Do you use ice baths or compression tights after running? Have you given much thought as to whether they actually work? We take a look at some common methods of recovery for athletes, and find out which are the most beneficial. And, the final push to remove trachoma in Indigenous communities.

https://soundcloud.com/thinkhealth/35-whats-the-best-method-of-recovery-for-athletes-trachoma-in-indigenous-commnities

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Speakers:
Anna Kolomycki – Massage therapist, Paramount Sports Recovery
Rob Duffield – Associate Professor, Sport and Exercise Science, UTS Faculty of Health
Jackie Adems-Barton – Manager of the Indigenous Australia program, Fred Hollows Foundation
Professor Hugh Taylor – Harold Mitchell Professor of Indigenous Eye Health, University of Melbourne

Presenter: Ellen Leabeater
Producers: Ninah Kopel

START OF TRANSCRIPT

Ellen Leabeater: Hi, welcome to the show. I’m Ellen Leabeater. Today the final push to remove Trachoma in indigenous communities.

Hugh Taylor: We need to continue the effort to make sure we actually eliminate Trachoma from the Australian children. If we start halfway it’s like a spring. If it’s not actually locked out, it will just spring right back up again.

Ellen Leabeater: First on the show. It’s just past 8am on a Saturday, and Park Run is in full swing. Park Run is a free 5 kilometre run held at venues across Australia and the world, and runners compete against each other for the best time. On this particular Saturday, 5 kilometres was just a warm up for a running festival happening in Sydney the following day with runners planning on competing in a 9 kilometre, half marathon, or marathon race. I was actually gearing up for my second half marathon on Sunday, but skipped today’s 5 kilometre park run. I was here for a very different reason.

I work for a program called Think:Health, and I’m just working on a story about recovery in athletes and what different people use. Yeah, just something a bit fun.

Interviewee: Yeah, why not? Do you run yourself?

Ellen Leabeater: Yeah, I do. I’m doing the half marathon tomorrow.

Interviewee: Oh okay, okay. Good luck. Good luck with that.

Ellen Leabeater: But first, a bit of context. If you are serious about training for a half marathon or marathon, you can be running anywhere between 30 and 60 plus kilometres a week. As you can imagine, clocking that many Ks can take a serious toll on your body, so in these running circles there is understandably a focus on recovery. For the uninitiated, recovery is important as you want to return your body to what it was pre training, give it time to rest and repair, so when race day rolls around, you can perform at your best. Recovery’s important because your body needs to have some down time in order to heal.

Ellen Leabeater: This is Anna.

Anna Kolomycki: Hi, I’m Anna. I’m a massage therapist at Paramount Sports Recovery. There’s a lot of muscle breakdown that can occur during really high intense training. You’ve got to give the body the time to heal that so it can get back out there and do it again.

Ellen Leabeater: We’ll hear more from Anna a little later. Okay, now fast forward to the real reason why I was at Park Run. In prepping for the half marathon, I’ve tried compression, massage, ice baths, foam rolling, carb loading, but always wondered how much of an impact any of these methods had come race day. I thought I would check in with some other runners to see what worked for them, and what better way to do so than getting people to jump in an ice bath.

What’s your name and what time did you do today?

Belinda: I did 25:18 and my name’s Belinda.

Ellen Leabeater: What sort of recovery methods do you normally use after running?

Belinda: Just mainly stretching. Yeah, I use a bit of a roller on my calves in particular, rest, and cold packs.

Ellen Leabeater: Cold packs?

Belinda: Yeah, I’m looking forward to this.

Ellen Leabeater: You going to jump in?

Belinda: Yeah. Take my shoes off.

Ellen Leabeater: Are you doing the half marathon or the marathon tomorrow?

Belinda: I’m doing the 9K tomorrow, yeah. The only reason I came today is because I knew you were coming with the bath so I thought that’s my excuse to come and run today and then run tomorrow.

Ellen Leabeater: Have you used ice baths before?

Belinda: No, I haven’t. Would you like to tell me what I am to expect here?

Ellen Leabeater: Probably a lot of numbness.

Rory was another runner who ran 5K this morning and was attempting the half marathon the next day. Rory says he has used ice baths in the past especially when the running season starts to ramp up.

What time did you do today?

Rory: 20:57.

Male in background: Just jump in then.

