REST, RELAX AND RECOVER

Z Altug, PT, MS, CSCS, NSCA-CPT Physical Therapist / Fitness Consultant Los Angeles, California www.zaltug.com

Overreaching and Overtraining

OVERREACHING Excessive training on a short-term basis. May be due to poorly structured programs or inexperience Recovery may be achieved within a few days to a week of rest.

OVERTRAINING A consequence of imbalance between stress and adaptability of the body (Verkhoshansky and Siff, 2009). Excessive frequency, volume, or intensity. May be due to poorly structured programs or inexperience. Results in extreme fatigue, illness or injury. Often due to lack of sufficient rest, recovery and perhaps nutrient intake Also known as burnout, chronic overwork, physical overstrain, overfatigue, chronic fatigue, staleness. Recovery may take months.

Sources: Baechle TR, Earle RW, eds. Essentials of Strength Training and Conditioning, 3rd ed. Champaign IL: Human Kinetics, 2008, pg. 114. Kreider RB, Fry AC, OToole ML, eds. Overtraining in Sport. Champaign, IL: Human Kinetics, 1998. Richardson SO, Andersen MB, Morris T. Overtraining Athletes: Personal Journeys in Sport. Champaign IL: Human Kinetics, 2008. Verkhoshansky Y, Siff M. Supertraining, 6th ed expanded edition. Rome, Italy: Verkhoshansky, 2009, pp. 441-467.

Dr. Yuri Verkhoshansky and Dr. Mel Siff Overtraining

OVERTRAINING A consequence of imbalance between stress and adaptability of the body.

Overtraining is closely related to an inadequate rate of recovery and adaptation of: The energy systems of the body Cell repair and growth mechanisms Hormonal systems Nervous processes

Sources: Verkhoshansky Y, Siff M. Supertraining, 6th ed expanded edition. Rome, Italy: Verkhoshansky, 2009, pp. 441-467. www.verkhoshansky.com. www.melsiff.com

Sympathetic Nervous System

Part of the autonomic nervous system nerves originate in the midbrain, the hindbrain, and the sacral region of the spinal cord. Involuntary response to alarm Fight or Flight. Functions: Speeding the heart rate Raising blood pressure Dilations of the bronchioles Dilating the pupils of the eyes Vasodilation in the skeletal muscles Slowing of peristalsis Conversion of glycogen to glucose Vasoconstriction of the in the skin and viscera

Sources: American College of Sports Medicine. ACSMs Resource Manual for Guidelines for Exercise Testing and Prescription, 6th ed. Philadelphia, PA: Wolters Kluwer Lippincott Williams & Wilkins, 2010, pp. 542-543. Agnes M. Websters New World College Dictionary, 4th ed. Cleveland, OH: Wiley . Publishing, 2009, pg. 1450. Venes D, ed. Tabers Cyclopedic Medical Dictionary, 21st ed. Philadelphia, PA: FA Davis Company, 2009, pg 2255.

Types of Overtraining Sympathetic

SYMPATHETIC OVERTRAINING SYNDROME (elevated sympathetic activity at rest) Increased heart rate Increased blood pressure Elevated basal metabolic rate

Sources: American College of Sports Medicine. ACSMs Resource Manual for Guidelines for Exercise Testing and Prescription, 6th ed. Philadelphia, PA: Wolters Kluwer Lippincott Williams & Wilkins, 2010, pp. 542-543. Agnes M. Websters New World College Dictionary, 4th ed. Cleveland, OH: Wiley . Publishing, 2009, pg. 1450. Venes D, ed. Tabers Cyclopedic Medical Dictionary, 21st ed. Philadelphia, PA: FA Davis Company, 2009, pg 2255.

