Recovery & Cryotherapy in Football [Le Meur - BAFD 2019]

1. Controversies in Football Medicine
CRYOTHERAPY
& RECOVERY
YLMSportScience
Conference of the Belgium Football Doctors & Associates | October 2019

2. Introduction

3. Introduction
COMPETITION CALENDAR
July 0
August 3
September 6 (2)
October 5 (2)
3 2 3 2 2
2 2
League + Cup matches
League + national team matches
777
7

4. Introduction
Late-evening
matches
Physical & cognitive
demands of the match
Excitement
& arousal
Social
pressureInconsistency in
daily schedule
Match
outcome &
related mood
Etc.

5. Promoting training
adaptations
Dissipating
fatigue
Congested fixtures

6. Potential solutions
Etc.

7. Tart cherry juice
Milkshake: 25g of whey
+ 5g of creatine
End of the
match
Meal (proteins)
Cold bath
Chocolate milk or cottage
cheese or casein
Compression / foam rolling /
massage / electrostimulation
Post-match protocol: build your routine

8. How to decide?

9. What about cryotherapy?
1. Is cryotherapy really effective to promote muscle
recovery? Is the response the same for cold water
immersion, WBC, PBC & recovery boots?
2. What is the best protocol: How intense? How
long? When?
3. Does cryotherapy work for other aspects of
recovery?
4. Is it true that these recovery techniques can limit
the adaptations to training?

10. Is cryotherapy
effective to promote
muscle recovery?

11. Leeder et al. BJSM 2011
Cold water immersion reduce muscle
soreness (analgesic effect)
1. Are cold recovery techniques effective to promote muscle recovery?

12. Leeder et al. BJSM 2011
1. Are cold recovery techniques effective to promote muscle recovery?

13. INFLAMMATION
OEDEMA
↓ Muscle perfusion
↓ Muscle metabolism
↑ Hypoxic cell death
↑ Secondary muscle damage
1. Are cold recovery techniques effective to promote muscle recovery?

14. 1. Are cold recovery techniques effective to promote muscle recovery?
Strength
Power
Although CWI is beneficial in attenuating
decrements in neuromuscular performance
24 hours following team sport, the
indications of this systematic review are that
those benefits were not evident 48 hours
following team sport
CMJ
Sprint

15. Rose et al. IJSM 2017
1. Are cold recovery techniques effective to promote muscle recovery?
• 16 eligible articles extracted
• 10 induced muscle damage
using controlled exercise in a
laboratory setting,
• 6 induced damage during
sport-specific training

16. 1. Are cold recovery techniques effective to promote muscle recovery?
WBC
PBC

17. 1. Are cold recovery techniques effective to promote muscle recovery?
WBC Immersion
More research is needed

18. 1. Are cold recovery techniques effective to promote muscle recovery?
Pay attention to your players’
beliefs & preferences

19. 1. Are cold recovery techniques effective to promote muscle recovery?

20. 1. Are cold recovery techniques effective to promote muscle recovery?
~Game-ready vs Cold
water immersion 12°C
Similar effect on
muscle temperature
Bieuzen et al. unpublished data

21. What is the
best protocol?

22. 2. What is the best protocol?
3min at -110°C (WBC)
or -160°C (PBC)

23. 2. And if they don’t like it?
Milkshake: 25g of
whey + 3g of creatine
Alternate with
a hot bath

24. Does cryotherapy
work for other
aspects of recovery?

25. -100
-80
-60
-40
-20
0
20
40
60
Day 1 Day 2 Day 3 Day 4 Day 5
Qualityofsleepdifference(%)vsday1
CWI CON
3. Can cold techniques demonstrate other benefits to speed up recovery?
Al Haddad et al. IJSPP 2012
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26. 3. Can cold techniques demonstrate other benefits to speed up recovery?
Overload #2
2 weeks
100%
50%
Overload #1
2 weeks
Control Period
2 weeks
125%
Wash
out
1week
Parameters WBC effect
Actual Sleep Time ↑, Moderate (98%)
Sleep Onset Latency ↓, Small (66%)
Sleep Efficiency ↑, Small (59%)
Bed Time ↓, Small (66%)
Time in Bed ↑, Moderate (97%)
Schaal et al. MSSE 2015
Whole-body cryotherapy may
limit sleep disturbances during
overload periods

