June 2020

Recovery and Regeneration Strategies for Foot Performance: Part I

These 2 complex processes are necessary components of quality training programs for athletes at all levels. This article, which covers fundamentals, is the first in a 2-part series.

Figure 1. The existing continuum between sequential (low force) and simultaneous (high force) muscle actions.

By Antonio Robustelli, MSc CSCS

Taking care of the recovery and regeneration of the foot is an integral part of a well-rounded approach to high performance development.

To start, recovery, from a global and general point of view, is a necessary consequence of training (ie, stress application). It cannot be seen as a separate entity as all the physiological processes involved in its progression are strictly related to each other despite having different times for return-to-baseline and compensation.

Second, specific recovery and regeneration of the feet is required to allow adequate function of all the complex structures handling the mechanical load and stress of daily training and extracurricular daily life activities.

For mechanical stress, we refer to the complex quantity (symbolized with the s) measuring the intensity a load is exerting on a material to change its shape: when talking about the foot, this mechanical stress, which has the same unit of pressure  (N/cm2), is a reflection of how much load is exerted at the structural level (bones, joints, soft tissues) in the anatomical region of the foot and ankle complex.

For the sake of proper biomechanical understanding, mechanical stress is a complex quantity called a tensor, which is a generalized vector with multiple directions1: the stress is the force applied per unit area of the tissue and the strain “indicates the change in length of the tissue relative to its initial length.”2

Given that the biomechanical and performance output of the foot/ankle complex is a consequence of proper function and structural integrity of the tissues contributing to foot stiffness during locomotion (plantar aponeurosis and windlass mechanism representing 2 of the most important), having an optimized protocol is of utmost importance to ensure all the structures surrounding the foot—and handling all the force and power output exerted by the major muscle groups involved in each movement pattern—recover and regenerate properly.

While the concept of stiffness and the stress-strain relation are outside the scope of this article,  it should be clear that foot structures receive a great amount of mechanical stress and tissue deformation that needs to be taken into account when considering priorities for recovery.

Recovery and Regeneration: Differences in Terminology

Although the 2 terms are often used interchangeably, there is a thin line differentiating the 2 concepts from a methodological and physiological point of view.

In an international Consensus Statement published on 2018,3 recovery is defined as a “multifaceted restorative process relative to time;” further, it is “an umbrella term, which can be further characterized by different modalities of recovery such as regeneration or psychological recovery strategies.” The authors define regeneration as “the physiological aspect of recovery which follows physical fatigue induced by training or competition.”

By looking at the evidence as well as on-field application, I suggest the following definitions for practical everday use:

Recovery is the necessary physiological response consequent to the training-induced fatigue and it represents the systemic biological output of the human system in order to compensate and restore the homeostatic balance. It doesn’t care about the various sub-systems involved in the process.

Regeneration is a more specific term that takes into account the local response to stress in terms of magnitude and timing of the various sub-systems involved in the training/stress application process (glycogen restoration, thermal response, neurological function, soft tissue properties, etc.). In summary, regeneration includes all the different strategies adopted to improve (and not necessarily accelerate) the quality of the recovery cycle.

The foot is the complex structure enabling the optimal expression of movement efficiency and proficiency needed for high performance.

Regeneration Strategies for the Foot and Movement Proficiency/Efficiency

Movement proficiency and efficiency, defined as a result of body/joint positioning (kinematics), tissue status, and force application (kinetics), can only be accomplished by optimally integrating the coordination of motor skills (Figure 1) with segmental interaction (ie, the optimal force transfer through the various joints and body segments).

We keep our regeneration strategies for the foot/ankle complex as a focal point of the overall recovery process because the foot is the complex structure enabling the optimal expression of movement efficiency and proficiency needed for high performance.

Our regeneration protocols for the feet are structured over 3 levels/layers:

  1. Structural (Tissue recovery)
  2. Functional (Functional movement recovery)
  3. Sensory (Skin)

In Part II of this series, I will explain why we target these 3 levels and provide specific methods and techniques used for each protocol.

 Antonio Robustelli is a professional sports performance consultant and elite coach from Italy; his areas of expertise include injury prevention, sports technology, strength training programming, speed development, recovery monitoring, and return to play assessment. He has worked worldwide for nearly 20 years with semi-professionals, professionals, and Olympic athletes as well as professional teams in various disciplines. Regularly invited as a Keynote Speaker for international conferences in Sports Science and Strength & Conditioning, he is currently a consultant for Federations, Governing Bodies, Olympians and for First Division football and basketball teams in Europe, Asia, and USA.  He is a member of the LER Editorial Advisory Board and can be reached at Antonio.robustelli@omni-athlete.com.

REFERENCES
  1. Knudson D. Fundamentals of Biomechanics. 2nd ed. Springer; 2007.
  2. Enoka RM. Neuromechanics of Human Movement. 4th ed. Human Kinetics; 2008 
  3. Kellmann M, Bertollo M, Bosquet, et al. Recovery and performance in sport: consensus statement. Int J Sports Physiol Perform. 2018;13(2):240-245.

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