Recovery

Cold water therapy

Cold water therapy is increasingly popular in Australia, particularly among athletes and wellness enthusiasts. A survey indicates that many Australians are adopting cold water immersion practices, with many using it for muscle recovery, mental health benefits, and overall well-being. According to Pursue Performance, approximately 82.6% of users engage in cold plunges 5-7 times per week, highlighting its regular use in personal health routines.

In my hometown of Torquay, cold water therapy boomed during COVID lockdowns. Groups such as “Torquay ocean waders” became conduits for community connection through ocean dipping and then coffee sipping outside the local Salty Dog café. This sense of community, based on an ethos of adventure, social connection, and a positive attitude, has grown to 1800 members in just three years, offering a supportive network for all.

The number of local female participants in this group intrigued me. I initially wondered if the group’s growing popularity was more about connection than the benefits of cold-water therapy. However, over time, the scientific evidence supporting and validating the health benefits of cold-water therapy has grown, providing reassurance and confidence in its effectiveness.

The menopausal transition adds another layer of complexity to health and fitness. Hormonal changes can affect metabolism, energy levels, and body composition. Despite sound nutrition and plenty of exercise, women in this life stage often complain of central weight gain.

Over 75% of Australian perimenopause or menopausal women will experience vasomotor symptoms (hot flushes and night sweats). Many women also experience sleep disturbances, mood changes and fatigue, as mentioned in our blog.

Cold water therapy is linked to improvements in exercise recovery, hormonal balance, and the management of symptoms such as hot flushes associated with menopause. This knowledge empowers women to take control of their health and well-being.

Cold water therapy can offer many benefits for women.

  1. Regular exposure to cold water can help reduce inflammation.
  2. In a study conducted at the University College of London, women reported cold water therapy reduced levels of anxiety, mood swings and depression.
  3. Cold water therapy can improve your immunity. Following exposure to cold water, the body releases catecholamines such as epinephrine and norepinephrine, which stimulate the immune system.
  4. Cold water immersion post-exercise for active women can aid muscle recovery, reduce soreness, and enhance overall physical resilience.
  5. Cold water therapy has also been suggested to reduce the frequency and severity of hot flushes.
  6. Regular exposure to cold water therapy may reduce cortisol levels associated with stress.
  7. Exposure to cold water is a habit spreading for the selective reduction of adipose tissue, improvement in insulin sensitivity, and is popular with anti-ageing proponents.
  8. Cardiovascular risk factors associated with heart disease are also reported to be reduced after just three weeks of cold-water therapy.

The evidence is clear- regular cold-water therapy holds many benefits for women, especially those experiencing symptoms associated with menopause.

Visit the Athlete Sanctuary for more personalised advice and resources. We support athletes in achieving their best selves through tailored strategies and a compassionate community.

 

References:

AusPlay. (2022). Participation data for running and jogging. Retrieved from Australian Sports Commission.

Australian Institute of Sport. (2023). Nutritional considerations for female athletes. 

Bleakley, C. M., & Davison, G. W. (2010). What is the biochemical and physiological rationale for using cold-water immersion in sports recovery? A systematic review. British Journal of Sports Medicine, 44(3), 179-187.

Doets, J. J., Topper, M., & Nugter, A. M. (2021). A systematic review and meta-analysis of the effect of whole body cryotherapy on mental health problems. Complementary therapies in medicine63, 102783.

Esperland D, de Weerd L, Mercer JB. (2022).Health effects of voluntary exposure to cold water – a continuing subject of debate. Int J Circumpolar Health.

Janssen, H., Ada, L., Karayanidis, F., & McElduff, P. (2016). Ankle dorsiflexion strength after cold-water immersion in older adults: Implications for early stroke rehabilitation. Journal of Stroke and Cerebrovascular Diseases, 25(4), 867-872.

Miller, E. G., Maren, K., & Swanson, S. (2020). Cold-water immersion therapy and its effect on the alleviation of menopause symptoms: A randomized controlled trial. Journal of Women’s Health, 29(7), 951-958.

Smith, D. L., McHugh, M. P., & Allen, D. W. (2019). Cold-water immersion and recovery from exercise: Effects on menopause-related symptoms. Menopause, 26(8), 870-876.

 

Normatec recovery

Normatec recovery therapy is suitable for athletes of all levels.

