Physical Therapy Corner: Why Recovery?
By Gina Pongetti Angeletti, MPT, MA, CSCS, ART-Cert.
Table of Contents
What Is Recovery
Diamond Rest and Recovery Room (DR3), along side Achieve Orthopedic Rehabilitation Institute Sports Medicine, provides you with the edge on life. It allows the client to recover like a professional athlete, in order to continue to train like one or just win the day. Our concierge services are unparalleled in creating the best environment for your body to not just survive, but to thrive, walking each client through what is best for them, their issues, goals, and lifestyle.
This can include single-use platforms or combinations of
- NormaTec Compression
- Taping Techniques-Kinesiotaping and stabilization performance and education
- Rolling of all kinds from large body rollers, to trigger point release balls
- Hot/cold therapy
- Flexibility routines and programs
- Posture and breathing assessments and subsequent home programs
- Metabolic Testing for Resting Metabolic Rate
- Body Fat analysis(Muscle, fat, water) and plan creation
- VO2 analysis – Bike or Run, Pre-and Post-testing
- Former Physical Therapy with a dual focus in Biomechanics and Manual Therapy and featuring techniques such as Active Release Techniques (ART), Graston Technique (GT), Trigger Point Dry Needling (TPDN), Cupping, Joint mobilization, MyoFascial Release (MFR), Soft Tissue Mobilization (STM) and additional
- Concussion baselines testing, analysis and return to play management
- and more.
Fit to your needs, your schedule, your lifestyle.
The concept of recovery is ever-present in today’s media- from health magazines, to gimmicks for home units. We are DR3 offer you the best that medicine has to offer to optimize your cellular function, muscle building, athletic performance, chronic illness maintenance and exertional recovery. Come monthly for a refresher. Use us weekly for your recovery process in conjunction with physical therapy. Use packages for consistent use for injury prevention and peak athletic function. Or, just because it feels good!
Diamond Edge Therapy is here to help you to Recover, Rest and Restore.
Who are we? (And why does that matter…)
Our staff starts with Doctorate and Masters level Physical Therapists with unmatched post-graduate continuing education in both hands-on rehabilitation and scientific concepts of recovery and injury prevention. We have Masters Degreed Athletic Trainers who have adolescent, high school, collegiate, and pro athlete treatment and management experience. Our Masters Exercise Physiologists know, at the cellular level, how nutrition, activity, exertion, lymphatics, water, organ function and rest will help or hinder performance.
We are former world-class athletes, NCAA scholarship recipients, Master’s level sports participants to this day. We have families, and understand the balance struggle with combining a career, relationships, families and children and your personal health and fitness goals. We are…YOU!
We are not, however, local business owners who work out, who hopped on a bandwagon for a day-spa concept, hiring technicians to run the equipment, but can offer no medical and training advice.
The Science Behind It All
From a scientific perspective, research is constantly evolving based on the current needs of the human body, and how to most efficiently and effectively maximize from a time and resource perspective, health and wellness. Recently, in the last decade or so, the focus has been on being able to “push the envelope” with our bodies. Historically, many athletes miss out on opportunities for championship performances, Olympic teams, and game-day opportunities because of five main factors:
- Lack of preparedness
- Not enough time to train
- Overuse injuries
- Non-peak muscular performance
It is concluded that there are controls that can be placed in to daily, weekly, and training cycle life to attempt to prevent burnout and sub-par performance based on reversing “diagnoses” and backtracking to prevention. All five of the above variables are effected by the following aspects of sustained life:
- Muscle Health
- Flexibility and pliability
- Strength and stability
- Lymphatic system health
- Post-workout lactic acid accumulation
- Decreasing inflammation
- Turnaround time- decreasing time between training sessions
- Injury recovery, if applicable
A little Bit About Each of the Above:
Muscular fatigue, or being tired, can be a result of the day or two’s previous workout regimen in quantity or intensity. At times in training, this is necessary to push the envelope for peak performance and muscle building, but not always. In a perfect work, one would sleep 8-10 hours at a natural time, be a sponsored professional athlete with no outside work responsibilities, and be able to nap and recover after that Sunday morning 5 hours bike ride. In reality, we sleep the same, rarely make dietary changes, and push our bodies to maintain the same stress and demands of school, work, and family, sprinkling in high level athleticism with no additional apologies.
At DR3, we can help with all of these! Although we cannot make you sleep better, and don’t provide you with dream mattresses, our state-of-the-art technology as well as manual therapy treatments will help your body to ease stress and make the most out of the restful hours.
