Recently, I have been helping athletes break through the plateaus in their training progress and injury recovery. They were experiencing decreased performance, inability to bounce back to training the next day, not achieving personal records, or falling behind with their training results. These roadblocks don’t have to be career-ending, nor do you have to continue to suffer from pain.
In this article, I will share with you the potential root causes that had kept my pro-athlete patients from their desired training progress and complete injury healing before they came to see me. Then, I’ll also share a few technologies and treatment options that help with these cases.
6 science-based reasons you are hitting plateaus in your training and injury recovery
Being a professional athlete is very demanding on your physiology. You’re living a lifestyle that produces a tremendous amount of oxidative stress, and tissue wear and tear. Yet, when athletes hit a plateau, rarely do the root causes get examined.
1) Mitochondrial dysfunction
The mitochondria are your cell’s energy powerhouse. They burn fat and glucose molecules into energy (ATP). Aside from producing energy, your mitochondria are also responsible for detecting threats and coordinating the cellular threat response.
High oxidative stress can result in sluggish mitochondria that cannot produce energy efficiently, and thus, a poorly fueled cell.
As a professional athlete, you have a lot of oxidative stress from intense and high volumes of training. Toxic exposure and mental-emotional stress can make it worse. These are especially problematic if your body doesn’t have enough antioxidants to counteract these.
The ATP produced by your mitochondria is critical for exercise recovery and injury healing. Therefore, mitochondrial dysfunction is the #1 factor inhibiting your recovery from training and injuries. They may even cause chronic pain.1 In fact, most biohacks that help with these processes (see below) work by jumpstarting the mitochondria.
2) Chronic inflammation or “inflammaging”
Injuries normally go through four separate but overlapping phases of healing:
- Blood clotting to stop bleeding
- Local inflammation to fight infection and remove damaged tissues
- Proliferation to fill a wound with new and healthy tissue
- Maturation or remodeling, in which the new tissues gain strength and flexibility
Chronic injuries indicate that the healing process has become stuck between the inflammatory and proliferative phases. This happens when excessive inflammation is present, often due to systemic inflammation or insufficient blood supply.2 The unfavorable healing environment creates a cycle that traps the injury in the inflammatory phase, which may cause the injury to become chronic.
Training and recovery also often involve phases 2 through 4. Here, systemic inflammation or poor blood circulation can block sufficient recovery progress or create prolonged soreness.
Fortunately, there are many biohacks that can help you break the cycle.
But, beyond biohacking, there is a deeper root cause. You may feel that you used to recover from training and injuries just fine, but once you hit a certain age, this is no longer the case. You may have aged, which means more systemic inflammation, so you need to adjust your recovery strategies and start addressing the age itself.
By “aging,” I don’t mean chronological age. Rather, it’s your biological age, as governed by the hallmarks of aging. These include3:
- Genomic instability
- Shortening telomere
- Epigenetic changes, such as certain methylation marks
- Reduced ability to stabilize proteins and rejuvenate cellular components (autophagy)
- Declining hormones and hormone sensitivity
- Mitochondrial dysfunction
- Stem cell exhaustion
- Cellular senescence
Being biologically young is the biggest edge you can have as a professional athlete. It enables the best hormonal functions, inflammation resolution, and training recovery. This is why I test my professional athletes for their biological age and recommend anti-aging treatments. Fortunately, there is a lot you can do naturally to reduce your biological age and improve your longevity.
3) Insufficient sleep, stress, and under-recovery
Training should work as hormesis, or as a stressful stimulus that helps your body get stronger once you recover from it. It’s only beneficial if the dose and intensity are within your capacity to recover. Therefore, you may need to improve the quality of your recovery or dial down your training so that your body can recover from your training.
Wearable data, including sleep quality, heart rate variability, strain, and body temperature are extremely helpful to monitor your recovery. But often, athletes are stuck with their training or injury recovery because they have not fully optimized their sleep and recovery.
Sleep, especially deep sleep, is critical for training recovery and injury healing. When you are not getting the results you are seeking, it is important to optimize both sleep quality and quantity. When you are training hard or recovering from an injury, you need all the high-quality deep sleep. To do so, it is critical to optimize your sleep hygiene and circadian rhythm, and remove all factors that interfere with your sleep.
Heart Rate Variability (HRV) measures the sum effects of stress and levels of sympathetic and parasympathetic nervous system activities. Factors that may affect your HRV include:
- Your training
- Sleep quality
- Postural issues that stress the body or affect the nerves
- Massages and manual therapies
- Brain health
- Overall inflammation, including from food and infections
- Other sources of stress, including mental-emotional stress
If your HRV always appears to be suboptimal regardless of the interventions, it will be important to examine and address all these possible contributors. This is why I incorporate a holistic mind-body approach, while monitoring useful biofeedback like HRV.