Rory: It’s cold.

Ellen Leabeater: What sort of recovery methods do you normally use Rory?

Rory: Well, normally just do a bit of stretching. At the start of the season, I do this more because my legs normally hurt more.

Ellen Leabeater: Do you think ice baths actually work for you?

Rory: They take the pain away a bit which is good. I got the idea. I don’t know much about the science, but yeah that the cold water stops the blood flowing to the muscles, or it stops it flowing around the body, and then when you take it out, then it gets warmer. Then it lets new blood flow in more effectively, but that’s about as far as I know. I might be wrong.

Ellen Leabeater: Belinda’s friend Kelly also jumped in the bath which was by now pretty cold as the ice was well and truly beginning to melt.

Ellen Leabeater: What time did you do today Kelly?

Kelly: 26:35

Ellen Leabeater: Good. Good job.

Kelly: I think that’s a PB so I’m happy… Holy crap that’s cold.

Ellen Leabeater: Have you ever used an ice bath before?

Kelly: No.

Ellen Leabeater: What sort of recovery methods do you normally use?

Kelly: Stretch and that’s about it. Stretch down.

Ellen Leabeater: Have you heard about ice baths before?

Kelly: Yeah, yeah because my boyfriend plays league and stuff so he’s always talking about ice baths for recovery. I’ve never done it though.

Ellen Leabeater: Should try it more often. Should come down every week. It was Belinda wasn’t it? Yeah, how are you feeling now that you’ve been in for a couple of minutes?

Belinda: Yeah, I’m getting a bit numb. My feet are definitely really frozen out and wrinkly as you can see, but I feel good. Yeah.

Ellen Leabeater: Everyone had a perception that ice baths were helpful, but what does the research say? I asked Rob Duffield, associate professor in sport and exercise science at the University of Technology Sydney.

Rob Duffield: It allows a flushing effect though the muscle by basically having vasoconstriction to the periphery so vasoconstriction is shutting down the blood flow to the periphery and then funnelling that blood into the muscles. That’s the theoretical argument. There’s not really the proof for that. Cold water immersion really works best it seems when the environmental conditions are hot so it helps as a cooling agent following exercise in the heat when the muscle damage is maybe higher or the extent of use is higher, so an unaccustomed bout. If you’re used to running 10 kilometres and you do a 12 to 15 kilometre effort, that excessive load from training. Cold immersion has benefits there.

Ellen Leabeater: Cold water immersion in an Aussie summer, if you’re doing a marathon or a half marathon?

Rob Duffield: Absolutely, pre cooling, post cooling. It’s a great option.

Ellen Leabeater: For you to really see the benefits of an ice bath, though, you need to stick it out for a good 15 minutes.

Rob Duffield: Normally whole body immersion in 10 to 12 degrees for 15 to 20 minutes, so quite substantial cold immersion. If you go into any professional football team if you can get 5 to 8 minutes out of the guys, you’re doing very well. If you go into any amateur, if you can get more than 2 to 3 minutes in that environment, you’re doing exceptionally well. What the research tells us about the extent of cold water immersion you need and what people actually do, there’s a bit of a difference.

Ellen Leabeater: Back at Park Run I noticed a lot of runners in compression gear. Here’s Belinda again.

You’ve got compression leggings on as well. Do you use compression for recovery.

Belinda: Yeah, I would do yeah. Yeah I did have there a calf injury at some point, so I went and got some of these compression tights, and I’ve found that it’s a lot nicer to run in, yeah.

Ellen Leabeater: Do you think it actually physically works for you, like the cold packs and compression and that?

Belinda: Actually yeah.

Ellen Leabeater: Full disclosure. I was also in compression tights all day prior to the race in the hope they would do… something? But unlike ice baths, there is minimal research to back up compression clothing as an effective form of recovery. Do compression garments have any benefit during exercise?

Rob Duffield: Again, most of the evidence would suggest no from research from crossover trials and counter balance trials and placebo trials. Most of it is belief. There are some studies that show repeated jumping for peak power and repeated cycling efforts have some improvement in performance with compression garments, but most sprinting, power jumping, running studies don’t show any improvement.

Ellen Leabeater: There’s another type of recovery that I hadn’t heard of until I met with Anna. It’s a salt bath. 350 kilos of salt dissolved in a tank that apparently helps sore muscles and helps you to relax. In the name of research, I decided to give it a try.

