Category Archives: Sports

Recovery Strategies in Soccer

In the formerly published part I of this two-part review, we examined fatigue after soccer matchplay and recovery kinetics of physical performance, and cognitive, subjective and biological markers. To reduce the magnitude of fatigue and to accelerate the time to fully recover after completion, several recovery strategies are now used in professional soccer teams.
During congested fixture schedules, recovery strategies are highly required to alleviate post-match fatigue, and then to regain performance faster and reduce the risk of injury. Fatigue following competition is multifactorial and mainly related to dehydration, glycogen depletion, muscle damage and mental fatigue. Recovery strategies should consequently be targeted against the major causes of fatigue.
Strategies reviewed in part II of this article were nutritional intake, cold water immersion, sleeping, active recovery, stretching, compression garments, massage and electrical stimulation.
Some strategies such as hydration, diet and sleep are effective in their ability to counteract the fatigue mechanisms. Providing milk drinks to players at the end of competition and a meal containing high-glycaemic index carbohydrate and protein within the hour following the match are effective in replenishing substrate stores and optimizing muscle-damage repair. Sleep is an essential part of recovery management. Sleep disturbance after a match is common and can negatively impact on the recovery process.

Cold water immersion is effective during acute periods of match congestion in order to regain performance levels faster and repress the acute inflammatory process. Scientific evidence for other strategies reviewed in their ability to accelerate the return to the initial level of performance is still lacking. These include active recovery, stretching, compression garments, massage and electrical stimulation. While this does not mean that these strategies do not aid the recovery process, the protocols implemented up until now do not significantly accelerate the return to initial levels of performance in comparison with a control condition.

In conclusion, scientific evidence to support the use of strategies commonly used during recovery is lacking. Additional research is required in this area in order to help practitioners establish an efficient recovery protocol immediately after matchplay, but also for the following days. Future studies could focus on the chronic effects of recovery strategies, on combinations of recovery protocols and on the effects of recovery strategies inducing an anti-inflammatory or a pro-inflammatory response.

Sports Med. 2013 Jan;43(1):9-22. doi: 10.1007/s40279-012-0002-0.
Recovery in Soccer : Part II-Recovery Strategies.
Nédélec M, McCall A, Carling C, Legall F, Berthoin S, Dupont G.

Stretching and deep and superficial massage do not influence blood lactate levels after heavy-intensity cycle exercise

While this is now well known in massage therapy, researchers from University of Milan , Italy, conducted a study aimed to assess the role of deep and superficial massage and passive stretching recovery on blood lactate concentration kinetics after a fatiguing exercise compared to active and passive recovery.

Nine participants (age 23 ± 1 years; stature 1.76 ± 0.02 m; body mass 74 ± 4 kg) performed on five occasions an 8-min fatiguing exercise at 90% of maximum oxygen uptake, followed by five different 10-min interventions in random order: passive and active recovery, deep and superficial massage and stretching. Interventions were followed by 1 hour of recovery. Throughout each session, maximum voluntary contraction (MVC) of the knee extensor muscles, blood lactate concentration, cardiorespiratory and metabolic variables were determined. Electromyographic signal (EMG) from the quadriceps muscles was also recorded. At the end of the fatiguing exercise, blood lactate concentration, MVC, EMG amplitude, and metabolic and cardiorespiratory parameters were similar among conditions.

During intervention administration, blood lactate concentration was lower and metabolic and cardiorespiratory parameters were higher in active recovery compared to the other modalities. Stretching and deep and superficial massage did not alter blood lactate concentration kinetics compared to passive recovery. These findings indicate that the pressure exerted during massage administration and stretching manoeuvres did not play a significant role on post-exercise blood Lactate levels.

J Sports Sci. 2012 Dec 21.
Stretching and deep and superficial massage do not influence blood lactate levels after heavy-intensity cycle exercise.
Cè E, Limonta E, Maggioni MA, Rampichini S, Veicsteinas A, Esposito F.

