00:00
you

00:11
Hey everyone, it's Mikki here. You're listening to Mini mikkipedia on a Monday. And this Monday, I want to chat about recovery. Over the last couple of weekends, I have had really good friends and clients go and undertake some almost insurmountable challenge. On one hand, we've got people who have just completed Hawaii Ironman.

00:38
the world championship, the female race, that took place October 14th. And on the same day, we had the Taupō Ultra. So people undertaking 24, 50, 100 kilometer run, which is just amazing. Now, I have had the privilege to be a spectator at Hawaii Ironman. I will never do that.

01:04
and also have been a participant in the 50k at Taupo and it is a phenomenal race. But of course, with any of these ultra undertakings, there's a significant amount of recovery that also needs to take place because these types of events push people's bodies to the limits of their capabilities. So the athletes subject themselves to a significant amount of stress and it is important to consider the muscle damage,

01:32
the inflammation, the potential cardiac stress, and also the mental fatigue. And these are significant things that require an element of recovery from, and this is what I wanna chat about today. Now, the length of recovery for each athlete will vary depending on a range of factors. So you've got the severity of muscle damage is the first one. And not every athlete will experience the same degree of muscle damage.

02:02
You've got factors like training adaptation, pacing strategy, nutrition and hydration during the race can influence the extent of damage that occurs. And I'll chat about how to quantify damage in a minute, not that you necessarily would do that, but interesting to look at the biomarkers. Of course you've got training load. So athletes who have trained appropriately for the event and have conditioned their bodies for the demands of the event.

02:29
are much less likely to experience the same muscle damage as people that just get up and go right I'm going to run a marathon or I'm going to run an ultra. People who are have are underprepared. Now of course you never want to go into an event over cooked but to go into something that you haven't properly trained for not only does it make it a little bit miserable on the day it means that the amount of time taken to recover post event is going to be so much greater.

02:59
We've got to consider the post-race recovery strategies as well, like immediately after the race. Things like getting in proper nutrition, hydration, any potential cool down exercises, stretching, any sort of bodywork, ice baths or compression garments. These can facilitate faster recovery, even if the science doesn't necessarily support some of these tactics.

03:26
certainly can from a perception perspective make a difference to the athlete in question. Of course individual variability will always come into play just as individuals respond differently to training. They also recover at different rates. Genetics, age, overall health and previous injury history can all play a role here. And then also the type of damage. So is it that you've just got

03:54
delayed onset muscle soreness which typically peaks 24-72 hours post exercise and gradually subsides or is it some sort of more severe muscle injury and strains that take longer to heal as a consequence of doing the race? Nutrition and sleep obviously play a huge role following an event and I will chat about

04:23
maximise your ability to recover better. So not that I anticipate athletes will be running out for blood tests post their events under the usual conditions of recovery. I still think it's interesting to think about biomarkers that are related to muscle damage that can provide insights into the level of stress experienced by the skeletal muscle tissues. As I said, like if you are just generally recovering from your event,

04:51
and you're taking a usual amount of time to recover, you know, one to two weeks, probably not a major. However, if it has been several weeks since your event and you're still, or at least three weeks since your event and you still have significant soreness, it could be worth investigating some of these biomarkers. They can be detected in the blood after the event and they can increase obviously after that intense or prolonged.

05:20
physical activity. Some of the most commonly evaluated biomarkers would be creatine kinase or CK. So this is a primary marker for muscle damage and it's an enzyme found in the muscles. Its levels increase when there is muscle damage and it's typically observed to be the case after intense physical activities. Nothing abnormal about that still being raised post activity but several weeks down the line this is something to consider.

05:49
Lactate dehydrogenase or LDH is involved in the conversion of sugar to energy in cells and is present in many body tissues, mostly the heart, liver, kidneys, muscle, brain and lungs. Pretty much covers the gamete doesn't it? An increase in LDH can indicate general tissue damage including muscle damage. Now myoglobin isn't something that you, it's not routinely tested.

06:15
It is a protein that helps transport oxygen in muscle cells and when muscle damage occurs myoglobin is released into the bloodstream so it's going to be more obvious there. Alanine aminotransferase ALT and aspartate aminotransferase AST are enzymes primarily found in the liver but also located in skeletal muscles. Elevated levels can suggest muscle damage particularly under conditions such as these that we're talking about.

06:44
but then most commonly associated with liver injury. Traponin is primarily a marker of heart muscle damage and what you would find raised when someone has a heart attack, but intense endurance exercise can also lead to a transient increase in troponin levels. And C-reactive protein isn't a direct marker of muscle damage, but it is a marker of inflammation in the body.