4) Movement dysfunction and misalignments
Movement dysfunctions and compensatory patterns can come from structural misalignments, imbalances, and tissue adhesions. They can put your body in a threatened or restricted state, which can cause pain and injury, prevent optimal performance, and hinder recovery.
Given how hard athletes train, compensatory movement patterns can have ripple effects throughout the body, so it is very important to correct them sooner than later. It is, therefore, important to see an osteopathic physician who can assess these and correct them accordingly, especially if foam rolling and stretching haven’t been providing results.
In my practice, I use a variety of techniques to help correct movement restrictions, restore alignment, promote healthy blood flow, and relieve pain. These modalities work with your biomechanics and nervous system to help your body get out of the threatened or restricted state, so it can repair itself.
Osteopathic manipulations involve checking for tissue texture changes, asymmetry, restricted range of motion, and tenderness. Then, I use a variety of manual adjustments that work with your joints, nerves, soft tissues, and fascia to correct any dysfunctions found.
Cupping is an ancient Chinese medicine technique that involves using suction cups in the area. It promotes blood flow and jumpstarts the healing process when there is healing stagnation.
Dry needling involves using acupuncture needles to treat myofascial trigger points to relieve pain or spasms in the area. Trigger points are knots or taut bands that develop in muscles, often developing secondary to a chronic injury or compensatory movement patterns.4
Fascial stretch therapy is a type of assisted deep stretching. It involves stretching the connective tissues that connect your muscles, tendons, ligaments, bones, nerves, and organs. It improves mobility and flexibility throughout the body, which typically results in decreased pain and stress, and often improved sleep.5
Having professional assessments and targeted therapy can mean a difference between a few weeks to complete injury recovery and nagging ones that last for years. One of my patients could not lift at all due to shoulder pain. Within 6 – 8 weeks after beginning treatment, he could finally do chest press in the gym.
5) Nutritional deficiencies
To recover from your training and heal from your injury, your nutrition has to be on point, which also means that your gut health has to be optimal. And the only way to know is to test. I use the Metabolomix test to identify any functional nutritional imbalances or deficiencies, along with other blood and gut tests.
Based on the test results and clinical findings, I help you individualize your diet, add the right supplements, eliminate inflammatory foods, and give yourself the nutrients your body specifically needs.
Biohacks that can help with training recovery and injury healing
Many powerful biohacking technologies and treatments can further improve your training results and support your injury healing. However, keep in mind that unless you address the root causes above, the biohacks may work as temporary symptoms management.
Photobiomodulation (PBM) is also commonly known as red light therapy or low-level laser therapy (LLLT). It uses red (630-660 nm) or near-infrared (800-880 nm) light to activate your mitochondria and increase ATP production. The near-infrared penetrates deeper into the joints, whereas the red light treats the skin and tendons closer to the skin surface.
The increase in ATP and reduction in oxidative stress jumpstarts the healing processes that have been stagnant due to mitochondrial dysfunction. Other cellular effects of PBM includes:
- Increasing cyclic AMP
- Reducing inflammatory cytokines, such as TNF-alpha, which causes chronic inflammation
- Blocking nociceptor (pain-sensing neurons) function to decrease pain sensitivity6
- Reducing creatine kinase and lactate dehydrogenase, which are markers of muscle fatigue7
Studies show that PBM helps athletes with:
- Enhancing muscle performance8
- Reducing inflammation9
- Decreasing muscle fatigue and damage after high-intensity exercise7
- Improving flexibility, passive range of motion, and reducing pain after surgical tendon repair10
- Relieving acute and chronic musculoskeletal pain11,6
Pulsed Electromagnetic Field Therapy
Pulsed electromagnetic field therapy (PEMF) involves applying low-power and low-frequency electromagnetic pulses to an area of the body.
Scientists are still trying to fully understand how PEMF works, but the most well-known mechanism of action of PEMF is by moving calcium into the cells. The calcium entry triggers a cellular cascade that improves blood flow to the injured area and increases the production of growth factors and other regenerative proteins.12
PEMF supports both the injured area and the surrounding blood vessels, fibrous tissues, muscles, bones, and the immune cells that help clean up the injured area.12 Through these mechanisms, PEMF accelerates healing of acute injuries and restarts the healing process for chronic injuries, allowing them to finally resolve.
Clinical studies have shown that PEMF therapy can benefit athletes of all types suffering from any of the following:
- Tendonitis and bursitis including tennis elbow, golfers’ elbow, and pitcher’s shoulder12
- Patellar and meniscal injuries13
- Spinal pain due to degeneration of intervertebral discs, vertebral joints, or whiplash12
- Bone fractures14
- Osteoarthritis, rheumatoid arthritis, and arthrosis12
Heat exposure and infrared sauna are not only relaxing but also deliver many recovery and anti-aging health benefits.
Infrared saunas use either near-infrared (NIR), far-infrared rays (FIR), or both. Infrared rays penetrate into the body to heat it from inside and also deliver health benefits in ways that are independent from heat.
