Cycling Only 10 Min After Workouts Promotes Recovery as Effectively, Cheaper and More Conveniently Than Ice Baths

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Cold water immersion and active recovery are common post-exercise recovery treatments you’ve read about before at theSuppVersity. With the publication of the latest study from theQueensland University of Technology, this is yet the first article to discuss a comparison of both recovery methods in a nine trained male individuals – a study that shows “that cold water immersion is no more effective than active recovery for minimizing the inflammatory and stress responses in muscle after resistance exercise” (Peake. 2016).

Just like the previously reported anti-adaptive effects of ice-baths (yes, they will impair your gains, the study at hand adds to the accumulating evidence that cold water immersion, one of the most commonly used post-workout recovery strategies, is everything but a gold standard.

But how do Peake et al. know that? Well, the researchers compared the effects of cold water immersion versus active recovery on inflammatory cells, pro-inflammatory cytokines, neurotrophins and heat shock proteins (HSPs) in skeletal muscle after a standardized intense resistance exercise.

“The resistance training sessions for the two experimental trials were identical and involvedsingle-leg exercises such as 45° leg press (six sets of 8–12 repetitions), single-leg squats (three sets of 12 repetitions), knee extensions (six sets of 8–12 repetitions), and walking lunges (three sets of 12 repetitions). The total duration of the session was ~45 min” (Peake. 2016).

Five minutes after the workout, the subjects either jumped into an inflatable (ice-)bath (iCool iBody, iCool, Miami, Australia) for 10 min (both legs immersed in water up to the waist) or they performed 10 min of active recovery at a self-selected low intensity (on average a meager 36.6 ± 13.8 W) on a stationary cycle ergometer (Wattbike, Nottingham, UK).

Figure 1: Post-exercise changes in CD66b+ neutrophil infiltration, CD68+ macrophage infiltration, and MAC1 and CD163 mRNA expression. Data are presented as the change in the median +/- interquartile range for neutrophils and CD163 mRNA, and the geometric mean +/- 95% confidence interval for macrophages and MAC1 mRNA. ACT, active recovery; CWI, cold water immersion. n = 9. * P < 0.05 versus pre-exercise value (Peake. 2016).

Muscle biopsies were collected from the exercised leg before, 2, 24, and 48 h after
exercise in both trial to access the intramuscular neutrophil and macrophage counts, as well as the inflammatory markers MAC1 and CD163 mRNA, IL1, TNF, IL6, CCL2, CCL4, CXCL2, IL8 and LIF mRNA expression (P<0.05); and the analysis of this data, as well as creatine kinase, subjective feelings of hyperalgesia, the expression of NGF and GDNF mRNA and the levels of B-crystallin and HSP70 showed no difference between the two recovery treatments.

Even simple compression socks will cost you $25+ If you want a complete “compression suit” consisting of shirt, tights, and more, you will probably have to spend roughly $200. Against that background you may be happy to hear that there’s some scientific backup that the money you spend could not be wasted.

Compression garments – do they help? No, they usually don’t look sexy, but they are the latest craze among recovery modalities. The question whether they just sell, or even work, has now been addressed in a systematic review with meta-analysis by Marqués-Jiménez (2016); a paper that found “conclusive evidence increasing power and strength”, “conclusive evidence reducing perceived muscle soreness and swelling” but “no clear evidence of decreased lactate or creatine kinase” and “little evidence of decreased lactate dehydrogenase”. Overall, the existing evidence does therefore suggest that “the application of compression clothing may aid in the recovery of exercise induced muscle damage, although the findings need corroboration” (Marqués-Jiménez. 2016).

I guess, that’s, figuratively speaking, an accolade for the simplest recovery technique there is: low(est) intensity exercise, a recovery modality of which previous studies have shown that it will (a) significantly reduce your blood lactate concentration after various activities (Rontoyannis. 1988) and (b) increase your performance after workouts such as the parallel squat workout in a Y2k study by Corder et al. (2000), the HIIT workout in Connolly, et al. (2003), the supra-maximal exercise tests in Spierer, et al (2004 | see Figure 2), the swimming protocols in Toubekis’ 2008 study, or the 2007 resistance training study by Anna Mika et al. who concluded that “the most appropriate and effective recovery mode after dynamic muscle fatigue involves light, active exercises, such as cycling with minimal resistance” (Mika. 2007).

