Sports Med (2013) 43:922

DOI 10.1007/s40279-012-0002-0

REVIEW ARTICLE

Recovery in Soccer
Part IIRecovery Strategies

Mathieu Nedelec Alan McCall Chris Carling

Franck Legall Serge Berthoin Gregory Dupont

Published online: 16 November 2012

Springer International Publishing Switzerland 2012

Abstract In the formerly published part I of this two-part optimizing muscle-damage repair. Sleep is an essential part
review, we examined fatigue after soccer matchplay and of recovery management. Sleep disturbance after a match
recovery kinetics of physical performance, and cognitive, is common and can negatively impact on the recovery
subjective and biological markers. To reduce the magni- process. Cold water immersion is effective during acute
tude of fatigue and to accelerate the time to fully recover periods of match congestion in order to regain performance
after completion, several recovery strategies are now used levels faster and repress the acute inflammatory process.
in professional soccer teams. During congested fixture Scientific evidence for other strategies reviewed in their
schedules, recovery strategies are highly required to alle- ability to accelerate the return to the initial level of per-
viate post-match fatigue, and then to regain performance formance is still lacking. These include active recovery,
faster and reduce the risk of injury. Fatigue following stretching, compression garments, massage and electrical
competition is multifactorial and mainly related to dehy- stimulation. While this does not mean that these strategies
dration, glycogen depletion, muscle damage and mental do not aid the recovery process, the protocols implemented
fatigue. Recovery strategies should consequently be tar- up until now do not significantly accelerate the return to
geted against the major causes of fatigue. Strategies initial levels of performance in comparison with a control
reviewed in part II of this article were nutritional intake, condition. In conclusion, scientific evidence to support the
cold water immersion, sleeping, active recovery, stretch- use of strategies commonly used during recovery is lack-
ing, compression garments, massage and electrical stimu- ing. Additional research is required in this area in order to
lation. Some strategies such as hydration, diet and sleep are help practitioners establish an efficient recovery protocol
effective in their ability to counteract the fatigue mecha- immediately after matchplay, but also for the following
nisms. Providing milk drinks to players at the end of days. Future studies could focus on the chronic effects of
competition and a meal containing high-glycaemic index recovery strategies, on combinations of recovery protocols
carbohydrate and protein within the hour following the and on the effects of recovery strategies inducing an anti-
match are effective in replenishing substrate stores and inflammatory or a pro-inflammatory response.

M. Nedelec
A. McCall
F. Legall
S. Berthoin
G. Dupont 1 Introduction

Universite Lille Nord de France, Lille, France
In the formerly published part I of this two-part review [1],
M. Nedelec
A. McCall
C. Carling
F. Legall
G. Dupont
we reviewed dehydration, glycogen depletion, muscle
LOSC Lille Metropole Football Club, Camphin-en-Peve`le,
France damage, inflammation, oxidative stress and mental fatigue
as potential factors associated with magnitude of fatigue
G. Dupont (&) following a soccer match. A recovery strategy involves the
Laboratory of Human Movement Studies,
implementation of a technique or a combination of tech-
Artois and Lille 2 Universities, 9 rue de lUniversite,
59790 Ronchin, France niques in order to accelerate the time to achieve full
e-mail: [email protected] recovery and potentially reduce the risk of injury [2, 3].
10 M. Nedelec et al.

This review summarizes current research that evaluates of a match is necessary. An intake of *1.2 g carbohydrate/
recovery strategies, using soccer (Association Football) as kg/h with a high GI immediately after a match, and at
the main sport of interest. A computerized literature search 1560 min intervals for up to 5 h [6], enables maximum
was performed using PubMed between January 2011 and resynthesis of muscle glycogen stores. However, the effect
January 2012. The following keywords were used in of high-carbohydrate meals with high GI on subsequent
different combinations: soccer, football, recovery, soccer-specific performance is still unclear [7]. When a
modality, strategy, nutrition, diet, hydration, lower amount of carbohydrate is consumed, co-ingestion of
inflammation, cryotherapy, cold water immersion, protein (0.4 g/kg/h) could be useful to increase post-exer-
cold bath, contrast therapy, sleep, active recovery, cise muscle glycogen-synthesis rates, as it may stimulate
stretching, compression garments, massage, electrical insulin secretion, glucose uptake and muscle glycogen
stimulation and electromyostimulation. All titles and synthase [6]. Nevertheless, Gunnarsson et al. [8] failed to
abstracts were carefully read and relevant articles were find an increase in glycogen resynthesis 48 h after a soccer
retrieved for review. In addition, the reference lists from both match following ingestion of a whey protein and carbo-
original and review articles retrieved were also reviewed. hydrate-enriched diet compared with a normal diet. As
According to Bishop [4], key gaps in the evidence exercise stimulates muscle protein synthesis and muscle
informing sports practice will only be recognized when the protein breakdown, the absence of protein intake after
sport-science community frequently consults the evidence exercise can lead to a negative net protein balance [9].
base for answers [4]. Scientific research guides practice, Indeed, a positive muscle protein balance is required to
but practice can also guide research and a survey about the repair exercise-induced muscle damage [10], which is
current recovery strategies used in elite soccer was per- common following a soccer match [1]. Protein consump-
formed in March 2011. Following a literature search using tion stimulates muscle protein synthesis [11] necessary for
PubMed to establish a complete list of recovery strategies, positive muscle protein balance; although, the quantity,
32 practitioners in charge of recovery strategies in French type and timing of protein ingestion to maximize post-
professional soccer teams were questioned on the strategies exercise muscle protein synthesis remains a topic for
they implemented. The results showed that cold water debate, a consumption of *20 g milk protein, or an
immersion and contrast water therapy (88% of teams), equivalent of *9 g essential amino acids, seems to be
active recovery (81%), massage (78%), stretching (50%), sufficient to stimulate muscle protein synthesis rates during
compression garments (22%) and electrical stimulation the first 2 h of post-exercise recovery [12]. A high-protein
(13%) were the strategies used. Nutrition and hydration diet with branched chain amino acids also positively
were considered as very effective recovery strategies by impacts other factors associated with recovery such as
97% of the practitioners, while sleep was also considered mental performance or sensation of fatigue [13]. The
as an effective recovery strategy (95% of practitioners). addition of protein to post-exercise carbohydrate feedings
In part II of this review, the advantages and the limits of can reduce muscle soreness [14, 15] and decrease the
these recovery strategies are discussed in an attempt to creatine kinase (CK) concentration [1517] and myoglobin
select the most appropriate strategy/ies following a single concentration [17, 18]. It can also improve subsequent
soccer match and/or a period of match congestion. muscle function [17, 18] and cycling performance exercise
[16] in comparison with a simple carbohydrate beverage.
Following a match, flavoured milk, which is an easily
2 Nutritional Strategies accessible and relatively inexpensive dairy product, could
be an effective beverage for post-exercise recovery. It
As presented in part I [1], rehydration, carbohydrate and contains carbohydrate and proteins in amounts similar to
protein consumption after a match are effective recovery those used in studies demonstrating improved post-exercise
techniques for replenishing water and substrate stores, and recovery. Numerous studies have confirmed the significant
optimizing muscle-damage repair. However, guidelines effects of post-exercise chocolate milk supplementation on
including quantity, timing and composition are required in subsequent exercise performance [17, 1922], intracellular
order to maximize their effectiveness. signalling stimulus for protein synthesis [21], perceived
After match-induced dehydration (*2% of body mass), soreness [23], and CK levels [24].
research has shown that consumption of a high sodium Other studies have found that omega-3 fatty acids,
drink (61 mmol/L) equivalent to 150200% of sweat loss is curcumin, tart cherry juice and tomato juice improve the
sufficient to attain a state of hyperhydration 6 h after recovery process due to their anti-inflammatory and anti-
ingesting the drink [5]. oxidant effects. Increased omega-3 concentrations in the
To optimize the resynthesis of muscle glycogen stores, a blood are associated with decreased levels of proinflam-
high glycaemic index (GI) carbohydrate intake at the end matory markers (interleukin [IL]-6, IL-1ra, tumour necrosis
Soccer Recovery: Part IIStrategies 11