In the earliest stages, it results in physically feeling tired, worn down, in a constant state of recovery and catching up. In the mid stages, it can effect sleep patterns, increase irritability, focus and drive. In the later and more serious stages, Chronic Fatigue Syndrome (CFS) can develop as well as Adrenal Fatigue, which is a serious condition. Ignoring small signs can simply lead to an acceleration on this path, and ultimately time off of life, sports, and activities to allow a “re-set,” along with medical treatment and more. Otherwise known as Myalgic Encephalomyelitis (ME) or Systemic Exertion Intolerance Disease (SEID), Mayo Clinic cites noticeable symptoms such as memory and concentration issues, fatigue, non productive sleep, random muscle pains without explanation and a “down time” in exhaustion without ability to recover or bounce back for more than a day after an activity. Often caused by, or thought to be, a plethora of variables, well noted in literature is a decrease in the immune system, imbalance in hormones, pituitary and thyroid issues and more. Stress is universally paralleled to SEID, citing life balance, physical stress and systemic function. The CDC even cites that up to 2.5 million people in the US, according to an Institute of Medicine (IOM) report from 2015, suffer and are undiagnosed, reporting feeling symptomatic however assuming it was normal life wear and tear. Wow.
Recovery methods that DR3 and AOSI offer can help to decrease this.
- Education in breathing, stretching, and physical muscular recovery to help with control of stress.
- Hands-on manipulation with massage and other techniques such as ART, joint work, cupping, Dry Needling and more to allow for muscular health and return to as close as homeostasis, or resting normal, as possible.
- CryoTherapy for blood flow, lymphatic circulation, muscular health and cellular turnover.
- Hot/Cold contrast therapy for localized edema control or prevention in anticipation of a hard workout or activity.
- Massage for relaxation and increase in sleep patterns
- Compression, with NormaTec, for localized body and joint flushing
2. Lack of Preparedness…. And 5. Non-Peak Muscular Performance
How, you ask yourself, does recovery and physical therapy have to do with preparedness? Well, we are not your coaches, nor are we your parents. We cannot make lunches for your with full nutrition, or run better plays on the field. What we can do, however, is buy you time. By participating in ongoing injury prevention and recovery tactics (which, yes, do take time), you allow yourself the ability to be more prepared, train more physical time when you are not as fatigued, and put more into your training.
Muscular performance, power output, endurance, and overall strength can be improved by allowing the muscles to flush out toxins, repair themselves, and refresh from the previous workout, prior to the next. Without this, one is functioning at sub-par levels, and even is pushing through with higher exertion (effort or even heart rate) due to a non-perfectly tuned machine (i.e. body!) Delayed Onset Muscle Soreness (DOMS) happens after workout, when lactic acid is built up and inflammation is present in the tissues. Most people are sore from a normal workout for less than 24 hours. An untrained muscle that is placed through abnormal stress can remain sore and non-optimal for up to 3-4 days!
Scientifically, when the demand of the activity is higher than the available resources that the body has (energy, muscle fluctuations and contraction, and available Oxygen), pH decreases (meaning that the acidity increases). When this happens, it also prevents, or “clogs” the system that breaks down glucose to energy. This prevents “cell turnover”, if you will, because of lack of ADL rephosphorylation. Clearing out the structures, and re-optimizing pH allows for proper muscle recovery and performance, allowing each workout to contribute to the best preparedness that it can!
3. Not Enough Time to Train
When oxygen flows freely through the body, one not only performs better, but sleeps better. If sleep is improved, and more productive (i.e. better hormonal balance, mood recovery, and regeneration of tissues). Most importantly for the physicaly active, sleep is when the hormones are released that stimulate tissue growth, meaning the new tissue that has to form from the old tissue being “beaten up” in a workout. With workouts, your heart is taxed. Sleep also naturally lowers your blood pressure, meaning that your heart is on a small “break” as well . How does this have to do with training time? If your sleep is more productive, you may get 100% of required in the 7-8 hours you sleep, instead of a lack of quality rest in 8-10 (or what you wish and yearn for), and getting 6, leaving you at bad odds.
4. Overuse Injuries
Orthopedic and Performance Medicine, in general, is not rocket science. It is, algorhythmic in nature. For example: if one has strength in pecs, abs, and arm in combination with movement understanding, the ball will travel faster than if the strength is not there. If this, then this. Period. The problem happens in two possible scenarios:
- when the “then this” motion (such as pitching a ball, or jumping for a “set” in gymnastics”) happens anyway with a lack of proper motion compensations happen, because the “if this” part (jump height and neuromuscular understanding of the order of activation, shoulder strength, etc) is not present. Or at least, to the 100% demands of the activity.
- Because of the need for repetitive motion to attain perfection of activation, strength, body position and training, simply too many movements are performed and the body inflames, or breaks down.
Inherent to all sports, no matter if it is ping pong or high jump, are specific sport motions that are used and overused, and cannot be avoided. Can we do 15,000 instead of 45,000 in a year? Of course. But we cannot do 1,000 to be at the Elite level. Just not possible.
If we know, as we have known for years, about the theory of repetition, then we have to work backwards from how we treat these injuries (controlling inflammation, nursing the tendon, ligament, muscle and joint back to health, rest, strengthening the area around it, encouraging fluid homeostasis with regards to red and white cells, rebuilding cells, pH levels and so on), we just work backwards.
