, says current evidence suggests complete rest is no longer supported after a concussion.

“[In terms of current evidence], nothing exists to support complete rest post-concussion, but high levels of cognitive and physical activity may also delay recovery. So we want to find a balance between strict rest and high-level activity,” Nairn said during her Science for Sport presentation titled ‘Concussion Rehab.’
“Strict rest and ‘darkroom’ strategies are no longer recommended, as they are found to be outdated and ineffective. Complete rest increases risk of mental health challenges, social isolation, prolonged recovery, physical deconditioning, sleep irregularity.

“Research supports early [within one week] initiation of [low intensity] aerobic exercise. Rest during [the first] 24-48 hours, followed by early, light physical activity below symptoms threshold, such as a 10-15 minute walk, is recommended for improving recovery.”

While complete rest was not appropriate unless the symptoms were severe, Nairn said some activities should be minimised during the post-concussion period.

“Avoid reading, video games, TVs, phones and highly visual activities like shopping trips and spectating at sports events,” she said. “As tolerated, audio books, soft music, slow walks, short phone calls, sitting/eating outside [are all acceptable].”

Sleep is also a key part of the recovery process

Sleep was another key area to focus on for post-concussion, Nairn said.

“Sleep difficulty is a common complaint post-concussion – it can lead to protracted recovery and is linked to symptoms of anxiety, depression, slower rehab process,” she said.

Nairn said there were several ways to improve sleep, including developing a sound bedtime ritual, sleeping in a dark, silent room, not eating too much before bed, reduced caffeine intake and minimal use of TVs or computers before bed.

“Try to put all these elements in place,” she said.

Brooke Nairn is a strength and conditioning coach (NSCA-CSCS) and physiotherapist with a passion for helping athletes reach their full potential, through injury prevention, injury rehabilitation and strength and conditioning training. Currently, Brooke works at the Limerick Sports Injury Clinic and at PEAK health in Limerick, Ireland. 

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