2. Recovery versus Adaptation - podcast episode cover

2. Recovery versus Adaptation

Jun 01, 202045 minSeason 1Ep. 2
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Episode description

The concepts of "recovery" and "adaptation" are often confused by athletes and coaches alike.  Though not mutually exclusive, optimizing for one will often lead to a decline in the other.  In this episode, we talk about when to target recovery, when to aim for adaptation, and how to ensure you do this successfully.

Transcript

Dr. Sprouse

Welcome to The Podium, the podcast about optimal health and high-performance. I'm Dr. Kevin Sprouse. This discussion was created as a resource for the patients in my practice, where I have the pleasure of working with a very small group of professional athletes and high performing individuals from around the world. So why podium? Well, it represents the pinnacle.

The winner of any race takes their place atop of the podium, much as any expert in their field is often asked to share their wisdom and present from the podium. For me, it represents the intersection of athletic and cognitive performance. Our podcast dissects the principles of performance for my patients, and then disseminates, pertinent, actionable information with them in mind. If you happen to have found us and are not a patient, that's great. I hope you enjoy.

Please understand if you're not a current patient, any information contained herein is not meant for you to take as medical advice. You need to speak with your doctor before implementing any change in your health and fitness regimen. There is no doctor patient relationship established via this podcast. For my patients, of course, that relationship already exists. Season 1 of The Podium is sponsored by The Feed.

The team at the The Feed is where I send all my athletes, whether they are pros racing the Tour de France or recreational athletes looking for better health. The Feed does their due diligence on curating products that have trusted ingredients and show real effectiveness and promoting health and optimal performance. Seriously, they're on the cutting edge of sports, nutrition, and always have something new to try or that old standby favorite that you love.

They have a wide selection of supplements, and there's no better place to shop for sports nutrition than The Feed, whether you're an aspiring Olympian or a weekend warrior, The Feed has a team of experts to answer all of your training and nutrition questions, visit them@thefeed.com.

Patrick

Hello, and welcome to another episode of The Podium. I am Patrick Morris and I am here today with Dr. Kevin Sprouse.

Dr. Sprouse

Hello!

Patrick

Today we are going to be talking about recovery versus adaptation. These two terms are very popular and very confused with each other sometimes - your day-to-day recovery is going to look a lot different than the goal of adaptation coming from an exercise program. I'm going to give the mike over to Kevin and let him talk about the difference in these two definitions as it relates to our conversation, as well as the sports medicine literature.

Dr. Sprouse

I think a lot of people use the term recovery to be a blanket term for anything post-workout. In reality, there's the process of recovery and there's a process of adaptation. A lot of times people say 'recovery' when they mean 'adaptation'. Less frequently, but sometimes they say 'adaptation' when they mean 'recovery'.

What we're going to do today is tease out the differences in the two, because in understanding those differences, we will then see that you have to do slightly different things to encourage one or the other. Sometimes recovering and adaptation happen at the same time. They coincide and frequently what leads to the best recovery is perhaps counterproductive toward adaptation, and what leads to the greatest amount of adaptation is counterproductive to recovery.

So I think it's important that we untie those two concepts.

Patrick

Absolutely. So let's take a first look at adaptation , much different to the definition and kind of the way that recovery is used, as you said, I'm guilty of it. And in previous episodes talking about recovery in that blanket terminology way, but you don't hear, as people say, 'Oh, I'm adapting right now.' Supplements aren't like, 'Hey, boost your adaptation.'

Dr. Sprouse

Right. And I think that's ok. I think I'm guilty of it. And we'll probably continue to be guilty of it. What's important is that, even if we're using terms in certain ways, and it's frequent that we talk about something as recovery, that we understand the underlying processes and set things up appropriately. So adaptation , is really that process by which your body makes changes and accommodates to a given challenge or environment so that it becomes fitter.

That's the real key - over a period of time, your body is adapting and making changes so that the next time it encounters the same stress or environment, it is better suited to handle hat's really what the heart of fitness is. It's challenging yourself so that your body does make those adaptations to improve.

Patrick

You give yourself a stress, you reply to that stress. And ideally next time you're able to reply in a different way or be able to take on more stress and compensate and improve your ability to keep performing.

Dr. Sprouse

Yes and this occurs over time. It's not an overnight process. It's something that you build up a training load or a cumulative stimulus, and over time your body responds to that and gets fitter, ideally.