CryoTherapy helps with inflammation for numerous reasons. Assisting in blood flow, allowing “good” cells to come and turnover the “bad,” old, or damaged cells, and returning body to pH homeostasis are some of the main points. The risk for overuse injuries can decreased by lowering the ability for the tendons, ligaments, and muscles to become inflamed, irritated, torn, or frayed
Compression helps as well, allowing muscles to recover between sessions so that mechanics can be better in performance.
Massage helps to keep good blood flow in the area of the recovering and possibly overworked tissues, and helps lymphatic flow to recycle and renew local fluid and tissues.
Rest does not fix overuse, it simply stops the use… hence, some of the symptoms. If scar tissue is developed, within and around the muscle fibers, ligaments, tendons, joints and nerves, it must be removed to allow the body’s mechanics to return to a proper pulley system… in comes Achieve Sports Medicine with the hands-on techniques.
Modalities, such as heat and cold therapy, a combination of hot/cold contrast, electric stim, ultrasound, all also contribute to the help of blood flow and tissue turnover…but do not, alone, fix a long-standing issue.
So, as we work “backwards” to what fixes an existing problem, we can anticipate the probability of it happening, and “get in front of” the issue by forcing a sped-up recovery with DR3 offerings.
What Exactly IS CryoTherapy?
Whole Body CryoTherapy (WBC) has been around since 1978, and was started not for athletes, but for chronic pain sufferers, from rheumatoid arthritis. It was researched and invented in Japan. They were on track when it started, that the client with a chronic inflammatory disease that was auto-immune (the body fighting itself) in nature, would respond well to controlling this response of the body so that the side effects were better. And then… the sports world caught on.
Standing in a unit (similar, if you have been, to an upright tanning bed), the platform raises you so that your head is out of the unit. The CryoSense machine (state-of-the-art) heats you for 1 minute prior to cooling, to increase blood flow the extremities, and therefore, create a more dramatic physiological effect on the body. Then the cooling begins. Powered by liquid nitrogen, the tanks create “cool air” in your pod, allowing the temperature surrounding to decrease from -100F to -300F.
In “fight-or-flight- response, the body will always send the blood to the most important areas- the organs, and not the feet and hands, for example. As the brain senses that the skin is getting cold, the body sends the blood the core organs, flushing it out of the extremities. Vasoconstriction happens (shrining of the blood vessels) as the blood leaves, piggy-backing with toxins that are being flushed as well. This allows it to be re-oxygenated through heart and lungs, and filtered, at mass speed, obtain nutrients and more. In addition, hormones and endorphins are released that help the recovery phase. Stimulation of the vagus nerve happens as well, when the parasympathetic (fight or flight) system is activated. This has been noted in research to reduce fatigue over time as well as anxiety.
The main goal of cryo, however, is the “re-flushing,” when the blood flow returns to the extremities full of nutrients and love.
- Blood flow increase
- Mood enhancement
- Muscle tissue health
- Cell Turnover
- Release of testosterone and DHEA in some studies
- Improved sleep due to hormone balance
- Increased white blood cells leading to decreased inflammation or inflammability
- Immune system positive response for fighting illness, infection and fatigue
- Slight increase in temporary metabolism
Who Benefits from CryoTherapy?
- People with physical jobs
- Autoimmune diseases (Diabetes, Lupus, Lyme, Rheumatoid Arthritis)
- Overuse (Osteoarthritis)
- Chronic pain such as Fibromyalgia
- Sleep disorders
- Fatigue and malaise
- Systemic and Chronis issues such as MS
Full Body Compression Systems (FBCS)
We are proud to carry NormaTec systems for your use! DR3 is ready for your- whether big or small, little or tall! We have all three sizes, for all three body parts (upper body and hips/leg). You get a hand-held device that either a tech will program for you, or is pre-programmed if you are a regular user. If your need varies, so does the program. You can have high compression for decrease of inflammation. We can vary it for location on your extremity to focus, and even allow for pulsing for an increase of blood flow as well.
Citations (in no specific order) for more information on all of this science stuff!
- Sahlin, K. Muscle Fatigue and lactic acid accumulation. Acra Physiol Scand Suppl. 1986;556.
- Taheri, S. PLoS Medicine, Dec 7, 2004.
- Bettoni et al. Effects of 15 Consecutive Cryotherapy Sessions on the Clinical Output of Fibromyalgia Patients. Clnical Rheumatology. Sep 2013.
- Rymaszewska et al. Whole-Body Cryotherapy as Adjunct Treatment of Depressive and Anxiety Disorders. Arch Immunology Ther Exp. Feb 2008.
- Metzer et al. Whole Body Cryotherapy in Rehabilitation of Patients With Rheumatoid Diseases. Rehabilitation. April 2000.