Parasympathetic Nervous System

Part of the autonomic nervous system nerves originate in the lumbar and thoracic regions of the spinal cord. Oppose the sympathetic nerves in the regulation of many body processes. Functions: Slowing the heart rate Constricting the pupils of the eyes Stimulation of certain digestive glands Constriction of the bronchioles

Sources: American College of Sports Medicine. ACSMs Resource Manual for Guidelines for Exercise Testing and Prescription, 6th ed. Philadelphia, PA: Wolters Kluwer Lippincott Williams & Wilkins, 2010, pp. 542-543. Agnes M. Websters New World College Dictionary, 4th ed. Cleveland, OH: Wiley . Publishing, 2009, pg. 1046. Venes D, ed. Tabers Cyclopedic Medical Dictionary, 21st ed. Philadelphia, PA: FA Davis Company, 2009, pg 1711.

Types of Overtraining Parasympathetic

PARASYMPATHETIC OVERTRAINING SYNDROME (increased parasympathetic activity at rest) Decreased resting heart rate Decreased resting blood pressure With exercise an early onset of fatigue.

Sources: American College of Sports Medicine. ACSMs Resource Manual for Guidelines for Exercise Testing and Prescription, 6th ed. Philadelphia, PA: Wolters Kluwer Lippincott Williams & Wilkins, 2010, pp. 542-543. Agnes M. Websters New World College Dictionary, 4th ed. Cleveland, OH: Wiley . Publishing, 2009, pg. 1046. Venes D, ed. Tabers Cyclopedic Medical Dictionary, 21st ed. Philadelphia, PA: FA Davis Company, 2009, pg 1711.

Some General Markers Overtraining

PSYCHOLOGICAL Emotional instability (fatigue, apathy, depression, and irritability). Decreased desire to train. Decreased enjoyment from training sessions or competition. FUNCTIONAL Decline in performance. Loss of muscle strength, coordination, and work capacity. Prolonged recovery from typical training sessions and competition. Tenderness and soreness in muscles and joints. Overuse injuries. METABOLIC Loss of appetite and body weight loss Gastrointestinal disturbances, occasional nausea. Sleep disturbances PHYSIOLOGIC (see next 2 slides)
Source: American College of Sports Medicine. ACSMs Resource Manual for Guidelines for Exercise Testing and Prescription, 6th ed. Philadelphia, PA: Wolters Kluwer Lippincott Williams & Wilkins, 2010, pg. 543.

Some Markers of Aerobic Overtraining

PSYCHOLOGICAL Decreased desire to train Decrease joy from training PHYSIOLOGICAL Decreased percentage of body fat Decreased maximal oxygen uptake Decreased muscle glycogen Decreased lactate Decreased total testosterone concentration Decreased ratio of total testosterone to cortisol, and ratio of free testosterone to cortisol. Decreased sympathetic tone (decreased nocturnal and resting catecholamines) Increased sympathetic stress response Increased creatine kinase Increased muscle soreness Increased submaximal exercise heart rate Altered blood pressure Altered heart rate Altered cortisol concentration Altered oxidative stress PERFORMANCE Decreased performance
Source: Baechle TR, Earle RW, eds. Essentials of Strength Training and Conditioning, 3rd ed. Champaign IL: Human Kinetics, 2008, pg .138.

Some Markers of Anaerobic Overtraining

PSYCHOLOGICAL Decreased desire to train Decrease joy from training

PHYSIOLOGICAL Acute epinephrine and norepinephrine increases beyond normal exercise-induced levels (sympathetic overtraining syndrome).

PERFORMANCE Performance decrements - occur too late to be a good predictor.

Source: Baechle TR, Earle RW, eds. Essentials of Strength Training and Conditioning, 3rd ed. Champaign IL: Human Kinetics, 2008,pg. 116.

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What Influences An Athletes Recovery?

Program Design does it use periodization? (Fox et al 2008) Type of Training aerobic versus anaerobic Type of Contraction isometric, concentric, eccentric Genetics Age of the Athlete Training Experience Sleep Stress Control Diet Activities and Lifestyle Between Workouts Injuries Mental Outlook
Source: Fox ZG, Mihalik J, Blackburn JT. Return of postural control to baseline after anaerobic and aerobic exercise protocols. Journal of Athletic Training. 2008;43(5):456-463.