Patrick

Let's look at the other point - recovery. When we think about recovery, how are we going to describe that?

Dr. Sprouse

I think of recovery more as a day to day or exercise session to session process that's going on. It's basically getting through a given stressor, which in the confines of this conversation is an exercise session, a training session, an event, a competition, but it's getting through a defined period of time where you're stressing the body and then getting back to a baseline point where you can go again. Right? So recovery is in this type of definition, a much shorter term process.

It happens over the course of hours overnight , maybe a week to recover from a very hard training block, but it's time limited. It's not something where like with adaptation, we're looking at this process being ongoing over the course of days, weeks, months. Recovery is a bit more of a short term process to get you to the next start line.

Patrick

And we're definitely looking at it in the sense of, so I've had a big workout - what is my goal with that? Am I trying to wake up the next day and be able to put out that same effort, or am I looking to get up the next day, continue to build, and then have an event in 6-12 weeks that I'm trying to peak for. So, kind of looking at when we want to focus on adaptation and when we want to focus on recovery.

Dr. Sprouse

Right. In a multi-stage event, like the Tour de France, the goal is not to get better from the first stage to the last stage in Paris. It may happen a little bit, but the goal is really to recover day to day and get to the start line the next day in as best shape as possible to address that day's challenges. Adaptation is when that is the primary goal. It's a bigger picture. Now it's not to say these two things can't happen simultaneously. They often do.

And you can be in a big training block with a goal toward creating a big stimulus and adapting long- term, and you're still going to want to recover day to day. But there are some things that you may do that encourage one process , preferentially over the other. We want to make sure when we encounter those situations, that we're making the right choice to get the most bang for our buck with respect to our goal for that day.

Patrick

All right. So with that in mind, we'll start off looking at when adaptation is the goal and the main focus of our training efforts. What's that going to look like?

Dr. Sprouse

Typically when you're really focusing on adaptation, whether you're doing that consciously or not , you're looking at a block of training where you are trying to move the needle with respect to your fitness. So it may be a three or four week block of training where in typical periodization, the first week's hard, second week's harder. The third week is really hard. You've got this build with this prescribed goal of making it.

So at the end of week four, you are fitter than you were at the beginning of week one. So it's a longer process, usually reserved for training as opposed to competition.

Patrick

We're not looking to, like you said, gain a whole lot of fitness over a three week stage race, but for most of us, we're looking at this as: I have six months, I have three building blocks where I'm trying to dig a little bit deeper, training volume goes up each week, the intensity goes up each week, and then we're going to try to create a stimulus enough to where we trigger our body to adapt.

That's the goal of your training - to create enough stress, enough load on the body, to w here a lot of these mechanisms are going to start taking place. So, how is it that we do that?

Dr. Sprouse

It's really by overloading. The idea is that you take your body's capability on day one and you start to stress it beyond its capability, you're overloading or overreaching, what its limits truly are. By doing that, what we're looking to do is something called functional overreaching.

This idea of pushing the body a little bit further than it's able to do, and then backing off and allowing it to make the changes so it recognizes that, wow, that was really hard and we weren't suited to handle that. We better make sure to change so the next time we encounter this, we're ready for it. There is a process where you push a little bit beyond capability, then back off and let the body do its thing to adapt.

If your training plan never really pushes you beyond what you're capable of doing, you'll never do more than you currently can do. You have to push it and signal that you need the body to get stronger, fitter, better. It's this process of what we call super compensation. That's really at the heart of adaptation - pushing hard, backing off, pushing hard for a long period of time.

Not just one day, pushing hard, backing off, allowing super compensation to take place so that next time you go again, you're fitter and ready to push even harder.

Patrick

This is all definitely looking at it with a long-term view. We're talking about those week blocks, month blocks, your annual training plan and what that looks like. So that when you're in an adaptation phase of some sort you've dug in, you've created that stimulus, you've overreached in your training. Then you're going to try to super compensate.

So, say we've hit week four of our training block and our volume backs down, say we went 7, 8, 9 hours and then we're going to come back down to 6 or 7 hours for that next week. What are some ways that we can really maximize that week when we're still training, we're still putting out effort, but we want to make sure that our body is able to adapt and be able to keep improving the way that we want it to.

