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Paul Quantrill will never forget the feeling of pure exhaustion at the most important moment of his career. It was the fourth game of the 2004 American League Championship Series, at Fenway Park, with the Yankees trying to finish a sweep of the Boston Red Sox. The teams were tied, 4–4, heading into the bottom of the 12th. It was Quantrill’s 100th relief inning of the season. ‘We were done,’ Quantrill said. ‘We were wrecked. We battled, but we just weren’t where we needed to be.’, 31 March 2016

The concept of mechanotransduction (Chapter 17) recognises that when the body is exposed to mechanical stress, it adapts. In sport, careful manipulation of training parameters induces specific adaptations to enhance performance. Training-induced adaptations include improvements in strength, endurance, neuromuscular control and flexibility. Training to promote adaptation requires a delicate balance of overload and recovery. Strategies to expedite recovery are central to training and competition plans.

Effective recovery can permit greater levels and quality of training and thereby enhance performance. Conversely, inadequate recovery from training and competition impair performance and may eventually result in injury, illness or burnout. How performance changes in response to exercise depends on a complex interplay of factors that include peripheral muscle changes,1 central neural drive2 and psychological responses.3 Effective recovery should seek to address the physiological, structural, neural and psychological limitations of performance.

A range of modalities have been purported to facilitate various aspects of recovery; the evidence for many of these modalities is scant and at times conflicting.


As with many aspects of sports medicine, the most appropriate blend of recovery strategies depends on a detailed understanding of the sport and the athlete as well as the relative benefits of the choice of recovery modality.


The traditional way to assess the effectiveness of interventions has been to test the athlete and investigate markers of the ‘damage’ associated with the test. The primary test models are (i) eccentric contraction induced delayed onset muscle soreness (DOMS); and (ii) sports-related training sessions. The variable nature of the exercise regimens used to induce damage and/or physiological stress make effective generalisation of findings challenging in some cases.

Following such a test, a typical test battery would include analysis of:

  • general muscle function (peak torque maximum voluntary contractions: isometric and isokinetic)

  • specific performance tasks (counter-movement jump (CMJ), squat jump, repeated sprint ability) which may be more meaningful in terms of direct impact on performance

  • extent of tissue damage (creatine kinase, CK)

  • level of metabolite removal (blood flow, blood lactate) and perception of soreness (pain on visual analogue scale, VAS)

  • athlete’s self-perception of recovery as well as psychological measures (e.g. profile of mood states, POMS).


Active recovery ...

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