factor [TNF]-a, and C-reactive protein [CRP]), and higher this evidence in improving recovery between matches in
levels of anti-inflammatory markers (soluble IL-6r, IL-10, elite soccer players remains to be demonstrated.
and transforming growth factor [TGF]-b) [25]. Tartibian It is generally recognized that certain nutrients posi-
et al. [26] showed the effectiveness of supplementing tively influence the recovery process. In contrast, alcohol
subjects during 30 days with 1.8 g/day omega-3 fatty acids consumption can negatively affect a players ability to
on lower limb soreness 48 h after eccentric knee extensors recover following exercise. Soccer players occasionally
exercise. The authors suggested that their findings were due ingest moderate to large volumes of alcohol (ethanol) in the
to the anti-inflammatory effects of omega-3 family fatty hours after matchplay. Barnes et al. [34] investigated the
acids. Nevertheless, evidence of the effectiveness of effects of acute moderate alcohol intake (1 g/kg body-
omega-3 fatty acids in improving physical performance weight ethanol as vodka and orange juice) on muscular
measures post-exercise is lacking [27, 28]. The quantities performance during recovery from eccentric exercise-
employed in these studies could be provided in daily food induced muscle damage. The results showed that peak
intakes through consumption of a diet rich in a-linolenic strength loss at 36 h post-exercise was significantly greater
acid (e.g. linseed oil, rapeseed oil), eicosapentaenoic acid in the alcoholic beverage condition compared with an
and docosahexaenoic acid omega-3 fatty acids (e.g. isocaloric non-alcoholic beverage condition. A combina-
salmon, mackerel, anchovies). Curcumin also exhibits tion of decreased inflammatory response, altered cytokine
anti-inflammatory properties and Davis et al. [29] showed production and abnormal reactive oxygen intermediate
that feeding mice with curcumin (10 mg) daily for 3 con- generation after alcohol exposure may hinder the muscle
secutive days prior to downhill running significantly offsets repair and recovery process [35]. To minimize exercise-
the decrement in running performance (i.e. treadmill run related losses in muscle function and accelerate recovery,
time to fatigue, p \ 0.01; voluntary wheel running activity, participants in sports involving frequent eccentric muscle
p \ 0.05) and significantly (p \ 0.05) blunted the increase work, such as soccer, should consequently avoid alcohol-
in inflammatory cytokines IL-1b, IL-6, TNF-a and CK containing beverages in the post-event period [34]. Apart
compared with mice fed with a placebo. Curcumin intake from hindering the muscle repair process, alcohol con-
requires further investigation in humans during the post- sumption may also delay the recovery from dehydration
exercise recovery period. Tart cherry juice is also shown to [36].
enhance the recovery process. Tart cherries are loaded with To sum up, evidence suggests that flavoured milk
antioxidant anthocyanins, which exhibit in vitro antioxi- drinks should be given to players at the end of competi-
dant and anti-inflammatory activities [30]. Connolly et al. tion. In addition, a meal containing high-GI carbohydrate
[31] demonstrated that a daily dose of 0.682 L for 4 days and protein should be served to players within the hour
prior to and 4 days following eccentric contractions of the following play. Their habitual diet should include con-
elbow flexors reduced muscle soreness and attenuated the sumption of omega-3 fatty acids. In addition, tart cherry
loss in muscle force. In an investigation of the efficacy of juice consumed before the match, on the day of the match
tart cherry juice consumed before the day of a marathon and on the following days could be provided to the
run and for 48 h following the run, Howatson et al. [32] players, especially when two or three matches in 1 week
showed that the group who ingested the cherry juice are to be played. We recommend, however, that the
recovered isometric strength significantly faster (p \ 0.05) effects of systematic consumption of this product on the
and exhibited reduced inflammation (IL-6, p \ 0.001; recovery process should be studied before recommending
CRP, p \ 0.01; uric acid concentrations, p \ 0.05) and its chronic consumption. Further research is needed to
greater total antioxidant status (p \ 0.05) compared with determine when inflammation should be enhanced or
the placebo group during recovery. The authors assumed reduced after a soccer match. The outcomes would help to
that consumption of the cherry juice may have blunted the select a nutritional plan in order to increase or decrease
secondary muscle damage response, resulting in a more the inflammatory response. Currently, the inflammatory
rapid return of strength in the cherry juice group versus process is accentuated at the end of the match by con-
placebo. Ramaswamy and Indirani [33] found that 75 mL suming high-GI carbohydrate and protein in order to
of tomato juice (containing 10 lg of lycopene) consumed increase the glycogen stores and muscle function and to
for 60 days after each training session had a beneficial decrease muscle soreness. Finally, future studies may
effect on the oxidative stress and on the athletic perfor- investigate if it is necessary to adapt nutritional recovery
mance of athletes involved in track events. All of the strategies according to playing position and/or individual
studies detailed above examining the effectiveness of activity performed during the match. For example, a
nutrients on the recovery process have focused on recovery spontaneous higher carbohydrate intake is observed for
from non-soccer-specific exercises. Thus, the relevance of players in a more physically demanding position
12 M. Nedelec et al.

(i.e. fullbacks, midfielders and wingers) compared with arms, inducing a redirection of blood flow from the
goalkeepers and centrebacks [37]. periphery to the core and thereby improving venous return
and cardiac efficiency [49]. Cold water may also reduce
acute inflammation from muscle damage [51] and has a
3 Cold Water Immersion short-term analgesic effect related to reduction of nerve
conduction velocity, muscle spindle activity, the stretch-
The survey on recovery strategies used by professional reflex response and spasticity, thus inhibiting the pain-
soccer teams revealed that cold water immersion and spasm cycle [52].
contrast water therapy are the most common recovery In contrast, cold water immersion following matchplay
strategies employed in French professional soccer teams, as can present some limitations. Although scientifically
these are currently used by 88% of teams. Cold water unproven, the reduction in skeletal muscle blood flow
immersion performed immediately after exercise and induced by cold water immersion could, in theory, alter
repeated throughout the recovery process [3842] has glucose availability to the muscle during recovery and
proven to be a superior recovery modality when compared therefore alter the rate of post-exercise glycogen synthesis.
with passive recovery, contrast water immersion [41] and Additionally, using cold water immersion on a regular
hot water immersion [40]. Therefore, this section deals basis may hinder exercise-induced adaptations. Yamane
only with cold water immersion. Table 1 presents the et al. [53] proposed leg endurance training and forearm
effects of cold water immersion on physical performance flexor muscles resistance training 34 times a week for
and on subjective and biological markers following soccer- 46 weeks. Cold-water immersion was applied after each
specific exercise. Cold water (temperature range: 910 C; training session to one leg and one arm of subjects, with the
duration range: 1020 min) immersion post-exercise pro- other leg and the other arm resting at room temperature.
vided worthwhile beneficial effects on anaerobic perfor- Significant training effects were three times higher in the
mances, i.e. maximal strength [38, 41, 43, 44], sprint control group than in the cold group (p \ 0.05), including
ability [41] and countermovement jump [45]. Moreover, increases in artery diameter in the control group but not in
cold water immersion was beneficial in reducing muscle the cold group. The authors proposed partial suppression of
soreness [38, 4147] and decreasing CK and myoglobin heat shock protein induction in the cooled relative to the
concentrations [38, 43]. Cold water immersion protocols non-cooled muscles to explain that post-exercise cold
are generally heterogeneous in terms of temperature, water immersion is an adverse treatment from the view-
duration and level of immersion [3842] and the best point of physical training. Exercise induces heat shock
compromise has yet to be determined. Other cold water protein expression such as an increase in muscle temper-
immersion protocols (temperature range: 1015 C; dura- ature [54]. As heat shock protein induction in training of
tion range: 515 min) were all found to provide beneficial elite male rowers depends on exercise intensity and volume
effects on maximal strength [40, 48], sprint ability [39], [55, 56], cooling recovery strategies after each training
cycling performance [49] and rowing performance [48], session should be avoided among elite athletes to allow
and reduced localized oedema [40]. However, these have natural induction of heat shock protein, which is respon-
not been tested in soccer players. Time (e.g. immediately sible for long-term muscle adaptations. However, the study
after the match, delayed several hours after the match, or by Yamane et al. [53] presents several limitations with
the day after) and frequency of use are other important respect to the present review. Non-athlete subjects exer-
issues related to cold water immersion. Work by Brophy- cised at an intensity below the threshold of delayed-onset
Williams et al. [50] found that running performance on the muscle soreness before immersing their leg for 40 min in
subsequent day between immediate cold water immersion water at 5 C. This model is unlikely to closely reflect the
and delayed cold water immersion trials were similar physical demands of elite soccer players. Moreover, it
(p = 0.147), while qualitative analyses demonstrated that should not be excluded that the cooled limb recovered
immediate cold water immersion resulted in a 79% likely better than the control limb during the training programme,
benefit when compared with delayed cold water immer- making the training stimulus too low to induce any training
sion. The study demonstrates that cold water immersion effect in the cooled limb. In support of these limitations,
immediately after a high-intensity exercise session was Howatson et al. [57] found that cold water immersion did
more beneficial for next-day running performance than not inhibit the repeated bout effect when given four times
cold water immersion performed 3 h after the session. after the first of two bouts of drop jump exercise separated
The recovery benefits of cold water immersion are most by 1421 days.
likely due to water temperature rather than hydrostatic Generally, cold water immersion is an effective recov-
pressure [41, 42]. Full-body immersion in cold water at ery strategy during acute periods of fixture congestion to
15 C for 15 min reduces blood flow to the legs and to the improve physical performance and reduce muscle soreness.
Table 1 Effects of cold water immersion on physical performance and on subjective and biological marker changes following soccer-specific exercise
Study Subjects Exercise Recovery Measurement timing Main findings

Ascensao et al. [43] 20 elite M Soccer match 10 min cold water or 0, 24, 48 h post-match : K EX MVC, ; DOMS, ;
thermoneutral water after myoglobin, ; CK, ; CRP
the match with cold water
Bailey et al. [38] 10 trained M LIST [164] 10 min cold water or control 0, 1, 24, 48, 168 h : K FL MVC, ; DOMS, ;
after exercise post-exercise myoglobin with cold water
Soccer Recovery: Part IIStrategies