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Performance Recovery Tests

POSTURAL CONTROL AFTER ANAEROBIC AND AEROBIC EXERCISE
Fox ZG, Mihalik J, Blackburn JT. Return of postural control to baseline after anaerobic and aerobic exercise protocols. Journal of Athletic Training. 2008;43(5):456-463.

MUSCULAR ENDURANCE RECOVERY

McLester JR, Bishop PA, Smith J, et al. A series of studies a practical protocol for testing muscular endurance recovery. Journal of Strength and Conditioning Research. 2003;17(2):259-273. Jones EJ, Bishop PA, Richardson MT, et al. Stability of a practical measure of recovery from resistance training. Journal of Strength and Conditioning Research. 2006;20(4):756-759.

FIVE BOUND TEST

Coutts AJ, Slattery KM, Wallace LK. Practical tests for monitoring performance, fatigue and recovery in triathletes. Journal of Science and Medicine in Sport. 2007; 10:372-381.

PSYCHOLOGICAL TESTS FOR RECOVERY

Kellmann M, Kallus KW. Recovery-Stress Questionnaire for Athletes: User Manual. Champaign, IL: Human Kinetics, 2001.

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Simple Recovery Evaluation for the Clinician and Conditioning Coach

1. What the person says about their rest, stress, sleep, diet and mood since last workout session. 2. What is observed about the persons mood. 3. Posture and body language yawning, slumped posture. 4. Quality of movement (limping, movement while changing clothes and shoes). 5. Range of motion observation and measures. 6. Muscle soreness and fatigue reports on a scale of 0 10. 7. Pain level on a scale of 0 10. 8. Muscle and joint tenderness through palpation. 9. Resting blood pressure. 10. Resting heart rate.

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Overuse Injuries
CAUSES Repeated, abnormal stress applied to a tissue by continuous training or training with too little recovery time. Training errors (such as poor program design, poor technique). Suboptimal surfaces (too hard or uneven surface). Faulty biomechanics or technique during performance. Insufficient motor control. Decreased flexibility. Skeletal malalignment.

Source: Baechle TR, Earle RW, eds. Essentials of Strength Training and Conditioning, 3rd ed. Champaign IL: Human Kinetics, 2008, pg. 526.

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Tissue Healing
INFLAMMATION PHASE

REPAIR PHASE

REMODELING PHASE

Source: Baechle TR, Earle RW, eds. Essentials of Strength Training and Conditioning, 3rd ed. Champaign IL: Human Kinetics, 2008, pg. 529.

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Periodization Adapted Matveyevs Model

PERIODIZATION Preplanned, systematic variations in training specificity, intensity, and volume organized in periods or cycles within an overall program (Baechle and Earle 2008). PREPARATORY PERIOD TRANSITION PERIOD COMPETITION PERIOD TRANSITION PERIOD (active rest)

Sources: Baechle TR, Earle RW, eds. Essentials of Strength Training and Conditioning, 3rd ed. Champaign IL: Human Kinetics, 2008,pp. 508-522. Stone MH, OBryant. Weight Training: A Scientific Approach. Minneapolis, MN: Burgess, 1987.

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What Is Rest?
Peace, ease, and refreshment as produced by sleep. Refreshing ease or inactivity after work or exertion. A period or occasion of inactivity, as during work or on a journey. Relief from anything distressing, annoying, tiring. Peace of mind; mental and emotional calm; tranquility. Freedom from activity, as of mind and body. To lie down; to cease voluntary activity.

Sources: Agnes M. Websters New World College Dictionary, 4th ed. Cleveland, OH: Wiley . Publishing, 2009, pg. 1222. Venes D, ed. Tabers Cyclopedic Medical Dictionary, 21st ed. Philadelphia, PA: FA Davis Company, 2009., pg. 2014.

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What Is Relaxation?
To make looser, or less firm or tense. To make less strict or sever; soften. To release from intense concentration, hard work, worry. To become looser or less firm, as the muscles. To decrease tension or intensity; to be rid of strain, anxiety and nervousness.

