I have interviewed Carl recently (click here for the part one of this interview) and here is the second part. Carl shared some great thoughts on the recovery and regeneration in this part.
Mladen: Recovery Monitoring is all the rage now with teams. Why are people still getting hurt and ill from training and competition?
Carl: Simple. We are sometimes monitoring bad training, poor practice design, and voodoo sports medicine. With your experience with professional football I am sure you have seen a vast difference between clubs but monitoring is only as good as the training and as good as the willingness for the team coach to listen and make adjustments. GPS and even more precise instrumentation doesn’t replace or even guide coaching wisdom
Recovery monitoring is reactionary and not helpful unless the training is sound and well designed. Studying bad programs isn’t that helpful because the data isn’t going to make major changes that help. With all of this technology and science we should see some changes? Where are the freaks from all of the monitoring? Shouldn’t there be a legion of Barry Sanders and Usain Bolts? Where are all the Renaldo factories with these training facilities that do blood analysis and saliva swabs? Smith machine squats with machine lateral raises isn’t good training, so the information from it is junk data so why study that?
Mladen: Thermotherapy is a dying art of Regeneration is it worth it?
Carl: Hot and Cold will always be part of training regeneration, the question what is this really doing? Team cyrosaunas, exotic Russian hot sauna protocols, contrast options with special ratios, it’s all very nice but consistency is key. With any modality the big question is what measurable impact are we getting, and is it sustainable?
Mladen: Well what do you use? Are you still doing a lot of thermotherapies?
Carl: I am not saying I am a minimalist, but I only use them to compliment the training. You can just add modalities like you would pick sushi from a menu, it’s a very specific process. For example, what are we getting when we jump in a sauna? Less blood flow to the deeper areas of muscle, but near the skin will actually get warmer. Joints tend to feel better with heat as sometimes pain will diminish. Cold is also a surprise, as the bloodflow paradoxically will change over time during and after the application. Too many people think about the application duration and effects instead of what happens through the day and microcycle. Pain is still an enigma right now and everyone thinks they cracked the Da Vinci Code or something.
Thermotherapies do create some hormone changes but I don’t see anything anabolic necessarily but the environment is more favorable for anabolism. Let’s not think thermotherapy is going to make a major change in training. It mainly helps the tone of soft tissue. Just having more glucose is more favorable environment post training but don’t worry about testing positive from too much sugar in your latte. Regeneration is very subtle.
Mladen: Any simple tips with a complicated application?
Ice- Acutely after injury for one day with crushed pellets and thin towel. Maximum 2-3 days if exercise is an option. Prolonged ice will spell doom and treating pain with it is a bad idea for the most part.
Cold Shower- The depression studies excited a lot of people because the neurotransmitter adaptations and changes. One athlete had a HRM strap and did cold showers twice a week for 6 weeks and saw a dramatic rise in HRV with the Kubios software last year and morning wake seemed to be stable without travel impact and CNS drop. How much was placebo nobody knows but I treat some cold and hot therapies like passive workouts to the nervous system.
Cold Plunge- Some HRV studies show some positive benefits. Cold plunge tend to do a great job with athletes suffering major stiffness from pain, but no research shows extensibility changes from it. I believe fascia responds to passive parasympathetic interventions but muscle needs exercise. Some coaches say myofascial system is symbiotic muscle.
Hot Bath- I prefer this at night to help with sleep. Add in some power jet sprays and athletes seem to be compliant with it. Remember not to pull a “Hall Pass” and fall asleep! When traveling guys like to hop in the tub and get the tunes going so they can get deeper sleep. The research confirms this and hot bath’s are easy to get done. Many European hotels don’t have bathtubs and some hotels in New York are tiny so call in advance.
Sauna- Build up to 20 minutes by starting at 8 and add 2-5 minutes a week or per session if you are doing 2 a week. Alternating options cold showers and hot saunas are nice but compliance trumps the esoteric protocols. Longer applications are fine for some but each athlete needs to be accountable to what is their own “sweet spot”.
Contrast– If it feels good you are doing it right! Jokes aside contrast work is nice for athletes that seem to want to feel better but nothing is wrong with training loads. Training monotony can creep up and athletes need another stimulus but can’t just do random activities to refresh them. This is why advanced athletes crave change because they have been static stretching or foam rolling and need a break from the norm. Physiologically not much is happening with contrast methods but comfort options are part of a program, but no myogensis or protein synthesis is increasing here.
General- Never do external applications in the GPP unless you are doing triples or hard doubles. Sometimes I have done a few sessions of eternal applications to artificially do more for a teaching effect. More practice of skill in a short time period is helpful for a training camp or combine prep period. Access to good coaching is scarce so one has to max out the time. Still, in general you must build up natural capacities first before adding any modalities.
Mladen: You have done some interesting things with soft tissue therapy and imaging and orthopedic testing, any updates here?
Carl: One particular facility outside a major city in South Africa has some interesting imaging systems for soft tissue. Somehow they were able to digitize the body rapidly, very similar to Thermography but far more sensitivity and accuracy. Along with that data stream they have extremely high resolution MSK ultrasound. A rumor is that someone from Western Europe defected after spending time in Turku. Since you are from Serbia Boris Tadic received treatment from Dr. Orava, and what they are doing with major stars such as David Beckham and many elite athletics competitors in Finland is awesome. Vibromyography is not technically “imaging” but it is fascinating to see with post massage, but it’s commercially not ready yet. Like I said earlier some interesting bodysuits are showing some cool data, but are cost prohibitive unless you are the Navy Seals are using them. Myontec is a promising company but again with any data capturing device what is the impact? Undefeated Rugby teams? 4.1 combine runs? EMG is part of the imaging process, especially research wise. Tissue is not just static artwork on a computer screen, it’s a live ballet so the higher resolution MSK ultrasound equipment will rise in popularity with those in the know. Ed Ryan confirmed my beliefs when he shared his experience with the equipment. How many therapists in the US are using Elastography to assist with soft tissue therapy or even experienced it? We need to catch up here.