Sporting clubs, associations, and teams such as Australia Triathlon, AFL teams, USA Triathlon, Ironman US, USA Track and Field,  British Gymnastics, Belgian Cycling, American Cycling, USA Hockey, Ireland Hockey, and the Boston Ballet are just some of the crew ahead of the curve using Normatec recovery.

We have been so impressed with Normatec recovery we’ve made it accessible to athletes of all levels through our exclusive hire service. We also sell the Normatec recovery systems to those who like to take their training and recovery a bit more seriously.

What is Normatec?

Normatec is an evidence-based recovery system with proven results and research supporting its claimed benefits.

Normatec is a form of active compression therapy (peristaltic pulse dynamic compression) with a sophisticated massage pattern. Studies show reduced muscle soreness and fatigue, enhanced blood flow to the treated areas, decreased inflammation, improved clearance of waste products, and increased range of motion. Studies also demonstrate that the peristaltic compression process may deliver positive adaptive responses to exercise and improve artery endothelial function systemically, making it useful for individuals with circulation and lymphatic drainage issues.

Normatec Recovery boots can also be used post-surgery and to enhance injury recovery.

Key benefits of Normatec recovery

1. REDUCES PAIN: Journal of Strength and Conditioning 2015  – dynamic compression may accelerate and enhance recovery by reducing muscle tenderness from pressure stimuli.

2. INCREASES RANGE OF MOTION:  Journal of Strength and Conditioning 2014 -Peristaltic pulse dynamic compression rapidly enhances acute range-of-motion with less discomfort and time and has been shown to be more

3. REDUCES DOMS (DELAYED ONSET MUSCLE SORENESS), PAIN, and SWELLING: Journal of Athletic Training 2016  – a 30-minute treatment of pulse compression increases blood flow in the lower extremity, making Pulse compression a viable option in the management of exercise-induced muscle damage (DOMS). In general, DOMS-related swelling, range of movement limitations, and pain ratings were lower and returned to baseline faster while using NormaTec when compared to continuously-worn compression sleeve options  International Journal of Exercise Science 2018.

4.DECREASES MUSCLE FATIGUE AFTER ACUTE EXERCISE: PLOS One Medical Journal 2017. External pneumatic compression increases flexibility and reduces select skeletal muscle oxidative stress and proteolysis markers during recovery from heavy resistance exercise.

5. PASSIVELY CLEARS WASTE AND METABOLITES FROM BODY: Journal of Athletic Enhancement 2013 This form of compression significantly lowers blood lactate concentrations when compared to a passive recovery group.

6. IMPROVES ENDOTHELIAL FUNCTION: European Journal of Applied Physiology 2015. A single bout of peristaltic pulse compression improves artery endothelial function systemically and improves blood flow in the compressed limbs.

7. IMPROVES EXERCISE ADAPTATION AND GENE EXPRESSION: Journal of Experimental Physiology 2015. A 60-minute bout of whole-leg, peristaltic pulse compression transiently upregulates PGC-1α mRNA, while also upregulating eNOS protein and NOx concentrations in biopsy samples.

Clinical Physiology & Functional Imaging 2016. Peristaltic pulse compression may upregulate rps6 and downregulate Stat1, which may facilitate positive adaptive responses to exercise.

8. ENHANCE LYMPHATIC SYSTEM FUNCTION: Journal of Strength and Conditioning Research  Muscle stiffness, tenderness, strength loss, and oedema have been linked to exercise-induced muscle microtrauma.  Enhancement of lymphatic flow and clearance of waste may accelerate recovery.

“A goal of dynamic compression is to reduce lymphatic obstruction and thereby enhance the removal of the protein- and debris-rich fluid that accumulates in the interstitial spaces after exercise-induced inflammation”. Maintaining an anti-inflammatory diet can also speed up your recovery time. Ginger is one natural remedy that may help reduce inflammation. Read our blog on how easy it is to use ginger.

Normatec features

  • Individualised programs for rehab, recovery, and injury treatment to suit your needs.
  • Normatec can be set to focus on key problem areas of the body such as the quads or calves through a “zone boost” allowing extra attention where needed. There is also an option to deactivate zones of the body.
  • Setting can be set to varied pressures to suit you and your comfort
  • Portable in a durable case, battery powdered for remote use, and lightweight
  • Versatile- single control unit is compatible with leg, arm, and hip attachments. The calibration phase ensures a personalised fit for all body types.
  • Super easy to use- set up takes less than a minute, giving you more time to relax
  • Made from highly durable material
  • The Normatec app allows you to integrate Normatec use seamlessly with your training plan

HOW TO USE NORMATEC 

Typically, 20-30 minutes once a day is sufficient for most athletes. Athletes in heavy training may consider using it after each training session.

