“Precovery” Versus Recovery: Understanding the role of cherry juice in exercise recovery

Cherry juice has become a standard component of athlete recovery strategies. This review covers the history of cherry juice as a recovery drink to give context to its current use. Fifteen studies were identified that included a measure of muscle function, soreness, or inflammation on the days following exercise and had an exercise insult sufficient to assess the effectiveness of the tart cherry intervention. Eight studies used a concentrated juice, three used a juice from fresh-frozen cherries, two used a tart cherry concentrate gel, and two used a tart cherry powder. The effective juice dose was specific to the type of drink (fresh-frozen versus concentrate) but dose-response studies are lacking, and thus, the optimal dose for any specific type of cherry juice is not known. Timing of the dosing regimen is a critical factor. Studies have uniformly shown that muscle function will recover faster on the days after exercise if juice is provided for several days prior to exercise. Effects on soreness or systemic inflammation are more equivocal. The available evidence does not support a regimen that begins on the day of exercise or post-exercise. Tart cherry powder did not enhance any metric of recovery on the days after exercise. In conclusion, the term recovery implies an intervention that is introduced after an exercise insult. The term “precovery” may be preferable to describe interventions that should be introduced on the days prior to exercise to facilitate recovery on the days after exercise. The evidence supports cherry juice as a precovery intervention across a range of athletic activities

The efficacy of cooling with phase change material for the treatment of exercise-induced muscle damage: pilot study

Post-exercise cryotherapy treatments are typically short duration interventions. This study examined the efficacy of prolonged cooling using phase change material (PCM) on strength loss and pain after eccentric exercise. Eight adults performed 120 bilateral eccentric quadriceps contractions (90% MVC). Immediately afterwards, frozen PCM packs (15°C) were placed over the quadriceps, with room temperature PCM packs on the contralateral quadriceps. Skin temperature was recorded continually (6 h PCM application). Isometric quadriceps strength and soreness were assessed before, 24, 48, 72 and 96 h post-exercise. The protocol was repeated 5 months later, with room temperature PCM applied to both legs. There were three treatments: legs treated with 15°C PCM packs (direct cooling), legs treated with room temperature PCM packs contralateral to the 15°C PCM packs (systemic cooling), and legs tested 5 months later both treated with room temperature PCM packs (control). Skin temperature was 9°C–10°C lower with direct cooling versus systemic cooling and control (P < 0.01). Strength loss and soreness were less (P < 0.05) with direct cooling versus systemic cooling and control (strength 101%, 94%, 93%, respectively; pain 1.0, 2.3, 2.7, respectively). Six hours of PCM cooling was well tolerated and reduced strength loss and pain after damaging exercise

Extending travel-time based models for dynamic network loading and assignment, to achieve adherence to first-in-first-out and link capacities

AbstractAn important class of models for macroscopic dynamic network loading (DNL) and dynamic traffic assignment (DTA) is based on treating link travel times as a function of link occupancy. However, these models suffer from some problems or deficiencies namely (a) the link outflows can violate first-in-first-out (FIFO), (b) the link outflows can exceed the link outflow capacities, (c) the link inflows can exceed the link inflow capacities, and (d) the link occupancies can exceed the link occupancy capacities. In this paper we introduce methods to overcome each of these problems.To remove problems (a) and (b) we extend the link travel-time model to better reflect behaviour when traffic flow is varying over time. To remove problems (c) and (d) we introduce more substantial changes in the model, to introduce capacities, spillback and queues compatible with the model. These extensions strengthen the realism, behavioural basis and usability of the link travel-time model and the DNL and DTA models that are based on it. They have no obvious adverse implications or side effects and require little additional computational effort. The original model is a special case of the new/extended model: the above extensions are activated if and only if any of the problems (a)–(d) arise, otherwise the new model reduces to the original model

Don't Lose Your Cool with Cryotherapy: the application of phase change material for prolonged cooling in athletic recovery and beyond

Strenuous exercise can result in muscle damage in both recreational and elite athletes, and is accompanied by strength loss, and increases in soreness, oxidative stress, and inflammation. If the aforementioned signs and symptoms associated with exercise-induced muscle damage are excessive or unabated, the recovery process becomes prolonged and can result in performance decrements; consequently, there has been a great deal of research focussing on accelerating recovery following exercise. A popular recovery modality is cryotherapy which results in a reduction of tissue temperature by the withdrawal of heat from the body. Cryotherapy is advantageous because of its ability to reduce tissue temperature at the site of muscle damage. However, there are logistical limitations to traditional cryotherapy modalities, such as cold-water immersion or whole-body cryotherapy, because they are limited by the duration for which they can be administered in a single dose. Phase change material (PCM) at a temperature of 15°C can deliver a single dose of cooling for a prolonged duration in a practical, efficacious, and safe way; hence overcoming the limitations of traditional cryotherapy modalities. Recently, 15°C PCM has been locally administered following isolated eccentric exercise, a soccer match, and baseball pitching, for durations of three to six hours with no adverse effects. These data showed that using 15°C PCM to prolong the duration of cooling successfully reduced strength loss and soreness following exercise. Extending the positive effects associated with cryotherapy by prolonging the duration of cooling can enhance recovery following exercise and give athletes a competitive advantage

Does High Medial Elbow Stress During Pitching Compromise the Dynamic Stabilizers of The Elbow?