Mladen: Record keeping is a big burden, who is doing a great job now with athletes and data on recovery?
Carl: You should see some people’s record keeping. It ranges from “it’s in my head” to sophisticated ipad systems with internal algorithms. My favorite is what Ryan Reynolds, the ASU strength and conditioning coach, is doing with his teams. He is a respected coach and the 2011 NCAA champion softball team certainly didn’t struggle. Just because he has one of the most progressive data systems in the country, doesn’t mean that was all he was doing was taking notes. 95% of results stem from good training design before the training and constant effort on the floor. Brilliant coach and people need to listen to him, as his sport science knowledge is top of the line. I have only met him once but I need to go back to Arizona for another visit soon to see what he doing again.
Good record keeping kills off debates because either it’s measured or it’s imagined. Show me the numbers. At the end of the year are people better? How did it happen?
Mladen: You went to the Netherlands in 2008 and Finland and learned a lot about the practical use of lactate and HRV. What have you learned since?
Carl: Repeat Sprint Ability is diluted with many teams to the point that I am under the belief that we are overthinking conditioning to the level of being foolish. Speed and other relatives of it need to be compared properly. This is why I think more 15m dash times need to be tested fresh to see what people are capable of. Remember the average “speed” of some of these repeat “sprints” are slower than high school JV hurdlers over one barrier! If you want more ketchup get more tomatoes, not add more tomato juice. Elite soccer is played in two time periods split in half with rest, not 90 minutes straight, so some sport scientists forget to adjust to the fact that the game does allow for some internal recovery. Condition only enough to keep acute power drops from occurring and to support practice and immune health. Nothing more. RSA is about Repeat Sprint Ability and not Repeat Slow Ability.
HRV is tricky because no matter what you use it’s an estimate of total load. Some of the studies of parasympathetic reactivation smells like some of the electrical discussions that Coach Francis had 7 years ago, but let’s be honest here. HRV is one data stream and only a few set-ups are doing live acquisition during sprints. Analyzing post game is going to get fatigue, but after each sprint is a nice feature because it helps performance more. Monitoring recovery helps decide what to do, but monitoring training helps getting better.
Lactate scores is not a magic number generator as clearance rate is important. When I see low lactate scores after slow sprints, I don’t see sprint capacity I see endurance volume interference and the smell of “fitness coaches”. On the other hand doing too much power work will create a Ferrari with a transmission ready to blow since team sports are not track meets and need more conditioning. What is optimal is unique to the program and the athletes being trained. Team chemistry is important and one has to think that Kobe Bryant (Knee degeneration) spending time on the bench instead of practice could be an example with some need for more experimentation. Everyone preaches individualism at coaching conferences but I don’t see the tailoring when I visit.
Mladen: Sleep is talked about, what aspects of interventions seem to work best for you? How do you visualize sleep data yourself?
Carl: The metrics of sleep from a hypnogram are going to be trendy but relationships and honesty between coaches and athletes will trump the data crunchers. I am more interested in the Data Benders, those that improve outcomes than those that show scatterplots of failed training experiments. Actigraphy and products like www.myzeo.com are good ways to create hypothesis of interventions but usually the athletes that are not compliant with the data capturing are the ones that need the interventions! No matter how great the biomechanical data collection or supplement protocol is, many professional athletes are passed out in the back of a Hummer Limo before game day from massive “ethanol battles”. Does the blood panel after game day calculate that? We need more Tony Dungy coaches that are able to make a connection with people and coaches that seem like second fathers. Those are the true masters.
After some reduction in fiestas and stability is created, a constant sleep and wake time is the strongest way to improve sleep besides good training loads. One can do REM and other sleep scoring methods but most of the impact is gong to come from precise loading, stimulant and alcohol reduction, and good sleep hygiene. Add in a hot bath and massage here and there and now you are doing something special.
Mladen: Nutrition is always going to be a focal issue with athletes but what do you use? Anything besides the tips one usually sees in articles?
Carl: My nutrition information isn’t going to be earth shattering but the tricks of the trade is what KPI like variables one can change. First buying custom wide mouth water bottles with measurement lines is paramount. Add in a team logo and color of choice now we are getting somewhere. The wide mouth cap allows for protein powders to be used.
After the basics are covered I stick to the 3 meals and 3 snack philosophy since athletes simply don’t have the time to cook. 45 minute desert recipes? Who does that? Athletes need explicit shopping lists and restaurant suggestions and how to budget money. Some coaches even scan grocery receipts.
Buy fishoils, protein powders, creatine, and functional foods in 90 day orders every 80 days or so. Only a handful of supplements work so save your money on things like dried fruit, lean protein sources, and fresh fruits and vegetables. Protein powders are vital as they save money and are portable. Again three meals only- what people usually do as athletes is much different than physique people. Bodybuilding has a lower frequency of training so more meals is not practical with many athletes unless they live at a training center. Digestion is a real issue so sometimes GES and bars are helpful.
Mladen: You have spent some time with some exceptional therapists and coaches learning what works and what is not very useful or significant. Anything the readers would want to get to shed some light on regeneration?
Carl: If people wish to know more about what world class therapists are doing and what coaches are doing in case studies. They can email me at email@example.com if they want to join a small group of coaches that crowd source money for some great educational mini courses in mediacast format.