Category: Exercise Therapy

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Resistance Training and the Older Adult

Resistance Training and the Older Adult

From the American College of Sports Medicine, Comments and Position Statements

This article has some plain English and some sciencey stuff. Give it a try if you don’t usually like the longer, data-filled articles. The bits in quotes are directly from the article, written for the American College of Sports Medicine by Darryn S. Willoughby, Ph.D., CSCS, FACSM. I have included a few of my own comments in parentheses. Italics and bold type are also my additions. And, yes, I have used most of the ideas outlined here and adapted them for old pet rehabilitation–RehabDeb.

Great Dane, Miss Moneypenny, Taking a Break From Old Pet Rehabilitation
Great Dane, Miss Moneypenny, Taking a Break After Exercise Program

Benefits of Resistance Training in Older Adults –

“The health benefits of appropriately prescribed long-term (more than 12 weeks) resistance training in older adults–ages 65 and older–are well known. They include improvements in muscle strength and endurance; other possible health benefits include increase in muscle mass, which translates into improvements in functional capacity. In addition, increased weight bearing with resistance training is considered beneficial in improving bone density and combating the effects of osteoporosis.”

(Rehabdeb note: the above is basically true for other mammals as well.)

Appropriate Programs for Function –

“Achieving appropriate levels of function is very important for older adults so they are able to carry out most of the daily living skills necessary to lead independent lives. Due to the fact that muscle wasting (sarcopenia) and weakness, exacerbated by physical inactivity, is prevalent in the aging population, more emphasis has been placed on developing resistance-training programs for older adults. When developing resistance-training programs for this group, important components to consider are the various training-related variables: frequency, duration, exercises, sets, intensity, repetitions, and progression.”

Orthopedic Issues and Resistance Training –

“Older adults often have orthopedic issues that contraindicate resistance training of the affected joint(s). Older adults are also at a higher risk of cardiovascular disease, and in many cases have even been diagnosed with it. Therefore, it is critical that the older adult receive prior approval from their physician before participating in resistance training.

It should be noted that proper supervision of the individual’s resistance-training program, including any testing procedures, by an appropriately trained exercise professional, is highly recommended. It should also be noted that performing maximum strength testing in many older adults is not recommended. Therefore, when strength testing is appropriate, sub-maximum testing protocols for estimating maximum strength are recommended.”

Frequency –  

“Exercise may be categorized as either multi-joint, meaning more than one joint is dynamically involved to perform the exercise (e.g., bench press, shoulder press, leg press), or uni-joint, meaning only one joint is dynamically involved (e.g., bicep curls, triceps extensions, leg extensions). In the older adult, the resistance-training program should focus primarily on multi-joint exercises. Uni-joint exercises are not discouraged entirely but should not make up the majority of exercises within the training program.

If a person is performing both multi-joint and uni-joint exercises for a particular muscle group, it is recommended that the multi-joint exercise(s) be performed before the uni-joint exercise. Additionally, within each resistance-training workout, larger muscle groups (i.e., legs, back, and chest) should be worked before smaller muscle groups (i.e., arms and shoulders).”

Equipment for Humans –

Additionally, machines are recommended over free weights (i.e., barbells and dumbbells) due to skill-related and safety factors. As the individual progresses, they can use free-weight exercises appropriate for their level of skill, training status and functional capacity.

(Rehabdeb note: I design some programs using weights for pets. Otherwise, we don’t have weight machines, per se, in veterinary rehabilitation. There are some standard tools and equipment recommended in veterinary rehabilitation programs. Most practitioners use those tools before building a good foundation. They are also often troublesome for a client to use successfully at home. Veterinary rehab clinicians often use a water treadmill when other work would be more effective. It really helps a practitioner to know functional recovery at the professional human sports level.)

