48-72 hours.

This is roughly the amount of time it takes for our body to downregulate protein synthesis after an acute bout of intense exercise. Arguably, this is the most important marker we have to measure recovery. It’s an incredibly useful timeframe to keep in mind when we are thinking about how long we should wait between intense activities.

With this said, there are many other key factors involved in an effective recovery. There are more systems at play than just our muscular system & our tissues that are governed by protein synthesis (i.e. nervous system, deeper connective tissue, physiological system etc.). What’s more, is that most people don’t really work at a level intense enough to create an adaptive stimulus that requires a full 72 hours of recovery. This is to say that a lot of people would probably benefit from doing some lighter forms of activity more frequently, coupled with their intense work.

To illustrate this further, let’s think back to the levels concept outlined in our last article. For the purposes of this analogy, we will say that it takes anywhere from 20-100 sessions for someone to effectively progress up a functional level (keep in mind that this figure is based purely on our own clinical experience & is arbitrarily based on someone’s relative functional ability). If it takes a full 48-72 hrs hours to properly recover & adapt from our bouts of exercise (generally speaking), then this means we are looking at anywhere from 6-12 weeks at a minimum to move up a level. This is at the lowest levels of the functional spectrum (i.e. levels 1-5). When we get to the higher levels of this spectrum, it becomes exponentially harder to move up a level as per the law of diminishing returns (we’re dealing with limited biological systems at the end of the day).

“We would go as far as to say that arguably the biggest thing that stops most people achieving the results they want out of exercise & rehabilitation is having unrealistic expectations for their recovery”

A nice guide to the various levels that we like to use in our clinic can be found at the bottom of this page. Using the various levels & the descriptions listed can help to give you an idea of where you’re at & where you can get to. You can then use the guide above to give yourself a rough timeframe.

By thinking of things in this way, we can start to give ourselves a more realistic estimation of the timeline required for adaptation (i.e. decreases in pain, improvement of our condition, increases in muscle mass etc.). We would go as far as to say that arguably the biggest thing that stops most people achieving the results they want out of exercise & rehabilitation is having unrealistic expectations for their recovery. Because we’re dealing with our human body, something that is constantly adapting to whatever we do (or don’t do) and can easily last for up to 100+ years, we have to keep the long term in mind.

We should be thinking about how we can make progress over the next 50 years, instead of giving up because we can’t make the progress we want in 6 weeks. 

To help further give context to this idea of realistic timeframes is to divide the amount of time we have been struggling with an issue by half. When we do this, we can start to get a realistic look at how long it might take to cause our body to adapt enough in order to free ourselves from a particular movement issue, ache or pain. Our body adapts to pain & injury over time, so if we have had an issue for a certain amount of time, then we have been slowly adapting to this issue more and more (check out the video below to see how this plays out through a visual representation). The longer we struggle with that issue, the longer it can take to climb out. It certainly doesn’t always take this long, but by keeping this in mind, we can prevent ourselves from waving the white flag too soon, setting ourselves up for success over the long term!

4 Simple Tips For Recovery 

Why is recovery so important?

1. Better progression
2. Reduced pain
3. Increased mobility
4. The best possible results from the effort you are putting in

1. Nutrition
2. Hydration
3. Sleep
4. Movement

1. NUTRITION

To strengthen your muscles, replenish your energy levels, and recover your connective tissues, you need adequate and efficient fuel sources.

• Pre-exercise: 1-4hrs prior to activity
  • Consume carbohydrate prior to exercise eg. wholegrain cereal, banana etc.
  • Avoid attending on an empty stomach

• Post-exercise: 15mins-60mins following exercise
  • Consume a high protein snack or meal within 15-60mins of finishing your exercise to maximise muscle recovery

We also recommend that our patients who struggle with OA consider weight management & lifestyle options such as Healthy Weight For Life. This program is offered up at absolutely no out of pocket costs for OA sufferers with a BMI > 28 & can help significantly with the lifestyle factors associated with osteoarthritis. As weight management is one of the biggest factors shown in the research to impact upon OA, this aspect of nutrition & lifestyle is critical to dial in. If this is something you would like to explore, please reach out to us & we will set you up with the program.