Effect of Static Stretching on Maximal Muscle Performance

A Study from Western Australia by Kay & Blazevich  reviewed the Effect of Static Stretching on Maximal Muscle Performance, it was published in Med Sci Sports Exerc. Journal July 2011.

The authors addressed the benefits of pre-exercise muscle stretching, which have been recently questioned following reports of significant post-stretch reductions in force and power production. However, there are many methodological issues and equivocal findings have prevented a clear consensus being reached.

The authors conducted a systematic review for randomized or quasi-randomized controlled trials and intervention-based trials published in peer-reviewed scientific journals examining the effect of an acute static stretch intervention on maximal muscular performance.

From 106 good studies they found that:

Clear evidence exists indicating that short-duration acute static stretch (less than 30 seconds) has no detrimental effect, with overwhelming evidence that stretch durations of 30-45 seconds also imparted no significant effect, however a significant reduction likely to occur with stretches greater than 60 sec.

This strong evidence was independent of performance task, contraction mode or muscle group. Studies have only examined changes in eccentric strength when the stretch durations were>60 s, with limited evidence for an effect on eccentric strength.

The authors concluded that the detrimental effects of static stretch are mainly limited to longer durations (≥60 s) which may not be typically used during pre-exercise routines in clinical, healthy or athletic populations. Shorter durations of stretch (<60 s) can be performed in a pre-exercise routine without compromising maximal muscle performance.

Short-duration massage at the hamstrings musculotendinous junction induces greater range of motion

Short-duration massage at the hamstrings musculotendinous junction induces greater range of motion

Massage has been used as part of a warmup to help increase acute flexibility. However, the physiological benefits and mechanisms of massage are not well known. The purpose of the present study was to investigate the effectiveness of 3 massage conditions on hip flexion range of motion (ROM).
This experimentation involved a novel massage technique, which focused the massage on the musculotendinous junction for a short duration. Ten recreationally active women ranging from 21 to 36 years in age participated in this study. Participants were subjected to 3 massage conditions (no massage, 10-second massage, and 30-second massage) in a random order on separate days. Hip flexion angle, passive leg tension, and electromyography (EMG) were measured thrice before and within 10 seconds after the intervention.
A main effect for conditions was found with the 30-second massage providing a 7.2% increase in hip flexion ROM that was significantly greater than the control condition (p < 0.05). Significant interactions occurred with an increased ROM (p < 0.05) from pre to posttests of 5.9 and 7.2% for the 10-and 30-second massage conditions, respectively.
There were no significant differences in passive tension or EMG for any conditions or time. With a significant increase in hip angle and no associated increase in passive tension or EMG, there is a suggestion that 10 and 30 seconds of musculotendinous massage induces greater ROM through a modified stretch perception, increased stretch tolerance, or increased compliance of the hamstrings.
Musculotendinous massage may be used as an alternative or a complement to static stretching for increasing ROM.

Huang, S.Y., Di Santo, M., Wadden, K.P., Cappa, D.F., Alkanani, T., Behm, D.G. 2010 Journal of Strength and Conditioning Research 24 (7), pp. 1917-1924. Short-duration massage at the hamstrings musculotendinous junction induces greater range of motion

