Osteopath Wellington | Sports Recovery | Sports Massage | Sports Medicine


Learn how to Improve your
Performance with Recovery

by Vicky Tate


Ironman. Half Ironman. Marathon Swim. Whatever the event they all need a wellstructured plan, dedication and focused training blocks.

The anticipation of the event keeps you focused.

On the day you’re sorted with your fuelling, hydration and race plan. You execute this plan. Finishing the race you’re exhausted but elated.

Celebrations with friends, a beer and your favourite meal are all you can think about before the adrenalin starts to wane and complete exhaustion hits you.

Happy to see your bed, after a long and successful day, you finally fall asleep.

What’s Next on the Training Plan?

Confused? What do I mean what’s next?

The event’s completed, you’ve executed your plan. Your coach hasn’t said anything about what to do after the event except rest for a week.

You may have heard of or competed in the Epic Swim in Taupo. 5km, 10km and 2.5km distance option, and inthe last few years the combined 17.5km option for those crazy enough to want to do that amount of swimming in one go.

In January 2016 I was one of those crazies. Progressing through the distances over some years, I had the crazy aspiration to swim the Cook Strait. Instead I thought I should first see if I could manage that level of training. I decided on the Epic Epic 17.5km swim.

I was well organised. Training blocks of 6-8 weeks with set agendas. Sleeping was imperative. Increased intake of protein and lots of fruit and veges.

The training was hard work as expected. Leading up to the event I did long swims in the pool weekly. I trialled what worked best for me with regards to hydration and feeding.

Days before the big swim I was increasing my fluid intake, carbo loading and writing my race plan.

On the day I managed to execute my plan and completed the 17.5km.

Exhausted, elated, and just a little bit sore I headed to the pub with friends to have a celebratory beer and dinner. That night I barely slept, apparently common after an endurance event.

This was my first big ultra-endurance event, and all I’d focused on was completing it. I hadn’t thought past the event about my recovery.

I hadn’t even prepared or thought too much about the first few days after the event. Friends telling me I would have a period of time where I was emotionally down and not know what to do with myself.

Like you I had plans to compete in other events throughout the rest of the season.

As seasoned athletes we often have a number of races that we plan to complete other than the “A” race we are focused on. The fatigue and pains I was experiencing from my “A” race stopped me dead in my tracks.

I would see other athletes getting out there and training or competing and I would wonder why and
how they were able to do this?

This experience made me look deeper into how to maintain my body at optimal function so that I can
continue to take part in the thing that I love.

In this blog I’m going to share with you what I learnt. Taking you through and providing you with an understanding of:

  1. What happens physiologically to the body after an endurance event. Giving
    explanation of why we experience certain symptoms
  2. What you can do to best aid your recovery so that you are able get back into
    training for your next event.

What Happens Physiologically to the Body during and after an
Endurance Event?

Ultra-endurance exercise, such as an Ironman triathlon, induces muscle damage and a systemic inflammatory response.

Muscle Damage:

During an endurance event your muscles get a hammering. You would have experienced the “DOM’s”, delayed onset muscle soreness and stiffness. DOM’s are caused by muscle damage. This occurs due to:

  • Mechanical stress causing muscle cell damage, disruption and deconstruction.
  • Breakdown of muscle proteins. This occurs in the later stages of an event when your blood glucose levels drop. This triggers the secretion of the stress hormone Cortisol. Cortisol assists in the breakdown of carbohydrate, fats and proteins as an energy source.
  • Oxidative stress. During the body’s process of energy release many oxygen molecules become unstable creating oxygen free radicals. These damage muscle cell membranes, DNA and proteins. Oxygen demands and consumption are high during endurance exercise so Oxidative stress is also higher.

A recent study shows 2 hours post ironman race an individuals’ creatine kinase, the blood marker measurement of muscle damage, can be increased by 40 times, showing significant muscle damage during an endurance event.

Inflammation, Lowered Immunity and the Hormonal Stress Response:

Ever wondered why you often get sick after an intense amount of training or completing an event?

