Originally published in Maastohiihto.com, Recovery – Part 2 introduces the reader to these three recovery-focused treatment methods, which are not universally utilized by all endurance athletes. Massage is likely the most common method for accelerating recovery among endurance athletes, but there are also athletes who never get massages and still achieve top results. These methods are individual, and it’s worth trying them out and drawing personal conclusions based on one’s own experience.

Compression Garment  

Paula Radcliffe was perhaps one of the first elite runners to become known for her compression socks, bringing them to the public’s attention nearly two decades ago. Nowadays, many others, such as the American marathoner Shalane Flanagan, are known for wearing knee-length compression socks.

Originally, compression or support socks were developed for long flights and hospital settings, situations where blood flow in the lower extremities may be compromised due to issues like lymphatic system or circulatory disorders. The compression provided by the sock is thought to improve venous return, prevent swelling, and reduce inflammation. Enhanced blood flow promotes the removal of waste products from muscle cells, aiding in recovery. Compression is also thought to reduce muscle soreness due to these mechanisms.

According to one study, the muscle soreness (delayed onset muscle soreness, DOMS) in recreational runners was less than 24 hours after a 10 km run when compression socks were worn during the run. Running pace was also slightly faster when wearing socks compared to not wearing them. The socks used in the study were commercially available socks with the highest compression at the ankle (18-22 mmHg), gradually decreasing upwards, with the lowest compression being about 30% of the maximum below the knee.

Another study compared cyclists’ performance after using compression garments and passive recovery. Cyclists performed a 20-minute incremental exercise, followed by a 12-minute recovery period with compression pants (from ankle to hip) or without. Then a 5-minute maximal performance was conducted to monitor peak power.

The cycling performance (in watts) significantly improved after compression, indicating that compression garments may promote recovery, especially in the short term. Since there is limited research on compression socks, it is too early to say definitively whether they are beneficial in sports. It appears that the evidence for enhancing recovery is stronger than any potential performance-enhancing effect. So far, compression garments have not been found to provide any significant benefit, but if they don’t hinder performance, their use can be tried during activity or recovery.

Many skiers also use compression socks in races and training. In long-distance skiing, compression socks can provide even greater benefits due to the duration of the performance. It’s worth trying socks during training, and if they prove beneficial, they can also be used during long-distance skiing. I myself use compression socks in skiing competitions, and during the 24-hour world record ski event, I wore compression socks designed for skiing underneath and on top of another pair due to quite cold nighttime temperatures. I have found the socks to be a useful addition in long ski performances.

Love-Hate Relationship with Foam Roller

The foam roller, which has become popular in recent years, is likely familiar to many athletes. Surprisingly convenient, available in local stores with different hardness and surface materials, this inexpensive roller/tube serves as an excellent aid in releasing muscle tension and tightness. You can use it for areas such as calves, outer thighs, and the back and shoulder area, wherever necessary. The foam roller is a good aid for an athlete’s daily muscle maintenance when massage is not available or affordable.

Advocates of foam rolling praise its ability to help correct muscle imbalances, alleviate muscle pain, improve nerve-muscle system function, and increase limb mobility. There is relatively little research on this fairly recent method of enhancing recovery, but foam rolling has been found to reduce DOMS and performance decline after exercise.

Foam rolling mimics myofascial release therapy, in which pressure is applied to the muscle fascia and any scar tissue, aiding in its removal. Foam rolling thus functions similarly to traditional massage and can be used both before exercise as part of warm-up and after exercise to promote recovery and prevent muscle damage.

It is said that connective tissue is the area where exercise-induced stress is concentrated, and where the pain signaling muscle damage mainly originates. Foam rolling targets precisely the connective tissue and may enhance blood circulation where metabolism is otherwise weak, such as in muscle-tendon junctions, which often have poor circulation. Therefore, foam rolling may theoretically help in the recovery of soft tissue micro-injuries/pain.