Post-exercise massage affects skeletal muscle gene expression

Post-exercise massage affects skeletal muscle gene expression

Massage therapy is commonly prescribed for individuals that suffer from chronic pain, inflammation, or musculoskeletal injury. Despite the widespread belief that massage augments muscle repair and reduces inflammation, there is little objective, scientific evidence to support its practice. Therefore, the purpose of this study was to evaluate the molecular effects of massage following a single unaccustomed bout of exercise. Eleven recreationally active, healthy males (age 22±1 yrs, VO2peak 46±2 ml·kg–1·min–1) volunteered to participate in this study. Each subject completed an exhaustive endurance cycling protocol. After 15 mins of recovery, one quadricep was randomly chosen for 10 mins of massage (MASS) and the contralateral leg served as a control (CON). Muscle biopsies were acquired from the vastus lateralis at rest, immediately following massage, and 2.5h after massage was administered. Histology revealed that exercise induced significant muscle damage from rest at 2.5h (P<0.05), however there was no effect of massage (P>0.05). No differences were seen between CON or MASS in the oxidative stress markers 4HNE or protein carbonyls at any timepoint (P>0.05). Gene microarray analysis displayed 4 genes that were differentially expressed (P<0.05) for MASS vs CON immediately following massage as well as 11 genes at 2.5h that relate to pathways of inflammation and cellular remodeling. In summary, these data provide evidence that massage stimulates molecular events that may justify its use in the remediation of muscle injury.

FASEB Journal

The effects of precompetition massage on the kinematic parameters of 20-m sprint performance

The effects of precompetition massage on the kinematic parameters of 20-m sprint performance.
Fletcher IM. J Strength Cond Res. 2010 May;24(5):1179-83.

Exercise Physiology Laboratory, School of Physical Education and Sports Sciences, University of Bedfordshire, Bedfordshire, United Kingdom.


The purpose of this study was to investigate what effect precompetition massage has on short-term sprint performance. Twenty male collegiate games players, with a minimum training/playing background of 3 sessions per week, were assigned to a randomized, counter-balanced, repeated-measures designed experiment used to analyze 20-m sprints performance. Three discrete warm-up modalities, consisting of precompetition massage, a traditional warm-up, and a precompetition massage combined with a traditional warm-up were used.

Massage consisted of fast, superficial techniques designed to stimulate the main muscle groups associated with sprint running. Twenty-meter sprint performance and core temperature were assessed post warm-up interventions. Kinematic differences between sprints were assessed through a 2-dimensional computerized motion analysis system (alpha level p

Results indicated that sprint times in the warm-up and massage combined with warm-up conditions were significantly faster than massage alone. Also, step rate and mean knee velocity were found to be significantly greater in the warm-up and massage combined with warm-up modalities when compared to massage alone. No significant differences were demonstrated in any measures when the warm-up and massage and warm-up combined conditions were compared. Massage as a preperformance preparation strategy seems to decrease 20-m sprint performance when compared to a traditional warm-up, although its combination with a normal active warm-up seems to have no greater benefit then active warm-up alone. Therefore, massage use prior to competition is questionable because it appears to have no effective role in improving sprint performance.

Massage impairs postexercise muscle blood flow and “lactic Acid” removal

Massage impairs postexercise muscle blood flow and “lactic Acid” removal
Wiltshire, E.V., Poitras, V., Pak, M., Hong, T., Rayner, J., Tschakovsky, M.E. 2010
Medicine and Science in Sports and Exercise 42 (6), pp. 1062-1071

PURPOSE: This study tested the hypothesis that one of the ways sports massage aids muscle recovery from exercise is by increasing muscle blood flow to improve “lactic acid” removal.

METHODS: Twelve subjects performed 2 min of strenuous isometric handgrip (IHG) exercise at 40% maximum voluntary contraction to elevate forearm muscle lactic acid. Forearm blood flow (FBF; Doppler and Echo ultrasound of the brachial artery) and deep venous forearm blood lactate and H concentration ([La-], [H+]) were measured every minute for 10 min post-IHG under three conditions: passive (passive rest), active (rhythmic exercise at 10% maximum voluntary contraction), and massage (effleurage and pétrissage). Arterialized [La-] and [H+] from a superficial heated hand vein was measured at baseline.

RESULTS: Data are presented as mean ± SE. Venoarterial [La -] difference ([La-]v-a) at 30 s of post-IHG was the same across conditions (passive = 6.1 ± 0.6 mmol•L -1, active = 5.7 ± 0.6 mmol•L-1, massage = 5.5 ± 0.6 mmol•L-1, NS), whereas FBF was greater in passive (766 ± 101 mL•min-1) versus active (614 ± 62 mL•min-1, P = 0.003) versus massage (540 ± 60 mL•min, P < 0.0001).