A recent study undertaken on Ironman athlete’s shows that up to 5 days after an Ironman race there is persistent low grade systemic inflammation which indicates incomplete recovery.

Two processes are at play that compromise of the immune system during endurance exercise:

1) Reaction to Muscle Damage

The muscle cell damage that occurs stimulates immune cells, which is part of the body’s initial stages of healing. This immune response further triggers an inflammatory reaction and muscle damage due to release of oxidative free radicals.

The immune system will down regulate its inflammatory response to tissue damage. This prevents out of control systemic inflammation.

This down regulation impairs the immune systems’ ability to fight foreign invaders. You are now more susceptible to illness.


2) Release of Stress Hormone Cortisol

To maintain energy in the later stages of an endurance event the body responds to the low blood sugar state by breaking down carbohydrates, fats and proteins and converting it to energy.

Your body will respond to this prolonged stress by increasing its release of stress hormone Cortisol. This stimulates the production of glucose from stored carbohydrates, fats and proteins in the body.

Cortisol has an adverse effect on the immune system if maintained at a high level in the body.

Sustained high levels of Cortisol will:

  1. Reduce the body’s inflammatory response to tissue damage. Deactivating your body’s natural selfrepair mechanisms leaving you more susceptible to illness and infection.
  2. Inhibits the uptake of amino acids into the muscle cells. Making it near impossible to fuel muscle cells when cortisol levels are too high for too long.
  3. Decreases insulin sensitivity, insulin is needed for the body to transform glucose into energy
  4. Inhibits bone formation and decreases calcium absorption in the intestine. Increasing your chances of suffering from bone conditions such as stress fractures
  5. Decreases digestive system function causing a lack of absorption of essential nutrients. This can lead to reflux due to increased gastric acid production.
  6. Suppresses production of serotonin the hormone that impacts on your mood. Making you susceptible to the “post Ironman blues”
  7. Affects sleep. Cortisol levels are supposed to drop at night time, allowing your body to relax and recharge. If your cortisol levels are too high you may get disrupted sleep.

Although inflammation and cortisol production are part of the adaptation mechanism, it is necessary to control these responses to prevent over-training symptoms such as injury and chronic illness.

Common Warning Signs and Symptoms of Overtraining Syndrome

  • Washed-out feeling, tired, drained, lack of energy
  • Mild leg soreness, general aches and pains
  • Pain in muscles and joints
  • Sudden drop in performance
  • Insomnia
  • Headaches
  • Decreased immunity (increased number of colds, and sore throats)
  • Decrease in training capacity / intensity
  • Moodiness and irritability
  • Depression
  • Loss of enthusiasm for the sport
  • Decreased appetite
  • Increased incidence of injuries.
  • A compulsive need to exercise

Inadequate rest following prolonged, intensive exercise might cause a chronic systemic inflammatory state. This in turn leads to over training syndrome.

What you can do to Best Aid your Recovery

Finding an appropriate balance between training, competition and recovery is an essential challenge in maintaining a high level of performance and to minimize potential health consequences.

Recovery is a relatively new area of scientific research. The following suggestions are based on the current research and knowledge base.

I would encourage you to experiment with recovery techniques to identify useful individualized strategies.

Muscle Repair Strategies

Muscle repair and inflammatory processes need at least 2–3 weeks of active recovery before returning to more intensive training.

DOMS presents as dull muscular ache developing 24 to 48 hours after the performance. It will result in muscle stiffness plus tenderness.

DOMS can result in a short term loss of muscle strength, reduced joint range of motion and swelling of the affected muscle groups.

How to treat DOM’s and encourage muscle repair:

Ice/Contrast Therapy

Research shows that DOMS should be treated with active rest and anti-inflammatory measures such as ice.

Recent research shows that Contrast water immersion of 15mins provides benefit for recovery. Alternate with 1min hot water 38–40°C and 1min cold water 10–15°C

Contrast immersion causes changes in blood flow and muscle temperature. This may have an effect on inflammation, immune function, muscle soreness and perception of fatigue.