# Background The flexor carpi ulnaris (FCU) and flexor digitorum superficialis (FDS) are thought to provide dynamic stability to the medial elbow, with a lesser contribution from the pronator teres (PT). # Hypothesis/Purpose The purpose of this study was to determine if baseball pitchers with higher valgus elbow torque experience greater FCU and FDS strength loss. # Study Design Controlled Laboratory Study # Methods A pilot study was performed to determine if middle and ring finger flexion strength tests preferentially activated the FCU and FDS versus the PT (10 men age 36±12 yr). EMG amplitudes, expressed as percent of maximal voluntary contraction (MVC) were compared between tests and muscles. In a field study of college baseball pitchers, middle finger, ring finger and grip strength were tested prior to, immediately after, and one day after 14 pitching performances in 10 pitchers (21±2 yr). Elbow valgus torque was measured from an inertial measurement unit, housed in a compression sleeve and pitchers were categorized as having high or low valgus torque. # Results For the pilot study EMG activations were 74% FDS, 66% FCU and 35% PT for the middle finger test (muscle effect p=0.032) and 93% FCU, 61% FDS and 23% PT for the ring finger test (muscle effect p=0.005). In the field study, pitchers with high valgus torque showed marked post-game middle finger fatigue (88% of baseline) and incomplete recovery the following day (95%), while pitchers with low valgus torque showed no strength loss (107% post game, 106% a day later; group x time p=0.022). Results were similar for ring finger strength (high torque: 94% post game 96% a day later; low torque: 114% post game 107% a day later; group x time p=0.048). By contrast, grip strength was not different between pitchers with high versus low valgus torque (p=0.143). # Conclusion High medial elbow stress during pitching fatigues the dynamic stabilizers of the medial elbow. # Level of Evidence Level 3 ©The Author(s

Travel-Time Models With and Without Homogeneity Over Time

In dynamic network loading and dynamic traffic assignment for networks, the link travel time is often taken as a function of the number of vehicles x(t) on the link at time t of entry to the link, that is, τ(t) = f(x(t)), which implies that the performance of the link is invariant (homogeneous) over time. Here we let this relationship vary over time, letting the travel time depend directly on the time of day, thus τ(t) = f(x(t), t). Various authors have investigated the properties of the previous (homogeneous) model, including conditions sufficient to ensure that it satisfies first-in-first-out (FIFO). Here we extend these results to the inhomogeneous model, and find that the new sufficient conditions have a natural interpretation. We find that the results derived by several previous authors continue to hold if we introduce one additional condition, namely that the rate of change of f(x(t), t) with respect to the second parameter has a certain (negative) lower bound. As a prelude, we discuss the equivalence of equations for flow propagation equations and for intertemporal conservation of flows, and argue that neither these equations nor the travel-time model are physically meaningful if FIFO is not satisfied. In §7 we provide some examples of time-dependent travel times and some numerical illustrations of when these will or will not adhere to FIFO

The Effect of Phase Change Material on Recovery of Neuromuscular Function Following Competitive Soccer Match-Play

Aim: Cryotherapy is commonly implemented following soccer match-play in an attempt to accelerate the natural time-course of recovery, but the effect of this intervention on neuromuscular function is unknown. The aim of the present study was to examine the effect of donning lower-body garments fitted with cooled phase change material (PCM) on recovery of neuromuscular function following competitive soccer match-play. Methods: Using a randomized, crossover design, 11 male semi-professional soccer players wore PCM cooled to 15°C (PCM cold) or left at ambient temperature (PCM amb; sham control) for 3 h following soccer match-play. Pre-, and 24, 48, and 72 h post-match, participants completed a battery of neuromuscular, physical, and perceptual tests. Maximal voluntary contraction force (MVC) and twitch responses to electrical (femoral nerve) and magnetic (motor cortex) stimulation (TMS) during isometric knee-extension and at rest were measured to assess central nervous system (CNS) (voluntary activation, VA) and muscle contractile (quadriceps potentiated twitch force, Q tw,pot) function. Fatigue and perceptions of muscle soreness were assessed via visual analog scales, and physical function was assessed through measures of jump [countermovement jump (CMJ) height and reactive strength index (RSI)] performance. A belief questionnaire was completed pre- and post-intervention to determine the perceived effectiveness of each garment. Results: Competitive soccer match-play elicited persistent decrements in MVC, VA measured with femoral nerve stimulation, Q tw,pot, as well as reactive strength, fatigue and muscle soreness (P 0.05). The belief questionnaire revealed that players perceived that both PCMcold and PCMamb were moderately effective in improving recovery, with no difference between the two interventions (P = 0.56). Conclusion: Although wearing cooled PCM garments improved MVC and VA 48 h following match-play, the lack of effect on measures of physical function or perceptual responses to match-play suggest that PCM offers a limited benefit to the recovery process. The lack of effect could have been due to the relatively small magnitude of change in most of the outcome measures studied