Total FBF area under the curve (AUC) for 10 min after handgrip was significantly higher in passive versus massage (4203 ± 531 vs 3178 ± 304 mL, P = 0.024) but not versus active (3584 ± 284 mL, P = 0.217). La- efflux (FBF × [La-] v-a) AUC mirrored FBF AUC (passive = 20.5 ± 2.8 mmol vs massage = 14.7 ± 1.6 mmol, P = 0.03, vs active = 15.4 ± 1.9 mmol, P = 0.064). H+ efflux (FBF × [H+]v-a) was greater in passive versus massage at 30 s (2.2 ± 0.4e-5 vs 1.3 ± 0.2e-5 mmol, P < 0.001) and 1.5 min (1.0 ± 0.2e-5 vs 0.6 ± 0.09e-5 mmol, P = 0.003) after IHG.

CONCLUSIONS: Massage impairs La and H+ removal from muscle after strenuous exercise by mechanically impeding blood flow.

Effleurage massage, muscle blood flow and long-term post-exercise strength recovery

Effleurage massage, muscle blood flow and long-term post-exercise strength recovery
Wilfrid Laurier univ., dep. physical education, Waterloo ON, CANADA

Résumé / Abstract
Manual massage is commonly assumed to enhance long term muscle recovery from intense exercise, partly due to its ability to speed healing via enhanced muscle blood flow. We tested these assumptions by daily (for four days) massaging the quadriceps muscles of one leg on subjects who had previously completed an intense bout of eccentric quadriceps work with both legs. Immediate post-exercise isometric and dynamic quadriceps peak torque measures had declined to approximately 60-70% of pre-exercise values in both legs. Peak torques for both the massage and control leg tended to slowly return toward pre-exercise values through the subsequent four days (96 hrs). There was no significant difference between the isometric and dynamic peak torques between massage and control legs up to 96 hours post-exercise. Leg blood flow was estimated by determining femoral artery and vein mean blood velocities via pulsed Doppler ultrasound velocimetry. Massage of the quadriceps muscles did not significantly elevate arterial or venous mean blood velocity above resting levels, while light quadriceps muscle contractions did. The perceived level of delayed onset muscle soreness tended to be reduced in the massaged leg 48-96 hours post-exercise. It was concluded that massage was not an effective treatment modality for enhancing long term restoration of post-exercise muscle strength and its use for this purpose in athletic settings should be questioned.
Revue / Journal Title
International journal of sports medicine ISSN 0172-4622 CODEN IJSMDA
Source / Source
1995, vol. 16, no7, pp. 478-483 (34 ref.)

Long toes, short heels

IS ATHLETIC prowess attained or innate? Those who have suffered the tongue-lashing of a tyrannical games master at school might be forgiven for doubting the idea that anyone and everyone is capable of great sporting achievement, if only they would put enough effort into it. Practice may make perfect, but not all are built in ways that make it worth bothering in the first place.

The latest evidence of this truth has been gathered by Sabrina Lee of Simon Fraser University in Vancouver and Stephen Piazza at Pennsylvania State University. They have looked at the anatomy of sprinters and found that their feet are built differently from those of couch potatoes.

Dr Lee and Dr Piazza already knew that sprinters tend to have a higher proportion of fast-twitching muscle fibres in their legs than more sedentary folk can muster. (These fibres, as their name suggests, provide instant anaerobic pulling power, rather than the sustained, oxygen-consuming effort that is needed by longer-distance runners.) They suspected, though, that they would find differences in the bone structure as well. And they did.