Normatec boots and hip attachments are popular with athletes preparing for and recovering from events. Committed athletes use the system daily as an ongoing recovery tool.

Promotional banner with an image of a Normatec compression boot and the wording: Normatec Recovery: Innovative portable massage technology. Try before you buy! 
Available for hire or purchase.

Normatec Hire – TRY BEFORE YOU BUY

Normatec Pulse 2.0 boots (upper and lower legs and feet) are available for hire from our Torquay clinic. Take a look at our Normatec Hire and Purchase page for more information.

BUY YOUR NORMATEC RECOVERY SYSTEM:

*Normatec pants 3.0 includes compression for the legs, ankles, and feet

*Normatec lower leg (includes attachments for the feet, ankles, legs, and hips)

*Normatec Full Body Recovery System – includes attachments for the legs, ankles, arms, and hips for the ultimate recovery experience

*Normatec Arms – great for swimmers, rowers, adventure racers and canoeists

*Normatec Hips- a great addition to the lower leg attachment

We recommend purchasing a Normatec carry case or backpack to keep your Normatec protected, and secure during transport and at home.

Visit the Athlete Sanctuary online shop to view the Normatec recovery systems we stock.

Tart cherries

Tart cherries have been used for decades to treat gout and osteoarthritis, but they also contain phytochemicals which stimulate melatonin, enhance sleep, recovery and sports performance and reduce inflammation.

Tart cherries contain the phytochemicals anthocyanins, flavonoids, flavanols and phenolic acids. Tart Cherries have a higher content of anthocyanins than sweet cherries and contain potassium, calcium, iron, magnesium, vitamins A, C, B6, E, and folic acid. Some sources suggest cherries have 19 times as much vitamin A & beta carotene as strawberries and blueberries!!

Evidence supports tart cherries

A 2016 study involving soccer players found tart cherry juice is efficacious in accelerating recovery following prolonged, repeat sprint activity, movement patterns often seen in soccer, AFL and rugby. The study also supports evidence that polyphenol-rich foods such as tart cherry juice are effective in accelerating recovery following various types of strenuous exercise.

A 2010 study involving recreational male and female runners competing in the London marathon, who  supplemented tart cherry juice twice daily for 5 days prior and 2 days after the marathon showed improvements in muscle strength recovery, reduction of inflammatory markers and uric acid. The athlete’s total antioxidant status was 10% greater, while oxidative stress was lower in comparison to placebo.

Studies involving trained cyclists have also shown significant benefits when using Montmorency tart cherry concentrate on reduced oxidative stress, inflammation and muscle damage across 3 days of 109 minutes of road cycling racing when used twice daily for seven consecutive days.  They concluded tart cherry juice has direct application for athletes competing in scenario’s where back-to-back performances are required.

How tart cherries help

Tart cherry juice may reduce pain and accelerate recovery after exercise and decreases blood markers of inflammation/oxidative stress in both strength and endurance exercise.

1. Reduces creatine kinase (CK) a pathology marker for muscle damage and breakdown

2. Reduces inflammation -shown in studies by reductions in interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α), interleukin-8 (IL-8), interleukin-1-beta (IL-1-β) and C-reactive protein (CRP),

3. Reduces oxidative stress- it’s ORAC rating of 12,800 is one of the highest in the world.

4. Increases tryptophan, melatonin levels and improves sleep quality.

How to use Tart Cherry Juice for recovery and sleep

Tart cherry juice is unlikely to have beneficial effects during the adaptation/build stage of training, but when there is competition or intense training or multiday tournaments it may improve recovery.  Examples of such competitions include: a rugby or AFL tournament, a marathon, a multiday cycling event, triathlon or an ultramarathon.

It is unlikely to be beneficial for consistent use where adaptation to the training stimulus is the athletes’ priority.

General recommendations found in the literature suggest having 30ml of tart cherry juice concentrate in 100ml of water twice daily. This equates to 60-90 cherries per serving.

Tart Cherry juice represents a more convenient way to ingest a large quantity of these polyphenolic compounds without associated side effects such as stomach pain or diarrhoea.

Take the 30ml in water first thing in the morning and in the evening. The evening dose is typically suggested one hour before bed to help facilitate quality sleep, which is of course an athlete’s primary innate recovery tool.