Muscle Groups –

“Traditionally, muscle groups are classified as the following: 1) chest, 2) shoulders, 3) arms, 4) back, 5) abdomen, and 6) legs. Specifically, the chest group contains the pectoral muscles, the shoulder group contains the deltoid, rotator cuff, scapular stabilizers and trapezius muscles, the arm group contains the biceps, triceps, and forearm muscles, the back group contains the latissimus dorsi of the upper back and the erector muscles of the lower back, the abdomen group contains the rectus abdominis, oblique, and intercostals muscles, and the leg group contains the hip (gluteals), thigh (quadriceps), and hamstring muscles.

In the older adult, it is important to attempt to incorporate all six of these muscle groups into the comprehensive resistance-training program.”

(Rehabdeb note: same for other animals ^^. A practitioner with enough experience in program design and implementation can design programs for you. You may use my programs at home with your pet to meet the goals in this statement paper.)

How Much Exercise for Benefits?

“It has been recommended that one to two exercises per muscle group is normally adequate. Noteworthy here is to understand that by employing primarily multi-joint exercises in the resistance training program one may actually exercise more than one muscle group or specific muscle per exercise.

For example, in performing the leg press exercise the quadriceps, hamstrings, and gluteal muscles are all involved and, in many cases, this could eliminate the need to perform any uni-joint exercises for those particular muscles.

Studies have shown improvements in muscle strength employing ranges of one to three sets of each exercise during the training program.”

Some Human-Based Guidelines –

“Based on current guidelines, it would be recommended that the individual start with one set of each exercise and, depending on individual need, possibly progress up to no more than three sets when the fitness professional deems it appropriate. It should be noted, however, that an average of two sets of each exercise would be beneficial for most individuals. To avoid excess fatigue, a two-to-three minute rest period between sets and exercises is recommended.”

(Rehabdeb note: I have based my basic programs and my advanced pet rehab work on principles of sport science recovery. I also incorporate advanced human surgical recovery plans and exercise science program design.  Often I need to merge elements of neuroscience and neurology. Veterinary medicine plays the part of diagnosis, prescribing medication, and oversight of cases in collaboration with a professional rehabilitation specialist. I design programs taking into account the busy status of most people’s lives. I plan for practical application of physical recovery principles, and timing of work for best recovery.)

Intensity of Work –

“Intensity refers to the amount of weight being lifted, and is a critical component of the resistance-training program, considered by many fitness professionals to be the most important training-related variable for inducing improvements in muscle strength and function.

In other words, the more weight lifted, the more strength gained. Even though this may not always be the case, the importance of intensity in facilitating strength improvements is well documented.

Intensity is often expressed as a percentage of the maximum amount of weight that can be lifted for a given exercise (1RM). For example, if someone who has a maximum effort of 100 pounds on the bench press exercise performs a set with 80 pounds, they would be training at 1RM of 80%. Studies have suggested that older individuals are able to tolerate higher intensities of exercise, up to 85%.

However, research has also shown intensities ranging from 65%-75% of maximum to significantly increase muscle strength. Therefore, in order to increase strength while simultaneously decreasing the risk of musculoskeletal injury that often accompanies higher intensities of resistance training, a low-intensity to moderate-intensity range of 65%-75% is recommended.”

(Rehabdeb note: So, for example, this is why I don’t recommend hill repeats for your knee or hip injury pet only 2 weeks into a foundation program. I have seen this recommendation on discharge instructions. If a person doesn’t have experience with program design and lots of implementation, they often push too much too fast.)

Repetitions –

“Repetitions (reps) refer to the number of times an individual performs a complete movement of a given exercise. There is an inverse relationship between intensity and repetitions, indicating that as the intensity increases the repetitions should decrease.

Based on previous research, a rep continuum has been established that demonstrates the number of repetitions possible at a given relative intensity. For example, an intensity of 60% relates to 16-20 reps, 65% = 14-15 reps, 70% = 12-13 reps, 75% = 10-11 reps, 80% = 8-9 reps, 85% = 6-7 reps, 90% = 4-5 reps, 95% = 2-3 reps, and 100% = 1 rep.”