Massage and Compression Gear

Research shows that gentle massage and pressure garments reduces the duration and severity of DOMS.

Massage is suggested to improve recovery by increasing blood flow and improving clearance of metabolic waste products.

Pressure created from compression garments may reduce swelling and promote alignment of muscle fibres. As well as reducing the inflammatory response and muscle soreness.

Active Recovery

You should avoid aggressive exercise during the recovery phase. Your muscles have a reduced ability to cope with shock absorption. There is also altered muscle recruitment patterns, reduced strength balance and contraction intensity.

The most important thing you can do to recovery quickly is to listen to your body.

Let’s get intelligent with active recovery!

If you are feeling tired, sore, or notice reduced performance you may need more recovery time or a break from training altogether. If you pay attention, in most cases, your body will let you know what it needs, when it needs it.

The problem for many of us is that we don’t listen to those warnings or we dismiss them with our own self talk.

“I can’t be tired, I didn’t run my best yesterday” or “No one else needs two rest days after that workout; they’ll think I’m a wimp if I go slow today”.

Person Apple And Water

Nutrition-Carbohydrates and Protein

The goal for post-race fuelling is recovery.

This will help you replenish glycogen stores used and optimize protein synthesis to repair damaged muscle tissue. It will stimulate
the development of new tissue, and replace fluids and electrolytes lost from sweat.

Carbohydrate functions to replenish muscle glycogen, spike insulin secretion and reduce cortisol. Protein functions to reduce muscle
damage and build fitness infrastructure.

Muscles are very insulin sensitive post exercise. Studies show that insulin levels don’t need to be too high for nutrient uptake to occur.

Interesting most studies on post-race fuelling were undertaken with the participants in a fasted stage.

Research suggests an ideal refuelling ratio is 3:1 carbohydrate to protein 30mins after exercise.

Let’s think about this for a minute…. As an Endurance athlete you have learnt what’s needed to maintain glycogen and protein levels throughout your race.

If your race feeding plan is well executed it will not leave you in a fasted state. This means that your glycogen levels are not completely depleted and the importance of post-race refuelling timing is not as vital.

Yes, you still need to replenish your carbohydrate and protein stores but the timing is not critical.

A useful podcast by tri-talks Ben Greenfield goes into the science behind race and postrace nutrition


Pain associated with muscle damage is most likely due to Oxidative tissue damage causing an inflammatory response. This produces oxygen free radicals and increases secondary muscle soreness. The molecules known to disarm these free radicals are called antioxidants.

Antioxidants are an essential part of your recovery

Common antioxidants include:
Vitamin C, Vitamin E, Polyphenols, bioflavonoids and anthocyanins

Fruits high in these antioxidants to include in your recovery diet are:
Bananas Oranges, Apples, Grapes, Pineapples

Research shows that Tart cherries may have a protective effect in reducing muscle damage and pain during strenuous exercise. Tart cherries are rich in antioxidants and anti-inflammatory properties. Ingesting tart cherry juice for 7 days prior to and during a strenuous event can minimize post-event muscle pain

Antioxidant Foods

Stress Hormone Reduction and Immune Support

Immune Support

The immune system plays a major role in helping the body recover after exhaustive exercise. But the immune system itself is overwhelmed by the stress of endurance racing and its aftermath. Immune cell function remains depressed for as long as three days after such an experience. This greatly increasing your susceptibility to viral and bacterial infections.

How to Support your Immune System and Balance Cortisol Levels:


We need 8.5 hours of sleep per night, 3-5 90 minute cycles of REM and non-REM sleep. During the deeper stages of sleep your body repairs and regrows tissues, builds bone and muscle, and strengthens the immune system.

Why Is Sleep Important

If you suffer from an inability to fall asleep this is a sign that your cortisol level is too high, you are still in the fight or flight mode. This produces stimulatory brain messengers, which keep you from going to sleep.