This protocol is suggested for 2-3 days post an event or strenuous training session.

We still need further research and larger studies involving athletes to substantiate claims that a preloading phase of 4-5 days prior to competition is required. It is unlikely that the compounds responsible for its benefits stay in your body long enough to accumulate over many days.  Therefore, it remains questionable as to whether the loading phase is really necessary.

What to look out for and where to purchase?

There are many brands of tart cherry juice available online, in health food shops and in supermarkets.

Montmorency and Balaton TC varieties have both been studied; however, most researchers have used Montmorency brands (more predominant and widely available commercially to athletes).

Check the label on the bottle states the juice specifically contains either of these varieties.

The beneficial compounds (anthocyanins) in tart cherries are reduced with heat. Therefore it is important to source tart cherry products that are cold pressed if you wish to maximise the anthocyanin levels and possible benefits. There are a few companies who do this, so check before you purchase.

As a general rule most juices contain around 25 grams of sugar per 250mls but just remember you should only be having 30mls at a time. Low sugar options are available that contain stevia or vanilla extract but generally speaking the sugar content (3 grams per serve) is not an issue for most athletes.

You can expect to pay around $26-28 Aus for organic start cherry juice (450-950ml). The cheaper juices found in chemists or supermarkets are less likely to be cold-pressed.

We hope this information may inspire you to try something new that you may not have otherwise considered. As with all things, moderation and targeted use is more likely to yield desired benefits than overconsumption.

About the Author: Kate Smyth is a Sports naturopath, nutritionist and female-centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes. For more information visit www.https://https://athletesanctuary.com.au/wp-content/uploads/2023/03/normatec-3-lower-body-system-thumb_720x-1.webp.com.au/wp-content/uploads/2020/05/Seed-Cycle-Blends-scaled-1.jpg.com.au

References:

Bell, P.G.; Walshe, I.H.; Davison, G.W.; Stevenson, E.; Howatson, G. (2014).Montmorency Cherries Reduce the Oxidative Stress and Inflammatory Responses to Repeated Days High-Intensity Stochastic Cycling. Nutrients, 6, 829-843.

Bell, P. G., Stevenson, E., Davison, G. W., & Howatson, G. (2016). The effects of montmorency tart cherry concentrate supplementation on recovery following prolonged, intermittent exercise. Nutrients, 8(7), 441.

Howatson G, McHugh MP, Hill JA, et al. (2010). Influence of tart cherry juice on indices of recovery following marathon running. Scand. J. Med. Sci. Sports 20:843–52.

McCormick, R., Peeling, P., Binnie, M., Dawson, B., & Sim, M. (2016). Effect of tart cherry juice on recovery and next day performance in well-trained Water Polo players. Journal of the International Society of Sports Nutrition, 13(1), 41.

Szalóki-Dorkó, L., Végvári, G., Ladányi, M., Ficzek, G., & Stéger-Máté, M. (2015). Degradation of anthocyanin content in sour cherry juice during heat treatment. Food technology and biotechnology, 53(3), 354-360.

Vitale, K. C., Hueglin, S., & Broad, E. (2017). Tart cherry juice in athletes: a literature review and commentary. Current Sports Medicine Reports, 16(4), 230-239.

Optimise recovery

The amino acid leucine is of particular importance to female athletes keen to optimise recovery across the menstrual cycle. Leucine is one of the nine essential amino acids the body needs to obtain through the diet. Leucine along with other amino acids, are required for protein synthesis, tissue repair and nutrient absorption.

The demand for protein changes throughout the menstrual cycle.  The fluctuations in estrogen and progesterone have a profound effect on muscle turnover and protein synthesis. Amino acids like leucine are harder to access during the high hormonal phase (day 12 to day 23 of a typical 28 day cycle).  It is suggested to be harder for females to build and maintain muscle during this hormonal phase making it even more important to ensure adequate intake of essential amino acids during this time.

Strength training including weights or resistance stimulates muscles to take up leucine (and other amino acids) and triggers muscular growth.  Leucine can help prevent the deterioration of muscle with age so it is super important for masters athletes to obtain adequate leucine in order to optimise recovery.

The richest sources of bio-available protein including leucine are in eggs, milk, fish, and meats. Milk contains both whey and casein protein.  Whey is more easily absorbed and is higher in leucine than casein.  Whey is also digested at a much faster rate than casein, ensuring blood leucine levels rise soon after ingestion and triggering protein synthesis responsible for building muscle. Hence why many athletes swear by chocolate milk as their preferred recovery drink. Female athletes need additional leucine to optimise recovery and would benefit from options such as a post-workout smoothie including yogurt, milk, protein powder or almond butter.