Figure 2: The 2004 study by Spierer et al. is also interesting, because it shows that the benefits of active recovery on the performance and perceived fatigue after supra-maximal exercise tests may vary according to the training status of the study subjects; with less trained or simply sedentary subjects benefitting more (Spierer. 2004).

Now, Peake et al. are certainly right, when they point out that their “findings indicate that cold water immersion is no more effective than active recovery for reducing inflammation or cellular stress in muscle after a bout of resistance exercise,” there’s one thing that will have to be done in the future: a comparison of active vs. ice-tub recovery on the longitudinal adaptational response (VO2max, power, strength, hypertrophy) to various training modalities. After all, any modulation of the post-exercise inflammatory response, be it via cold water immersion or light exercise, could exert detrimental effects on your “gainz” (in the broadest sense of the word) – the only pertinent study by Yamagashi, however, shows that this is not the case and using an active recovery protocol at 40% of V̇O2peak significantly enhances, not impairs, the endurance adaptations to HIT (Yamagashi. 2016).

SuppVersity Classic: “Cupping for Pain, Health & Performance | Must Be Good, if Phelps Does it, Right? Let’s See What the 100+ Studies Say” – The “cups” come in various forms and sizes… and no, there’s no meta-analysis yet that can tell you what the optimal size and form for the treatment of a given problem would be

Bottom line: If you’ve been thinking about buying an ice tub, forget it. There’s, as Anthony Barnett pointed out in his 2006 review, a profound lack of evidence of positive effects of current recovery modalities such as massage therapy, contrast temperature water immersion, hyperbaric oxygen therapy (HBOT), stretching and EMS. Eventually, the time and money you spend on any of them between your workouts may thus be wasted – plus: a simple 10-minute ergometer ride at an extremely low exercise intensity can likely do the same as any of the en-vogue but costly recovery techniques, devices and modalities.

With the recently published PhD study by Yamagashi, there’s also initial evidence that active recovery strategies won’t, as it has been shown for ice baths, impair the adaptational VO2max response to high-intensity exercise…

Whether that’s also the case for resistance training and the corresponding training goals hypertrophy and strength, however, will have to be elucidated in future long(er)-term studies in trained and untrained individuals.


  • Barnett, Anthony. “Using recovery modalities between training sessions in elite athletes.” Sports medicine 36.9 (2006): 781-796.
  • Connolly, Declan AJ, Kevin M. Brennan, and Christie D. Lauzon. “Effects of active versus passive recovery on power output during repeated bouts of short term, high intensity exercise.” J Sports Sci Med 2.2 (2003): 47-51.
  • Corder, Keith P., et al. “Effects of Active and Passive Recovery Conditions on Blood Lactate, Rating of Perceived Exertion, and Performance During Resistance Exercise.” The Journal of Strength & Conditioning Research 14.2 (2000): 151-156.
  • Marqués-Jiménez, Diego, et al. “Are compression garments effective for the recovery of exercise-induced muscle damage? A systematic review with meta-analysis.” Physiology & behavior 153 (2016): 133-148.
  • Mika, Anna, et al. “Comparison of recovery strategies on muscle performance after fatiguing exercise.” American journal of physical medicine & rehabilitation 86.6 (2007): 474-481.
  • Peake, Jonathan M., et al. “The effects of cold water immersion and active recovery on inflammation and cell stress responses in human skeletal muscle after resistance exercise.” The Journal of Physiology (2016).
  • Rontoyannis, George P. “Lactate elimination from the blood during active recovery.” Journal of sports medicine and physical fitness 28.2 (1988): 115-123.
  • Spierer, D. K., et al. “Effects of active vs. passive recovery on work performed during serial supramaximal exercise tests.” International journal of sports medicine 25.02 (2004): 109-114.
  • Toubekis, Argyris G., et al. “Swimming performance after passive and active recovery of various durations.” Int J Sports Physiol Perform 3.3 (2008): 375-386.
  • Yamagishi, Takaki. “Role of active and passive recovery in adaptations to high intensity training.” (2016).