Dr. Sprouse

If you have that week, you've got a steady build and then you've got a week that backs it off a little bit to really encourage adaptation. If you take that week and have all kinds of other stressors in your life, you're shooting yourself in the foot. You really need to back it off, focus on things like sleep and appropriate diet - give your body what it needs for these processes to take place. Sleep is a huge one.

If you are not getting adequate sleep, then your body doesn't go through the hormonal and anabolic processes that really allow you to build up. Night is when growth hormones release, testosterone , all those things that you think of as being kind of muscle building. And it doesn't mean that you're going to get necessarily bigger hypertrophy, but repair and super compensate. So sleep is hugely important.

If you were to spend three weeks training really hard and then have a week off, but say, 'I'm not really training this week. I'm going to stay up and binge watch Netflix and and get 5 - 5 1/2 hours of sleep each night.' Then , you're really being counterproductive with respect to all the training you've put into that point. Diet is also huge. By the same token, your body has to have the fuel, the building blocks the components it needs to really build and adapt to the training.

And if you've done three big weeks of training and you hit a week where you're not training that hard and you say, 'Oh, well , I'm not training this week. I'm going to either slack off on the diet and eat a bunch of crap' or more likely, 'I've got to dial the calories way back', worried about putting on weight or anything like that. You're also setting yourself up to be less productive with regard to that super compensation.

Patrick

Absolutely. And that's a big one you mentioned there with dialing your calories back - when you're out there and you're getting those big training weeks and you're adding an extra 500 to 1000 calories a day in intake because of what you're burning. Then you come into that week when it's a little bit lighter. Certainly you need to approach that and assess - bring some things down - but you also have to realize your body is still in somewhat of a depleted state.

So it's important to, as we've talked about in other episodes, keep your protein up, eat a balanced diet, good nutrition. Approach it the same way you would if you were trying to have a really big training week and focus on getting out and hitting those big rides because that's what you're trying to get your body to do. There's no reason to slack off on that or use it as an excuse to stay up late or have a few extra pieces of pizza.

Obviously relax and enjoy yourself because stress is super important and finding ways to minimize the stress outside of your training environment is key, but also keeping in mind that you still have a goal of improving for the longterm through this adaptation process. So you don't want to mitigate that by saying, 'Oh, I'm on a rest week. I'm just going to throw caution to the wind.'.

Dr. Sprouse

And just to be clear too , this isn't only important in that rest week. The whole build, every part of it - sleep, diet, etc - hugely important. You've got to give your body the chance to respond to training stress and to adapt.

There's some other things that you can do as well to kind of trigger these processes - cold exposure, heat exposure - those types of things that further stress the body and may lead to hormonal responses, release of things like heat shock proteins, that (without getting into the minutia on the science ,) these are strategies that you can use to encourage and push the adaptation process so that you get as much as you can out of that training.

But I wouldn't go down those tracks before you first, make sure that you've got your sleep and diet kind of nailed. Again, like we're talking about today, understanding that the purpose of this part of your training is adaptation, and we'll look at recovery next, and not getting the two confused.

Patrick

Sleep is one that definitely runs independent of both adaptation rand ecovery. We're never going to advise you to get less sleep.

Dr. Sprouse

Right. You've got to sleep!

Patrick

That is going to remain constant. We'll also add some resources if you're interested in learning a little bit more about heat, shock proteins and things like that. There's a lot out there as it's become more popular and I think it's a really interesting topic to dive into, but it gets pretty granular pretty quick. So looking at adaptation, what are some ways that we can blunt the effects of those hard workouts throughout the week and throughout these phases of training?

Dr. Sprouse

When you talk about blunting the effects, just to be clear, what we're talking about is making the training less effective, not getting your bang for the buck, so to speak. So these are bad things, right? But they're bad in terms of effectiveness with regard to your trainer, with respect to your training. But they're common, so that's why we want to bring them up. There are things that people do all the time that potentially are problematic.

One is intake of antiinflammatory, medications: , Ibuprofen , Naproxen , etc which are fairly common among athletes. You get aches and pains and, fairly common to reach for the bottle of Ibuprofen, but there's numerous studies that show that intake of those t ype of medications and chemicals really decrease the signaling that stimulates your body to respond to exercise. I think there's some grasp on that now that athletes know that they shouldn't be just hitting the Ibuprofen all the time.

One that is a little newer to some people listening to this, is the idea that antioxidants may have a similar effect. We've been taught for years t hat antioxidants are beneficial for athletes. It goes back to this whole idea that when you exercise, muscles that are contracting - especially muscles that are contracting at levels to respond to higher intensity activities - produce reactive oxygen species, or what we know as free radicals.

