Running Recovery Physio

Recovery Physio

How physio can help your running

Running Sydney running season is upon us. We have just had the half-marathon in May, City2Surf is around the corner, and the Sydney Marathon is now just over 3 months away. With this in mind we thought we would touch on some of the evidence behind how physio can help with running and recovery. So the question is can physio help with running? Absolutely. Even in the absence of pain or injury, a consultation with a physio can supercharge your training. Depending on the needs of the runner and their experience, we aim to give an understanding of:
  • Training volume
  • Differences in muscle and tendon loading
  • Injury prevention strategies
  • Advice to aid recovery
  • Exercises to prevent injury and enhance performance
  • Advice around individualised supports such as taping, shoes, orthotics etc
As physios in Randwick, we see a heap of runners this time of year. Many of the problems we see are a result of ramping up a training period too hard and too fast in the lead up to a race. For the purposes of this blog, we will focus on recovery.

Rest and load management is the key to recovery physio

Recovery physio involves considerations of time and load. It is different for everyone. Our body becomes so good at accommodating the loads we consistently expose it to. A runner who is used to running 60 kms a week can tolerate much less recovery than a runner starting out at 5-10 kms per week. We always explain to our patients that our muscles and tendons need added time for recovery when dealing with increasing or novel loads. When we increase the kms, our tendons and muscles undergo a process of wear and repair. This adaptation is ever evolving. As a general rule, we say it takes several days for these tissues to respond to the new loading we put in them. So we want to be mindful of not ramping up our training too quickly in the days immediately after adding in new training stimulus. When increasing mileage, we suggest sticking to a 10% per week increase over the previous 4 week rolling average.

What does the evidence say about different recovery physio strategies?

There are several things you can do to improve your recovery after running. Here are some evidence-based tips:
  • Cool down properly: After running, it’s important to gradually decrease your heart rate and ease your body back into a resting state. A proper cool-down can help to reduce muscle soreness and improve recovery. A study published in the Journal of Strength and Conditioning Research found that a 10-minute cool-down jog reduced muscle soreness and improved performance in runners.
  • The ever controversial foam roller can be utilised immediately after running to help with the recovery process as well. Rolling through muscles that have been worked hard can help to restore range of motion after exercise.
  • Stretching: A review published in the British Journal of Sports Medicine found that stretching after exercise reduced muscle soreness and improved range of motion in the short-term.
  • Hydrate: Running can cause dehydration, which can impair recovery. Make sure to drink plenty of fluids before, during, and after your run. A study published in the Journal of Athletic Training found that dehydration can increase muscle damage and delay recovery.
  • Elevation: After a long run or intense workout, elevation can be a great way to enhance recovery. After intense bouts of exercise we like to use a straight leg up the wall elevation / calf stretch to help facilitate.
  • Eat a balanced diet: Eating a balanced diet that includes carbohydrates, protein, and healthy fats can help to support muscle recovery and repair. A study published in the International Journal of Sport Nutrition and Exercise Metabolism found that consuming protein after exercise improved muscle recovery and reduced muscle damage.
  • Get enough sleep: Sleep is essential for recovery after exercise. Getting enough sleep can help to reduce inflammation and improve muscle recovery. A study published in the European Journal of Applied Physiology found that sleep deprivation impaired muscle recovery after exercise.
  • Use active recovery: Light exercise, such as walking or cycling, can help to improve recovery by increasing blood flow to the muscles and reducing muscle soreness. A study published in the International Journal of Sports Medicine found that active recovery improved performance and reduced muscle soreness in athletes.
In summary: cool down, move and stretch, hydrate and eat healthily.

What are the benefits of good recovery?

To improve at running, we need to gradually increase load and intensity, so our physical body and energy systems adapt. This is only possible when our recovery needs are met. Improved performance: Scientific studies have shown that proper recovery after exercise is crucial for optimal performance and reducing the risk of injury. A study published in the Journal of Strength and Conditioning Research looked into active recovery techniques. Using light jogging or cycling as recovery, athletes had lower levels of muscle soreness and better performance than those who did passive recovery (such as rest).

Does massage help with athletic recovery?

The question is, what does scientific evidence say about massage? Massage can be an effective way to enhance athletic recovery, as it can help to reduce muscle soreness, improve circulation, and promote relaxation. Here’s what the scientific evidence says about the benefits of massage for athletic recovery:
  • A 2021 systematic review looked at the effect of sports massage on performance and recovery. They found massage can help improve flexibility and reduce delayed onset muscle soreness (DOMS) after exercise.

Normatec for athletic recovery – what does the evidence suggest?

NormaTec compression therapy is a type of intermittent pneumatic compression device. Basically, it creates sequential compression along the muscles to help promote blood flow, waste product removal and recovery.
  • Evidence suggests that Normatec compression can be beneficial in reducing lactic acid in the acute phases post exercise. Studies also support improved blood flow, decrease muscle soreness, and reduced swelling.
Results of the Normatec often lag slightly behind that of active recovery. We often advise using the Normatec system as an adjunct to normal active recovery methods, rather than as a sole source of recovery after exercise.

Powerplay and GameReady Ice/Compression recovery systems

Ice and compression are commonly used together as a recovery modality to aid in the recovery of athletes after exercise. Research suggests that combined ice and compression systems can:
  • Improve recovery time
  • Reduce muscle damage after marathon running
  • Decrease inflammation and swelling
As above with the Normatec, the Powerplay ice/compress should be used as an addition to active recovery. It can be particularly useful when exercises with lingering minor acute injuries where we want to limit excessive swelling and pain.

Does shockwave help with recovery post exercise?

Extracorporeal Shockwave Therapy (ESWT) is the new kid on the block for sports medicine gadgetry. Research is showing that it can help with recovery for lower limb tendon problems. Some practitioners are utilising shockwave for other conditions. The idea being that similar to recovery in tendons, the shockwave can help stimulate a better healing response in recovering muscles. Currently there isn’t enough evidence for this off-label use to promote ESWT as a significant solution. That said, where indicated and safe, we do use it to help with pain, inflammation and healing after exercise. It’s important to note that shockwave is often more painful than other therapies, and has other contraindications that may limit its use. We are happy to talk through its suitability for any of our patient’s recovery needs.

Recovery physio summary

For the best possible recovery, focus on:
  • Understand your training load, and keep it consistent
  • This includes rest periods between training days
  • Perform an active recovery after exercise: cool down, active movement through range, stretches, foam roller
  • Hydrate and eat a healthy diet – particularly around periods of higher training load
  • Try to ensure quality sleep
  • Utilise massage, compression therapy (Normatec), ice/ compression (Powerplay or Gameready) as adjuncts to help recovery – not as your only recovery
  • Keep on top of acute injuries and niggles – consult your recovery physio for advice on how to manage these while keeping up an appropriate level of training.
Come and see our team at the Movement Centre for tailored advice on training and running recovery.
Disclaimer: The Movement Centre provides this information as an educational service. The information contained on this website and in this blog is not intended to serve as or replace actual medical advice. Anyone seeking specific advice or assistance should consult their local Randwick Physio, general practitioner, medical specialist, or otherwise appropriately skilled practitioner.