Buchheit et al. [165] 5 trained M 2 soccer matches within 48 h 18 min spa treatment (sauna, 48 h post-match 1 (during : Low-intensity running,
(matches 1 and 2) jacuzzi, cold water) or match 2) sprinting distance, peak
control 1215 h post-match match speed, number of
1 sprints and RSS in match 2
with spa treatment
Ingram et al. [41] 11 trained M Simulated team sport exercise 15 min cold water, contrast 0, 24, 48 h post-exercise : K EX MVC, : K FL MVC, :
[166] therapy or control 0, 24 h RSA, ; DOMS with cold
post-exercise water
King and 10 trained F 2 simulated intermittent-sprint 15 min cold water, contrast 0 h post-exercise 1 and 2, : CMJ pre-exercise 2, ; DOMS
Duffield [45] exercises within 24 h therapy, active recovery or pre-exercise 2 pre-exercise 2 with cold
(exercises 1 and 2) control after exercise 1 water
Kinugasa and 28 trained M Soccer match 9 min cold water ? active 0 h post-match, post-recovery ; DOMS, : perceived quality
Kilding [46] recovery or contrast therapy session, 24 h post-match of recovery with cold water
or stretching ? leg raising
after the match
Pointon and 10 trained M Simulated intermittent-sprint 20 min cold water or control 0 h post-exercise, 0, 2, 24 h : K EX MVC, VA, RMS, peak
Duffield [44] exercise [167] with tackling after exercise post-recovery session twitch, ; DOMS with cold
water
Rowsell et al. [47] 13 elite M 4-day soccer tournament, 10 min cold water or *22 h post-match ; DOMS, ; fatigue with cold
1 match each day thermoneutral water after water
each match
Rowsell et al. [42] 13 elite M 4-day soccer tournament, 10 min cold water or *22 h post-match : total distance run, ; DOMS, ;
1 match each day thermoneutral water after fatigue with cold water
each match
Rupp et al. [168] 13 elite M, 2 YIRTs [169] within 48 h 15 min cold water or control 0, 24, 48 h post-exercise No significant difference
9 elite F 0, 24 h post-exercise between recoveries
CK creatine kinase, CMJ countermovement jump, CRP C-reactive protein, DOMS delayed-onset muscle soreness, F female, K EX knee extensors, K FL knee flexors, LIST Loughborough
Intermittent Shuttle Test [164], M male, MVC maximal voluntary contraction, RMS root mean square, RSA repeated-sprint ability, RSS repeated-sprint sequences, VA voluntary activation,
YIRT yo-yo intermittent recovery test [169], : indicates increase, ; indicates decrease
13
14 M. Nedelec et al.

Apart from these periods, and particularly during training loss is also characterized by sleep architecture disturbance.
periods, it should be avoided to prevent treatment duration- Sallinen et al. [76] found that the proportion of stage 4
dependent interference with the repair and adaptive process sleep is highest in the sleep debt condition but the pro-
[5860]. Additional studies on anti-inflammatory recovery portions of stages 1 and 2 sleep are lower during a night of
strategies are necessary to determine the optimal time after limited sleep than in the normal sleep condition. Addi-
exercise to implement the treatment. A biphasic recovery tionally, sleep loss may impose a reduction in the ability to
pattern of muscle performance after exercise-inducing commit new experiences to memory [77]. Close connec-
muscle damage is reported, i.e. a rapid recovery related to tions also exist between sleep and the immune system.
metabolic fatigue subsidence within the first hours after Cohen et al. [78] showed that subjects with less than 7 h of
exercise, followed by the second and slow phase of the sleep per night in the weeks preceding exposure to a rhi-
recovery during subsequent days related to the muscle novirus are threefold more likely to develop a cold than
repair [6164]. Implementing anti-inflammatory recovery those with 8 h or more of sleep. Partial sleep deprivation
strategies according to the evolution of the inflammatory (being awake from 11:00 pm to 3:00 am) induces a functional
response may increase their effectiveness. alteration of the monocyte pro-inflammatory cytokine
response and alters the expression of pro-inflammatory cyto-
kine genes [79]. In the morning after a night of sleep depri-
4 Sleeping vation, inflammatory responses are enhanced compared with
morning levels following uninterrupted sleep [79]. Studies
Neurometabolic theories of sleep function propose that on the link between sleep loss and illness in the elite soccer
sleep repays the neural and metabolic cost of waking [65]. player are warranted.
Slow-wave sleep, which includes four distinct stages To counteract a disturbed nights sleep among soccer
(stages 1, 2, 3 and 4), is characterized by slow breathing, a players, several factors have been proposed to improve
low heart rate, low cerebral blood flow and a large increase sleep after the match and during the following nights. A
of growth hormone secretion allowing physiological resti- high-GI carbohydrate, which is recommended for rapid
tution [66]. Both slow-wave sleep and rapid-eye-movement restoration of muscle glycogen stores [80], may also pos-
sleep are implicated in the plastic cerebral changes that itively influence sleep. Afaghi et al. [81] showed that a
underlie learning and memory [6769]. In this respect, the high-GI meal resulted in a significant shortening of sleep-
question of sleep in the recovery management should be onset latency compared with a low-GI meal (9.0 min vs.
studied. 17.5 min, respectively; p \ 0.01) and was most effective
When playing an evening soccer match, professional when consumed 4 h before bedtime compared with the
soccer players are subjected to a high physical and mental same high-GI meal given 1 h before bedtime (p = 0.01).
work load, in addition to high emotional stress. Players Sleep initiation depends on a thermophysiological cascade
must perform at their peak when psychomotor vigilance with body heat loss promoting sleepiness and the rapid
and subjective alertness tend to decrease after a typical day onset of sleep [82]. Recovery strategies such as cold water
of activity [70]. Irregular sleep-wake schedules influence immersion reduce body temperature [49], which may
the homeostatic and circadian regulation of sleep and, in consequently promote sleep onset. Other recommendations
turn, its quality and quantity [71]. Post-match routines (i.e. for sleep induction include benefiting from a dark and quiet
medical care, recovery strategies, meals and the return trip) environment by using eye shades and ear plugs, listening to
frequently lead to a very late bedtime, which may also alter relaxing music and adopting regular sleep-wake schedules
sleep quality and quantity [72]. Another potential cause of [83]. Conversely, consumption of caffeine prior to the
sleep disturbances after a match is waking several times match for performance enhancement [84], consumption of
during the night because of hyperhydration [73]. As a alcohol as a means of celebrating after the match [85], and
result, many players experience a disturbed nights sleep hyperhydration [73] potentially lead to sleep disturbance.
following competition, which can have multiple negative However, a poor nights sleep may be compensated for by
consequences. As extensive sleep loss (i.e. 30 h of sleep a short post-lunch nap [86, 87]. Waterhouse et al. [87]
deprivation) is associated with reductions in muscle gly- found that a nap followed by a 30-min recovery period
cogen content [74], and chronic sleep restriction (i.e. improves alertness and aspects of mental and physical
restriction to 50% of the habitual time over 12 days) may performance following partial sleep loss. The ability to nap
contribute to the amplification of soreness [75], future for short periods during the day may be a useful skill for
studies are required to investigate the acute and chronic players to develop, especially during a congested schedule.
effects of a disturbed nights sleep after a match among Moreover, nocturnal sleep following a night of partial
soccer players or over periods of match congestion. In sleep loss should also be promoted during several nights.
addition to its impact on sleep quantity, a night of sleep Sallinen et al. [76] found that, after a night of limited sleep,
Soccer Recovery: Part IIStrategies 15

an 8-h recovery sleep opportunity the following night any differences in the pro- or in the anti-inflammatory
markedly improved both cognitive performance and alert- cytokine response between the active recovery group and
ness but did not lead to complete recovery [76]. Finally, the passive group. Finally, the active recovery regimen had
resting periods and sleep-wake schedules are normally no effect on changes in oxidative stress markers and anti-
planned for the entire team, regardless of individual dis- oxidants [108]. According to these results, implementing
tinctions. Planning individualized schedules based on 1 h of active recovery during the 3 days following a match
players preferred sleep schedules may be another effective does not seem beneficial, nor detrimental to the outcome of
countermeasure to restore good sleep [72, 88]. the recovery process. Further research on exercise mode,
duration and intensity and the time of active recovery is
needed to clarify its interest as a recovery modality.
5 Active Recovery