27. Does cryotherapy
limit the adaptations
to training?

28. COMPETITION CALENDAR
July 1
August 6
September 6 (2)
October 5 (2)
November 6 (2)
December 6
January 6
February 7
March 5 (2)
April 9
May 6
June (+)
PRE-SEASON
CB
Int. break
Int. break
Int. break
Int. break
4. Are cold recovery techniques limiting the adaptations to training?

29. Promoting training
adaptations
Dissipating
fatigue
4. Are cold recovery techniques limiting the adaptations to training?

30. INFLAMMATION
OEDEMA
↓ Muscle perfusion
↓ Muscle metabolism
Training adaptations?
4. Are cold recovery techniques limiting the adaptations to training?

31. Endurance performance
- No significant difference of
inconclusive effect +
Yamane
Cycling TTE
X
Halson
10-min cycling TT
X
Agular
15-km cycling TT
X
Broatch
20-km cycling TT
X
Broatch
2-km cycling TT
X
Broatch et al. 2018
Strength performance
- No significant difference of
inconclusive effect +
Roberts
Leg press 1RM
X
Yamane
Wrist-flexor 1RM
X
Frohlich
Knee flexion 1RM X
Yamane
Wrist-flexor 1RM
X
Ohnishi
Handgrip 1RM
X
Fyfe
Leg press 1RM
X
4. Are cold recovery techniques limiting the adaptations to training?

32. 2015
2019
4. Are cold recovery techniques limiting the adaptations to training?

33. Roberts et al. 2019
4. Are cold recovery techniques limiting the adaptations to training?

34. Fyfe et al. 2019
• Improvements in 1-RM leg press were
similar between groups
• (Peak CMJ force increased at POST only for
CON with a greater change vs. COLD)
4. Are cold recovery techniques limiting the adaptations to training?

35. How to deal with cryotherapy modalities during overload training periods?
Periodize cryotherapy and use it only:
• The day preceding a session involving a high skill component or high intensity,
• When a player is reporting early signs of overreaching (high level of fatigue & impaired
performance level), especially when impaired sleep quality is reported

36. Conclusion
1. Yes, cold recovery techniques are effective at speeding up
muscle recovery: reduced muscle soreness, reduced
increase in [CK], faster muscle recovery kinetic,
2. You can maximize the effect of cyrotherapy on recovery even
if you just have access to a cold bath,
3. Protocols: 5-15 min between 10-15°C depending on the
context for cold water immersion; 3min at -110°C or -160°C
for whole- & partial-body therapy (optimal?),
4. Cold water immersion & whole-body cryotherapy have been
shown to positively impact sleep quality during overload
training periods & to reduce the risk of training
maladaptations,
5. Cold water immersion may blunt resistance training induced
muscle growth and should be implemented carefully with
injured players, young players aiming at increasing their
muscle mass & during intensified training periods

37. Education & teamwork are key to maximize the players’ compliance

38. One last word

39. The post-match
recovery is strongly
dictated by the fitness
level of the player
Fitness & Recovery

40. COMPETITION CALENDAR
July 1
August 6
September 6 (2)
October 5 (2)
November 6 (2)
December 6
January 6
February 7
March 5 (2)
April 9
May 6
June (+)
PRE-SEASON
CB
Int. break
Int. break
Int. break
Int. break
4. Are cold recovery techniques limiting the adaptations to training?

41. Always keeping the whole picture in mind
Post-match recovery strategies (nutrition,
rehydration, cold etc.)
Physical fitness
Players’ compliance (education)
Workload management
(rest days, squat rotation)

42. THANK YOU
FOR YOUR
ATTENTION
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Conference of the Belgium Football Doctors & Associates | October 2019
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