Anna Kolomycki: In the tank, there’s 350 kilos of Epsom salt. The water depth is only about 25 centimetres, so what you’ll find is that with the amount of salt in the solution, it becomes more buoyant than it is in the Dead Sea, so when you hop in you will quite literally float very effortlessly on the surface. The whole idea when you’re floating is that you don’t know where your skin ends. You don’t know where the water begins. It’s dark. It’s quiet. You don’t feel the pressure of anything underneath you, so it’s an environment where you can really easily lose yourself which is quite nice. That’s the relaxation side of stuff. Epsom salts are a magnesium and a sulfate, so it’s a muscle relaxant and a protein builder for your joints. You absorb a lot of that whilst you’re floating. You get to experience a bit of an anti-gravity effect as well in that you don’t feel sort of anything underneath you. You get the sense of being suspended, which is nice.

You need to have a quick rinse before you hop in just to get the dirt off you. The door behind you, shower’s on the right, toilet’s on the left.

Ellen Leabeater: Fantastic.

Anna Kolomycki: Any questions?

Ellen Leabeater: No.

Anna Kolomycki: That’s it. Perfect. Enjoy. I’ll leave you to sort that side of stuff out.

Ellen Leabeater: All right thanks. We’ll see you in an hour. Okay. Shower off, and I’m about to get in the tub. So I had a really punishing swim session last night, and I’ve backed it up with a gym session this morning, so let’s see if this bath does anything. Kind of feels, I’m in I’ll say half way up my calf. It feels, eew. There’s a scab on my toe that really hurts from it. Now I guess it’s time to turn the mike off and relax.

This is a kind of really surreal experience. I still now that I’m out of the tub, I still feel like I’m in the tub. It’s like when you go to the beach and you spend too long in the waves, and then you go to bed that night and you can still feel the waves. It feels like I still feel a little bit weightless, and my body’s still … Everything, yeah it really feels really loose I guess. I’m not sure it’s had any immediate benefit, but I definitely feel more relaxed. My arms are really sore from an arm workout this morning, and yeah I guess they feel really really loose as well.

It was weird once you were in there and you do float. Anna was right, you do feel like you can’t feel the end of your fingers and your toes. It just all becomes one in this bath. It’s like laying down on a mattress, and the mattress being the most supportive mattress ever, but also super comfortable like you can’t feel the mattress. You just … It’s the ultimate floating experience. I’m really thirsty from all the salt.

The next day after the float, I must admit I didn’t have that moment of feeling like a new person. Now is probably the time to say that all of this recovery stuff comes down to one thing. You may have heard Rob say it earlier.

Rob Duffield: Most of it is belief.

Ellen Leabeater: Take for example another form of recovery; massage. There is no evidence saying massage helps recovery, but Rob says the majority of athletes can’t get enough of it.

Rob Duffield: Athletes love massage, but the proof of it in terms of scientific validity for recovery is not that strong, but show me an athlete who doesn’t want massage following an exercise bout or training bout, and well probably can’t find one. Although from a physiological or scientific perspective, you’d argue well massage has no place because the evidence from a perspective of the athlete being ready to train and what they believe in, it’s a massive one. Recovery is combining that physiological state with the mental preparation to believe they can train or compete again.

Ellen Leabeater: This is something massage therapist Anna agrees with.

Anna Kolomycki: Massage is one of those tools that’s awesome for recovery during training blocks because it works to get a lot of tension out of the body. Works to release a lot of trigger points, and we find that there is that intense perceived benefit by clients because they feel good after having a session. They feel relaxed after having a session. They certainly get up the next day. They can tell that they’re looser.

Ellen Leabeater: If you truly believe compression or floating in a salt bath or an ice bath or massages work, then they probably do. Rob says that at the end of the day we are human and belief is a pretty big driver of success for athletes.

Rob Duffield: They believe they feel better. They believe that muscle soreness is lower. They believe that their readiness to train or readiness to compete is higher. That’s where the placebo effect comes in.

Ellen Leabeater: Before you go stocking up on ice cubes and compression tights, keep in mind that these forms of recovery are what’s known as marginal gain. If you think of recovery as a pie chart, Rob reckons around 2% is made up of the methods we have talked about so far. The biggest chunks that will affect your performance are sleep, hydration, nutrition, and reducing your training load when you need to.

