Inflammation and Athletic Recovery Time: Role of Nitric Oxide

As a performance coach, I care about athlete’s recovery as much as I care about their performance. My motto is, “An under-recover athlete is an injured athlete”. That is why I always search for the most effective, and safe modalities that can assist them to bounce back from strenuous practices and workouts.

Over the last several years I educated myself about nitric oxide and its affect on endurance in athletic performance. We know dietary nitrate has been proven to have a range of beneficial vascular effects including enhancing exercise performance in healthy individuals (Satnam and Webb 2013).

Also pre-clinical studies with nitrate have shown to enhance endothelial function, suppress inflammation, and inactivate ROS (Satnam and Webb 2013).

However, I always wondered why we don’t pay more attention to what we consume after workouts to assist us in recovering more efficiently by promoting blood flow throughout the body, support cardiovascular and endothelial health, and target inflammation due to exercise.

Strenuous exercise-induced changes to muscle function have extensively been investigated by many research groups, and a lot of focus has been on acute performance. But in real life, athletes need to maintain peak performance over longer periods and to do so, muscle recovery and muscle function, both mechanically and metabolically, has to be addressed.

If ATP levels (energy levels) cannot be maintained, intense muscle contraction near fatigue cannot relax as usual. The contraction/relaxation cycle of the muscle shortens and slowly diminishes, leading to fatigue. When physical micro-damage results to muscles, working muscles are flooded by breakdown components, activating specific receptors that instigate the output of inflammatory mediators. However, this is a normal, healthy part of the healing process from overexertion and the rate of recovery depends on resolving the production of these inflammatory mediators and allowing the next wave of inflammatory signals to induce healing responses.

Efforts to accelerate the resolution phase of muscle healing post-exertion have focused on reducing the overall inflammatory mediator release.

Antioxidants were thought to exert some benefits by oxidative stress associated with inflammation, but application of antioxidants has brought mixed results – too fast of a decrease in exercise-induced inflammation can actually slow recovery.

But most antioxidants are also anti-inflammatory, and in general, these molecules, whether naturally occurring in foods or from pharmaceuticals, have been associated with better recovery, partly, but not wholly, by an effect on speeding resolution by lowering inflammatory mediator output. Nutrients with these properties are found in ginger, turmeric (as curcuminoids), and other polyphenols in berries and vegetables.

Natural compounds that influence nitric oxide metabolism have been shown to improve circulation, and certain types of muscular performance, especially repeated exercise bouts with short rest periods. Thus, ingestion of nitric oxide mediators before exercise has merit to improve performance and delay expression of inflammatory mediators, one mechanism to improve recovery.

But again what about post-exercise? Improving circulation after exercise by hot baths, massages, myofascial release and mental relaxation techniques (which themselves affect nitric oxide production), offer improvements...

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