Recovery: Part 2 – Stretching and Rolling

For my money, the ideal post-ride recovery looks something like this:

    • Nothing happens before a shower. Wash the grime off first.
    • Set the bathtub at full-cold and fill ‘er up!
    • Static stretch-down while the tub is filling. 30+ sec all muscle groups lower extremity and neck, upper back, shoulders
    • Putter around on Strava
    • Bathtub is full.¬†Dump in half-dozen ice trays out of the freezer
    • Mentally psych up for 10min at ~10¬į C waist-deep¬†ice bath
    • First 30sec is the worst.¬†Podcasts provide a good distraction. Don’t drop the phone in…
    • Emerge, dry off, pull on compression tights
    • Complete lower body¬†foam roll-out
    • Refuel your energy reserves with proper nutrition. Cookies are necessary, but insufficient
    • At least 8 hours of quality sleep¬†– this may be the most¬†critical

These are my recovery protocol of choice. I feel better immediately after and often the next day compared to when I have to skip the full routine, but are these methods supported by the evidence?

I’ve tried to find the latest systematic reviews on these topics¬†to estimate their efficacy for¬†recovery. Again, this isn’t a comprehensive literature review, but just me looking for the most recent,¬†mostly comprehensive review of the evidence.

In Part 1 I looked at Ice Bathing and Compression Garments. In this Part II¬†I’ll look at¬†Foam Rolling and¬†Static Stretching;¬†if, how and when both methods can be used to enhance recovery.

Foam Rolling

I’ve been very lucky with the timing of this literature investigation with articles seemingly published precisely within the last 6 months for my convenience!¬†My first PubMed search¬†returned a handful of exactly the review papers I was hoping for.

The latest Systematic Review on rolling, published in November, 2015 in the International Journal of Sports Physical Therapy (Cheatham et al, 2015) looked at the efficacy of foam rolling and roller massagers (includes anything from tennis balls to The Stick-type tools) on joint range of motion (ROM) muscle recovery and delayed onset muscle soreness (DOMS) and muscle performance.

14 articles up to April, 2015 met the search criteria but like our previous look at ice bathing and compression garments, the individual studies suffered from small sample sizes and a high level of heterogeneity between methods and outcome measures. Despite the limitations, the review concluded:

“SMR¬†[Self Myofascial Release] using either foam rolling or roller massage¬†may have short-term effects of increasing joint ROM without decreasing muscle performance…¬†[and] may also attenuate decrements in muscle performance and reduce perceived pain¬†[ie. DOMS] after an intense bout of exercise.”

(Cheatham et al, 2015)

The review confirms the commonly perceived benefits of rolling but once again finds the existing literature insufficient to explain precise physiological mechanisms or prescribe a specific a specific treatment protocol.

In addition to the positive findings for enhanced perception of recovery, the review paper finds that:

“Short bouts of foam rolling or roller massage… prior to activity does not enhance or negatively¬†affect muscle performance but may change the perception of fatigue”.

(Cheatham et al, 2015)

The paper discussed possible mechanisms for foam rolling that would explain the perceptual benefits without offering any change in physiological or performance outcomes:

    • Benefits to DOMS and¬†associated symptoms may be attributable to changes in connective tissue rather than muscle tissue directly;
      • Mechanical pressure influencing viscoelastic properties of fascia;
      • Friction increasing intramuscular temperature and blood flow, and;
      • Mechanically breaking down scar tissue
    • Rolling protocol typically consisted of 10 to 20-minute sessions, rolling a given muscle longitudinally (along direction of function) for 30 seconds for foam roll or 2 minutes for roller massage. The difference here is due to applying greater pressure from bodyweight foam rolling than from manually applied roller massage.
    • Rolling¬†pressure and cadence were typically not controlled and self-selected as per tolerance by the test subjects.

Hamstring Rolling

I won’t link to specific rolling techniques – those are easy enough to read about and watch on video on your own, but I’m perpetually shocked that the internet apparently isn’t aware of rolling hamstrings specifically over the edge of a chair, bed or bench with your knee bent and muscle relaxed!