They also produce reactive nitrogen species, which we don't hear quite as much about, but fall in the same category for this discussion. So, you exercise, you have a little bit of muscle damage, your body releases these free radicals. There's been this idea that we need to potentially take antioxidants to knock those down a nd get rid of those free radicals, let things recover very quickly, and that's going t o be beneficial to health and fitness.

What we've seen in probably the last 5-10 years are more and more studies that call that into question. These studies seem to show that these reactive oxygen species that we've always thought of as being kind of bad players in the whole physiologic paradigm actually work as signaling molecules, and they tell your body that you've just encountered this big exercise stress and that you need to adapt to get better at it for next time you face it.

If you get rid of that signal on the front end really quickly, then there's evidence that you may not get as much fitness as a result of your workout t han you would, if you just let that free, radical release burn for a little while and do a signaling job.

Patrick

I think it's been really interesting to see how a lot of products have shifted as the research has been pushing this direction. You used to see a lot of post-workout supplements and things like that, loaded with various antioxidants that may work, may not work, some things that we know work. The though was that you've got to immediately boost your recovery. You've got to get in there and knock these free radicals out of your system.

Now that we understand a little bit more about what's actually happening, you really don't want to remove that stress from your body because that's the whole goal of your activity. Even if it's one less interval that - not at all scientifically equated to something - but you're pushing through those last intervals and that training response and that training stimulus. So even if you're negating the effect of one of those there's no purpose in doing that.

Dr. Sprouse

If you're going to put yourself through that , and it's fun too , but if you push yourself to the point that you're cross-eyed and about to vomit , why would you not want to get the full benefit of that?

To be fair in this topic, there are some studies that suggest that maybe antioxidants don't have this effect , but more and more studies that are coming out at least raise enough concern that there's probably some effect of what we call blunting the training effect, which is making it so you don't get all the effect from your training. It stands to reason that we should be setting things up to account for this potential downside.

And again, it's not like your workout becomes useless, but again, if you can get more of an effect by just changing a little bit in what you do dietarily, I don't see the downside and and moving that direction.

Patrick

Even if it's half of a percent or 1%, it can create a massive change for sure. One caveat, we actually had a discussion about this with a product that had an antioxidant after we had talked about this episode and I asked you about it - it's Glutathione. I thought, 'this is interesting.' I know you believe in this product, you gave it to me and suggested it, but what is it about this product when we've been talking about the downsides of these antioxidants? They aren't all created equal.

Dr. Sprouse

It's true. Even within the body, there are different types of antioxidants that serve different roles in terms of what they do intracellularly. So Glutathione is one of the body's primary indogenous or internally made antioxidants. And it is one that some studies suggest taking after a training session. It does not have the same blunting of the training and effect that we might see with say vitamin E or vitamin C or more of these typical exogenous or externally created antioxidants.

So again, there's no one study to point to and say, this is right, this is wrong, but there's reason to think that if you're going to build some strategies on this Glutathione, maybe one that can fall in the mix after training without much detriment where high dose of vitamin C, probably not.

One of the things that we see in terms of a mechanistic reason for these things happening is in studies where athletes take higher levels of vitamin E or C, or carotinoids (like beta carotene , different known exogenous or externally produced antioxidants) is we'll see a decrease in the number of mitochondria that are generated in response to exercise. So mitochondria are the little energy factories in the cell.

All things being equal, you'd like to have as many well-functioning mitochondria as possible. So your body will produce fewer of those and the ones you do produce will be smaller. We see that with vitamin C with Ibuprofen - those things that tend to blunt that signal. The studies that look at glutathione, and then also n-acetylcysteine (NAC), which is a dietary precursor of glutathione , have not shown that same effect.

And some studies with NAC, there's one study with cyclists in particular, that show taking NAC prior to - or even during - a training session, a time trial, made them i ncrease their performance. So this is not a clear cut topic in terms of what is absolutely right and what's absolutely wrong.

Instead how we want to look at it is, we see that s ome t hings fall in a bucket that probably are best used in a timeframe that's far away from exercise - so hours and hours before or after, and some might have a role right around exercise. That's where we want to go with i t. Thanks again, to The Feed, our sponsor for season one of The Podium. If you've not yet checked out all the foods , supplements and recovery tools available on The Feed, head over there.

