The practical, science based guide to post exercise recovery

Why you get sore and what your muscles need

What your muscles need to help recover

Knowing what causes the pain and reduced performance we understand that your muscles need the following to help recovery.

• helping the microscopic damage heal
• help remove the metabolic wastes and break down products
• help relieve the tension off the muscles

Matching recovery options to those needs

We now have two ways to evaluate each each post recovery option.

1. How does this option help provide these needs (physiological benefits).
2. What results have been achieved in scientific trials.

The essentials

During recovery you you absolutely need:

• adequate sleep and rest
• adequate diet and hydration

Sleep and rest

You need to have adequate sleep and rest during recovery.

Diet and hydration

There are a lot of recommendations with regard to hydration and dietary supplements. We don’t claim expertise in relation to dietary supplementation, but these and hydration need to be considered from the principle of homeostasis. This is your body’s inbuilt mechanisms to maintain it’s internal environment. Lets look at how this works, then how it relates to your fluids and dietary needs.

Hydration

To aid in recovery your body needs optimum fluid levels. This helps recovery by helping deliver fresh nutrients and flushing wastes from your healing muscles. If you have too little fluids and become dehydrated this will be impaired, but if you drink too much this will be harmlessly expelled. Therefore, the optimum re-hydration is to drink a bit more than your body actually needs. After exercise drink a bit more than you have lost, then drink a few extra glasses of water during the day.

How do you know how much fluids you have lost? You can get a good estimate by weighing yourself before and after. Most weight loss will be fluid, with a litre of water weighing one kilogram (one pint is approximately one pound).

Protein and other nutrients

Your body will need proteins and other nutrients to rebuild the damaged muscles, so adequate supplies are essential. Supplements are heavily advertised, but just like with excess fluids your body will regulate the levels. If your body is lacking it will most welcome the supplements. If levels are adequate they will be expelled. However, unlike water excesses may cause harm. As an example your body breaks down protein into building blocks called amino acids. If your body has too much of an amino acid it just breaks them down, salvaging the usable parts and expelling the rest.

• The usable part gets converted to energy, which can be used as fuel or stored as fat.
• The unusable part is a nitrogen compound which your body must expel, and is toxic in higher concentrations.

Recommendations

You need adequate nutrition so your body has the “building blocks” it needs to repair your muscles, but too much may not be a good thing. As we have seen in the case of proteins too much i) can cause a build up of fat, ii) can load your body with toxic wastes, iii) create stress on your body breaking down and expelling the excess, and ultimately iv) created expensive urine. What we recommend you do is discuss your needs with a qualified dietitian to ensure you have an adequate diet, and to only take supplements that are needed.

Therapies that will help

There are two therapies found to really help post exercise recovery and reduce DOMS.

1. manual massage performed by a professional therapist
2. vibration massage

Additional therapy useful with conditions

• active recovery

Vibration massage

Like manual massage, vibration massage is also shown to give very worthwhile reductions in pain and to speed recovery (1,5–13) . Science shows that vibration massage relaxes muscles and increases blood flow, plus as discussed in our article on vibration assisted healing it has some quite remarkable additional effects.

• Speeding the growth of muscle fibres
• reducing the amount of scar tissue formed
• causes and increase in the body’s production of growth hormones

Multiple applications are better than one: the need for self massage

Both therapies will be more effective if applied regularly rather than once. As an example, in one clinical trial of vibration massage this therapy was applied after exercise then each day during recovery. Some professional sports people may be able to do this, but for most this will require self therapy. We have seen that the results of self massage using foam rollers is poor, but on the other hand vibration massage is ideal for self application.

Active recovery

Active recovery is the use of light or moderate exercise during the recovery phase. If we look at what it actually does for healing we see it can do both good and harm.

The positive effects of active recovery

• help stretch and relax muscles
• help stimulate blood flow

The harmful effects of active recovery

• can damage healing muscle fibres

What that means is that if you do active recovery it should be done enough to utilise the positive effects while avoiding the harmful effects. Of course this may not be judged correctly, which is why clinical trials have only shown inconsistent short term pain relief (3,4,14–16)⁠. We recommend that active recovery be used, but be done conservatively.

(Popular) therapies with marginal benefits

Next we will look at several therapies with little or no benefits. Although these are popular we could not see many worthwhile physiological benefits and clinical trial results were poor.

• Cold/Ice baths
• Contrast baths
• Compression garments
• Electrotherapies

Cold/Ice therapy

Cold/Ice therapy is cooling the body down after exercise, such as using an ice bath. It is said to reduce swelling and inflammation. This may be of some benefit for non-microscopic injuries where swelling is an issue, but inflammation associated with the microscopic damage is actually part of the healing process. Clinical trials of this therapy agree, showing that this therapy only gives a small and inconsistent reduction in post exercise soreness (2–4,15)⁠.