(Rehabdeb note: it might be obvious that this recommendation is specifically for humans. This information is based in large part on specific observation of and verbal feedback from human subjects. The research is based on many other measurements, though, as well. I’d love to do the work on determining rep protocol for pets, specific for breeds and species. Nonetheless, the information should be helpful to you if you are an exercise scientist.)

“In view of the previously mentioned recommendations for an intensity of 65%-75% of maximum, this would suggest that for each training exercise the individual perform an adequate amount of weight that would allow for 10-15 reps. In the event that no initial strength testing was performed, simply through trial-and-error an individual could determine appropriate training loads that would allow them to perform only 10-15 reps. They could then be sure of training at 65%-75% of maximum effort.”

(Rehabdeb note: I have designed my broad foundation-building program, as well as my specific programs, to allow for info like that above.)

Continued Improvement Needs Work –

“In order to continually enjoy improvements in strength and functional capacity, it is important to consistently incorporate progression and variation into the resistance-training program.

Progressing and varying one’s program commonly involves incorporating the overload principle.

The overload principle involves making adjustments to the training variables of the resistance-training program such as frequency, duration, exercises for each muscle group, number of exercise for each muscle group, sets and repetitions.

In terms of adjustment, normally the overload principle involves making increases to these variables. For example, making progressive increases in intensity has been shown to be important in increasing muscle strength. In terms of the rate of progression, one should consider attempting to progress their resistance-training program on a monthly basis. However, it should be noted that increasing the intensity in some older adults may be contraindicated due to orthopedic and/or other medical limitations. As a result, making adjustments in other training variables would be recommended.”

(Rehabdeb note: I work to change the nature of veterinary rehabilitation to better instruct practitioners. It is important to incorporate principles specifically noted in the last section, above, into a veterinary physical rehabilitation program.)

Thanks for reading and for looking for solid help for your pet-

Deborah

Paper published August, 2009 and originally posted on my website around that time. My comments updated May 16, 2018

 

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More Than Half of All ACL Reconstructions Could Be Avoided, Five-Year Follow-Up Study Shows

Another Human-Based Study, and I’ve Been Proving This in Canine Cases For Over 10 Years-

From RehabDeb: This report is from human medical research, however Colorado State University has since conducted some animal studies. I would love to conduct studies with advanced exercise physiology protocol that I have been using for over 20 years even with my own pets before doing “official” vet med work. I look forward to when I have resources to do those studies.

When I began independent practice in 2007, I used my accumulated research studies, experience, and knowledge begun decades before my work in veterinary medicine in order to create some simple functional exercise and drill protocol. These programs benefited hundreds of my pet patients whose people opted to not pursue surgery. I have used these programs for both cats and dogs.

In every case where people follow my protocol (and where there are no extenuating circumstances), the pets have stabilized the knee or other joint with muscle growth and strength and with proper scar tissue (sometimes we want some scar tissue).

These pets have also functioned very well after rehabilitation. You may do all this work in the home environment with no dependence on specialized equipment in a clinic. There is no need for specialized equipment when we are drawing from centuries of known exercise physiology.

My programs for conservative (no surgery) treatment are clinically and anecdotally successful. This means that clients and veterinarians do the work and get good results. You can too, if you want to do the work 🙂

Jan. 30, 2013 — In the summer of 2010, researchers from Lund University in Sweden reported that 60 per cent of all anterior cruciate ligament (ACL) reconstructions could be avoided in favour of rehabilitation. The results made waves around the world, and were met with concerns that the results would not hold up in the long term. Now the researchers have published a follow-up study that confirms the results from 2010 and also show that the risk of osteoarthritis and meniscal surgery is no higher for those treated with physiotherapy alone.