They looked at seven university sprinters who specialise in the 100-metre dash and five 200-metre specialists, and compared them with 12 non-athletic university students of the same height. In particular, they looked at the sizes of bones of the toes and heel. They also used ultrasonic scanning to measure the sliding motion of the Achilles tendons of their volunteers as their feet moved up and down. This allowed them to study the length of the lever created by the tendon as it pulls on the back of the heel to make the foot flex and push off the ground.

Dr Lee and Dr Piazza found, as they report in the Journal of Experimental Biology, that the toes of their sprinters averaged 8.2cm in length, while those of non-sprinters averaged 7.3cm. The length of the lever of bone that the Achilles tendon pulls on also differed, being a quarter shorter in sprinters.
Sprinters are different from other people

These findings suggest sprinters get better contact with the ground by having longer toes. That makes sense, as it creates a firmer platform to push against. In a sprint race, acceleration off the block is everything. Cheetahs, the champion sprinters of the animal kingdom, have non-retractable claws that give a similar advantage.

The reason for the difference in the Achilles tendons, though, is less immediately obvious. At first sight, sprinters might be expected to have more Achilles leverage than average, not less. First sight, however, is wrong. When muscles have to contract a long way, they usually do so quickly and with little force. When contracting short distances, though, they move more slowly and generate more force. Having a short Achilles lever allows the muscles that pull on the tendon to generate as much as 40% more force than the same muscles in a non-sprinter would be able to manage.

It is possible—just—that these anatomical differences are the result of long and rigorous training. But it is unlikely. Far more probable is that the old adage of coaches, that great sprinters are born not made, is true. Everyone else, games masters included, should just get used to the idea.

Understanding acute ankle ligamentous sprain injury in sports

This paper summarizes the current understanding on acute ankle sprain injury, which is the most common acute sport trauma, accounting for about 14% of all sport-related injuries. Among, 80% are ligamentous sprains caused by explosive inversion or supination. The injury motion often happens at the subtalar joint and tears the anterior talofibular ligament (ATFL) which possesses the lowest ultimate load among the lateral ligaments at the ankle.

For extrinsic risk factors to ankle sprain injury, prescribing orthosis decreases the risk while increased exercise intensity in soccer raises the risk. For intrinsic factors, a foot size with increased width, an increased ankle eversion to inversion strength, plantarflexion strength and ratio between dorsiflexion and plantarflexion strength, and limb dominance could increase the ankle sprain injury risk. Players with a previous sprain history, players wearing shoes with air cells, players who do not stretch before exercising, players with inferior single leg balance, and overweight players are 4.9, 4.3, 2.6, 2.4 and 3.9 times more likely to sustain an ankle sprain injury.

The aetiology of most ankle sprain injuries is incorrect foot positioning at landing – a medially-deviated vertical ground reaction force causes an explosive supination or inversion moment at the subtalar joint in a short time (about 50 ms). Another aetiology is the delayed reaction time of the peroneal muscles at the lateral aspect of the ankle (60–90 ms). The failure supination or inversion torque is about 41–45 Nm to cause ligamentous rupture in simulated spraining tests on cadaver.

A previous case report revealed that the ankle joint reached 48 degrees inversion and 10 degrees internal rotation during an accidental grade I ankle ligamentous sprain injury during a dynamic cutting trial in laboratory. Diagnosis techniques and grading systems vary, but the management of ankle ligamentous sprain injury is mainly conservative. Immobilization should not be used as it results in joint stiffness, muscle atrophy and loss of proprioception.

Traditional Chinese medicine such as herbs, massage and acupuncture were well applied in China in managing sports injuries, and was reported to be effective in relieving pain, reducing swelling and edema, and restoring normal ankle function. Finally, the best practice of sports medicine would be to prevent the injury. Different previous approaches, including designing prophylactice devices, introducing functional interventions, as well as change of games rules were highlighted. This paper allows the readers to catch up with the previous researches on ankle sprain injury, and facilitate the future research idea on sport-related ankle sprain injury.

Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology 2009, 1:14