Now as you know, sponsorship of this podcast is limited only to companies, I already recommend to patients and know will be of benefit to them. The Feed is a fantastic source for so many of the things that will help you excel throughout your day. And they're always finding new foods, supplements, and tools to try. Go to thefeed.com and check out all they have to offer .

Patrick

Stepping away from adaptation, let's look at recovery and when that's going to be the goal, say we're doing The Tour de France or the Haute route or something, where we have several days in a row we need to not necessarily be increasing the stimulus, but we need to be at our best each and every day.

Dr. Sprouse

I think this can even apply to cognitively at work. If you've got a big week at work, you want to make sure that every day you're coming in at your best. If you're a golfer, those of you on the PGA, you've got four days each week where you want to make sure that each day you're just as good as the day before, that you're not having declining performance.

So that's what we're talking about when we're looking at recovery - your fitness is what it is coming into these events, and recovery gets you back to baseline each day. The processes involved with this are numerous and involves sleep. It involves diet. It can involve some muscular treatments, massage compression and things like that. It's across the board in terms of what gets you to the starting line feeling good , the next day. I'd say one of the most important is glycogen repletion.

So the glycogen is stored and carbohydrate is the fuel tank, so to speak. We know that if athletes continue to have declining fuel stores, day after day after day , there may be an appropriate adaptation response to that, but in terms of recovery day-to-day, you're not going to get your best effort on subsequent days.

Patrick

We've actually talked about trying to empty that tank a little bit and then operating with a slightly under-fueled state in some of these different techniques, but in terms of trying to maximize recovery, your goal is to never have a fully empty tank or to let it get below three quarters.

You're not supposed to do that anyway, but typically I let mine get down to heat before I go to refill at the gas station, but if we're trying to keep everything running at an optimal level, we want everything to be right where it needs to be.

Dr. Sprouse

During those recovery times, it's really important that you finish a workout, finished the day's event and you make sure that you start that dietary recovery process immediately. So it's carbohydrates , right off the bat, some proteins, getting in some real food. But that's not the time to skimp on it and maybe say, 'Oh, well, I just finished. I'm tired. I'm actually not terribly hungry.

I'm going to have a little water, I'll take a shower and get a massage, and then I'll eat later.' That's, that's a bad strategy for recovery.

Patrick

Especially as it pertains to some of these events that we've talked about. I know it's very easy to hang around after, and maybe even dip into having a few beers, but having a little bit of alcohol can blunt the recovery effects , outside of even just disturbing sleep and things like that.

Dr. Sprouse

Sleep is a, it's a fantastic thing to talk about with respect to recovery. So many things happen overnight with muscle repair, with hormonal processes that are necessary for recovery and regeneration of energy for the next day, that if you don't sleep well, you may get away with that for a day or two. And if you have a bad night's sleep you don't necessarily have to catastrophize that, but if you're repeatedly not sleeping well, recovery will just tank.

Like you said earlier, sleep is crucial to both adaptation and recovery, and it's something you cannot skimp on.

Patrick

It's definitely tough for a lot of our athletes who travel. L ike a lot of the guys, the P GA golfers, you're staying in a hotel, you're in a different house and there's all kinds of different stimuli that can influence how you sleep, - s ponsorship requirements, things that you have to do after day. So really focusing on having that good sleep hygiene is going to be good.

And we'll get more into that in another episode later on, but just knowing that you have a practice routine to really come into that recovery period, and you're really g oing t o boost it as best you can.

Dr. Sprouse

We've talked about , different modalities or tools that you can use for recovery. Compression , massage, percussion massage devices, ice baths, sauna - the list goes on and on and on. The scientific evidence for these things isn't great. You can find studies here and there to support them. You can find a lot that are kind of ambiguous with regard to their outcome. Across the board, what we see is their subjective benefit. In other words, athletes like them.

Anybody who's used this stuff knows that whether it's compression legs or anything that I was talking about, is that they feel good. And usually you feel better the next day for having done it. It's hard to tease that out objectively in a study. I actually looked at this during my fellowship awhile back and did a study to see if we could tease out what variables we should be looking at. We looked at core body temperature , return of heart rate, back to baseline, return of lactate to baseline.

