Dear Readers,

If you have come to see me, you have probably heard me say “the days that you take off are almost just important as the days that you are going at it.” For athletes who push their bodies to the limit in pursuit of peak performance, understanding and optimizing recovery can mean the difference between reaching new heights and hitting frustrating plateaus. Join us in our latest edition of "The Overhead Athlete's Edge" as we delve into recovery, a crucial aspect of athletic success, and discuss which recovery methods are fads, and which are here to stay.

In Focus: Active Recovery

I want you to push hard during practice, strength training, and rehab, but I also want you to respect your recovery time. What this doesn’t mean is laying down all day and doing nothing on the couch, watching TV, or mindlessly scrolling on your phone. I advocate for active recovery. This may look like:

• Aerobic Activities such as light jogging, cycling, and swimming

• Movement focused activities such as yoga and dynamic stretching

• Active Myofascial Release such as foam rolling, using a VooDoo band, and Cupping with movement

• Blood Flow Restriction (BFR)

• Mindfulness and Meditation Techniques

• Neuromuscular Training such as Functional Range Conditioning®

Benefits of Active Recovery: Improved circulation, reduced muscle soreness (such as DOMS), increased flexibility and range of motion, & mental recovery leading to faster return to training

Expert Insights: Passive Recovery for Injury Prevention and Rehab

#1: Sleep. We have all heard our parents tell us to put our phones down, turn off the TV’s and go to sleep “because I said so.” But why is it important?

• Release of Growth Hormone for tissue repair

• Increased immune system activity for regulating inflammation

• Decreased cortisol and increased endorphins for reducing stress and pain response

• Memory consolidation and procedural learning for acquiring new skills

• Check out this article about how sleep affects muscle growth. They found that just one night of sleep deprivation resulted in an 18% decrease in protein synthesis, a 21% increase in cortisol (prolonged high cortisol levels lead to muscle breakdown), and a 24% reduction in testosterone. This is not good for any athlete.

#2: Nutrition. The diet I recommend for a specific athlete depends on the demand of that athlete’s sport, as well as their age, gender, and body type. The commonalities between all of the diets I recommend include grass-fed meats, well-sourced chicken, fish, eggs, and fruits, combined with the right kinds of fats and minimally processed foods. See our blog post for more details:

#3. Modalities. Here are my opinions based on experience and what the pros had to say.

• Cold Baths - There’s something to it for recovery if there is an injury or inflammatory condition. Cold baths also help manage cortisol levels and have a positive nervous system effect by making you comfortable with being uncomfortable. The pro baseball players would say they don’t really feel the benefits right away if they use a cold bath after a game, but would feel less wear and tear and more refreshed the end of season.

• Contrast Baths - This is a game changer right after a practice, game, or intense workout, or when you are recovering from an injury. While I think consistent use of ice can negatively impact healing and growth, I don’t believe contrast inhibits muscular adaptations after a training session.

• Saunas - The effects of repeated sauna use can significantly decrease cortisol levels within the body while slightly increasing testosterone levels. This is very beneficial to the athlete looking to maintain strength during their season.

• Ice - I used to watch tv and every starting pitcher would have an ice bag on their shoulder when they were done pitching. I don’t like this strategy unless there’s a big injury, since ice will typically slow blood to the area and delay healing. I truly only push ice when an injury is fresh or so sore that it prevents the athlete from getting a good night’s sleep.

• BFR - Blood Flow Restriction Training. Sounds crazy, right? I thought so at first, too. But I’ve seen the benefits firsthand, year after year, after year. The benefits have been shown and the evidence proves it’s here to stay.

• Marc Pro - This is a great alternative to icing as it uses electrical stimulation to flush the entire limb of waste products

• Class 4 Laser - This laser generates a great deal of heat and uses a specific frequency of light that promotes healing. It works at a cellular level to increase metabolism and ultimately accelerate tissue repair and regeneration. However, they can be a high price with little proven benefit.

• Normatec - These compression devices can help you feel refreshed after a game or workout. But this alone isn’t going to do it all for you and get you ready for your next game.

• Red light therapy - I believe in it. You get all of the great benefits of the sun without the UV damage.

• Trigger Point Dry Needling - I love it and athletes swear by it. I practiced this for 10 years on pro athletes and had fantastic results. Unfortunately, physical therapists are not allowed to dry needle in California :(
  

Technique Spotlight: Enhancing Recovery Through Mobility

Check out this lower body foam rolling routine that is great pre-workout, post-workout, or on your off days to keep the blood flowing and your muscles loose. Follow this up with foam-rolling of your spine to get the full-body benefit.

Success Story: Overcoming Adversity

Today we are highlighting one of our high level climbing athletes, Niko. Niko came to me after a snowboarding accident just 10 weeks before he was supposed to compete at Nationals, one of the most decorated events of the year in the climbing world. Niko had a grade 3 AC joint sprain, which affects the structures that support the joint, and presented with a raised clavicle compared to the other side. Nico worked his way back through pure grit and determination. Congrats to Niko for competing at Nationals!

Ask the Expert: What Should Recovery Look Like For A Starting Pitcher?

As soon as you finish pitching, your goal is to get ready for your next appearance. If you are a starting pitcher, we can assume you won’t pitch for several days. If you are a relief pitcher, the protocol is a little cloudy and is more on a case by case basis to get you ready for the potential to make an appearance the next day.

Immediately following your last pitch, I would encourage arm care exercises.

After your arm care exercises, we would do a soft tissue massage/flush or use the Marc Pro on your throwing arm.

Then contrast in the whirlpools. 1 minute in the cold, 3 in the hot for about 4 cycles. If you have to pitch the next day or have just routine soreness, you can finish in the hot. If you have a lot of soreness and aren’t pitching the next day, finish in the cold.

Optional: Full Body Mobility. I like to encourage it for keeping the hips open and the spine moving.

If you are a PO, then you will shut your upper body down completely the next day, except for passive modalities. Don’t even pick up a baseball. It is perfectly fine if you would like to lift your lower body. By organizing your week this way, you are essentially “creating a day” so that you can better prepare for your mid-week bullpen. If you are a position player also, the plan changes.

*On a case by case basis I will use BFR on a starting pitcher. It is heavily debated by the baseball community because of the trauma that the nervous system takes during pitching.

Stay Connected: Join Our Community

Connect with our vibrant online community of fellow overhead athletes, coaches, and sports enthusiasts by giving us a follow on Instagram @TheTrainingRoomOC. Share your experiences, seek advice, and stay updated on the latest developments in sports performance physical therapy for overhead athletes. Together, we can elevate our performance and achieve new heights in our respective sports.

Closing Note:

Thank you for embarking on this journey with us through the world of sports performance physical therapy for overhead athletes. We hope you found this issue of "The Overhead Athlete's Edge" insightful and empowering. Stay tuned for more valuable information and inspiration in our next edition. Until then, keep honing your skills, pushing your limits, and trusting the process!

Best regards,

Dr. Sam