Sources: Agnes M. Websters New World College Dictionary, 4th ed. Cleveland, OH: Wiley . Publishing, 2009, pg. 1209. Venes D, ed. Tabers Cyclopedic Medical Dictionary, 21st ed. Philadelphia, PA: FA Davis Company, 2009., pg. 1998.

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What Is Recovery and Restoration?

RECOVER To regain normal state To regain health To get back to a state of control, balance, or composure

RESTORE To return something to its previous state To bring back to a former or normal condition, as by repairing, rebuilding, altering

Note: Some texts and sources use the words recovery, restoration, regeneration interchangeably.

Sources: Agnes M. Websters New World College Dictionary, 4th ed. Cleveland, OH: Wiley . Publishing, 2009, pp. 1198, 1222. Venes D, ed. Tabers Cyclopedic Medical Dictionary, 21st ed. Philadelphia, PA: FA Davis Company, 2009, pp 1983., 2015. Athletes Performance. Mentorship Week Manual: Phase 1. Carson, CA: Athletes Performance Properties. June 22-26, 2009.

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Benefits of Rest, Relaxation and Recovery

Recovery between workouts Decrease general anxiety Decrease in anticipatory anxiety related to phobias Reduce in the frequency and duration of panic attacks Improved concentration Control over moods Increased self-esteem Increased spontaneity and creativity

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Restoration and Recovery Verkhoshansky and Siff

Professor Verkhoshansky and Dr Siff in their book Supertraining say, Scores of Soviet training programmes are quoted, Western athletes frequently follow them religiously, yet they pay scant attention to the contents and structure of the phases between training exercises and sessions.

Sources: Verkhoshansky Y, Siff M. Supertraining, 6th ed expanded edition. Rome, Italy: Verkhoshansky, 2009, pp. 441-467. www.verkhoshansky.com. www.melsiff.com

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Restoration and Recovery Strategies Adapted from Verkhoshansky and Siff

Part 1 - COACHING RESTORATION

Part 2 - MEDICAL AND BIOLOGICAL RESTORATION

Part 3 - PSYCHOLOGICAL RESTORATION

Sources: Verkhoshansky Y, Siff M. Supertraining, 6th ed expanded edition. Rome, Italy: Verkhoshansky, 2009, pp. 441-467. Kellmann M, ed. Enhancing Recovery: Preventing Underperformance in Athletes. Champaign, IL: Human Kinetics, 2002. Bompa TO, Haff GG. Periodization: Theory and Methodology of Training, 5th ed. Champaign, IL: Human Kinetics, 2009. Mujika I. Tapering and Peaking for Optimal Performance. Champaign, IL: Human Kinetics, 2009.

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Restoration and Recovery Strategies Part 1 - Coaching Restoration

PERIODIZATION Designing a good plan Being prepared Being organized

CROSS TRAINING Incorporating mental and physical variety

INTERVAL TRAINING Incorporation high intensity and low intensity

PERSONAL CUES Your Voice calm versus intense Body Attitude arms crossed versus hands in your pockets Facial Expression smile versus game face

Sources: Verkhoshansky Y, Siff M. Supertraining, 6th ed expanded edition. Rome, Italy: Verkhoshansky, 2009, pp. 441-467. Kellmann M, ed. Enhancing Recovery: Preventing Underperformance in Athletes. Champaign, IL: Human Kinetics, 2002. Bompa TO, Haff GG. Periodization: Theory and Methodology of Training, 5th ed. Champaign, IL: Human Kinetics, 2009. Mujika I. Tapering and Peaking for Optimal Performance. Champaign, IL: Human Kinetics, 2009.