We looked at muscle damage proteins and really couldn't find anything that was objectively noticeable using one of these things versus not using it. But honestly, I think we just don't know yet what to measure because anyone who's used them knows that there's some benefit there. It's hard to put your finger on it. It's hard to say exactly what it is, but these things help. Sometimes i t's different devices help different people, but they are worth trying.

And I do think there's a benefit day to day with using some of these recovery devices.

Patrick

I love compression boots. They might do nothing for me, but I think my legs feel better. And then the next day I'm like, 'alright, my legs felt good.' So, what does it matter if it's a little bit of placebo? It's pretty powerful.

Dr. Sprouse

And some of that soreness and muscle damage potentially is coming from these reactive oxygen species that we were talking about previously. This is a time, during a recovery stage or an event where you're going to have efforts day-to-day-to-day, where antioxidants make a lot of sense.

The same thing that we would say during an adaptation phase - don't take an antioxidant with vitamin E or vitamin C right after you finish a workout - this is a time where it might make a lot of sense to have some of that in your supplementation regimen.

Patrick

Boosting up those antioxidant supplements can be great during that recovery phase and that comes back to getting the foods that have alot of natural antioxidants. Eating that nice balanced diet, getting your greens and your fruits and things like that after your workout are going to make a huge difference. If you're filling yourself up with good stuff, you're going to have a much higher ability to recover the next day.

Dr. Sprouse

I'm glad you brought up foods because this isn't just about supplements. Foods are an excellent source of antioxidants. I really think that what we're talking about primarily - with respect to blunting the training effect and whether to use them during a period of adaptation and recovery and when it works best - we're really talking about supplemental, unnatural, large concentrated doses of antioxidants.

So during an adaptation period, you should still eat your spinach and your citrus fruit, and whole unprocessed foods are still a good thing. Don't forget about those. What I think is important to remember is that utilization of supplementary antioxidants in a capsule or liquid or anything else - any bottle that you're opening - that's when you want to be a little bit careful about when you use those things.

Patrick

Let's say we're not living in a perfect world and we've really done a number on our recovery and we're declining. What do you think is going on?

Dr. Sprouse

It's multifactorial. If there's muscle damage on a microscopic level, there's a hormonal dysregulation - what we call the HPA axis. It's probably impacting your sleep, which sleep can be the chicken or the egg in this scenario. We know that athletes who are over-trained sleep more poorly. Now certainly poor sleep will predispose to poor recovery and over-training , but even when those things are controlled fo,r just a high training load actually makes it harder to sleep a lot of times.

So it's not that there's one thing going on. It's not, there's one process we have to address. It's really taking more of a global picture and seeing how we can set things up to recover better. In a period of adaptation, we also don't want to over push or reach beyond the point that it's functional. We actually have a term for nonfunctional overreaching where you've gone too far. If you find yourself in a period of adaptation and you're going too far, maybe you're starting to get sick.

You're having a hard time waking up in the morning. You don't want to do the workout. That's a time where it's okay to switch from adaptation to recovery and say, 'Ok, I pushed the envelope a bit too far for whatever reason.

I'm not waking up ready to attack the day, and it's time to switch the focus back to recovery.' I think the big take-home is really recognizing where you are in a training plan - what your goal is for a given day, week, month - and make sure that you set things up appropriately to address that.

Patrick

Looking at alot of the wearable devices out there now and how they produce a recovery score, a day readiness score, whatever it might be, what are the key takeaways that you would use to figure out how you're doing? For example, the subjective - I feel good, but my metrics say that I'm not doing well or the opposite - I don't feel good, but my metrics are good. How do we discern when to keep pushing, when to dial it back or when we might need to focus on improving some of these techniques?

Dr. Sprouse

I think having some of these tools is incredible. I love, I being able to dig into the data from Oura ring and Whoop. There are some other ones out there, but I'd say those are the big two at the moment. What I don't like on any of them is the algorithm-derived recovery score or readiness score because you don't really know how they're weighting things or how the various inputs are impacting that score. So, I'm not a huge fan of that. I glance at it.

You can see some trends, but what I really like to pay attention to is: resting heart rate and it's variation from baseline and heart rate variability and it's variation from baseline. Then you can start to get a little more granular with things like deep sleep , skin temperature.

On the Oura ring there are inputs that can help you decipher these things, but if you want to keep it pretty simple, looking at a resting heart rate and a heart rate variability score can be a good objective component to your daily assessment. It doesn't mean that you need to just forget about your subjective - how do you feel going into a day - but it can be another input there to help confirm how you're feeling.