07:09
and muscle damage can lead to that inflammatory response and elevate CRP levels. And ferritin is a marker related to iron storage, however it is also an acute phase reactant in response to inflammation as well. So this can also indicate an inflammatory process in the body and actually this is one of the reasons why you can't just rely on ferritin as a marker of iron when there is inflammation present. Which is

07:38
A side topic but worth remembering. What these biomarkers tell us is the extent of muscle damage. So elevated levels, especially of CK and myoglobin, can suggest the extent of muscle damage which can help athletes and clinicians gauge recovery needs and evaluate potential risks. For example, like rhabdomyolysis with very high myoglobulin levels. So rhabdo, it's commonly called.

08:07
It's actually a serious condition occurring when skeletal muscle tissue breaks down rapidly, releasing myoglobin into the bloodstream. Now, it can lead to kidney damage as the kidneys can struggle to filter the excessive myoglobin out of the blood. And the main symptoms of rhabdomyolysis include muscle pain and weakness, especially in the shoulders, thighs, or lower back. Dark or T-colored urine, a sign that the kidneys are trying to remove the excess myoglobin.

08:37
decreased urine output, signifying potential kidney involvement, and then general symptoms like fever, nausea, vomiting, confusion, agitation and rapid heartbeat. And outside of extreme physical exertion as to what you find with an Ironman or an ultra run, other things such as prolonged immobility, trauma or crush injuries, infections, and

09:07
electrolyte imbalance and toxins are all sort of risk factors or causes of rhabdomyolysis. And what makes it more likely, not that it's a common thing, but what makes it more likely in an ultra-event are things like dehydration, so not consuming enough fluids can elevate the risk, high temperatures and humidity can accelerate muscle breakdown,

09:36
and dehydration, inadequate training or preparation, so jumping into this event without that proper conditioning. If you've previously had rhabdomyolysis, you are at higher risk of getting it again, and of course pushing beyond your limit. So ignoring those signs of muscle pain or fatigue and continuing to push oneself can exacerbate that muscle breakdown. And also certain medications and supplements can also impact.

10:05
Things like statins, fibrates, which are another class of cholesterol-lowering drugs, antipsychotics, antiretroviral, some antihistamines, some antibiotics, some antidepressants, anesthetics, alcohol, heroin, cocaine, and amphetamines, just so you know. And also medications that interfere with temperature regulation can also increase your risk of rhabdomyelitis.

10:35
on a bit of a tangent here but just so you know. And from a supplement perspective, caffeine in very high doses, synthetic cannabinoids, bitter orange and certain herbal supplements. So just really be mindful of what you take in the lead up to your event to make sure that you're not placing yourself at unnecessary risk. But anyway that's sort of a tangent but I did just want to mention or go

11:05
What else do these biomarkers tell us? So I mentioned, of course, the extent of muscle damage, which is how I got on to Rabdo, and then the inflammatory response. So CRP certainly provides insights into the body's inflammatory response post exercise. Now, a CRP level of below one is considered normal and healthy, and a level above that does indicate some inflammation. And particularly after an event like this, you would obviously expect

11:35
inflammation to be present and that might be as high as 8, 10 or 12. And I wouldn't worry about that because it is actually just this normal process that's occurring because your inflammatory processes are part of your immune system, it's part of the healing process. And as I said, the other interesting thing these biomarkers can tell us is of course those potential complications such as what I was describing with rhabdomyelitis, which does require immediate medical attention.

12:05
So these will provide information on that aspect of damage. I did mention troponin as a marker of damage to the heart. And it's worth double clicking on this for a bit, as it's not often mentioned in the discussion of recovery, but it's important especially for athletes who participate in an event where there is considerable environmental stress, such as the Hawaii Ironman. As studies show that there are transient changes in the heart that does require recovery.

12:36
So it's not uncommon for athletes to show elevated levels of these cardiac biomarkers. It's also worth noting that you can get transient cardiac dysfunction. So some studies have shown a temporary reduction in right and left ventricular function post endurance events. This is typically assessed via echocardiography. The right ventricle which pumps blood to the lungs may be more affected than the left ventricle which pumps blood to the rest of the body.

13:06
but fortunately these are typically temporary and resolve within a week. There's also an element of cardiac remodeling and swelling. Though swelling might not be the most accurate description, there is evidence of that remodeling, so structural changes in the heart chambers in response to prolonged endurance training. And this is often considered a normal adaptation to the increased demands placed on the heart.