Hmastring Ball
I had to scroll way too far down Google Images to find this! Thank you azumio.com

Quick anatomy lesson: the Hamstring is a very long (group of) muscle(s) that cross the hip and knee joints. Meaning if your knee is straight and hip is bent Рas they are in the typical long-sit rolling floor position Рthe muscle and surrounding fascia are under tension and more force will be required to perceive any pressure or release in the target muscle.

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In practice, this means using bodyweight in a long-sit position is insufficient to exert enough pressure into the muscle to elicit any perceptual benefits. Stacking the foam roller on top of a block (or stack of anatomy textbooks, as in my living room) allows a more relaxed muscle position if unable to use a bench or other raised surface.

 

Static Stretching

I was going to start this topic with the presumption that static stretching should only be used for post-exercise cool-down/recovery due to static stretch causing decrements to subsequent muscle force output, and therefore potentially negatively affect performance when used in a warm-up routine. However, falling down that particular rabbit hole produced surprising results:

Behm et al (2016) just released a comprehensive review of the acute effects of muscle stretching with mixed results for Static Stretching, Dynamic Stretching and PNF Stretching (contract-relax protocol). To summarize their findings:

    • Static Stretching produced a small to moderate negative effect on immediate (within 3-5 min) subsequent performance, with stretch length >60s (-4.6%) worse than <60s (-1.1%)
    • Static stretch before¬†strength-based tasks (1 rep-max, maximal volunary contraction; -4.8%) resulted in worse performance¬†than power-speed tasks (jumping, sprinting, throwing; -1.3%).
    • PNF stretching produced moderate negative overall effect on performance (-4.4%)
    • Dynamic Stretching demonstrated the only small positive overall effect on performance (+1.3%)with the suggestion that¬†at least part of the benefit of dynamic stretching is from a practice effect at tasks similar to the performance or test.

(Behm et al, 2016)

Behm et al (2016) went on to conclude that combining static and dynamic stretching as part of a warm-up routine was probably beneficial and not harmful to subsequent performance:

“Considering the small-to-moderate changes immediately after stretching…¬†stretching within a warm-up that includes additional poststretching dynamic activity is recommended for reducing muscle injuries and increasing joint ROM with inconsequential effects on subsequent athletic performance.”

(Behm et al, 2016)

So what about stretching for post-activity recovery? I had to look back a few years in the literature to find a relevant review for static stretching used as part of post-exercise recovery.

Herbert, Noronha and Kamper (2011) reviewed Stretching to prevent or reduce muscle soreness after exercise for a Cochrane Collaboration review. They found a high degree of consistency of results across studies that showed:

“pre-exercise stretching reduced soreness at one day after exercise by, on average, half a point on a 100-point scale.¬†Post-exercise stretching reduced soreness at one day after exercise by, on average, one point on a 100-point scale”

“The evidence…¬†suggests that muscle stretching, whether conducted before, after, or before and after exercise, does not produce clinically important reductions in delayed-onset muscle soreness in healthy adults.”

(Herbert, Noronha and Kamper, 2011)

Herbert & Gabriel (2002) reviewed the effects of stretching before and after exercise on the risk of injury and concluded that:

“Stretching before exercising does not seem to confer a practically useful reduction in the risk of injury…¬†Insufficient research has been done with which to determine the effects of stretching on sporting performance.”

(Herbert & Gabriel, 2002)

Conclusion

So the literature seems to support at least positive perceptual¬†benefits of the recovery protocol covered here¬†and in Part 1, although all this being nothing more than glorified placebo effect can’t be ruled out.

My own suggestion would be that having a warm-up & recovery routine that consistently makes you feel better, for anyone engaged in regular physical activity is still absolutely valuable. Build positive habits around your training Рthe time immediate before and after exercise Рand you should find your body & mind primed and prepared for the task at hand.

 

Resources

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