“We have continued with our study and for the first time are able to present a five-year follow-up on the need for and results of ACL surgery as compared with physiotherapy. The British Medical Journal published the findings and they are basically unchanged from 2010.

This will no doubt surprise many people, as we have not seen any difference in the incidence of osteoarthritis,” says Richard Frobell, one of the researchers behind the study, who is an associate professor at Lund University and a clinician at the orthopaedic department, Helsingborg Hospital.

Richard Frobell explains that the research group’s results from 2010, which were published in the New England Journal of Medicine, caused a stir and questions were raised as to whether it was possible to say that an operation would not be needed in the long term.

Half of the patients who were randomly assigned not to undergo reconstructive surgery have had an operation in the five years since, after they experienced symptoms of instability.

“In this study, there was no increased risk of osteoarthritis or meniscal surgery for ACL injury treated with physiotherapy alone compared to treated with surgery. Neither was there any difference in patients’ experiences of function, activity level, quality of life, pain, symptoms or general health,” says Richard Frobell.

“The new report shows that there was no difference in any outcome between those who had operations straight away, those who had operations later, and those who did not have an operation at all.

“The message to the medical experts who are treating young, active patients with ACL injuries is that it may be better to start by considering rehabilitation rather than operating straight away.”

In Sweden, over 5000 people every year suffer an anterior cruciate ligament injury, mainly young people involved in sport. There are different schools of treatment and Sweden stands out with treatment that is in line with the results of the study.

“On an international front, almost all of those with ACL injuries have operations. In Sweden, just over half have surgery, but in southern Sweden we have been working for many years to use advanced rehabilitation training as the first method of treatment. Our research so far has confirmed that we are right in not choosing to operate on these injuries immediately. Longer-term follow-up is important to look more closely at the development of osteoarthritis in particular,” says Richard Frobell.

KANON, Knee ACL NON-operative versus operative treatment is the name of the research group. They are now moving on to the next stage. This year, the third part of the study will begin, following up the patients ten years after acl injury.

Richard Frobell has also entered into a collaboration with researchers at the School of Economics and Management at Lund University. He is evaluating the health economics aspects of different treatment methods for ACL injury.

Journal References

  • R. B. Frobell, H. P. Roos, E. M. Roos, F. W. Roemer, J. Ranstam, L. S. Lohmander. Treatment for acute anterior cruciate ligament tear: five year outcome of randomised trial. BMJ, 2013; 346 (jan24 1): f232 DOI:10.1136/bmj.f232
  • Richard B. Frobell, Ewa M. Roos, Harald P. Roos, Jonas Ranstam, L. Stefan Lohmander. A Randomized Trial of Treatment for Acute Anterior Cruciate Ligament Tears.New England Journal of Medicine, 2010; 363 (4): 331 DOI:10.1056/NEJMoa0907797

From ScienceDaily

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Degenerative Myelopathy: Nutrition and Exercise

1/27/16

Q:

I THOUGHT I WOULD ASK YOU IF YOU EVER USED DR CLEMMONS PROTOCOL FOR DEGENERATIVE MYELOPATHY IN DOGS, AND DO YOU PUT ANY FAITH IN IT? DOES IT WORK AT ALL. OR IS IT THE EXERCISE THAT HELPS THE MOST? THANK YOU, MARK. LOST MY LAB COAL TO DM, RECENTLY, AND IT JUST IS KILLING ME , THANKS AGAIN.

A:

Hi Mark-
First, I wish you peace and healing regarding the pain and loss of Coal…I would already guess you are a good dog dad just based on your having cared for a DM dog and seeming like you are pursuing information to help with your thought processes.

I have been familiar with Dr. Clemmons’ protocol for about 10 years (I think…time flies…), and prior to my coming into veterinary rehab, I had already about a 30 year background in progressive and varied approaches to nutrition. I have worked with many humans over the years to improve health status when they have been fighting a debilitating illness, and I have worked with world-class athletes to hone and “perfect” the body machine for competition. We began eliminating preservatives and colorings from our house at my mom’s instigation in the mid-’70’s and ate almost no refined foods at all, making many food items from scratch for our family to eat. I was also a distance runner in high school, and Mom got into nutrient supplementation for endurance sports, too.