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Restoration and Recovery Strategies Part 2 - Medical- Biological Restoration

STRESS CONTROL General Adaptation Syndrome Hans Selye, MD, PhD (1907-1982) endocrinologist. Three stage response to stress: Alarm phase new stress or more intense stress Resistance phase body adapts to stimulus Exhaustion phase extended stress loss of ability to adapt to stressor Activity and rest must be judiciously balanced, and every person has his own characteristic requirements for rest and activity. The best way to avoid harmful stress is to select an environment (wife, boss, friends) which is in line with your innate preferences to find an activity which you like and respect. Only thus can you eliminate the need for frustrating constant re-adaptation that is the major cause of distress.

Sources: Selye H. Stress Without Distress. Philadelphia, PA: Lippincott, 1974. Selye H. The Stress of Life, revised edition. New York, NY: McGraw-Hill, 1976. Selye H. Stress in Health and Disease. Boston, MA: Butterworths, 1976.

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Restoration and Recovery Strategies Part 2 - Medical- Biological Restoration (cont.)

SLEEP QUOTES Early to bed and early to rise, makes a man healthy, wealthy and wise. ~ Benjamin Franklin A good laugh and a long sleep are the best cures in the doctor's book. ~ Irish Proverb Sleep is the best meditation. ~ Dalai Lama There is a time for many words, and there is also a time for sleep. ~ Homer

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Restoration and Recovery Strategies Part 2 - Medical- Biological Restoration (cont.)

SLEEP AND MOTOR LEARNING RESEARCH In the 2009 issue of the Physical Therapy journal, researchers report that despite certain unanswered questions in sleep research, Therapists should consider encouraging sleep following therapy sessions as well as promoting healthy sleep in their patients with chronic stroke to promote off-line motor learning of the skills practiced during rehabilitation.

Source: Siengsukon CF, Boyd LA. Does sleep promote motor learning? Implications for physical rehabilitation. Physical Therapy. 2009;89(4):370-383.

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Restoration and Recovery Strategies Part 2 - Medical- Biological Restoration (cont.)

VACATIONS

PROGRESSIVE MUSCLE RELAXATION Progressive Relaxation Edmund Jacobson, PhD, MD (1888-1983) - psychiatrist Technique Muscle contraction followed by relaxation head to toes

AROMATHERAPY

MASSAGE

Sources: Jacobson E. You Must Relax, 5th ed. New York, NY: McGraw-Hill Book Company, Inc., 1976. Jacobson E. Progressive Relaxation, 4th ed. Chicago, IL: University of Chicago Press, 1962. Jacobson E. Anxiety and Tension Control. Philadelphia, PA: JB Lippincott, 1964. Jacobson E. Self-Operations Control Manual. Chicago, IL: National Foundation for Progressive Relaxation, 1964.

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Restoration and Recovery Strategies Part 2 - Medical- Biological Restoration (cont.)

HYDROTHERAPY (Whirlpool, pool, shower techniques) STEAM

SAUNA

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Restoration and Recovery Strategies Part 2 - Medical- Biological Restoration (cont.)

NUTRITION (Glycogen replenishment, rehydration)

ACUPUNCTURE / ACUPRESSURE

ELECTRICAL MODALATIES (stimulation, ultrasound, laser)

MANUAL THERAPY (physical therapist, athletic trainer, chiropractor, osteopath)

SUNLIGHT

BRIGHT LIGHT

Sources: Holick MF. The Vitamin D Solution. New York, NY: Hudson Street Press, 2010. Turner PL, Mainster MA. Circadian photoreception: ageing and the eyes important role in systemic health. British Journal of Ophthalmology. 2008;92(11):1439-1444.

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Restoration and Recovery Strategies Part 2 Medical- Biological Restoration (cont.)

FELDENKRAIS METHOD Created by Dr. Moshe Feldenkrais (1904-1984)

ALEXANDER TECHNIQUE Created by Frederick M. Alexander (1869-1955)

TAI CHI

QI GONG

YOGA

DANCE

Sources: Feldenkrais M. Awareness Through Movement: Health Exercises for Personal Growth. New York, NY: Harper & Row, 1972. Feldenkrais, M. The Master Moves. Cupertino, CA: Meta Publications, 1984. Alexander FM. The Universal Constant in Living. New York, NY: E. P. Dutton and Co., Inc,1941. Alexander FM. The Use of The Self. New York, NY: E. P. Dutton and Co., Inc.,1932.