Rob Duffield: We tend to talk about recovery in general as being our big blocks or our big drivers of recovery, so we’re talking reducing the training load, reducing the amount of work you do in the next session if it’s appropriate; making sure you get appropriate nutritional intake so carbohydrate and protein immediately after, and then in the ensuing couple of hours; and then avoidance of factors that reduce sleep. They’re the big 3 primary drivers to provide good recovery.

Ellen Leabeater: Props to our Park Run guinea pigs. Most of whom were good sleepers and eaters.

What about sleep and nutrition? Do you pay attention to that after you’ve done a race.

Belinda: Probably not as well as I should, but yeah. I do sort of have a good diet I guess. I do watch what I eat. I have a lot of protein, a lot of smoothies. I don’t eat a lot of rubbish. Sleep. I’m a good sleeper. About 8:30 on the lounge every night. I have a good 8 hours every day.

Rory: I think sleep’s important. If you don’t have a good night’s sleep I find the run pretty hard in the morning. A good night sleep’s good for your running. Prior to, the best power food in the world, you have a banana. After the race, you have to, you’ve trained all week for it, and you tend to reward yourself and have a nice breakfast. Heaps of carbs afterwards.

Ellen Leabeater: Whatever recovery you use, whether it’s ice baths or a good night’s sleep, Anna says it is important that you stick with your recovery methods to avoid injury and to maximise training. It all comes down to looking after yourself.

If you are going to commit to doing a sport, whatever sport it be, know that it doesn’t matter how much you spend on shoes, or how much you spend on your bike, you’ve got to service yourself, too because if you’re the one who’s doing everything and you’re not servicing you, you’re not looking after yourself. There’ll come a point in time where you may have an injury that’s going to cost you more in lost time, lost training, than if you’d have just slotted things into place to give you support to help you get through. As always, if you would like to find out more about that story and see the ice bath in action, visit 2SER.com/thinkhealth.

Voiceover: Think health on 2SER 107.3.

Ellen Leabeater: Trachoma is the world’s leading cause of infectious blindness, but Australia is the only high income country in the world that hasn’t eliminated it. Trachoma, or as it used to be known, sandy blight, is caused by bacteria in the eye which creates a swelling under the inner eyelid and leads to scarring. Australia has tried to tackle this in the past, so why is it still an issue in some Aussie communities? Ninah Kopel finds out.

Ninah Kopel: It’s been 40 years since Fred Hollow’s brought eyesight for Australia’s indigenous population to the nation’s attention.

Jackie Adems-Barton: Fred Hollows and a team including Aboriginal health workers went out across Australia on what is called the National Trachoma and Eye Health program.

Ninah Kopel: This is Jackie Adems-Barton, manager of the Indigenous Australia program at the Fred Hollows Foundation.

Jackie Adems-Barton: It’s the first of its kind to look at eye health across Australia particularly in the remote areas so that program. That program commenced 40 years ago, so you can imagine back then the landscape was very different to what it is now.

Ninah Kopel: The government provided 1.4 million dollars with the aim of eliminating Trachoma and improving eye health among Aboriginal and Torres Strait Islander Australians. Fred Hollows and the team set out across Australia in four-wheel drives.

Jackie Adems-Barton: He was totally flabbergasted at the state of Aboriginal health, so not only is Fred a leading ophthalmologist in Australia, but he was also a leading advocate for health equity for Aboriginal and Torres Strait Islander people, but obviously back from the learning of Fred and the team in the national program was the need to engage people at a local level so talk to and listen to Aboriginal people on the ground and give them the tools in order to make the right decisions around health, in particular eye health.

Ninah Kopel: The rates of Trachoma in indigenous communities are better than they once were, but in some areas of Australia, 4% of indigenous kids aged 5 to 9 still have an active Trachoma infection. In the Northern Territory, it’s at 5% which is considered endemic.

Hugh Taylor: Well, Trachoma, we used to call it sandy blight, but it disappeared from mainstream Australia over 100 years ago as our living conditions improved.

Ninah Kopel: This is Professor Hugh Taylor, Harold Mitchell Chair of Indigenous Eye Health at the University of Melbourne. He was also part of the team in the 70’s working on the National Trachoma and Eye Health program with Fred Hollows.