Health benefits of infrared saunas include:
- Stimulation of heat shock proteins and autophagy, which helps renew old cellular components.15 It also helps with muscle recovery and muscle building.
- Increase of nitric oxide, which dilates the blood vessels, improving circulation and blood flow.16 The improved blood flow reduces swelling through improved drainage and removal of metabolic waste.17 Moreover, sauna bathing after exercise has been shown to improve aerobic endurance due to the increase in nitric oxide.18
- NIR stimulates the mitochondria via photobiomodulation. However, in an infrared sauna that provides NIR, you’re getting a much higher dose of the infrared than with a PBM device.
- FIR may create structured water inside your cells and your blood. The structured water has antioxidant and anti-inflammatory properties19
- Increase of IGF-1 and growth hormone, which are important for injury recovery20
- Improvement in sleep21
Many studies have described the tremendous health benefits of FIR, although scientists still don’t fully understand how it works. FIR reduces joint and blood vessel inflammation, and improves microcirculation.22,23
A study found that FIR improved training recovery and thus, performance in athletes who are intensely training. However, the benefits of FIR did not replace sleep, nutrition, and bodywork.24
For the injured athlete, an infrared sauna can help with pain, swelling, and stiffness, particularly in those with chronic diseases.25,17 The cardiovascular and aerobic endurance (VO2max) effects of sauna use can maintain some of their aerobic capacity if they are unable to train.
Hyperbaric Oxygen Therapy
Hyperbaric oxygen therapy (HBOT) refers to the administration of 100% oxygen at a pressure higher than that of the atmosphere.26 Although it’s best known for resolving non-healing wounds and carbon monoxide poisoning, athletes are also finding it helpful for training and injury recovery.
In the short term, HBOT boosts oxygen delivery to tissues throughout the body. After multiple treatments, it promotes new blood vessel growth and collagen production,26 which are important for injury healing.
By creating hormetic doses of free radicals in the cells, it stimulates the production of growth factors, mobilizes stem cells, and reduces neutrophil adhesion.27 As a result, HBOT helps with swelling, inflammation, infection, and accelerating healing times of injured tissues.28
For injured athletes, HBOT jumpstarts the transition from the inflammatory phase to the proliferative phase, allowing muscle regeneration after an injury.29 This reduction of the inflammatory phase has also proven to promote faster recovery of neurologic tissue following a spinal injury.30
While generally regarded as safe, HBOT does have potential adverse effects, most notably trauma due to pressure (particularly to the eardrum), and oxygen toxicity. These adverse events are usually mild and reversible, but HBOT should only be considered after a thorough discussion of your medical history with your doctor to minimize any potential risks.
Peptides are small proteins that naturally occur in your body. Some of them are particularly helpful in enhancing the healing processes of the body. The peptides most commonly used for injury healing are those which upregulate the growth factors that are important for tissue healing.
Body protective compound 157 (BPC 157) is naturally found in stomach secretions. It promotes tissue healing by increasing growth factors, new blood vessels, and modulating nitric oxide synthesis.31
Thymosin beta 4 (Tβ4 or TB500) comes from the thymus. It has anti-inflammatory activity and supports the repair of injured bone, ligaments, and nerves.32,33
You can inject these yourself under the skin into fat tissues (subcutaneously). Whereas, intramuscular and joint injections should be done by a medical professional. We do perform these injections in the clinic.
Delivering substances directly to the bloodstream is the fastest way for them to reach their intended target tissue and have their intended effect. I use a variety of IV therapies to complement the methods listed above, mixing and matching them based on your individual needs:
- Rehydration therapy – appropriate hydration and electrolyte balance are important in boosting performance, reducing fatigue, and accelerating recovery from high-intensity workouts. Calcium and magnesium deficiencies are extremely common among athletes. Rehydration is also helpful for recovering from hangovers or jet lag.
- Glutathione – an important antioxidant that helps to remove toxins, promotes the immune system, and reduces inflammation and muscle fatigue.34
- N-acetylcysteine (NAC) – another antioxidant that is a precursor to glutathione, NAC helps reduce inflammation and thins mucus,35 which is important for athletes with asthma or other respiratory conditions.
- Nicotinamide adenine dinucleotide (NAD) – NAD is present in every cell of the body and plays a role in nearly every bodily function. It is a potent anti-aging molecule. I recommend it for maximizing brain health and cellular regeneration.
- Glycine – glycine an amino acid used to improve memory and cognitive function, along with relaxation response and collagen formation.
Training plateau and nagging injuries don’t have to be career-ending for professional athletes. To bust through these plateaus, the most critical step is to identify and address the root causes.
By optimizing your mitochondrial function, biological age, sleep, stress management, movement quality, and nutrition, you will maximize your athletic potential and longevity in your athletic career.
Many biohacks and technologies can support your recovery and rehab goals. However, these will not replace the need to optimize other factors you need to be at the top of your game.
Identify your personal weak links and address the root causes that are keeping you from your full potential.