All that to say that I tend to have at this point a wide and broad history of work with nutrition ideas, and I’ve been able to see effects of a lot of different protocol on a lot of types of beings. A shorter answer is that nutrition is very important in the healing process. People considered experts on the subject don’t all agree on a recipe for this nutrititive health. I don’t agree in total with most of the “experts” whose protocol I read, and I do read a LOT of research, too.

I am a big fan of eliminating all sorts of additional items in the nutrition protocol, in a less-is-more methodology, and beginning by giving the body only a bare minimum of basic, whole, biologically-appropriate nutrition for a 2-4 week foundation at the least. The body is designed to do a lot of good with the right amount of the right types of fuel. In the U.S. we tend to overdo it. We feed/eat too much. We feed/eat too much of biologically inappropriate foods. And we pile on a bunch of “good” foods and supplements in the hope and with the notion that they will right additional wrongs, as it were.

Successes in nutrition occur, despite inexact protocol, and with incomplete pictures, more of the same inaccurate protocol is pursued. I have seen the best results regarding nutrition for any problem be very minimized and simplified. Only after a few weeks of clean and lean animal protein and minimal non-grain-based carb sources should supplements be added. This is because many, many fringe issues will clear up as the body is allowed to pursue it’s own healing to whatever extent it is able. Short story.

Without going more into the nutrition aspect, I will say proper nutrition plays a big part in any recovery, but it is equally or even more important to focus on proper exercise to make real gains. Exercise of the right type for whatever condition will make a huge difference regardless of the nutrition protocol, however good nutrition without the right type of challenging exercise for the condition will make less of a difference.

There were no good exercise protocol broadly shared (or anywhere that I found) for neurological issues for small animals in veterinary rehab when I came into this work in 2004. I developed a lot of helpful foundational exercises and drills for strength and proprioception in an ordered method over time to use successfully in my practice. I intend to publish them more definitively this year. In the meantime, all the different types of neuro cases I dealt with, including D.M., have made progress so long as they were able to begin with my foundational 4 week exercise base program. If the pets I encountered could not move on their own, I had a different set of protocol and drills, depending on the condition. As they progressed to auto-ambulating, most would get up to doing my intro program. Right now that is only published under this title: Guidelines for Home Rehabilitation of Your Dog: Instead of Surgery for Torn Knee Ligament: The First Four Weeks, Basic Edition

Because I have broad and extensive experience utilizing principles of exercise physiology and functional recovery exercise, I see the tremendous benefit to adding the right type and amount of the right exercise and drills to any being’s life. I have been working over 10 years to get more exercise-physiology-based protocol into veterinary small animal rehab. I hope to be able to compile data from my cases and publish more of the successful protocol I’ve developed through this year.

I hope this helps some with your thought processes. I would guess it doesn’t help much to know my perspective regarding how important the right amount of the right kind of exercise is, mostly because it’s not a view that is widely promoted in vet medicine…yet! But I think little strides are being made. In the meantime, some of the same barriers and lack of cross-training in human medical science exist, too. For more on some of my favorite and some of the best sport science information, visit the National Strength and Conditioning Association and the American College of Sports Medicine.