Hugh Taylor: That persists in areas where there’s poor personal and community hygiene. It’s a blinding infection that gets spread repeatedly from one child to another with infected eye secretions so that every child with a dirty face is a health hazard and is likely to infect other people with the Trachoma germs. Trachoma really revolves around the need for to keep every child’s face clean in these remote communities so that they don’t spread the infection. We’re also teams, health department teams are going out treating everybody who needs treatment with antibiotics to reduce the level of infection. That’s very specifically targeted at the younger children and their families. The older people who at the end stage of Trachoma end up with the eye lashes rubbing on the eyes, that needs the other health care systems, so that there is referral to ophthalmologist or eye surgeons to have the corrective surgery. The main thrust is to stop the children of today developing the scarring and eyelash problems that they would otherwise develop in later life.

Ninah Kopel: It’s not all doom and gloom when it comes to Trachoma.

Hugh Taylor: We are actually making good progress. We’re making very good progress. The rates of Trachoma in the remote areas have dropped from being somewhere between 15 to 20% in children down to now less than 5%, and that’s a dramatic change in the last half dozen years. I think the healthcare systems are working so most of the people who have the in-turned eyelashes are now being detected and referred and receiving the corrective surgery they need. What we need to do is we need to continue the effort to make sure we actually eliminate Trachoma from the Australian children now. If we stop half way, it’s like a spring. If it’s not actually locked out, it’ll just spring right back up again.

Ninah Kopel: Professor Taylor says the government is on board with fighting the disease, but he won’t be counting the funding until he sees it.

Hugh Taylor: The Australian government committed to eliminate Trachoma by the year 2020, and so there’s good progress on that. One of the problems with these government programs is that the funding is only for a certain number of years, and the current round of funding ends in 2017, and although everybody says, ‘oh yes, it’ll be, the funding will continue’, until you actually see it in the budget, it’s still a certain degree of uncertainty. Certainly there’s a lot of interest in support from both the commonwealth and the Australian territory governments to actually see this job done.

Ninah Kopel: When it comes to people like Professor Hugh Taylor entering communities and teaching them about health and hygiene, there are cultural sensitivities that can be hard to navigate.

Hugh Taylor: Very much so, and we certainly have done a lot of research, but also have used that research to inform the health intervention and health promotion activities that we’re doing. With that we work very closely with the communities themselves with the aboriginal health services and then with the state and national bodies because changing social norms and changing a behaviour is a very sensitive issue that has to be handled carefully, so it’s been very important for us to have strong community engagement and input in the way we develop and shape the messages.

Ninah Kopel: One of the ways they’re doing this is through Milpa, the Trachoma Goanna.

[Milpa the Goanna theme music plays]

Milpa is part of a campaign to prevent Trachoma through the S.A.F.E. strategy, which is ‘S’ for surgery to correct inward eyelashes, ‘A’ for antibiotics to reduce levels of infection, ‘F’ to promote face washing, and ‘e’ for environmental impacts in sanitation.

Jackie Adems-Barton: Where we see the most benefit and the most value added in terms of what needs to be achieved to eliminate Trachoma. It is around the ‘E’ side of the S.A.F.E. strategy.

Ninah Kopel: Jackie Adems-Barton again from the Fred Hollows foundation.

Jackie Adems-Barton: The environmental health side which is about improving or giving people access to the right tools and equipment and running water and hygiene facilities to insure that environmental health activities are linked to the elimination of Trachoma but more broadly that it’s a whole of health, whole of household, whole of family approach to better health for the community. In order to insure that the elimination of Trachoma and efforts around eliminating Trachoma are sustainable. We need to and we must look at the e side of the strategy and resource and listen to communities about what they need to implement environmental health activities that will better the health of their community.

Ellen Leabeater: Jackie Adems-Barton, manager of the indigenous Australia program at the Fred Hollows Foundation ending that report by Ninah Kopel.

If you would like to find out more about that story, head to 2SER.com/thinkhealth. We’re also available wherever you are. Just search for ‘Think Health’ in your favourite podcast app. If today’s program has raised any issues with you, go and see your GP. The show is produced with the support of the University of Technology Sydney Faculty of Health. I’m Ellen Leabeater. This has been Think:Health. See you next week for more in health research and news.

END OF TRANSCRIPT