Good sleep habits are vital

  • Turn your bedroom into a Sleep inducing environment. A quiet, dark, and cool environment can help promote sound slumber.
  • Set a bedtime that is early enough for you to get at least 7 hours of sleep
  • Don’t work in bed; turn off mobile phone and computers. Light emitted from devices fools your body into thinking it is daylight which affects sleep hormones.
  • Reduce caffeine late in day
  • Avoid high protein food and large meals a few hours before bed
  • Establish a soothing Pre-Sleep Routine and develop a consistent sleep schedule
  • Take day naps early or not at all- 20 minutes at 2pm

Stress Hormone Reduction

Reducing Cortisol levels with Diet

Dietary changes can aid in reducing cortisol levels and minimise the impact that cortisol will have on the body.

Inhibit inflammation. They also help to reduce cortisol levels and perceived stress. Foods such as Walnuts, fish and sardines are excellent sources. Krill Oil and Fish oil supplement are also an option.

Can help inhibit the secretion of cortisol. Beef, lamb, oyster, pumpkins seeds or cashews are high in Zinc

Dark Chocolate
Naturally occurring antioxidants in dark chocolate can help your body decrease inflammation and slow cortisol production. 40 grams per day aids in reducing cortisol levels.

Vitamin C
Vitamin C-rich produce, like oranges and kiwis, help slow the production of cortisol

Leafy greens helps balance your body’s production of cortisol.

Vitamin B
Works to reduce the hypersecretion of cortisol. Paradoxically, excess cortisol depletes B vitamins from the system. Vitamin B is crucial in restoring energy levels. Mushroom, Cheese, eggs, Fish, avocado and pork.

Dehydration can induce a stress response and spike cortisol levels. Drink water first thing in the morning, as you become dehydrated during sleep

Stress Reduction

Cortisol levels are not only heightened during a race but can be affected by the many other stresses of life. If you can manage your stress then your recovery will also benefit.

Leaving Pain

As an athlete you are very good at creating training plans, setting goals and following through with them. Managing your stress should be no different.

Create a stress management plan and implement it just as you would a race plan. Identify the stressors and investigate some strategies to use to reduce the stress.

Remind yourself that after a big event your body is vulnerable. Acknowledging the things in your life that may be adding to your stress levels is a start.

Mindfulness meditation and Yoga are great coping strategies for stress.

Catching up and having a laugh or beer with those friends you have put off for months while you have been training will help to reduce stress.

Here is a link with many more specific tips to help manage stress:

Injury Management

One of the main limiting factors to recovery is injury. Injury prevention and management should be incorporated in any athlete’s training program.

It is vital that you address any injuries you have sustained from racing before you get back into training. If you don’t do this you may end up with an injury that will limit your ability to compete in future event. It could stop you dead in your tracks completely….nobody wants that.

You should be guided by your health professional with regards to graduated return to training.

An early diagnosis will lead to better recovery outcomes meaning less impact on your training and competing schedule.

As an Osteopath the joy that I get from my work is being able to enable an athlete back to the thing they love doing. I understand that drive to get out there amongst the elements…nothing worse when my body limits me from getting into the harbour for a sea swim.

So I would encourage you to seek help with those injuries.


This post is for educational purposes only. It is not a substitute for seeking professional advice. Don’t just go to any health professional…Go to someone who has a special interest and expertise in the assessment and treatment of athletes….Someone who understands the ups and downs of endurance training and competing.

There is no way that I can know your specific situation. I would need to know your medical history, complete a thorough examination and then come up with a plan that meets your individual needs.

I’m sure you understand that I disclaim any and all responsibility for anything you do as a result of reading this post. By reading this post you agree to and take responsibility for anything you do as a result of reading this post.

If you would like to talk through some of the things raised in this post that may be specific to you I’d love to help you out. If you email me directly on Vicky@focusosteo.co.nz with your details I will call you back for a chat. Or you could book an appointment for an assessment and treatment via http://nzappts.gensolve.com/focus_osteo/site/details/wellington

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