13:32
However, immediately after an event, some degree of dilation or enlargement of the right ventricle has been observed, but again typically this will return to baseline within a week. It is worth noting that there is an element of risk for athletes over 35 around atrial fibrillation, a common irregular heart rhythm which appears to be more prevalent in long-term endurance athletes.

13:59
and the exact mechanisms aren't entirely clear. It is believed to be a combination of the heart's structural changes, the autonomic nervous system alterations, and inflammation. And athletes participating in extreme endurance events should undergo regular cardiac monitoring, especially if they have risk factors or a family history of heart disease, because this can help detect potential issues early and ensure that

14:26
any observed changes are indeed benign adaptations and aren't indicative of an underlying problem. I mean that said, at the conference that I attended a week or so ago, the Sports Medicine Conference, one of the doctors who was chatting about heart irregularities did say that family history wasn't really a good indicator as to who may experience these heart related issues. So the best idea is to actually get tested and get checked.

14:56
These are some of the potential sort of cardiac and body related physical things that occur post training, not to mention of course the fatigue. But outside of that physical fatigue, you can't forget the mental fatigue that occurs when you participate in these long events. The approvation of a long event, the time spent focusing on training in the lead up.

15:21
The slight to extreme anxiety of the lead up to the actual race in those last couple of days coupled with actually being out and engaged for a prolonged period of time does take its toll mentally. Your brain just gets tired. Things feel hard because they are hard. And it might not be initially like you might come off that event feeling super awesome because you've just achieved your goal.

15:49
and now you've completed it, it might be some real relief and it might feel amazing, but a lot of people obviously feel weary the 24 hours post-rates and then get excited to get back into it even later in that first week. However, the mental fatigue is still underlying and can come back with a vengeance much like physical fatigue can. So being mindful of this and taking the stress load off mentally as well as physically,

16:17
will allow you to recover better in a timely fashion. So you feel real motivation when you are ready to get back to it. The flip side of this can be that you have that initial weariness, you feel motivated to get back after the first week, but three or four or five or six weeks down the line you get that real fatigue comes back and you feel really demotivated. You

16:46
sort of depression, even that far out. So just really be mindful of that because it will impact on your ability to get back to doing what you love. So we really need to be mindful of taking the recovery required for an event like this. So where possible post-event, try to remove the work or home life stress, particularly in the 14 days post-event as much as possible. Now I'm not suggesting go on a holiday for two weeks, but hey.

17:16
How amazing would that be? But if you have anything extra that you don't necessarily have to do, can you offload it to someone else? Can you? And it might be, it's probably too late for those people who've just done these events, but when you're thinking about doing an event like this, so for anyone doing Tarahumara, for example, or The Wild, can you have a look at your calendar two weeks post and try to alleviate any of the

17:43
non-compulsory things to really just sort of clear your calendar out. Disengage the brain and literally chill out so you're not doing mentally demanding tasks as well. Obviously this is not possible in your work-based sort of setting if you work but I would try to eliminate any of the stuff that takes a lot of mental brain power because you will still feel fatigued.

18:11
in that first 14 days particularly. And don't get back to any actual structured training for at least 21 days post-event, which doesn't mean you can't train, and I've got a little few more tips about that, but do that without expectations or goals, as it can quickly lead you to feel demotivated. You will get a fitness bump post your event, but you will lose that, and you should lose it in the few weeks afterwards.

18:40
you will feel less fit, you will be less fit, but your body needs to go through that detraining in order to come back stronger and feeling fitter and motivated moving on. So in the one to four weeks post event, what are some of the things that you should be considering? I know firstly when it comes to food you will want to eat all of the things, particularly if you are very rigid.

19:07
in the lead up to your event about not including a whole lot of junk food, etc. into your diet. Even if you're not, I know that after an event like that you do just want to eat all the things. Of course it's not the best idea, but hey, give yourself a window with which you do that. And it might be in the day after the event, the two days after the event. Have that relaxed opportunity. But the more you put

19:33
quality protein and phytochemicals from vegetables and fruit into your diet, and good dietary fats back into your body, the quicker you will heal. Keep alcohol low or absent from your diet in that first week, ideally. Can you get a greens powder, such as New Zest Good Green Vitality that contains organic greens to help reduce oxidative stress and remove the free radicals and oxidative metabolites from your system?

20:02
The greens powders like the GGV, sounds like an ad, this isn't an ad, but it could be, because I love it so much. It does also contain these adaptogenic herbs. And those type of herbs work with your nervous system and help calm you. So your body currently is in this absolute recovery phase, and that's what it's using its energy for. So anything that you can help alleviate stress, the better.

