Tuesday 10th August, 2021

The practical, science based guide to post exercise recovery

Strenuous workout
In this article we look at the scientifically proven ways reduce post exercise soreness (DOMS) and speed recovery

There are a lot of articles with shopping lists of things to do to help your muscles recover after exercise, but which are the most useful and which are just added to make up the numbers. Our review of the scientific literature reveals the following.

Therapies that give worthwhile reductions in post exercise soreness and help recovery

  • Vibration massage
  • Manual massage by professional therapists

Therapies that give marginal or inconsistent benefits

  • Cold/ice baths
  • Contrast baths (hot/cold)
  • Compression garments
  • Active recovery

Therapies with no proven benefits

  • Electrotherapies

Things you need to do

  • Adequate hydration, nutrition, rest and sleep

So this all makes sense and you can make a sound choice for your own post exercise routine, in this article we’ll go over why you get sore, then in simple terms how each can potentially help, and finally summarise them with our recommendations.

CONTENTS

Why you get sore after a workout
Methods use to reduce post exercise soreness and speed recovery
Summary and recommendations
Professionals
References

Why you get sore after and need recovery after a workout

The microscopic structure of muscles
With strenuous exercise these fine fibres are damaged, plus you get a build up of metabolites and other chemicals from the breakdown

This diagram shows the microscopic fibres that make up a muscle. Strenuous exercise will damage some of these fibres. You will also get a build up of metabolic wastes and chemicals that result from the breakdown of damaged tissues. After exercise muscles also tend to tighten, which puts pressure on blood vessels restricting blood flow. These combine to cause post exercise soreness, also known as DOMS or delayed onset muscle soreness. In addition, until the muscle has healed and recovered the maximum strength and endurance of the muscle will be limited.

Methods used to reduce post exercise soreness and speed recovery

Understanding why you get pain and a reduction in performance, the goal of any recovery method should include:

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

Lets look at the different recovery methods and how they do this.

The best recovery methods

  • Manual massage performed by a professional therapist
  • Vibration massage
Sports massage
Massage by professional therapist is effective at reducing post exercise soreness and speeding recovery

Manual massage performed by a professional therapist

Manual massage therapy has been shown in clinical trials to give good results in reducing post exercise soreness and speeding recovery (1–5)⁠. Likely the main benefit would be from the squeezing and mechanical pumping effects of the massage increasing blood flow, flushing wastes and bringing in fresh nutrients and oxygen.

Massage ball (roller)
Self massage using balls and rollers is no where near as effective and safe as professional massage

This does not include the use of foam rollers
As discussed in our article on foam rollers, these are generally far less effective than professional massage therapy, and the results of using them in clinical trials is no where near as good. There are a host of reasons, but in summary professional massage therapy is performed by skilled knowledgeable therapists, usually on a client relaxed lying on a table. On the other hand foam rolling is usually done by people without this level of skill and knowledge, and muscles are often tightened in an attempt to adopt the correct position.

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 in addition 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

For more details on these effects please see our article The scientifically proven effects of vibration massage- with clinical applications.

Self massage with a vibration massager
Vibration massage can easily be self applied with no special skills

Self massage using vibration massagers
The big advantage of vibration massage is that it can easily be self applied. There is no special skill needed. Whereas self applied manual massage (such as foam rollers) requires skill and knowledge, all one needs to do is to place the vibrating pad of a massager over the muscle and let the vibrations penetrate. Without needing the physical pressure and penetration vibration massage is also much safer.

Percussion vs vibration massage

Percussion massagers such as massage guns are not vibration massagers
The use of percussion massagers such as massage guns have become a fad. However, as discussed in our article Should I get a percussion massager (massage gun) percussion massage is different to vibration massage, with less benefits and greater risks.

Therapies with marginal benefits

  • Cold/ice
  • Contrast baths
  • Compression garments
  • Active recovery

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. Clinical trials have only shown that this therapy gives a small and inconsistent reduction in post exercise soreness (2–4,14)⁠.