Recent research also suggests that the combination of other highly bio-available proteins rich in leucine results in more favourable muscle hypertrophy compared to other proteins such as whole milk protein, casein and soy protein.

Vegans and athletes with dairy intolerance

Athletes who choose to avoid dairy need not feel they are missing out. Interestingly, a recent study found both whey and rice protein isolate administration post-resistance exercise improved body composition and exercise performance with no differences between the two groups when taken in adequate amounts.

Leucine-rich foods

Leucine can also be found in plant-based proteins included including soy, lentils, kidney beans, tofu, quinoa, hummus, rice, and almonds. These plant proteins contain approximately 50% less leucine. Therefore vegan athletes need to pay attention to getting enough high-quality plant proteins that offer the optimal amount of leucine (about 2.5 grams per meal or snack).

Vegans want to consistently enjoy soy, beans, legumes, seeds and/or nuts regularly at every meal and snack. Don’t have just porridge for breakfast; add organic soy milk and walnuts.  Don’t snack on just an apple; slather apple slices with peanut butter.  A blend of rice and pea protein powders makes a good substitute for whey-based protein powders. Some plant-based protein powders also provide added amino acids, making them a good choice for dairy-intolerant or plant-based athletes.

As a general guide 2 grams of leucine can be found in 120 grams beef, 130 grams almonds, 400 grams tofu, 3 eggs, 600ml cow’s milk or 900ml soy milk, 380 grams lentils, 350 grams kidney beans, 70 grams cheddar cheese, 350 grams yogurt, 27 grams whey protein isolate,  50 grams rice protein powder.

Elite athletes with large volumes of training may struggle to obtain adequate leucine from their diet alone,  especially if vegan.  These athletes may consider using protein and collagen powders including leucine, isoleucine and valine 30 minutes pre and post-workouts in addition to a diet rich in leucine to optimise recovery.

This table compares the leucine content of plant and animal foods.

Animal food Plant food (swap) Leucine
(g) approx
Eggs, 1 large Peanut butter, 2 tablespoons 0.5
Milk, ½ cup Soy milk, low fat, 1 cup 0.5
Tuna, 25 grams Black beans, 1/2 cup 0.7
Chicken, 60 grams cooked Tofu, extra firm, 170 grams 1.4
Cheese, 14 grams Almonds, 21 grams 0.3
Beef, 40 grams Lentils, 1 cup 1.3

We recommend including a variety of leucine rich foods in your diet in order to optimise recovery.

Most women’s daily protein intake should account for 30% of their diet to optimise recovery. A gram of protein per kilogram of body weight is adequate for recreational athletes, while elite athletes may require up to 1.8 grams per kilogram of body weight, especially when competing in power and high-end endurance sports. On lighter recovery days protein intake can be reduced slightly keeping in mind other processes in the body require adequate protein intake (hormones and immune cells for example).

Consuming 20-25 grams of protein within 30 minutes of finishing a session is ideal for optimal recovery while having a protein-rich snack such as a high protein, low-fat yogurts such as YoPro or Chibani Fit at bedtime can boost protein synthesis by 22 %.

When you wake in the morning you are in a catabolic state after fasting for 10-12 hours during the night while sleeping. Having a protein-rich breakfast is really important to optimise recovery, restock your glycogen stores, fuel your daily activities and prevent overeating and sugar cravings later in the day. Great breakfast options to optimise recovery include scrambled eggs on toast or an omelette with sweet potato and veggies, a protein-rich smoothie, porridge with added yogurt or protein powder or scrambled tofu.

 

About the Author: Kate Smyth is a Sports naturopath, nutritionist and female-centric running coach. She is the founder of the Athlete Sanctuary- a holistic healthcare clinic for athletes of all levels and sporting codes. Kate has a thirst for knowledge with two bachelor’s and a master’s degree under her belt. She has been involved in sports for many decades and competed for Australia in the Commonwealth Games and Olympic Games marathons with a personal best time of 2 hours 28 minutes. For more information visit www.https://https://athletesanctuary.com.au/wp-content/uploads/2023/03/normatec-3-lower-body-system-thumb_720x-1.webp.com.au/wp-content/uploads/2020/05/Seed-Cycle-Blends-scaled-1.jpg.com.au