We have tonnes of great resources regarding nutrition from experts in the field in our Facebook Group (Check out the UNITS tab in the group for the section on nutrition) & will be happy to answer any questions you may have about nutrition (simply message our Facebook page & we will answer them for you, or find one of the experts in our network who will).

2. HYDRATION

Water is essential for life! Most people are quite under-hydrated. When it comes to pain and OA, maintaining hydration can significantly improve recovery and reduce pain.

• Drink a glass of water before bed.
• Keep a glass beside bed and drink as soon as you get up.
• Set a water reminder on your phone to go off every 2hrs.
• Consume 1 full glass of water during and immediately after your exercise sessions.
• If you dislike water, add sugar-free flavoured tea or a splash of juice to your glass.

3. SLEEP

Sleep comes easily to some but not for others. As we get older our sleep hours become shorter and more interrupted. Sleeping is the bodies repair and recovery time. If you’re new to exercise, you might factor in extra sleep to get the most out of your sessions.

Remember! Quality is just as important as quantity!

Here are some tips to maximise your sleep:

• Don’t look at rear-lit screens for at least 30mins prior to sleeping. A good way to set this habit is to read a book before you sleep!
• Shut out excess light – darker is better (provided you can safely get out of bed as required).
• Schedule yourself a mini nap during the day but limit this to 30mins so you don’t fall into multiple sleep cycles – this might make you feel sleepier!
• Incorporate Nutrition and Hydration tips above!

4. MOVEMENT

Your body is building up stress throughout the day. You find yourself in awkward positions getting in and out of a car, picking up or moving things that are unevenly weighted, or navigating unexpected obstacles.

The more you can apply the practices and positions we teach you in your exercise program to your everyday activities, the less irritated your joints will be and the better your recovery will be too!

How to improve your daily movement:

• Keep your shins vertical when you sit and stand
• Don’t let your knee collapse inward when stepping
• Avoid staying sedentary for extended periods (move around every 30mins of sitting)

• Do simple stretches that are no more than a 5/10 intensity.
• Hold each stretch for 30-60 seconds.
• Theragun, Foam roll or apply a lacrosse ball to tight spots.
  • Pro Tip: Apply maximal pressure when rolling back toward the heart and lower pressure when rolling away to promote better bloodflow to the affected area.

Consider your activity outside of the gym 

Another area that often goes unthought of is the activity that we’re doing outside the gym. Often, people that come to see us have stopped doing many of the things they usually do outside the gym due to concerns that it will make their condition/pain worse. This is a bit of a misnomer, as what we do outside the gym is the biggest thing that helps keep us healthy. Everything that we do inside the gym is designed to facilitate everything else we do in our life.

The sooner you can get back to doing the activities that you love doing, the sooner your condition will improve.

This is an incredibly important message to be accross. Everything we do in the knee & hip program is designed to get you back to your favourite activties. It doesn’t matter where you’re at now, you can get back to doing virtually anything. All it takes is time to adapt (hence the start of this article). Check out one of our examples HERE.

A great way to slowly progress back into doing the thigs that you love is to consider the concepts of load management outlined below. Essentially, using pain as our guide can help to manage our body’s tolerance for load & over time allow our tissues to adapt to being able to do our favourite activities again. Progressing slowly over time (i.e. 10% total volume per week) can make sure we don’t overdo things. The key to this is making sure we effectively measure what we are doing, while also understanding exactly what level we need to work at in order to stay below a 4/10 pain (This should increase slowly over time). When this is coupled with effective strength & movement training, we can make huge leaps in terms of our function & tissue strength. That’s not to mention our pain (keep in mind that pain is response of our brain to perceived threat & not necessarily indicative of damage).

A big problem for most people with this is progessing too fast!

So when applying this empowering concpet to your own life, make sure you know how to measure what you’re doing. We highly recommend speaking to your practitioner about this so they can give you some effective guidlines & things to be wary of.

Aside from that go for it! Get excited that you now have a plan to get back to doing everything you’ve always wanted, but never could because of you knee/ hip pain 🙂

Load Management Is Essentially a Simplified Way Of Capturing the Key Elements of Adaptation & Recovery

Happy recovery!

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