Contrast (hot/cold) baths

Contrast baths involve alternating between hot and cold baths. Clinical trials have shown these to produce a small decrease in post exercise pain (3)⁠. It is a fundamental principle of physics that things expand and contract with changes of temperature, so contrast baths would 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.

Compression garments

Compression garments are garments that exert pressure on the muscles. They are presumed to cause a reduction in swelling. Clinical trials show that these garments can give a small decrease in post exercise pain (3)⁠.

Active recovery

Active recovery is the use of light or moderate exercise during the recovery phase. If we refer back to the cause of post exercise soreness and the needs for recovery we see that such exercise could have both positive and negative effects.

Positive effects of active recovery

  • help stretch and relax muscles
  • help stimulate blood flow

Negative effects of active recovery

  • can damage healing muscle fibres

Because of this clinical trials have only shown inconsistent short term pain relief (3,4,14–16)⁠. However, active recovery is easy to do, and if done conservatively to minimize potential damage it is probably very worthwhile.

Therapies with no proven benefits

Electrotherapies

I’m not sure what these are trying to achieve, but clinical trials say they don’t help (16)⁠

Things you need to do

During recovery you need

  • adequate sleep and rest
  • adequate diet and hydration

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 environment. Lets look at how this relates to fluid levels and a dietary example.

Homeostasis and fluid levels
Your body will do it’s best to maintain optimal fluid levels. If you drink too much the excess will be expelled by your kidneys. If you don’t have enough your body will attempt to conserve fluids, but the dehydrated state will likely detriment your body’s ability to flush the wastes from the healing muscles and bring in fresh nutrients. What this means is you should re-hydrate after exercise with more fluids than you’ve lost, and drink a few extra glasses of water during the day.

Proteins
Protein supplements are often recommended during recovery, but your body’s homeostasis mechanisms regulate these too. The basic building blocks of protein are 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. As stated before, we are not experts in supplements so taking some may result in a beneficial short term increase, but by basic homeostasis principles as long as your diet has adequate amounts of proteins, vitamins, minerals and so forth it will keep and use what it needs and get rid of the rest.

Summary and recommendation

The following are our simple guidelines to reduce post exercise soreness and speed recovery. Keep in mind that this is for general information only. For specific advice consult a professional familiar with your own needs.

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

Massage or vibration massage

These therapies have proved to be beneficial when done before exercise, after exercise, and during the recovery phase. An effective program may be to use either therapy before, after and each day during recovery. A professional sports person with therapy provided will probably have this done by professional massage therapists. However, for most this will need to be self applied. As discussed, the use of foam rollers and percussion massagers (massage guns) is not that effective, so the best alternative is to use a good vibration massager. We have a lot of information about this elsewhere on our website, but the following would be a great place to start.

Video: How to choose a massager
Article: Percussion vs vibration massage
How to use your massager: Instructions page
Video: Our highly effective vibration 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.

Sleep, rest, hydration and diet

  • 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. Supplements may provide some advantage, but the principles of homeostasis tell us that your body will get rid of any excesses it doesn’t need, so there is the potential for supplements to be converted to very expensive urine.
Professional at desk
Professionals: click image to find out more and possibly trial vibration massage

Professionals

DrGraeme massagers were originally built by Dr Graeme for use in his clinic, and to prescribe to his patients for additional self use at home. Now these are used by colleagues and other professionals for similar purposes. If you are a professional and wish to know more about this therapy, or possibly get a sample massager to trial please check out our practitioner page.

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.
  7. Lau WY, Nosaka K. Effect of vibration treatment on symptoms associated with eccentric exercise-induced muscle damage. Am J Phys Med Rehabil. 2011;
  8. Bakhtiary AH, Safavi-Farokhi Z, Aminian-Far A. Influence of vibration on delayed onset of muscle soreness following eccentric exercise. Br J Sports Med. 2007;
  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.

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Dr Graeme

About Dr Graeme

Several years ago Dr Graeme, a Chiropractor practicing in Victoria, Australia was looking for a serious hand held massager his patients could use at home to get the extra quality massage they needed. The ones he found in the shops and on-line for home use looked nice but were not serious, and... read more



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