Alot of times we have patients who have a given workout plan and they wake up - they don't feel great, but they feel like they're giving up if they don't go do their workout; however, if they see their heart rate variability is cut in half, then they know, what they're feeling is real and today's not the day to do this workout. So, sometimes it can just be a good reminder or lend credence to how you feel.

On other days, if you're not quite sure and training load is getting really high but you look at your heart rate variability and again its cut in half, or it's been declining for three days, then that's probably a day to use that as rationale to back it off for a little while.

Patrick

I know I pay a lot attention to my resting heart rate, especially as it pertains to some of my potentially poor dietary choices. If it's an evening where I've been out and I had one too many IPAs and it'll get really high, but I know what caused that. While I've limited some of my recovery, have maybe blunted some training response, I'm still happy to go out and try to get my efforts in.

I think this is something that's interesting as you move away from a recreational athlete like me into someone like our professionals. You have much more of a grasp on the value of the big picture of your training goals, and that it's okay if one day you're not out there sending 100% effort, just crushing your workout, flogging yourself.

You understand that if I take it back today, I'm going to get three days of better workouts, as opposed to digging that hole a little bit deeper and then completely putting yourself off down the road. Having a grasp on that big picture of your goals and how your training block is developing i s really important.

Dr. Sprouse

I think that's a great point. The big picture is really what is most important. If we look at all this and try to figure out how we want to make sure that in the big picture we are supporting the process that we're going for at the time, whether that's recovery or adaptation, I think there's a few things that we need to look at. One - diet and sleep. Those are pretty steady.

We want to make sure - whatever our goal - that we're sleeping appropriately, that we're eating well and that we're monitoring metrics like you were talking about - looking at resting heart rate, heart rate variability, and just make sure that we've got a handle on how things are moving. We can look at massage bodywork - using things like that to really address the recovery component.

It doesn't mean that it won't have a role during an adaptation phases as well but since we all don't have the resources to get a massage every week or twice a week, save that for the times where you're really looking to recover and have that as part of your strategy there, looking at adaptation a bit differently. Then when we look at supplemental antioxidants, I think there's a big distinction here as to how they're best used in a recovery phase.

You can use supplemental antioxidants around your exercise much more closely. So you may take a morning multivitamin and then go out and do your training. You may even take a post-workout supplement that's got antioxidants in it, whether that's something like vitamin C or quercitin or any number of things that you may not want to do during an adaptive phase. During the adaptive phase, you may take a morning multivitamin and then wait three, four, six hours before you train.

Then when you finish training, wait another four to six hours before you take any kind of supplemental antioxidant . So you're still taking it and not huge doses, but you can still take these things in a multi or whatever else, especially if we've determined through bloodwork and similar that you need those things, but you're taking it spaced out from the activity. You give your body a chance to have that stress, start to respond to that stress.

Some of those processes take place before you're throwing a whole bunch of antioxidants in the mix. It's really taking a step back thinking about your activities, thinking about your goals and making sure that those things align.

Patrick

Excellent. That's alot of good, actionable advice as to understanding the goal of your training, where you are, and the best ways to maximize, whether you're trying to recover, get out the next day and be at your peak performance, or if you're trying to generate some of that adaptation by maybe digging a hole a little bit deeper and then bouncing back a little bit stronger.

Dr. Sprouse

Thanks, Patrick. I think this was a good conversation and a topic that often comes up with patients. I hope that it's one that everybody finds useful, informative and maybe generates some questions. Of course, if you do listen to this and questions arise, reach out to us - we'll be happy to sit down and talk through it with you and see if we can help come up with a strategy that really suits what you're doing at the moment in relation to your goals.

The content of this podcast is meant for general informational and educational purposes only. All listeners should speak with their doctor or medical practitioner before implementing any change in their health care regimen. If you're currently a patient at Podium, then you have an established doctor patient relationship with me, and I'm happy to discuss this with you.

If you're not currently a patient of Podium, nothing in this recording establishes a doctor, patient relationship between us, nor does it constitute the practice of medicine or the dissemination of medical advice. Should you implement any information contained herein without consulting your own physician, you do so at your own risk. Thanks for listening to The Podium. To hear more, be sure to subscribe wherever you get your podcasts. You can also follow us on Instagram and Strava.

Until next time, thanks for joining us.

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