Active recovery, also referred to as cooling down or 6 Stretching

warm down, is currently performed by 81% of French
professional soccer teams immediately after the match Elite soccer teams devote a substantial amount of training
and/or on the following days. This strategy involves run- and match preparation time to stretching. Dadebo et al.
ning, biking or swimming at low intensities for a duration [109] reported that the English Premiership clubs allo-
of 1530 min. This recovery strategy is often implemented cated almost 40% of total training time to flexibility
in professional soccer, as results from numerous studies training with static stretching, the most popular technique
[8994] have reported that active recovery, performed employed. The Premiership clubs reported a mean static
between 30% and 60% of maximal oxygen consumption stretching holding time of 31 s and a mean number of
and lasting at least 15 min, enhanced blood lactate removal repetitions per hamstring muscle group of three (range:
or accelerated pH recovery [95, 96] in comparison with 25) repetitions per session. Stretching exercises are per-
passive recovery. However, lactate removal should not be formed for several reasons, including improvement of the
the criterion used to test the quality of recovery. Faster range of motion and the decrement of musculotendinous
lactate removal does not necessarily involve better per- stiffness [110, 111] to prevent injury [109, 112, 113], as
formance during subsequent exercise. In several studies well as promoting recovery. In French professional soccer,
aimed at comparing active and passive recoveries, exercise 50% of teams currently use stretching as a recovery
performance after active recovery did not improve, despite strategy. However, there is no substantial scientific
lower lactate concentrations [91, 97, 98], while other evidence to support the use of stretching to enhance the
studies showed that passive recovery improved perfor- post-exercise recovery of soccer players [46, 114, 115]. In
mance in subsequent exercise [99103]. Several studies a meta-analysis including 12 studies, Herbert et al. [116]
[95, 104, 105] have reported that active recovery per- reported that stretching is not clinically worthwhile for
formed immediately after high-intensity exercises signifi- reducing muscle soreness in the days following exercise.
cantly impaired glycogen synthesis, especially in type I Stretching after eccentric exercise may even hinder the
muscle fibres [95]. According to these results, active outcome of the recovery process. Lund et al. [117] sug-
recovery performed immediately after a match does not gested that both stretching and eccentric exercise leading
present a benefit to implement this technique as part of a to delayed onset of muscle soreness may affect the muscle
recovery strategy. However, further studies are required to tissue, which may explain the fact that the seven untrained
justify what type of exercise should be performed in the women in their study showed a greater decrease in con-
days following a match. centric and eccentric quadriceps strength following both
In a set of studies on recovery between two elite female eccentric exercise and stretching in comparison with
soccer matches separated by 3 days, Andersson et al. eccentric exercise alone.
[106108] extensively investigated the effects of 1-h active
recovery (submaximal cycling at 60% heart rate peak and
low-intensity resistance training at \50% one-repetition 7 Compression Garments
maximum) performed at 22 h and 46 h after the first match.
The results showed that active recovery had no effects on Compression garments function by applying a pressure on
the recovery pattern of physical performance markers (i.e. the lower extremities in order to increase femoral blood
countermovement jump, 20 m sprint performance, and flow [118]. The principle is to increase the pressure on the
maximal isokinetic knee flexion and extension), perceived ankle and to decrease it on the mid-thigh in order to
muscle soreness and biochemical markers (i.e. CK, urea improve the venous return and thus reduce venous stasis in
and uric acid) [107]. Andersson et al. [106] did not report the lower extremities [118]. This section will only focus on
16 M. Nedelec et al.

the effects of compression garments on the recovery pro- this result suggests an accelerated inflammatory and repair
cess. Compression garments, especially for the lower body, timeframe induced by compression garments.
have recently become increasingly popular amongst In conclusion, the use of compression garments fol-
applied soccer practitioners in an attempt to accelerate lowing an elite soccer match may be useful to alleviate
recovery from training and competition. Twenty-two per muscle soreness but more research is required to demon-
cent of French professional soccer teams currently inte- strate the ergogenic benefits. Compression garments have
grate compression garments into their recovery protocol. no additional benefit in comparison with active recovery
While studies have shown possible interest in the recovery [126], contrast water therapy [126, 129] or massage [125].
of muscle soreness to pre-exercise levels, improvements in As no studies have reported negative effects on exercise
performance measures post-exercise are lacking. No ben- performance, the use of compression garments may pro-
efits in repeated-sprint performance [119, 120], peak power vide an easy-to-use recovery strategy in a team. They could
output [120], isokinetic strength [121], sprint, agility and be useful during air travel, especially during a long flight,
countermovement jump performance [122] have been to reduce the risk of deep vein thrombosis [130]. Never-
reported with regard to the use of compression garments theless, caution should be taken, as compression garments
during the recovery process, although all of these studies may be uncomfortable to wear during the night and are
reported subjective feelings of recovery improvement associated with an increase in body temperature, thereby
when using compression garments. As the studies did not disturbing subjects patterns of sleep [122].
have a placebo condition (i.e. using a garment, but no
compression), a placebo effect due to wearing the garments
should not be excluded [120]. 8 Massage
Up until now, studies demonstrating the potential utility
of compression garments for post-exercise recovery have Massage corresponds to a mechanical manipulation of
only addressed their use in elderly athletes [123] or body tissues with rhythmical pressure and stroking for the
untrained subjects [124, 125], who are unlikely to closely purpose of promoting health and well-being [131]. To
reflect the demands of elite soccer. With elderly athletes, promote recovery after a soccer match, numerous tech-
Chatard et al. [123] found that wearing compression gar- niques such as effleurage, petrissage, tapotement, friction
ments during an 80-min recovery period between two and vibration are currently used in 78% of French profes-
maximal 5-min cycling exercises led to a significant 2.1% sional soccer teams. Effleurage involves light pressure at the
increase in subsequent performance. Gill et al. [126] beginning to heavier deeper pressure towards the end and
reported effects on post-exercise removal of metabolites: aims to soothe sore muscles and to relax [132]. Petrissage
full-leg compression garments, worn for 12 h after a single involves a kneading motion where tissue is compressed and
rugby match, enhanced CK clearance more than passive lifted away; it aims to loosen muscle spasm [132]. Tapote-
recovery in elite male rugby players. However, the ability ment consists of repeated rapid hand striking and aims to
of compression garments to enhance the overall rate of stimulate muscle tissues [133]. Friction is short deep
recovery and especially physical performance after a match stroking parallel or transversally across the tissue fibre
is yet to be demonstrated. Another potential limitation of direction and aims to reduce muscle spasms [132]. Vibration
studies on compression garments is that the actual pres- consists of shaking and aims to facilitate muscle relaxation
sures applied by the garments to subjects are not measured [132]. Expected benefits of massage include both physio-
[122]. As a consequence, the minimum pressure of logical and psychological functions. Pulsed Doppler ultra-
18 mmHg at the ankle and 8 mmHg at the level of the sound and echo Doppler have been used to investigate
mid-thigh is not always guaranteed [127]. According to muscle blood flow and indicated that manual massage
Montgomery et al. [39] and Davies et al. [122], the level of effleurage, petrissage or tapotementdid not increase blood
compression may be insufficient to have a beneficial flow in small (forearm) or large (quadriceps) muscle mass
impact following normal exercise (i.e. a team sport com- [134136]. No beneficial effect was found for blood lactate
petitive match); however, after extreme eccentric exercise, removal [136, 137], H? removal [136] and neutrophil counts
compression garments may be effective when disruption to [138]. Whilst for physiological function, benefits of mas-
muscle architecture and swelling is more apparent. Trenell sage are still lacking, the scientific evidence supporting their
et al. [128] reported that 1 h after eccentric exercise, the psychological benefits is substantially greater. Weinberg
leg wearing a compression garment showed a significant et al. [139] observed a positive relationship between mas-
elevation (p \ 0.05) in phosphodiester on phosphorus sage and mood state. Two studies [140, 141] found that
magnetic resonance spectroscopy spectra relative to the massage decreased the subjective symptoms of delayed-
control leg (no compression). Phosphodiester is represen- onset muscle soreness. Hemmings et al. [137] investigated
tative of increased skeletal muscle membrane turnover, and the effect of massage on a measure of perceived recovery
Soccer Recovery: Part IIStrategies 17

