Rapid Paths to Recovery in Rugby

Recovery in Rugby

A number of years ago at Dublin City University, a group of their talented students were challenged to look at the rates of recovery in Rugby, various strategies used out there, the pros and cons of each, and finally to give their recommendations from the spectrum of a professional team level to grassroots. ( This is form a paper prepared and written into IRC Magazine.

Measuring recovery is much more difficult than assessing performance. Complete recovery has been defined as the ability to equal or exceed regular performance, and can be categorised in three forms:

1) Immediate recovery between exertions

2) Short-term recovery between repeated bouts

3) Recovery between training sessions

Recovery has been measured in many different forms, but becomes insignificant if subsequent performance is not equal to or better than the initial performance.

Muscle damage markers are also relatively simple to attain, where creatine kinase (CK) and lactate dehydrogenase in particular are both seen to rise following a training stimulus that may cause cellular disruption. These muscle damage markers are used to estimate the effectiveness of popular recovery strategies.

The cost and practical implications of various participation levels is also a factor influencing recovery strategies.

Rugby Recovery strategies

ice recovery systems for rugby

Massage

One of the problems with establishing massage effectiveness is the inconsistency of techniques.

Massage techniques range from a light massage to dynamic soft tissue mobilisation to intense deep tissue work.

Massage has been proposed as a means of  facilitating recovery by moving blood, fluid and swelling around the body, however this theory is concluded to be anecdotal in several studies where circulation and lymphatic flow did not appear to be improved with massage, or were not as effective as a simple warm down.

There was speculation that massage increases blood fl ow and distribution, but this was not the case in a study examining femoral artery blood flow and lactate clearance in the thigh.

There has been benefit of massage on creatine kinase levels, but this has often shown no improvement on subsequent performance when assessed.

Compression garments

Compression garments are becoming increasingly popular, and fashionable, as a method of recovery due to their proposed benefits, primarily improving venous return and fluid distribution around the body.

The companies claim that exerting pressure on the limbs provides performance and recovery benefits. Indeed, muscle damage markers have been found to be lower following use of compression garments, however any improvement in subsequent performance was of no significance.

Also, some studies have found no signifi cant difference in Lactate dehydrogenase and CK following 12 hours of post recovery with compression garments.

In a specific study, four recovery methods (active, passive, contrast water therapy and compression) were examined over 84 hours post regular training. The compression garments showed the highest level of interstitial creatine kinase removal after 48 hours, although the difference was not significantly more than both active and contrast water therapy at 84 hours.

The players used Skins on the lower body, concluding that this garment is as effective as active recovery and contrast water therapy.

Evidence supports compression garments as a means of reducing muscle damage and perceived muscle soreness following exercise, although subsequent performance has shown little benefit. Considering their ease of use, compression garments may have a place in the recovery routine simply for convenience, when combined with other practices.

Cryotherapy or Ice Baths on their own

Cryotherapy is used in many forms including ice baths, cold water therapy, ice packs and ice massage.

The limited research suggests that some subjective measures have been shown to decrease with the use of cryotherapy, and there has been reduction in creatine kinase levels following active recovery and the use of cryotherapy.

Whole Body Cryotherapy is also becoming a popular method for recovery and involves placing the body in a chamber and being exposed to -110°C air. Recent research in WBC found reduced levels of creatine kinase.

However, some studies have shown that cold water immersion has a negative effect on subsequent performance, and despite reported benefits on creatine kinase there is insignificant evidence on any performance variable to support its use.

Contrast Water Therapy -The alternate Ice and Heat treatments

Contrast Water Therapy usually involves the immersion of the body into a warm spa with a cold plunge pool or ice baths and hot showers.

Despite reports of perceived relief, there is a lack of evidence available to back this method. Contrast therapy is a combination of cryotherapy and thermo therapy, the belief being that the cooling aspect causes vasoconstriction which decreases swelling and inflammation by slowing down the production of metabolites, whereas vasodilation that occurs during the thermo therapy phase increases blood fl ow.

Contrast Water Therapy comes out on par with active recovery when it comes to removing lactate, but importantly creatine kinase, LDH and next day performance levels have not been found to be improve

 Active Recovery

Active Recovery, commonly known as a cool-down or a warm-down, involves low intensity exercise, dynamic stretching or a combination.

Active recovery has shown to lower creatine kinase and also blood lactate levels versus passive recovery, although not always.

For teams undergoing multiple training sessions per day, lactate clearance would benefit.

Coupled with cold water submersion or cryotherapy, active recovery has been shown to improve creatine kinase removal. Also, active recovery alone has been shown to improve subsequent performance.

From limited evidence, it would appear that active recovery, when employed immediately post training or game does have an effect of promoting serum creatine kinase clearance.

There is also evidence to show that active recovery promotes blood lactate clearance, however this will only be signifi cant if sessions are very close together (1-2 hours).

This would appear to be the gold standard recovery strategy with respect to the evidence available. The addition of other recovery modalities such as cryotherapy may also heighten the therapeutic effects of active recovery.

Hydrotherapy

Hydrotherapy involves any recovery in which the player(s) are submerged in warm water, usually in a swimming pool.

One study demonstrated that underwater massaging (using the jets in a spa) following plyometric exercises helped to maintain explosive performance the following day.

Passive recovery activities had a signifi can’t reduction in explosiveness. However, in contrast another study found that hot water

(38°C) immersion was ineffective at improving subsequent performance.

Reductions in muscle damage markers (creatine kinase, LDH), as well as improved subsequent performance levels have not been found to any significance, so more research is required.

Sleep as an element of Recovery

Sleep is considered critical for optimal performance and has been identified as an important aspect of recovery. Sleep is essential for the body to re-perform at its desired level. Sleep quality is more important than the time

 

RECOVERY JARGON – What does it mean

Creatine kinase (CK): a rise in the amount of CK in the blood stream indicates that there has been muscle damage. That’s where CK exists. A reduction in CK means recovery.

Lactate dehydrogenase :  (LDH): a rise in the amount of LDH in the blood stream also indicates there has been damage to the body tissues. A reduction in LDH means recovery.

Cryotherapy: a method of removing heat from the body, for instance ice baths or ice packs or in a Cryotherapy Chamber.