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Restoration and Recovery Strategies Part 2 - Medical- Biological Restoration (cont.)

DIAPHRAGMATIC BREATHING

Gray Cook, MSPT, OCS, CSCS says: Control of correct breathing can help relax and reset the system in the presence of unmanaged stress breathing related to dysfunction, anxiety and tension. Deep, slow breathing has been connected to parasympathetic nervous system stimulation and the production of alpha brain waves. The return to slow, controlled breathing between bouts of exertion is a hallmark of the supreme athlete and elite warrior.

Source: Cook G, Burton L, Kiesel K, Rose G, Bryant MF. Movement: Functional Movement Systems. Santa Cruz, CA: On Target Publications, 2010.

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Restoration and Recovery Strategies Part 2 - Medical- Biological Restoration (cont.)

BODY COMPRESSION GARMENT Under Armour Recharge www.underarmour.com

Source: Kraemer WJ, Flanagan SD, Comstock BA, et al. Effects of a whole body compression garment on markers or recovery after a heavy resistance workout in men and women. Journal of Strength and Conditioning Research. 2010; 24(3):804-814.

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Restoration and Recovery Strategies Part 3- Psychological Restoration

PROGRESSIVE MENTAL RELAXATION Progressive Relaxation Edmund Jacobson, PhD, MD (1888-1983) - psychiatrist Technique Think about relaxing a muscle head to toes VISUALIZATION

GUIDED IMAGERY

HYPNOSIS

MUSIC THERAPY

MEDITATION

BIOFEEDBACK

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Tips Reduce Daily Life Overload

Less cell phone time Drive slow Personal finances Family and friends Complain less Dont be a watch watcher Preparation Organization Time management

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REMEMBER Rest, Relax and Recover

Empty your mind, be formless, shapeless - like water. Now you put water into a cup, it becomes the cup, you put water into a bottle, it becomes the bottle, you put it in a teapot, it becomes the teapot. Now water can flow or it can crash. Be water, my friend. ~ Bruce Lee

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References
Agnes M. Websters New World College Dictionary, 4th ed. Cleveland, OH: Wiley . Publishing, 2009. Alexander FM. The Universal Constant in Living. New York, NY: E. P. Dutton and Co., Inc,1941. Alexander FM. The Use of The Self. New York, NY: E. P. Dutton and Co., Inc.,1932. American College of Sports Medicine. ACSMs Resource Manual for Guidelines for Exercise Testing and Prescription, 6th ed. Philadelphia, PA: Wolters Kluwer Lippincott Williams & Wilkins, 2010. Athletes Performance. Mentorship Week Manual: Phase 1. Carson, CA: Athletes Performance Properties. June 22-26, 2009. Baechle TR, Earle RW, eds. Essentials of Strength Training and Conditioning, 3rd ed. Champaign IL: Human Kinetics, 2008. Bompa TO, Haff GG. Periodization: Theory and Methodology of Training, 5th ed. Champaign, IL: Human Kinetics, 2009. Coutts AJ, Slattery KM, Wallace LK. Practical tests for monitoring performance, fatigue and recovery in triathletes. Journal of Science and Medicine in Sport. 2007; 10:372-381. Feldenkrais M. Awareness Through Movement: Health Exercises for Personal Growth. New York, NY: Harper & Row, 1972. Feldenkrais, M. The Master Moves. Cupertino, CA: Meta Publications, 1984.