made by the subjects rating their feeling on a 4-item linear electrical nerve stimulation [153] and low-frequency
scale (refreshed, recharged, rested and recovered) during the electrical stimulation [154157] are those most frequently
1-h recovery implemented between two simulated boxing used for recovery purposes [158]. The effects of electrical
bouts. The results showed that massage intervention sig- stimulation on the recovery of strength production capacity
nificantly increased perceptions of recovery compared with and on the reduction of muscle soreness were reviewed by
the passive rest intervention without improving punching Babault et al. [158]. Results concerning the benefits of
force during the second bout. Similarly, Hilbert et al. [138] electrical stimulation using transcutaneous electrical nerve
found that the intensity of soreness was significantly lower stimulation or low-frequency electrical stimulation on the
(p \ 0.05) in subjects receiving a massage treatment recovery process are equivocal. Among studies reviewed
(effleurage, tapotement and petrissage) relative to the con- by Babault et al. [158], 11 of 12 studies failed to find a
trol group at 48 h post-exercise. However, no significant significant effect of electrical stimulation on the ability to main-
treatment differences for eccentric hamstring peak torque tain performance after exercise [153155, 157, 159161].
were reported. This latter result confirms that soreness is Positive effects of low-frequency electrical stimulation were
poorly correlated with changes in muscle function, in terms found for CK clearance [160] and blood lactate removal
of both magnitude and time-course after exercise-induced [161, 162], with the limits previously evoked for these bio-
muscle injury [142]. In terms of performance recovery, most chemical markers in the recovery process.
of the studies failed to find a significant beneficial effect To our knowledge, only two studies on electrical stim-
of massage on subsequent exercise after local exercises ulation have been conducted so far in a soccer setting
[143146] or global exercises [92, 147]. It should not be [156, 163]. In these studies, no main effect of electrical
excluded that massage of injured tissue may lead to further stimulation was observed on anaerobic performances (i.e.
damage in muscle if given immediately after a training squat jump, countermovement jump, bounce jumping and
session that induced muscle damage. Viitasalo et al. [148] 10 m sprint) but electrical stimulation was more beneficial
found that CK and myoglobin concentrations were signifi- (p \ 0.01) than water-aerobic exercises and passive rest for
cantly higher in elite athletes receiving water massage after reducing muscle soreness [156, 163].
strength/power training sessions than during the control In conclusion, although electrical stimulation is often
week. However, results from our survey suggest that water used for recovery purposes, no scientific evidence exists
massage is not a common practice with elite soccer players. regarding its effects to maintain physical performance. The
The potential effects of effleurage, petrissage, tapotement, levels of scientific evidence concerning the decrement of
friction and vibration in further damaging injured tissue subjective rating such as muscle soreness are also limited.
remain, consequently, allusive.
In conclusion, the majority of the evidence points
towards massage being effective in alleviating muscle 10 Conclusion
soreness and improving perceptions of recovery, although
its effect on muscle function and performance is unclear. As mentioned in part I of our review [1], fatigue following a
The inconsistency in research findings could be attributed soccer match is multifactorial and related to dehydration,
to the large variety of massage techniques used and the glycogen depletion, muscle damage and mental fatigue. A
individual skill of the therapist [149, 150]. Further research multitude of recovery strategies are currently implemented
is required to identify the conditions of massage (the type, in professional soccer clubs to target these causes of fatigue.
duration and period) that produce positive benefits for the Recovery strategies aimed at reducing acute inflammation
recovery process. from muscle damage and enhancing its rate of removal are
particularly used in professional soccer settings.
Some strategies such as hydration, diet, sleep and cold
9 Electrical Stimulation water immersion are effective, with regard to their ability
to counteract the fatigue mechanisms. For dehydration,
Electrical stimulation is another recovery strategy used by Shirreffs et al. [5] recommended consuming a high-sodium
some professional soccer players (13% of French profes- drink (61 mmol/L) equivalent to 150200% of the sweat
sional soccer teams). Electrical stimulation involves the loss after a match inducing moderate dehydration (2% of
transmission of electrical impulses via surface electrodes to body mass). Proteins such as milk should be consumed at
peripherally stimulate motor neurons, eliciting muscular the end of a match or after a training session leading to
contractions [151]. Many electrical stimulation forms can muscle damage in order to reduce muscle soreness and to
be performed according to the frequency, the intensity or improve subsequent muscle function. A meal containing
current amplitude, pulse characteristics (the shape and high-GI carbohydrate and protein should be served to the
duration), duty cycle, electrode [152]; but transcutaneous players within the hour following the match to replenish
18 M. Nedelec et al.

substrate stores and to optimize muscle-damage repair. In Acknowledgments No sources of funding were used to assist in the
addition, some nutrients containing omega-3 fatty acids preparation of this review. The authors have no conflicts of interest
that are directly relevant to the content of this review.
and antioxidants should be included in the daily diet to
reduce potential muscle soreness and attenuate the loss of
muscle force. Sleep is an essential part of recovery man- References
agement, as sleep disturbances after a match are common
and can negatively impact on recovery processes. Adequate 1. Nedelec M, McCall A, Carling C, et al. Recovery in soccer: part
sleep allows a reduction in the amplitude of muscle sore- Ipost-match fatigue and time course recovery. Sports Med. In
ness and appears to be an important factor for mental press.
2. Ekstrand J, Walden M, Hagglund M. A congested football cal-
fatigue. For muscle damage, cold water immersion at a
endar and the wellbeing of players: correlation between match
temperature between 9 C and 10 C for 1020 min seems exposure of European footballers before the World Cup 2002
useful during acute periods of fixture congestion in order to and their injuries and performances during that World Cup. Br J
regain as quickly as possible the initial level of perfor- Sports Med. 2004;38(4):4937.
3. Dupont G, Nedelec M, McCall A, et al. Effect of 2 soccer
mance and to repress the acute inflammatory process.
matches in a week on physical performance and injury rate. Am
Further studies should analyse the effects of these recovery J Sports Med. 2010;38(9):17528.
strategies on central fatigue. Scientific evidence for the 4. Bishop D. An applied research model for the sport sciences.
other strategies reviewed, such as active recovery, stretch, Sports Med. 2008;38(3):25363.
5. Shirreffs SM, Taylor AJ, Leiper JB, et al. Post-exercise rehy-
compression garments, massage and electrical stimulation,
dration in man: effects of volume consumed and drink sodium
is still lacking in the ability to accelerate the return to initial content. Med Sci Sports Exerc. 1996;28(10):126071.
levels of performance. The lack of evidence, however, does 6. Jentjens R, Jeukendrup A. Determinants of post-exercise glycogen
not mean that these strategies do not aid recovery, but synthesis during short-term recovery. Sports Med. 2003;33(2):
11744.
means that the protocols implemented until now do not
7. Erith S, Williams C, Stevenson E, et al. The effect of high
significantly accelerate the return to the initial level of carbohydrate meals with different glycemic indices on recovery
performance in comparison with a control condition. of performance during prolonged intermittent high-intensity
Many studies examining the efficacy of recovery strat- shuttle running. Int J Sport Nutr Exerc Metab. 2006;16(4):
393404.
egies have focused on recovery in untrained individuals
8. Gunnarsson TP, Bendiksen M, Bischoff R, et al. Effect of whey
from non-soccer-specific exercise and/or recovery proto- protein- and carbohydrate-enriched diet on glycogen resynthesis
cols that do not closely reflect the physical demands of elite during the first 48 h after a soccer game. Scand J Med Sci
soccer play. The applicability of these to recovery between Sports. Epub 2011 Nov 23.
9. Bowtell JL, Leese GP, Smith K, et al. Modulation of whole body
matches for elite soccer players is consequently question-
protein metabolism, during and after exercise, by variation of
able and has yet to be shown. Other potential limitations of dietary protein. J Appl Physiol. 1998;85(5):174452.
studies regarding recovery strategies are that soccer players 10. Ivy JL. Regulation of muscle glycogen repletion, muscle protein
may respond differently to recovery strategies if they are synthesis and repair following exercise. J Sports Sci Med.
2004;3:1318.
accustomed, or not, to playing several matches during a
11. Witard OC, Tieland M, Beelen M, et al. Resistance exercise
congested schedule and the difficulty in implementing a increases postprandial muscle protein synthesis in humans. Med
control condition to prevent any placebo effect (e.g. com- Sci Sports Exerc. 2009;41(1):14454.
pression garments). 12. Beelen M, Burke LM, Gibala MJ, et al. Nutritional strategies to
promote postexercise recovery. Int J Sport Nutr Exerc Metab.
In the survey on recovery in the professional soccer
2010;20(6):51532.
teams, practitioners revealed that different recovery strat- 13. Portier H, Chatard JC, Filaire E, et al. Effects of branched-chain
egies are combined in overall recovery protocols. While amino acids supplementation on physiological and psychologi-
the importance of isolating each strategy to determine its cal performance during an offshore sailing race. Eur J Appl
Physiol. 2008;104(5):78794.
effects in future research remains important, it would also
14. Millard-Stafford M, Warren GL, Thomas LM, et al. Recovery
be interesting to analyse the potential interactions between from run training: efficacy of a carbohydrate-protein beverage?
the techniques. Longitudinal research protocols should be Int J Sport Nutr Exerc Metab. 2005;15(6):61024.
led to examine the chronic effects of recovery strategies on 15. Luden ND, Saunders MJ, Todd MK. Postexercise carbohydrate-
protein- antioxidant ingestion decreases plasma creatine kinase
cellular to molecular adaptations. If a robust pro- and anti-
and muscle soreness. Int J Sport Nutr Exerc Metab. 2007;17(1):
inflammatory cytokine response occurs following a single 10923.
elite soccer match, a dampened anti-inflammatory cytokine 16. Saunders MJ, Kane MD, Todd MK. Effects of a carbohydrate-
response occurs after a second match played within 72 h protein beverage on cycling endurance and muscle damage. Med
Sci Sports Exerc. 2004;36(7):12338.
[106]. For future studies, it would be rational to determine
17. Cockburn E, Hayes PR, French DN, et al. Acute milk-based
when to implement anti- or pro-inflammatory recovery protein-CHO supplementation attenuates exercise-induced
protocols according to the inflammatory response. muscle damage. Appl Physiol Nutr Metab. 2008;33(4):77583.
Soccer Recovery: Part IIStrategies 19