Blessings-
Deborah

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Successful Rehab Without Water Treadmill

Water Treadmill is Not Necessary for Your Pet’s Rehabilitation

Compared to the number of dogs in the world, then compared to the number of ruptured cruciate ligaments on aforementioned dogs, then compared to the number of these dogs with ruptured ligaments that are treated by a veterinarian, then compared to the number of those dogs who are taken to surgery after initial veterinarian assessment for surgical repair after the torn ligament, there are relatively very few rehab clinics in the world and fewer still with water treadmills…as compared to the number of these dogs with ligament tears, etc…

Dogs of the world do relatively “ok” in all areas of the rehabilitation treatment spectrum after torn knee ligament and/or meniscus and definitely do not need to be “put down” due to ruptured cruciate ligament (torn ACL, CCL). I have encountered clients in my practice who were told unless they had surgery performed on their dog, regardless of the size of dog (even), the dog would have to be euthanized. Just wanted to clear up that bit of misinformation (much to your delight, I hope).

That being said, and along with explaining the title of this blog, of foremost importance I will note that I came into veterinary functional rehabilitation in 2004 with approximately 25 years experience in human sport science, functional program design, and nutrition. I decided to call my practice “functional rehab”, not having seen that designation applied much but having presumably heard the term somewhere. I decided to use it when I began an independent, mobile rehab practice in 2007, two years after starting and running a rehab clinic for a veterinary specialty hospital.

I became more aware of the water treadmill via my work at the hospital, and I found that the use of it was/is widely promoted within small animal veterinary medicine and the canine rehab model, which draws heavily from structured, academic-oriented, human physical therapy concepts. I think the overall concept is decent, yet the wtm is one very, very small tool in the vast array of protocol and modalities that exist in order to better the health of your pet.

I also believe the introduction and overuse of the water treadmill in small animal medicine is due to a misunderstanding of the science that exists regarding functional physical recovery and a misapplication of “human” based machines and protocol from physical therapy models. Also, the use of the wtm was brought over into small animal veterinary rehab I presume because it has been such a great tool in equine medicine and has been for decades.

Quite simply put, horses and other very heavy animals often struggle with pain after injury/surgery, and the pain control medicines and protocol that exist for (especially) horses do not often alleviate pain as much as we’d like to see. That, coupled with the sheer weight of these large animals, can really do additional damage to a healing body. The water treadmill for an animal that weighs a ton or so is a godsend, I’d think. In those cases the water displaces just enough weight so as to encourage appropriate exercise protocol while building recovery and assisting with pain control (because all the weight isn’t on the damaged limbs).

Water treadmill for horses or other very heavy animals is extremely helpful for recovery. Water treadmill for smaller animals is not necessary, often a trauma to the pet, often an unnecessary additional cost to the pet caretaker, and definitely overused. After a week of easy recovery post-surgery the pet should have enough analgesic available (and dosed) and should definitely have ability to walk on dry land and should be pursuing a controlled plan daily in the home environment.

Unfortunately, I found that what is not taught within this same model of small animal veterinary rehab is a good basis and understanding of program design, writing training programs, and the development of dynamic activities/protocol designed to encourage healing and increase muscle and bone mass. These are principles I began learning over 30 years ago as an athlete, as a self-coached athlete, and then as a coach and trainer to others, even world-class athletes.

What does this mean to you and your pet (primarily dogs…)?

The chief complaint I hear from people who contact me is that they were referred to a veterinary rehab clinic or three (no, not all clinics are the same) for post-surgical rehab, and after many weeks of walking in the treadmill, moving around on balls, and doing a variety of other cookie-cutter things, the pet is not much better or is not to a place where the owner feels comfortable with letting them be loose and rambunctious.

Their pet isn’t where the owner thought they would be after surgery.

When I was in a clinic setting and working on utilizing the wtm we had and I helped design, I did structure the workouts to be progressively difficult, using a 3x workout adjustment protocol, meaning that if three workouts went well, then I changed the protocol, making the workout more dynamic. This could be done by increasing time or lowering water in the tank. Since I do not believe that much benefit is realized by walking in a wtm more than 20 min., and some data is published to recommend that animals not be worked beyond that time anyway, I find more benefit realised by lowering the water height, thus increasing the force on the joint/leg/muscle/bone.