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Elite Athletes Try a New Training Tactic: More Vitamin D

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Professional and college sports teams think they have found a cutting-edge advantage hidden in one of the most basic nutrients: vitamin D.

With millions of dollars at stake, elite teams are tracking player health more precisely than ever to make sure their athletes keep playing. As part of this push, teams in all U.S. major leagues, some college athletic departments and the U.S. men’s and women’s soccer teams have started monitoring players’ vitamin D levels and intake. A few are even recommending more time in the sun, which helps the body produce the nutrient.

The focus on vitamin D is part of a growing emphasis on player wellness, from proper sleep to carefully planned nutrition, to maximize performance. Team officials also are acting on eye-opening research that suggests vitamin D deficiency might increase an athlete’s risk of injury.

A study of the Pittsburgh Steelers published in 2015 in the American Journal of Sports Medicine was especially striking. It found that vitamin D levels were significantly lower in players with at least one bone fracture. Players who were released during the preseason due to injury or poor performance also had significantly lower D levels than those who made the team, the study found.


  • How can you get vitamin D? Through certain foods such as fatty fish and eggs, or sun exposure. More than 1 billion people world-wide are estimated to have insufficient or deficient vitamin D levels. Vitamin D3 is the preferred form of the nutrient in a supplement because of its similarity to the form produced by the body.
  • Who’s at risk? People at higher latitudes and in colder climates such as the northern U.S. and Europe are at risk because of their lack of sun exposure. Those with darker skin are at risk because pigmentation slows vitamin D production in the skin. Those who are older, overweight or obese also are at higher risk.
  • How much is necessary? The Institute of Medicine recommends 600 International Units (IU) daily for most adults (800 IU for those over 70). That’s equivalent to six cups of milk, most of which in the U.S. is fortified with 100 IU. Some sports dietitians encourage athletes to get 1,000 to 2,000 IU daily. Adults shouldn’t take more than 4,000 IU daily, the Institute says, though vitamin D toxicity is rare.
  • What are the risks of vitamin D deficiency? Low D levels have been associated with higher risk for diabetes, heart disease, many cancers and bone loss, among many other conditions.

Sources: Institute of Medicine, Mayo Clinic Proceedings, Harvard T.H. Chan School of Public Health

A 2011 study of the New York Giants, presented at a meeting of the American Orthopaedic Society for Sports Medicine, found an association between low vitamin D levels and injuries. Team officials launched that study to see whether levels of vitamin D, a hot research topic at the time, might be connected to soft-tissue injuries such as muscle strains, saysMichael Shindle, the study’s lead researcher.

Both studies were small—fewer than 100 players each. But they were intriguing enough that researchers plan to do a larger study with about 320 NFL players, says Mark Duca, a Steelers team physician and co-author on the Pittsburgh study.

“You can’t draw a definitive conclusion” that low vitamin D levels increase fracture risk, Dr. Duca says. “But it certainly piques our interest, particularly in a violent contact sport like football.”

For most people, sunlight is a major source of vitamin D. It is also found in foods such as fish, eggs and fortified milk, as well as pills and drops. Vitamin D helps the body absorb calcium to keep bones dense, and helps maintain a variety of metabolic functions.

Doctors are testing more patients in the general population for vitamin D deficiency as research connects the nutrient to more important functions. Debate continues about how much vitamin D is best, even after the nonprofit Institute of Medicine in 2010 tripled the minimum recommended daily intake to 600 international units (or 800 IU for those over age 70).

That is equivalent to six cups of fortified milk. But some sports dietitians say athletes should get at least 1,000 to 2,000 IU of vitamin D daily through food, supplements or both.

The U.S. women’s national soccer team is among those that charts the vitamin D levels of its players.