18. Valentine RJ, Saunders MJ, Todd MK, et al. Influence of car- 37. Iglesias-Gutierrez E, Garca A, Garca-Zapico P, et al. Is there a
bohydrate-protein beverage on cycling endurance and indices of relationship between the playing position of soccer players and
muscle disruption. Int J Sport Nutr Exerc Metab. 2008;18(4): their food and macronutrient intake? Appl Physiol Nutr Metab.
36378. 2012;37(2):22532.
19. Pritchett K, Bishop P, Pritchett R, et al. Acute effects of choc- 38. Bailey DM, Erith SJ, Griffin PJ, et al. Influence of cold-water
olate milk and a commercial recovery beverage on postexercise immersion on indices of muscle damage following prolonged
recovery indices and endurance cycling performance. Appl intermittent shuttle running. J Sports Sci. 2007;25(11):116370.
Physiol Nutr Metab. 2009;34(6):101722. 39. Montgomery PG, Pyne DB, Hopkins WG, et al. The effect of
20. Thomas K, Morris P, Stevenson E. Improved endurance recovery strategies on physical performance and cumulative fatigue
capacity following chocolate milk consumption compared with in competitive basketball. J Sports Sci. 2008;26(11):113545.
2 commercially available sport drinks. Appl Physiol Nutr Metab. 40. Vaile J, Halson S, Gill N, et al. Effect of hydrotherapy on the
2009;34(1):7882. signs and symptoms of delayed onset muscle soreness [pub-
21. Ferguson-Stegall L, McCleave EL, Ding Z, et al. Postexercise lished erratum appears in Eur J Appl Physiol 2008 May, 103(1),
carbohydrateprotein supplementation improves subsequent pp. 1212]. Eur J Appl Physiol. 2008;102(4):44755.
exercise performance and intracellular signaling for protein 41. Ingram J, Dawson B, Goodman C, et al. Effect of water
synthesis. J Strength Cond Res. 2011;25(5):121024. immersion methods on post-exercise recovery from simulated
22. Spaccarotella KJ, Andzel WD. The effects of low fat chocolate team sport exercise. J Sci Med Sport. 2009;12(3):41721.
milk on postexercise recovery in collegiate athletes. J Strength 42. Rowsell GJ, Coutts AJ, Reaburn P, et al. Effect of post-match
Cond Res. 2011;25(12):345660. cold-water immersion on subsequent match running perfor-
23. McBrier NM, Vairo GL, Bagshaw D, et al. Cocoa-based protein mance in junior soccer players during tournament play. J Sports
and carbohydrate drink decreases perceived soreness after Sci. 2011;29(1):16.
exhaustive aerobic exercise: a pragmatic preliminary analysis. 43. Ascensao A, Leite M, Rebelo AN, et al. Effects of cold water
J Strength Cond Res. 2010;24(8):220310. immersion on the recovery of physical performance and muscle
24. Gilson SF, Saunders MJ, Moran CW, et al. Effects of chocolate damage following a one-off soccer match. J Sports Sci. 2011;
milk consumption on markers of muscle recovery following 29(3):21725.
soccer training: a randomized cross-over study. J Int Soc Sports 44. Pointon M, Duffield R. Cold water immersion recovery after
Nutr. 2010;18(7):19. simulated collision sport exercise. Med Sci Sports Exerc.
25. Ferrucci L, Cherubini A, Bandinelli S, et al. Relationship of 2012;44(2):20616.
plasma polyunsaturated fatty acids to circulating inflammatory 45. King M, Duffield R. The effects of recovery interventions on
markers. J Clin Endocrinol Metab. 2006;91(2):43946. consecutive days of intermittent sprint exercise. J Strength Cond
26. Tartibian B, Maleki BH, Abbasi A. The effects of ingestion of Res. 2009;23(6):1795802.
omega-3 fatty acids on perceived pain and external symptoms of 46. Kinugasa T, Kilding AE. A comparison of post-match recovery
delayed onset muscle soreness in untrained men. Clin J Sport strategies in youth soccer players. J Strength Cond Res. 2009;
Med. 2009;19(2):1159. 23(5):14027.
27. Houghton D, Onambele GL. Can a standard dose of eicosa- 47. Rowsell GJ, Coutts AJ, Reaburn P, et al. Effects of cold-water
pentaenoic acid (EPA) supplementation reduce the symptoms of immersion on physical performance between successive mat-
delayed onset of muscle soreness? J Int Soc Sports Nutr. ches in high-performance junior male soccer players. J Sports
2012;9(1):2. Sci. 2009;27(6):56573.
28. Lenn J, Uhl T, Mattacola C, et al. The effects of fish oil and 48. Pournot H, Bieuzen F, Duffield R, et al. Short term effects of
isoflavones on delayed onset muscle soreness. Med Sci Sports various water immersions on recovery from exhaustive inter-
Exerc. 2002;34(10):160513. mittent exercise. Eur J Appl Physiol. 2011;111(7):128795.
29. Davis JM, Murphy EA, Carmichael MD, et al. Curcumin effects 49. Vaile J, OHagan C, Stefanovic B, et al. Effect of cold water
on inflammation and performance recovery following eccentric immersion on repeated cycling performance and limb blood
exercise-induced muscle damage. Am J Physiol Regul Integr flow. Br J Sports Med. 2011;45(10):8259.
Comp Physiol. 2007;292(6):R216873. 50. Brophy-Williams N, Landers G, Wallman K. Effect of imme-
30. Wang H, Nair MG, Strasburg GM, et al. Antioxidant and anti- diate and delayed cold water immersion after a high intensity
inflammatory activities of anthocyanins and their aglycon, cy- exercise session on subsequent run performance. J Sports Sci
anidin, from tart cherries. J Nat Prod. 1999;62(2):2946. Med. 2011;10:66570.
31. Connolly DA, McHugh MP, Padilla-Zakour OI, et al. Efficacy 51. Wilcock IM, Cronin JB, Hing WA. Physiological response to
of a tart cherry juice blend in preventing the symptoms of water immersion: a method for sport recovery? Sports Med.
muscle damage. Br J Sports Med. 2006;40(8):67983; discus- 2006;36(9):74765.
sion 683. 52. Meeusen R, Lievens P. The use of cryotherapy in sports injuries.
32. Howatson G, McHugh MP, Hill JA, et al. Influence of tart cherry Sports Med. 1986;3(6):398414.
juice on indices of recovery following marathon running. Scand 53. Yamane M, Teruya H, Nakano M, et al. Post-exercise leg and
J Med Sci Sports. 2010;20(6):84352. forearm flexor muscle cooling in humans attenuates endurance
33. Ramaswamy L, Indirani K. Effect of supplementation of tomato and resistance training effects on muscle performance and on
juice on the oxidative stress of selected athletes. J Int Soc Sports circulatory adaptation. Eur J Appl Physiol. 2006;96(5):57280.
Nutr. 2011;8(Suppl 1):P21. 54. Morton JP, Kayani AC, McArdle A, et al. The exercise-induced
34. Barnes MJ, Mundel T, Stannard SR. Acute alcohol consumption stress response of skeletal muscle, with specific emphasis on
aggravates the decline in muscle performance following stren- humans. Sports Med. 2009;39(8):64362.
uous eccentric exercise. J Sci Med Sport. 2010;13(1):18993. 55. Liu Y, Mayr S, Opitz-Gress A, et al. Human skeletal muscle
35. Szabo G. Consequences of alcohol consumption on host HSP70 response to training in highly trained rowers. J Appl
defence. Alcohol Alcohol. 1999;34(6):83041. Physiol. 1999;86(1):1014.
36. Shirreffs SM, Maughan RJ. Restoration of fluid balance after 56. Liu Y, Lormes W, Baur C, et al. Human skeletal muscle HSP70
exercise-induced dehydration: effects of alcohol consumption. response to physical training depends on exercise intensity. Int J
J Appl Physiol. 1997;83(4):11528. Sports Med. 2000;21(5):3515.
20 M. Nedelec et al.