20:28
Ensure protein intake is on point and it's of quality. Meat, eggs, protein powder. If you tolerate dairy, that is fine. If you know that you don't tolerate dairy, now is not the time to go gung ho on ice cream. Fish is another great source of protein, as you know. Aim for at least two grams per kg of body weight of protein distributed across the day, having at least 30 grams

20:55
I'd go up to 40 grams of protein actually, because our ability to optimize muscle protein synthesis is going to be above 30 grams in a meal. And that equates to around about 140 grams cooked meat. It's not a lot actually. And do this across the day. So you're having two, if not three, opportunities to hit that muscle protein synthesis maximum. Include creatine.

21:23
three to five grams a day to help with recovery. Have smoothies and add dark greens and berries for their phytochemical content. So I talked about the good green vitality, but get it through real food as well. Add turmeric and ginger to this to help with inflammation. And dietary turmeric may also help with gut modulation and reducing inflammation in the gut. This is something my mate Cliff told me about. So certainly supplemental.

21:52
curcuminoids from the turmeric spice, because that's their active component. That's very helpful, but even dietary turmeric actually can be useful. Include salmon, sardines, mackerel for their omega-3 content. Omega-3 fatty acids help reduce inflammation. And of course you can take fish oil supplements here. If you do not eat fish and do not like the idea of a fish oil supplement,

22:20
You've also got the Blue Algae supplement from Nordic Naturals, is one brand that springs to mind. Eat loads of salads and fresh greens. Like really get in good fiber, which will help you get rid of the metabolites from your system, help detox. And when I say detox, I just mean the metabolites from exercise and the muscle damage and things like that.

22:46
Obviously you want to be hydrating effectively across the day as well with the good electrolytes putting in that sodium with a product like Element or on the New Zealand market we've got Mineral, NNRL. There are a couple more that have popped up. I haven't really seen them in person myself so I can't really speak to what they're like but certainly the two that I've mentioned are really beneficial. So that's sort of like your dietary approach. So keep the things that...

23:15
cause inflammation low, particularly if you are sensitive, like gluten, like dairy, like sugar, and put the quality nutrients in, like the fatty acids I mentioned, the protein and the vegetables. Now sleep is obviously our biggest recovery tool. Ideally, you wouldn't set an alarm. I mean, that would be amazing. So you wouldn't have to be forced to wake up, but I know that very few people actually have the ability to.

23:45
do that so try to get to bed earlier if you can't. Offload mental stress load wherever possible as I mentioned. Also sauna and or ice bath to help with both blood flow and reducing inflammation could be really helpful with that. Body work if possible after the first week to help recovery so maybe think about some lymphatic massage work in the first week just really sort of flushing everything out.

24:13
two to three days post event and also a topical cream like Arnica to help reduce swelling and have that sort of anesthetic sort of feel about it. Keep active in that first week after like a few days rest but no structured training in that first week to 10 days. Swimming, spinning with no resistance, that kind of non weight bearing activity, yoga, body balance for gentle stretching. Think zone one to low zone two.

24:43
And then depending on how you feel, getting back into like some light jogging 10 to 14 days afterwards, no problem. Running is always the hardest to recover from. So that's sort of your first couple of weeks. And when you get to week three, start bringing back that scheduled training, bring back some strength work here as well. And think about bringing back in some tempo work in the non-weight bearing sport, if you feel recovered and your body feels good.

25:10
and always cue into that and how you're feeling about and how recovered you feel. And now would be a good time in week three to get like a decent sports massage done to really get into some tight spots. And week four can be a good time to consider training, specifically again, keeping a check on how you're feeling post sessions, being flexible and pulling back if you need to and being honest about how everything is feeling. You don't have to suddenly

25:39
put three events into your calendar or get super serious about training if mentally you're still just really happy to get out and be active, that's totally fine. But I know as athletes, you know, we are very prone to wanting to put something on the calendar to train for and that is totally fine, but you just want to always tune into how you're actually feeling. So hopefully that stuff is useful for you. My inspiration for this.

26:06
did come from Craig Alexander. He did a great talk at Sports Medicine Conference about what he did post-session. So I thought I just would share some of what he shared in addition to some of my nutrition and recovery expertise as well. As always, you guys know that if you've got any feedback, any DMs, if you want to share with me what you do, then contact me via Instagram, threads, or Twitter @mikkiwilliden.

26:35
head to Facebook@mikkiwillidennutrition or my website, mikkiwilliden.com. We can book a one-on-one call with me. All right, team, you have a great week. See you later.