The Institute of Medicine recommends no more than 4,000 IU of vitamin D daily to avoid potential risks, which include a calcium buildup in the blood, which can disrupt appetite and cause nausea and vomiting. Taking 50,000 IU a day of vitamin D for months can cause toxicity but such cases are rare, according to a 2015 study published in Mayo Clinic Proceedings.

Pro and college sports engage in “smack talk” about maintaining healthy vitamin D levels in their athletes, says Lisa McDowell, sports dietitian for the Detroit Red Wings and a member of the Collegiate and Professional Sports Dietitians Association. “It’s a source of pride when your team checks in with a good level.”

Some teams also test athletes for other nutrients such as iron and magnesium to make sure deficiencies aren’t slowing them down.

Ms. McDowell aims to get her hockey players’ vitamin D levels between 40 and 80 nanograms per milliliter. Many players show up to training camp with vitamin D levels in the teens, she says.

An adequate vitamin D level for the average person is between 20 and 50 ng/ml, with a level over 50 potentially producing adverse effects, according to the IOM. But some experts have said the bottom end of that range is too low, and the Endocrine Society recommends maintaining a level between 40 and 60 ng/ml.

The Detroit Red Wings made a point to get sun, which produces vitamin D in the body, on their recent trip to California.

Red Wings players get little sun due to the team’s Midwestern locale. Ms. McDowell encourages players to spend time outside when the team plays in California so they can soak up vitamin D.

Only a handful of studies have focused on elite athletes and vitamin D. But a few larger studies of military populations have drawn a link between vitamin D levels and injuries. One study, of more than 5,000 female U.S. Navy recruits, found a 20% drop in stress fractures after recruits received doses of calcium and vitamin D.

The University of Virginia has made 2,000 IU vitamin D supplements available to all of its athletes for at least the past six years, says Randy Bird, director of sports nutrition. It is the only vitamin he encourages every athlete to take, he says.

“The research on it outside of muscle and bone injuries is that it’s great for your immune system,” Mr. Bird says. “And we can’t afford to have athletes missing for illness.”

Even the University of Southern California, where sunshine abounds, checks its varsity athletes’ vitamin D levels annually. Despite all that sun, more than one-third of 223 USC athletes tested for a study published in 2015 had insufficient vitamin D levels.

The University of Virginia has made vitamin D supplements available to all of its athletes, including its women’s soccer team, pictured here.

Some USC athletes’ low vitamin D levels, along with conversations about player tastes, spurred a surprising addition to the athletic department’s food offerings: Frosted Flakes. It’s fortified with vitamin D. Along with vitamin D-fortified milk, it provides quick fuel for morning workouts and an important dose of the nutrient, says Becci Twombley, USC’s director of sports nutrition.

“After we put Frosted Flakes out, their vitamin D levels were much better,” she says. USC aims to get athletes to consume 1,000 to 2,000 IU daily of vitamin D through foods, including yogurt and fish, but provides vitamin D supplements for players who need them, she says.

The USC study, along with those of the Giants and Steelers, showed African-American athletes tend to have lower vitamin D levels. Athletes with darker skin are at higher risk for D deficiency because pigmentation slows vitamin D production in the skin.

Researchers are still exploring how race affects vitamin D levels. That is an important question in leagues such as the National Basketball Association, where a majority of players are African-American, says Elliott Schwartz, former physician for the Golden State Warriors.

In that team’s training camps of 2007, 2008 and 2009, between nine and 12 of 16 players tested vitamin D insufficient and were given 5,000-IU supplements daily, Dr. Schwartz says.

Dr. Schwartz, founder of the Northern California Institute for Bone Health and a physician for the Oakland Athletics, still tests and treats dozens of injured pro athletes for vitamin D deficiency. Yet he says the evidence isn’t overwhelming that vitamin D helps prevent injury.

He treats deficiency with supplements, he says, because “there’s no harm, and it may be helpful.”


For more information on our therapies including Vitamin D and appointments, please contact Clinic Director Charlie Blaisdell at

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Clinic: 781-269-5953