MacDonald et al. (2014) investigated the effects of foam rolling on exercise-induced muscle soreness, muscle contractility, drop jump performance, and limb mobility. Participants performed a strenuous 10×10 repetition squat series with 2-minute rests, at 60% of their one-repetition maximum. After the test and at 24 and 48 hours post-test, the intervention group foam rolled according to instructions, targeting the leg and buttock muscles through five different movements, 60 seconds each for each leg separately. Foam rolling reduced muscle soreness and improved mobility compared to passive recovery. Jump performance was also better for foam rollers at the 48-hour mark post-intervention.

I have personally used the foam roller for massaging stiff shoulder blades. With a handle-equipped roller, it’s quite easy to “massage” the shoulder blades and their trigger points. Of course, this is not as effective as a proper massage, but it provides temporary relief and comfort to trigger points in the shoulders.

Traditional Massage

Traditional massage has been part of athletes’ training for years. The scientific definition of massage roughly goes as follows: “mechanical manipulation of tissues through rhythmic pressure to promote health and well-being.” According to the American Massage Therapy Association, massage alleviates pain, tension, and depression and improves sleep and quality of life.

Despite massage’s popularity, knowledge of its benefits largely relies on anecdotal evidence without clear research evidence. The challenge in massage research includes difficulties in determining the amount of pressure applied, making it hard to compare study results.

What is known or presumed to be known about massage? Massage likely increases blood flow in muscles, promoting recovery from exertion. Waste products are removed more efficiently through massage as tissue metabolism improves. According to some information, massage may stimulate the formation of vascular endothelial growth factor (VEGF), an important factor in muscle vascularization, which may enhance recovery by increasing angiogenesis in muscles and reducing scar tissue formation.

In one study, massage was more effective than passive recovery when there was a 24-hour recovery period between performances. However, active recovery (i.e., light activity) and cold-water immersion proved to be better methods than massage in this study. In another study, massage was not any better than passive recovery, so once again, one study suggests one thing and another study’s results are entirely different.

Massage may also increase the number and activity of natural killer cells and lymphocytes important for immunity, at least in immunosuppressive cases such as cancer patients but also in healthy individuals. In one animal study, the amount of pro-inflammatory cytokines, which increase inflammation, was found to decrease after massage. Another study in rats found that massage increased inflammatory cells in the target area, and the reaction was stronger with higher pressure during massage.

So, massage has been found to reduce muscle soreness, but its effect on performance itself has often been questionable. Massage probably does not improve performance per se, only perceived recovery, which is why its use is most justified in injury prevention by alleviating muscle tightness.

As mentioned above, it is difficult to prove the direct effect of massage on recovery and performance improvement, but it is a common recovery-promoting treatment among athletes, regardless of the sport. Personally, I don’t often visit a massage therapist, and it may have been a couple of years between massages. However, this winter, I went for a massage three times before important races and the world record ski event, and I found that it brought muscle relaxation before the performance, at least. Of course, the effect of massage may be largely psychological, but all legal aids to improve performance should be utilized. Active rest was also mentioned, and it is strongly incorporated into my training program; I do a lot of light maintenance exercises. I only take a few passive rest days a year or when I’m on vacation.

In the next part, we’ll delve into the different temperatures (cold/hot) and hydrotherapy methods to aid in recovery. You can also read training-related articles on the ProXCskiing.com website.

*Editor-in-Chief Teemu Virtanen’s personal experiences

Sources: Halson, S. 2013. Recovery techniques for athletes. Sports Science Exchange 26(120), 1-6. Healey, K. et al. 2014. The effects of myofascial release with foam rolling on performance. J Strength Cond Res 28(1), 61-68. MacDonald, G. et al. 2014. Foam rolling as a recovery tool after an intense bout of physical activity. Med Sci Sports Exerc 46(1) 131-142. Menetrier et al. 2013. Effects of recovery using contrast water therapy or compression stockings on subsequent 5-min cycling performance. J Sci Cycling 2(2), 49-56. Waters-Banker et al. 2014. Immunomodulatory effects of massage on nonperturbed skeletal muscle in rats. J Appl Physiol 116, 164-175.