Overall, over time, and according to decades of research, however, the most benefit is realized by work on dry land, where possible, using gravity to strengthen bones, connective tissue, and muscle. I began developing protocol for just that for small animal rehab since I did not find any published when I arrived on the scene in 2004.

Your pet will use their leg to some extent and will use it increasingly after surgery if he/she is not in pain. That has been my finding after working with hundreds and hundreds of cases, some having had surgery and some going the conservative route. With that in mind, a structured workout program is entirely necessary and may vary from any standardized protocol depending on the nature of the pet and the owner.

If your pet is not using the leg within 2-3 days after surgery, then my findings are always that they are in pain, and that they are in pain due to

1) not enough post-op analgesic, which I believe should be a combo of at least two analgesics for potentially several weeks while we pursue the best activity and homework for healing (in this area we commonly use an nsaid and Tramadol, however I find more benefit and big-picture-science backing the combo use of Gabapentin and Tramadol);

2) infection, the pain of which will only be finally remedied by antibiotics (and subsequently the infection remedied as well); or

3) structural abnormality, i.e. some sort of failure related to the surgery, yet not necessarily the surgeons/your/your dogs *fault*.

The homework protocol I generically recommend is found here. If you are within range of my services, I recommend you contact me for an evaluation appointment and we establish a base for your dog and then you perform the exercises which will bring solid healing while helping to also protect the opposing limb.

Thank you!

Jicky E-Collar

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Intense Exercise, Muscle Soreness, Recovery, and Anti-inflammatories

Rehab Deb’s Comments:

One of the most important bits of this report is something I’ve been reading more and more research regarding, and that is that nsaids (non-steroidal anti-inflammatories) subdue, limit, delay the healing process. I have also read several reports regarding the same being true when ice is used.

Nsaids in animal medicine include Previcox, Peroxicam, Deramaxx, Rimadyl, Metacam, among others…and for humans include Advil, Ibuprofen, Motrin, Tylenol, Aspirin, Aleve (sodium naproxen), etc…Does this mean to cut them out altogether? No, but I do think it means to consider the necessity of application and what is hoped to be achieved…is it really necessary?? Pain is often very well controlled or minimized by combining smaller doses of several analgesics, pain relievers, depending on the issue, rather than higher doses of just one medication and/or continuous doses of nsaids that probably aren’t doing much to help the pain problem.

This is only one suggestion.

Ultimately this information should be discussed with the medical practitioner who prescribed the medications in the first place if/when you have questions. There are other reasons to minimize nsaids and use Tramadol and/or Gabapentin and/or other prescription analgesics to alleviate pain for the short run while building muscle to support damaged joints. Many practitioners are aware of using these other drugs, and while they may not know about this more recent news regarding nsaids delaying healing and muscle growth, which came out of human sport science, veterinarians in my area seem to be interested in the information when it is presented to them.

Article from Dr. Gabe Mirkin’s Fitness and Health E-Zine
May 6, 2012

How to Recover from Muscle Soreness Caused by Intense Exercise

Muscle soreness should be part of every exercise program.  If you don’t exercise intensely enough on one day to have sore muscles on the next, you will not gain maximum fitness and you are also losing out on many of the health benefits of exercise. The benefits of exercise are much greater with intense exercise than with casual exercising.

You must damage your muscles to make them grow and become stronger.  When muscles heal, they are stronger than they were before you damaged them. All athletes train by “stressing and recovering”. On one day, they take a hard workout in which they feel their muscles burning.  Eight to 24 hours after they finish this intense exercise, their muscles start to feel sore. This is called Delayed Onset Muscle Soreness (DOMS). Then they take easy workouts until the soreness is gone, which means that their muscles have healed.
DOMS IS CAUSED BY MUSCLE DAMAGE. Muscles are made up of fibers. The fibers are made up of a series of protein blocks called sarcomeres that are lined in a long chain. When you stretch a muscle, you stretch apart the sarcomeres in the chain. When sarcomeres are stretched too far, they tear.  Your body treats these tears in the same way that it treats all injuries, by a process called inflammation.  Eight to 24 hours after an intense workout, you suffer swelling, stiffness and pain.