Contrast (hot/cold) baths

Contrast baths involve alternating between hot and cold baths. The principle is that changes in temperature produce some sort of pumping action in the fluids in the muscles. However, it is hard to imagine this effect to be anywhere near that of the increased blood flow caused by manual or vibration massage. The clinical trials agree, showing that this therapy only produces a small decrease in post exercise pain (3)⁠

Compression garments

Compression garments are garments that exert pressure on the muscles. They are said to cause a reduction in swelling. However as with the ice baths, any swelling with microscopic damage is your body bringing in the things it needs for the repair. The clinical trials agree, showing that these garments can only give a small decrease in post exercise pain (3)⁠.

Electrotherapies

These are devices like TENS machines. We don’t know of any way these would help the muscles heal, and clinical clinical trials confirm that they don’t help (16)⁠

Summary and recommendation

Warmup and preparation

Before sport or strenuous exercise is advisable to warm up properly using light exercises and stretching. This helps prepare your muscles for exertion and will reduce the risk of injury

Sleep, rest, hydration and diet

During recovery:

• Make sure you get adequate sleep and rest
• After exercise drink more than enough to replace fluids lost, and supplement with several glasses of water each day
• Make sure you have an adequate diet. Consider the principles of homeostasis and discuss your needs with a properly qualified dietition.

Massage or vibration massage

Both these therapies have proved to be beneficial. Multiple applications will be better than a single one, and as discussed vibration massage is the effective choice for self application. For further information please see:

• how to choose a massager
• how to use a massager

Active recovery

As discussed above, active recovery has potential positive effects and detriment. We recommend that light exercise be done conservatively to minimise the risk of injuring healing muscle fibres.

References

1. Imtiyaz S, Veqar Z, Shareef MY. To compare the effect of vibration therapy and massage in prevention of delayed onset muscle soreness (DOMS). J Clin Diagnostic Res. 2014;
2. Naderi A, Aminian-Far A, Gholami F, Mousavi SH, Saghari M, Howatson G. Massage enhances recovery following exercise-induced muscle damage in older adults. Scand J Med Sci Sport. 2021;31(3):623–32.
3. Dupuy O, Douzi W, Theurot D, Bosquet L, Dugué B. An Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review With Meta-Analysis. Front Physiol. 2018;9(APR):1–15.
4. Bishop PA, Jones E, Woods AK. Recovery from training: A brief review. Journal of Strength and Conditioning Research. 2008.
5. Ntshangase S, Peters-Futre E. The efficacy of manual versus local vibratory massage in promoting recovery from post-exercise muscle damage – A systematic review. J Sci Med Sport. 2017;20(February):e42.
6. Veqar Z, Imtiyaz S. Vibration therapy in management of delayed onset muscle soreness. J Clin Diagnostic Res. 2014;8(6):10–3.
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9. von Stengel S, Teschler M, Weissenfels A, Willert S, Kemmler W. Effect of deep oscillation as a recovery method after fatiguing soccer training: A randomized cross-over study. J Exerc Sci Fit. 2018;16(3):112–7.
10. Timon R. Effects of whole-body vibration after eccentric exercise on muscle soreness and muscle strength recovery. J Phys Ther Sci. 2016;28:1781–5.
11. Kamandani R, Ghazalian F, Ebrahim K, Ghassembaglou N, Shiri Piraghaj M, Khorram A. The Effect of Acute Vibration Training on Delayed Onset Muscle Soreness in Young Non-Athlete Women. Heal Scope. 2015;2(3):119–24.
12. Lu X, Wang Y, Lu J, You Y, Zhang L, Zhu D. Does vibration benefit delayed-onset muscle soreness ?: a meta-analysis and systematic review. 2019;
13. Koeda T. A trial to evaluate experimentally induced delayed onset muscle soreness and its modulation by vibration. Environ Med. 2003;47:26–30.
14. Kinugasa T, Kilding AE. A comparison of post-match recovery strategies in youth soccer players. J Strength Cond Res. 2009;23(5):1402–7.
15. Toubekis AG, Smilios I, Bogdanis GC, Mavridis G, Tokmakidis SP. Effect of different intensities of active recovery on sprint swimming performance. Appl Physiol Nutr Metab. 2006;31(6):709–16.
16. Cortis C. Effects of post-exercise recovery interventions on physiological, psychological and performance parameters. Int J Sports Med. 2010;31:327–35.