57. Howatson G, Goodall S, van Someren KA. The influence of cold 80. Conlee RK. Muscle glycogen and exercise endurance: a twenty-
water immersions on adaptation following a single bout of year perspective. Exerc Sport Sci Rev. 1987;15:128.
damaging exercise. Eur J Appl Physiol. 2009;105(4):61521. 81. Afaghi A, OConnor H, Chow CM. High-glycemic-index car-
58. Lapointe BM, Fremont P, Cote CH. Adaptation to lengthening bohydrate meals shorten sleep onset. Am J Clin Nutr. 2007;
contractions is independent of voluntary muscle recruitment but 85(2):42630.
relies on inflammation. Am J Physiol Regul Integr Comp 82. Krauchi K. The thermophysiological cascade leading to sleep
Physiol. 2002;282(1):R3239. initiation in relation to phase of entrainment. Sleep Med Rev.
59. Howatson G, van Someren KA. The prevention and treatment of 2007;11(6):43951.
exercise-induced muscle damage. Sports Med. 2008;38(6): 83. Postolache TT, Hung TM, Rosenthal RN, et al. Sports chrono-
483503. biology consultation: from the lab to the arena. Clin Sports Med.
60. Smith C, Kruger MJ, Smith RM, et al. The inflammatory 2005;24(2):41556, xiv.
response to skeletal muscle injury: illuminating complexities. 84. Roehrs T, Roth T. Caffeine: sleep and daytime sleepiness. Sleep
Sports Med. 2008;38(11):94769. Med Rev. 2008;12(2):15362.
61. Lapointe BM, Frenette J, Cote CH. Lengthening contraction- 85. Feige B, Gann H, Brueck R, et al. Effects of alcohol on poly-
induced inflammation is linked to secondary damage but devoid somnographically recorded sleep in healthy subjects. Alcohol
of neutrophil invasion. J Appl Physiol. 2002;92(5):19952004. Clin Exp Res. 2006;30(9):152737.
62. Raastad T, Hallen J. Recovery of skeletal muscle contractility 86. Lagarde D, Batejat D. Some measures to reduce effects of
after high- and moderate-intensity strength exercise. Eur J Appl prolonged sleep deprivation. Neurophysiol Clin. 1995;25(6):
Physiol. 2000;82(3):20614. 37685.
63. Raastad T, Risoy BA, Benestad HB, et al. Temporal relation 87. Waterhouse J, Atkinson G, Edwards B, et al. The role of a short
between leukocyte accumulation in muscles and halted recovery post-lunch nap in improving cognitive, motor, and sprint per-
1020 h after strength exercise. J Appl Physiol. 2003;95(6): formance in participants with partial sleep deprivation. J Sports
25039. Sci. 2007;25(14):155766.
64. Paulsen G, Crameri R, Benestad HB, et al. Time course of 88. Samuels C. Sleep, recovery, and performance: the new frontier
leukocyte accumulation in human muscle after eccentric exer- in high-performance athletics. Neurol Clin. 2008;26(1):16980;
cise. Med Sci Sports Exerc. 2010;42(1):7585. ixx.
65. Frank MG. The mystery of sleep function: current perspectives 89. Belcastro AN, Bonen A. Lactic acid removal rates during con-
and future directions. Rev Neurosci. 2006;17(4):37592. trolled and uncontrolled recovery exercise. J Appl Physiol.
66. Akerstedt T, Nilsson PM. Sleep as restitution: an introduction. 1975;39(6):9326.
J Intern Med. 2003;254(1):612. 90. Bonen A, Belcastro AN. Comparison of self-selected recovery
67. Maquet P, Laureys S, Peigneux P, et al. Experience-dependent methods on lactic acid removal rates. Med Sci Sports. 1976 Fall;
changes in cerebral activation during human REM sleep. Nat 8(3):1768.
Neurosci. 2000;3(8):8316. 91. Bond V, Adams RG, Tearney RJ, et al. Effects of active and
68. Peigneux P, Laureys S, Fuchs S, et al. Are spatial memories passive recovery on lactate removal and subsequent isokinetic
strengthened in the human hippocampus during slow wave muscle function. J Sports Med Phys Fitness. 1991;31(3):35761.
sleep? Neuron. 2004;44(3):53545. 92. Gupta S, Goswami A, Sadhukhan AK, et al. Comparative study
69. Diekelmann S, Born J. The memory function of sleep. Nat Rev of lactate removal in short term massage of extremities, active
Neurosci. 2010;11(2):11426. recovery and a passive recovery period after supramaximal
70. Wyatt JK, Ritz-De Cecco A, Czeisler CA, et al. Circadian exercise sessions. Int J Sports Med. 1996;17(2):10610.
temperature and melatonin rhythms, sleep, and neurobehavioral 93. Taoutaou Z, Granier P, Mercier B, et al. Lactate kinetics during
function in humans living on a 20-h day. Am J Physiol. 1999; passive and partially active recovery in endurance and sprint
277(4 Pt 2):R115263. athletes. Eur J Appl Physiol Occup Physiol. 1996;73(5):46570.
71. Fischer FM, Nagai R, Teixeira LR. Explaining sleep duration in 94. Koizumi K, Fujita Y, Muramatsu S, et al. Active recovery
adolescents: the impact of socio-demographic and lifestyle effects on local oxygenation level during intensive cycling
factors and working status. Chronobiol Int. 2008;25(2):35972. bouts. J Sports Sci. 2011;29(9):91926.
72. Fietze I, Strauch J, Holzhausen M, et al. Sleep quality in pro- 95. Fairchild TJ, Armstrong AA, Rao A, et al. Glycogen synthesis in
fessional ballet dancers. Chronobiol Int. 2009;26(6):124962. muscle fibers during active recovery from intense exercise. Med
73. Halson SL. Nutrition, sleep and recovery. Eur J Sport Sci. Sci Sports Exerc. 2003;35(4):595602.
2008;8(2):11926. 96. Sairyo K, Iwanaga K, Yoshida N, Mishiro T, Terai T, Sasa T,
74. Skein M, Duffield R, Edge J, et al. Intermittent-sprint perfor- Ikata T. Effects of active recovery under a decreasing work load
mance and muscle glycogen after 30 h of sleep deprivation. Med following intense muscular exercise on intramuscular energy
Sci Sports Exerc. 2011;43(7):130111. metabolism. Int J Sports Med. 2003;24(3):17982.
75. Haack M, Mullington JM. Sustained sleep restriction reduces 97. Weltman A, Stamford BA, Fulco C. Recovery from maximal
emotional and physical well-being. Pain. 2005;119(13):5664. effort exercise: lactate disappearance and subsequent perfor-
76. Sallinen M, Holm J, Hirvonen K, et al. Recovery of cognitive mance. J Appl Physiol. 1979;47(4):67782.
performance from sleep debt: do a short rest pause and a single 98. Weltman A, Regan JD. Prior exhaustive exercise and sub-
recovery night help? Chronobiol Int. 2008;25(2):27996. sequent, maximal constant load exercise performance. Int J
77. Walker MP. Cognitive consequences of sleep and sleep loss. Sports Med. 1983;4(3):1849.
Sleep Med. 2008;9(Suppl 1):S2934. 99. Dupont G, Blondel N, Berthoin S. Performance for short inter-
78. Cohen S, Doyle WJ, Alper CM, et al. Sleep habits and sus- mittent runs: active recovery vs. passive recovery. Eur J Appl
ceptibility to the common cold. Arch Intern Med. 2009;169(1): Physiol. 2003;89(6):54854.
627. 100. Dupont G, Moalla W, Guinhouya C, et al. Passive versus active
79. Irwin MR, Wang M, Campomayor CO, et al. Sleep deprivation recovery during high-intensity intermittent exercises. Med Sci
and activation of morning levels of cellular and genomic Sports Exerc. 2004;36(2):3028.
markers of inflammation. Arch Intern Med. 2006;166(16): 101. Toubekis AG, Douda HT, Tokmakidis SP. Influence of different
175662. rest intervals during active or passive recovery on repeated
Soccer Recovery: Part IIStrategies 21