Countermovement Jump Recovery in Professional Soccer Players Using an Inertial Sensor

Purpose The purpose of this study was to assess the utility of an inertial sensor for assessing recovery in professional soccer players. Methods In a randomized, crossover design, 11 professional soccer players wore shorts fitted with phase change material (PCM) cooling packs or uncooled packs (control) for 3 h after a 90 minute match. Countermovement jump (CMJ) performance was assessed simultaneously with an inertial sensor and an optoelectric system, pre match, and 12, 36 and 60 h post match. Inertial sensor metrics were flight height, jump height, low force, countermovement distance, force at low point, rate of eccentric force development, peak propulsive force, maximum power, and peak landing force. The only optoelectric metric was flight height. CMJ decrements, and effect of PCM cooling were assessed with repeated measures ANOVA. Jump heights were also compared between devices. Results For the inertial sensor data there were decrements in CMJ height on the days after matches (88±10% of baseline at 36 h P=0.012, effect size 1.2, for control condition) and accelerated recovery with PCM cooling (105±15% of baseline at 36 h, P=0.018 vs. control, effect size 1.1). Flight heights were strongly correlated between devices (r=0.905, P<0.001) but inertial sensor values were 1.8±1.8 cm lower (P=0.008). Low force during countermovement was increased (P=0.031) and landing force was decreased (P=0.043) after matches, but neither were affected by the PCM cooling intervention. Other CMJ metrics were unchanged after matches. Conclusions This small portable inertial sensor provides a practical means of assessing recovery in soccer players

Adductor Strains in Athletes

Acute adductor injuries are a common occurrence in sport. The overall incidence of adductor strains across 25 college sports was 1.29 injuries per 1000 exposures, with men's soccer (3.15) and men's hockey (2.47) having the highest incidences. As with most muscle strains there is a high rate of recurrence for adductor strains; 18% in professional soccer and 24% in professional hockey. Effective treatment, with successful return to play, and avoidance of reinjury, can be achieved with a proper understanding of the anatomy, a thorough clinical exam yielding an accurate diagnosis, and an evidence-based treatment approach, including return to play progression

Accelerated muscle recovery in baseball pitchers using phase change material cooling

Purpose: The purpose of this study was to document recovery following a pitching performance and determine if prolonged post-game phase change material (PCM) cooling of the shoulder and forearm accelerates recovery. Methods: Strength, soreness and serum creatine kinase (CK) activity were assessed prior to, and on the two days following pitching performances in 16 college pitchers. Pitchers were randomized to receive either post-game PCM cooling packs on the shoulder and forearm, or no cooling (control). PCM packs were applied inside compression shirts and delivered cooling at a constant temperature of 15°C for 3 hours. Strength was assessed for shoulder internal rotation (IR), external rotation (ER), empty can test (EC) and grip. Results: Total pitch count was 60±16 for 23 PCM cooling games and 62±17 for 24 control games (P=.679). On the days following pitching IR strength (P=.006) and grip strength (P=.036) were higher in the PCM cooling group versus control. One day after pitching IR strength was 95±14 of baseline with PCM cooling versus 83±13 for control (P=.008, effect size d 0.91) and 107±9 versus 95±10 for grip strength (P=.022, effect size d 1.29). There was a trend for greater ER strength with PCM cooling (P=.091, effect size d 0.51). The EC strength was not impaired after pitching (P=.147) and was therefore unaffected by PCM cooling (P=.168). Elevations in soreness and CK were not different between treatments (Treatment by Time CK P=.139, shoulder soreness P=.885, forearm soreness P=.206). Conclusion: This is one of the first studies to document impairments in muscle function on the days following baseball pitching, and the first study showing a novel cryotherapy intervention that accelerates recovery of muscle function in baseball pitchers following a game