The most beneficial  intense exercise program  is:
* severe enough to cause muscle pain on the next day, and
* usually allows you to recover almost completely within 48 hours.

ACTIVE, NOT PASSIVE, RECOVERY:  When athletes feel soreness in their muscles, they rarely take days off.  Neither should you. Keeping sore muscles moving makes them more fibrous and tougher when they heal, so you can withstand greater forces and more intense workouts on your hard days.  Plan to go at low intensity for as many days as it takes for the soreness to go away. Most athletes try to work out just hard enough so that they recover and are ready for their next hard workout in 48 hours.

TIMING MEALS TO RECOVER FASTER:  You do not need to load extra food to recover faster. Taking in too much food fills your muscle cells with fat, and extra fat in cells blocks the cell’s ability to take in and use sugar. Sugar is the main source of energy for your muscles during intense exercise. Using sugar to drive your muscles helps them to move faster and with more strength. Timing of meals is more important than how much food you eat. Eating protein- and carbohydrate-containing foods helps you recover faster, and the best time to start eating is as soon as you finish a hard workout. At rest, muscles are inactive. Almost no sugar enters the resting muscle cell from the bloodstream (J. Clin. Invest. 1971;50: 2715-2725). Almost all cells in your body usually require insulin to drive sugar into their cells. However during exercise your muscles (and your brain) can take sugar into their cells without needing insulin.  Exercising muscles are also incredibly sensitive to insulin and take up sugar into their cells at a rapid rate.  This effect lasts maximally for up to an hour after you finish exercising and disappears almost completely in around 17 hours.  The best time to eat for recovery is when your cells are maximally responsive to insulin, and that is within a short  time after you finish exercising. Not only does insulin drive sugar into muscle cells, it also drives in protein building blocks, called amino acids.  The sugar replaces the fuel for muscle cells. The protein hastens repair of damaged muscle.  Waiting to eat for more than an hour after finishing an intense workout delays recovery.

WHAT TO EAT AFTER YOUR INTENSE WORKOUTS: Fatigue is caused by low levels of sugar, protein, water and salt.  You can replace all of these with ordinary foods and drinks. If you are a vegetarian, you can replace your protein with combinations of grains and beans. You can replace carbohydrates by eating virtually any fruits, vegetables, whole grains, beans, seeds and nuts. A recovery meal for a vegetarian could include corn, beans, water, bread, and fruits, nuts and vegetables.  If you prefer animal tissue, you can get your protein from fish, poultry,or meat.   Special sports drinks and sports supplements are made from ordinary foods and therefore offer no advantage whatever over regular foods.

BODY MASSAGE:  Many older studies have shown that massage does not help you recover faster from DOMS. Recently, researchers at McMaster University in Hamilton, Ontario showed that deep massage after an intense workout causes muscles to enlarge and grow new mitochondria (Science Translational Medicine, published online Feb, 2012). This is amazing. Enlarging and adding mitochondria can help you run faster, lift heavier weights, and even prevent heart attacks and certain cancers.

NSAIDS DELAY DOMS RECOVERY:  Non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen, may help relieve pain, but they also can block muscle repair and delay healing.

HOT BATHS:  Most research shows that a hot bath is not much better than doing nothing in helping muscles recover from exercise (European Journal of Applied Physiology, March 2006)

COLD OR ICE BATHS:  A recent review of 17 small trials, involving 366 participants, showed a minor decrease in DOMS with ice water baths.  They found “little quality research” on the subject and “no consistent method of cold water immersion” (Cochrane Library, published online February 15, 2012).  Cold water immersion can reduce swelling associated with injury, but has not been proven to speed the healing of DOMS.

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