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References (cont.)
Fox ZG, Mihalik J, Blackburn JT. Return of postural control to baseline after anaerobic and aerobic exercise protocols. Journal of Athletic Training. 2008;43(5):456-463. Holick MF. The Vitamin D Solution. New York, NY: Hudson Street Press, 2010. Jacobson E. You Must Relax, 5th ed. New York, NY: McGraw-Hill Book Company, Inc., 1976. Jacobson E. Progressive Relaxation, 4th ed. Chicago, IL: University of Chicago Press, 1962. Jacobson E. Anxiety and Tension Control. Philadelphia, PA: JB Lippincott, 1964. Jacobson E. Self-Operations Control Manual. Chicago, IL: National Foundation for Progressive Relaxation, 1964. Jones EJ, Bishop PA, Richardson MT, et al. Stability of a practical measure of recovery from resistance training. Journal of Strength and Conditioning Research. 2006;20(4):756-759. Kellmann M, ed. Enhancing Recovery: Preventing Underperformance in Athletes. Champaign, IL: Human Kinetics, 2002. Kellmann M, Kallus KW. Recovery-Stress Questionnaire for Athletes: User Manual. Champaign, IL: Human Kinetics, 2001. Kraemer WJ, Flanagan SD, Comstock BA, et al. Effects of a whole body compression garment on markers or recovery after a heavy resistance workout in men and women. Journal of Strength and Conditioning Research. 2010; 24(3):804-814. Kreider RB, Fry AC, OToole ML, eds. Overtraining in Sport. Champaign, IL: Human Kinetics, 1998.

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References (cont.)
McLester JR, Bishop PA, Smith J, et al. A series of studies a practical protocol for testing muscular endurance recovery. Journal of Strength and Conditioning Research. 2003;17(2):259-273. Mujika I. Tapering and Peaking for Optimal Performance. Champaign, IL: Human Kinetics, 2009. Richardson SO, Andersen MB, Morris T. Overtraining Athletes: Personal Journeys in Sport. Champaign IL: Human Kinetics, 2008. Selye H. Stress Without Distress. Philadelphia, PA: Lippincott, 1974. Selye H. The Stress of Life, revised edition. New York, NY: McGraw-Hill, 1976. Selye H. Stress in Health and Disease. Boston, MA: Butterworths, 1976. Siengsukon CF, Boyd LA. Does sleep promote motor learning? Implications for physical rehabilitation. Physical Therapy. 2009;89(4):370-383. Stone MH, OBryant. Weight Training: A Scientific Approach. Minneapolis, MN: Burgess, 1987. Turner PL, Mainster MA. Circadian photoreception: ageing and the eyes important role in systemic health. British Journal of Ophthalmology. 2008;92(11):1439-1444. Venes D, ed. Tabers Cyclopedic Medical Dictionary, 21st ed. Philadelphia, PA: FA Davis Company, 2009. Verkhoshansky Y, Siff M. Supertraining, 6th ed expanded edition. Rome, Italy: Verkhoshansky, 2009.

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Additional Sources
Bullock SH, Jones BH, Gilchrist J, et al. Prevention of physical training-related injuries recommendations for the military and other active populations based on expedited systematic reviews. American Journal of Preventive Medicine. 2010;38(1):S156 -181. Coutts AJ, Wallace LK, Slattery KM. Monitoring changes in performance, physiology, biochemistry, and psychology during overreaching and recovery in triathletes. International Journal of Sports Medicine. 2007;28(2):125-134. Ferri A, Narici M, Grassi B. Neuromuscular recovery after a strength training session in elderly people. European Journal of Applied Physiology. 2006;97:272-279. Hakkinen K. Neuromuscular fatigue and recovery in male and female athletes during heavy resistance exercise. International Journal of Sports Medicine. 1993;14(2):53-59. Tanskanen M, Atalay M, Uusitalo A. Altered oxidative stress in overtrained athletes. Journal of sports Sciences. 2010;28(3) :309-317. Vetter RE, Symonds ML. Correlations between injury, training intensity, and physical and mental exhaustion among college athletes. Journal of Strength and Conditioning Research. 2010;24(3):587-596. Wyon M. Preparing to perform: Periodization and dance. Journal of Dance Medicine & Science. 2010;14 (2):67-72.

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THANK YOU!

Z Altug, PT, MS, CSCS, NSCA-CPT Physical Therapist / Fitness Consultant Los Angeles, California www.zaltug.com

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