sprint swimming performance. Eur J Appl Physiol. 2005; 121. Duffield R, Cannon J, King M. The effects of compression
93(56):694700. garments on recovery of muscle performance following high-
102. Spencer M, Bishop D, Dawson B, et al. Metabolism and per- intensity sprint and plyometric exercise. J Sci Med Sport.
formance in repeated cycle sprints: active versus passive 2010;13(1):13640.
recovery. Med Sci Sports Exerc. 2006;38(8):14929. 122. Davies V, Thompson KG, Cooper SM. The effects of com-
103. Dupont G, Moalla W, Matran R, et al. Effect of short recovery pression garments on recovery. J Strength Cond Res. 2009;
intensities on the performance during two Wingate tests. Med 23(6):178694.
Sci Sports Exerc. 2007;39(7):11706. 123. Chatard JC, Atlaoui D, Farjanel J, et al. Elastic stockings, per-
104. Bonen A, Ness GW, Belcastro AN, et al. Mild exercise impedes formance and leg pain recovery in 63-year-old sportsmen. Eur J
glycogen repletion in muscle. J Appl Physiol. 1985;58(5): Appl Physiol. 2004;93(3):34752.
16229. 124. Jakeman JR, Byrne C, Eston RG. Lower limb compression
105. Choi D, Cole KJ, Goodpaster BH, et al. Effect of passive and garment improves recovery from exercise-induced muscle
active recovery on the resynthesis of muscle glycogen. Med Sci damage in young, active females. Eur J Appl Physiol. 2010;
Sports Exerc. 1994;26(8):9926. 109(6):113744.
106. Andersson H, Bhn SK, Raastad T, et al. Differences in the 125. Jakeman JR, Byrne C, Eston RG. Efficacy of lower limb com-
inflammatory plasma cytokine response following two elite pression and combined treatment of manual massage and lower
female soccer games separated by a 72-h recovery. Scand J Med limb compression on symptoms of exercise-induced muscle
Sci Sports. 2010;20(5):7407. damage in women. J Strength Cond Res. 2010;24(11):315765.
107. Andersson H, Raastad T, Nilsson J, et al. Neuromuscular fatigue 126. Gill ND, Beaven CM, Cook C. Effectiveness of post-match
and recovery in elite female soccer: effects of active recovery. recovery strategies in rugby players. Br J Sports Med. 2006;
Med Sci Sports Exerc. 2008;40(2):37280. 40(3):2603.
108. Andersson H, Karlsen A, Blomhoff R, et al. Active recovery 127. Lawrence D, Kakkar VV. Graduated, static, external compres-
training does not affect the antioxidant response to soccer games sion of the lower limb: a physiological assessment. Br J Surg.
in elite female players. Br J Nutr. 2010;104(10):14929. 1980;67(2):11921.
109. Dadebo B, White J, George KP. A survey of flexibility training 128. Trenell MI, Rooney KB, Sue CM, et al. Compression garments
protocols and hamstring strains in professional football clubs in and recovery from eccentric exercise: a 31P-MRS study.
England [published erratum appears in Br J Sports Med 2004 J Sports Sci Med. 2006;5:10614.
Dec; 38 (6): 793]. Br J Sports Med. 2004;38(4):38894. 129. French DN, Thompson KG, Garland SW, et al. The effects of
110. Bandy WD, Irion JM, Briggler M. The effect of time and fre- contrast bathing and compression therapy on muscular perfor-
quency of static stretching on flexibility of the hamstring mus- mance. Med Sci Sports Exerc. 2008;40(7):1297306.
cles. Phys Ther. 1997;77(10):10906. 130. Bartholomew JR, Schaffer JL, McCormick GF. Air travel and
111. Kay AD, Blazevich AJ. Reductions in active plantarflexor venous thromboembolism: minimizing the risk. Minn Med.
moment are significantly correlated with static stretch duration. 2011;94(6):439.
Eur J Sport Sci. 2008;8(1):416. 131. Galloway SD, Watt JM. Massage provision by physiotherapists
112. Witvrouw E, Danneels L, Asselman P, et al. Muscle flexibility at major athletics events between 1987 and 1998. Br J Sports
as a risk factor for developing muscle injuries in male profes- Med. 2004;38(2):2356; discussion 237.
sional soccer players: a prospective study. Am J Sports Med. 132. Weerapong P, Hume PA, Kolt GS. The mechanisms of massage
2003;31(1):416. and effects on performance, muscle recovery and injury pre-
113. McHugh MP, Cosgrave CH. To stretch or not to stretch: the role vention. Sports Med. 2005;35(3):23556.
of stretching in injury prevention and performance. Scand J Med 133. Standley RA, Miller MG, Binkley H. Massages effect on injury,
Sci Sports. 2010;20(2):16981. recovery, and performance: a review of techniques and treat-
114. Dawson B, Cow S, Modra S, et al. Effects of immediate post- ment parameters. Strength Cond J. 2010;32(2):647.
game recovery procedures on muscle soreness, power and 134. Tiidus PM, Shoemaker JK. Effleurage massage, muscle blood
flexiblity levels over the next 48 hours. J Sci Med Sport. 2005; flow and long-term post-exercise strength recovery. Int J Sports
8(2):21021. Med. 1995;16(7):47883.
115. Robey E, Dawson B, Goodman C, et al. Effect of postexercise 135. Shoemaker JK, Tiidus PM, Mader R. Failure of manual massage
recovery procedures following strenuous stair-climb running. to alter limb blood flow: measures by Doppler ultrasound. Med
Res Sports Med. 2009;17(4):24559. Sci Sports Exerc. 1997;29(5):6104.
116. Herbert RD, de Noronha M, Kamper SJ. Stretching to prevent or 136. Wiltshire EV, Poitras V, Pak M, et al. Massage impairs post-
reduce muscle soreness after exercise. Cochrane Database Syst exercise muscle blood flow and lactic acid removal. Med Sci
Rev. 2011;(7):CD004577. Sports Exerc. 2010;42(6):106271.
117. Lund H, Vestergaard-Poulsen P, Kanstrup IL, et al. The effect of 137. Hemmings B, Smith M, Graydon J, et al. Effects of massage on
passive stretching on delayed onset muscle soreness, and other physiological restoration, perceived recovery, and repeated
detrimental effects following eccentric exercise. Scand J Med sports performance. Br J Sports Med. 2000;34(2):10914; dis-
Sci Sports. 1998;8(4):21621. cussion 115.
118. Sigel B, Edelstein AL, Savitch L, et al. Type of compression for 138. Hilbert JE, Sforzo GA, Swensen T. The effects of massage on
reducing venous stasis: a study of lower extremities during delayed onset muscle soreness. Br J Sports Med. 2003;37(1):
inactive recumbency. Arch Surg. 1975;110(2):1715. 725.
119. Duffield R, Portus M. Comparison of three types of full-body 139. Weinberg R, Jackson A, Kolodny K. The relationship of mas-
compression garments on throwing and repeat-sprint perfor- sage and exercise to mood enhancement. J Sport Psychol.
mance in cricket players. Br J Sports Med. 2007;41(7):40914; 1998;2:20211.
discussion 414. 140. Farr T, Nottle C, Nosaka K, et al. The effects of therapeutic
120. Duffield R, Edge J, Merrells R, et al. The effects of compression massage on delayed onset muscle soreness and muscle function
garments on intermittent exercise performance and recovery on following downhill walking. J Sci Med Sport. 2002;5(4):
consecutive days. Int J Sports Physiol Perform. 2008;3(4):45468. 297306.
22 M. Nedelec et al.

141. Zainuddin Z, Newton M, Sacco P, et al. Effects of massage on 156. Tessitore A, Meeusen R, Pagano R, et al. Effectiveness of active
delayed-onset muscle soreness, swelling, and recovery of mus- versus passive recovery strategies after futsal games. J Strength
cle function. J Athl Train. 2005;40(3):17480. Cond Res. 2008;22(5):140212.
142. Warren GL, Lowe DA, Armstrong RB. Measurement tools used 157. Cortis C, Tessitore A, DArtibale E, et al. Effects of post-
in the study of eccentric contraction-induced injury. Sports Med. exercise recovery interventions on physiological, psychological,
1999;27(1):4359. and performance parameters. Int J Sports Med. 2010;31(5):
143. Hinds T, McEwan I, Perkes J, et al. Effects of massage on limb 32735.
and skin blood flow after quadriceps exercise. Med Sci Sports 158. Babault N, Cometti C, Maffiuletti NA, et al. Does electrical
Exerc. 2004;36(8):130813. stimulation enhance post-exercise performance recovery? Eur J
144. Jonhagen S, Ackermann P, Eriksson T, et al. Sports massage Appl Physiol. 2011;111(10):25017.
after eccentric exercise. Am J Sports Med. 2004;32(6):1499 159. Butterfield DL, Draper DO, Ricard MD, et al. The effects of
503. high-volt pulsed current electrical stimulation on delayed-onset
145. Hunter AM, Watt JM, Watt V, et al. Effect of lower limb muscle soreness. J Athl Train. 1997;32(1):1520.
massage on electromyography and force production of the knee 160. Vanderthommen M, Soltani K, Maquet D, et al. Does neuro-
extensors. Br J Sports Med. 2006;40(2):1148. muscular electrical stimulation influence muscle recovery after
146. Barlow A, Clarke R, Johnson N, et al. Effect of massage of the maximal isokinetic exercise? Isokinetics Exerc Sci. 2007;15:1
hamstring muscles on selected electromyographic characteristics 439.
of biceps femoris during sub-maximal isometric contraction. Int 161. Heyman E, DE Geus B, Mertens I, et al. Effects of four recovery
J Sports Med. 2007;28(3):2536. methods on repeated maximal rock climbing performance. Med
147. Robertson A, Watt JM, Galloway SD. Effects of leg massage on Sci Sports Exerc. 2009;41(6):130310.
recovery from high intensity cycling exercise. Br J Sports Med. 162. Neric FB, Beam WC, Brown LE, et al. Comparison of swim
2004;38(2):1736. recovery and muscle stimulation on lactate removal after sprint
148. Viitasalo JT, Niemela K, Kaappola R, et al. Warm underwater swimming. J Strength Cond Res. 2009;23(9):25607.
water-jet massage improves recovery from intense physical 163. Tessitore A, Meeusen R, Cortis C, et al. Effects of different
exercise. Eur J Appl Physiol Occup Physiol. 1995;71(5):4318. recovery interventions on anaerobic performances following
149. Moraska A. Sports massage: a comprehensive review. J Sports preseason soccer training. J Strength Cond Res. 2007;21(3):
Med Phys Fitness. 2005;45(3):37080. 74550.
150. Moraska A. Therapist education impacts the massage effect on 164. Nicholas CW, Nuttall FE, Williams C. The Loughborough
postrace muscle recovery. Med Sci Sports Exerc. 2007;39(1): Intermittent Shuttle Test: a field test that simulates the activity
347. pattern of soccer. J Sports Sci. 2000;18(2):97104.
151. Barnett A. Using recovery modalities between training sessions 165. Buchheit M, Horobeanu C, Mendez-Villanueva A, et al. Effects
in elite athletes: does it help? Sports Med. 2006;36(9):78196. of age and spa treatment on match running performance over
152. Seyri KM, Maffiuletti NA. Effect of electromyostimulation two consecutive games in highly trained young soccer players.
training on muscle strength and sports performance. Strength J Sports Sci. 2011;29(6):5918.
Cond J. 2011;33(1):705. 166. Bishop D, Spencer M, Duffield R, et al. The validity of a
153. Denegar CR, Perrin DH. Effect of transcutaneous electrical repeated sprint ability test. J Sci Med Sport. 2001;4(1):1929.
nerve stimulation, cold, and a combination treatment on pain, 167. Duffield R, Marino FE. Effects of pre-cooling procedures on
decreased range of motion, and strength loss associated with intermittent-sprint exercise performance in warm conditions.
delayed onset muscle soreness. J Athl Train. 1992;27(3):2006. Eur J Appl Physiol. 2007;100(6):72735.
154. Lattier G, Millet GY, Martin A, et al. Fatigue and recovery after 168. Rupp KA, Selkow NM, Parente WR, et al. The effect of cold
high-intensity exercise. Part II: recovery interventions. Int J water immersion on 48-hour performance testing in collegiate
Sports Med. 2004;25(7):50915. soccer players. J Strength Cond Res. 2012;26(8):204350.
155. Martin V, Millet GY, Lattier G, et al. Effects of recovery modes 169. Bangsbo J. Yo-yo tests. Copenhagen: AK Institute; 1996.
after knee extensor muscles eccentric contractions. Med Sci
Sports Exerc. 2004;36(11):190715.