Recovery and Stress in Sport

A Manual for Testing and Assessment

Michael Kellmann, Sarah Kölling

• Publisher: Routledge
• Year: 2019
• ISBN:
  9780429753244
• Edition: 1
• Topic: Psychologie
• Subtopic: Histoire et théorie en psychologie

Balancing training, stress, and recovery is essential for achieving optimal performance. The performance of professional athletes can be severely compromised by overtraining, injuries, prolonged periods of competition, or even life events outside their sporting lives.

The current recovery-stress state depends on preceding stress and recovery activities, but through simultaneous assessment of stress and recovery, a differentiated picture can be provided. This manual includes two measurement instruments to gauge individual recovery, enabling both athletes and coaches to better understand the often-unconscious processes that impinge upon peak performance, and to monitor the physical, mental, emotional, mental, and overall recovery-stress state before and after training. The Acute Recovery and Stress Scale (ARSS) and the Short Recovery and Stress Scale (SRSS) are instruments that systematically enlighten the recovery-stress states of athletes. Through utilization of the ARSS and the SRSS, athletes and coaches can better understand the importance of daily activities, including how they can relate to stress/recovery and the direct impact on athletic performance.

In addition to the instruments themselves, both of which are simple and easy to use, the manual also discusses their development, their basis in theory, and case studies showcasing their usage. The ARSS and the SRSS provide important information regarding the current recovery-stress state during the process of training, and are essential tools for coaches, sport scientists, sport psychologists, and athletes alike.

1
Overview

Application areas

The Acute Recovery and Stress Scale (ARSS) and Short Recovery and Stress Scale (SRSS) assess the current recovery-stress state of an athlete at an emotional, mental, physical, and overall level. They are developed for the use on active athletes aged 16 years and older. The SRSS is more economical (e.g., less time-consuming) and especially useful for high-frequency measurements (e.g., in the daily monitoring of training). The ARSS is better suited for deriving detailed information, which is useful for detecting smaller variations in an athlete’s emotional or mental state.

The questionnaires

The questionnaires are standardized self-assessment procedures and include the scales/items Physical Performance Capability, Mental Performance Capability, Emotional Balance, and Overall Recovery in the dimension of Recovery; and Muscular Stress, Lack of Activation, Negative Emotional State, and Overall Stress in the dimension of Stress. The ARSS was constructed based on an expert survey, Exploratory and Confirmatory Factor Analyses, and consists of 32 adjectives. The scales are generated by calculating the mean value of those adjectives with four adjectives for each scale. The SRSS was derived from the eight scales of the ARSS which were then grouped into the Short Recovery Scale and the Short Stress Scale and consist of four items each. As descriptors, the adjectives from the ARSS are listed underneath the SRSS items for a better understanding only. In both questionnaires, the level of agreement is determined by a seven-point Likert scale (‘0’ = does not apply at all to ‘6’ = fully applies).

Reliability

The internal consistency (Cronbach’s α) for the ARSS ranges between α = .77 and α = .88 and for the SRSS between α = .78 and α = .84.

Validity

The factorial validity of the exploratory model was confirmed by using factor analyses. The construct validity is supported by theory-conform relationships with the established methods of the Recovery-Stress Questionnaire for Athletes (Kellmann & Kallus, 2001, 2016), Profile of Mood States (McNair, Lorr, & Droppleman, 1992) and the visual analogue scale to assess Delayed-Onset Muscle Soreness (Ohnhaus & Adler, 1975) in sport-specific stress and rest situations. The sensitivity to change could also be verified for both questionnaires in the training monitoring of different sports.

Duration

The ARSS takes between 4 and 5 minutes to complete (depending on the familiarity with the questionnaire). Completion of the SRSS takes between 40 and 60 seconds.

2
Theory

The balance between recovery and stress and between training and rest is of high importance in the daily routine of competitive athletes, and is a substantial component for optimal competition preparation (Hausswirth & Mujika, 2013; Kellmann & Beckmann, 2018a). Fast and effective regeneration and recovery have become important due to the increased frequency of competition, which is related to social and media pressures and the constant pursuit for performance improvement. The greater demand on athletes is supported by literature findings of inadequate recovery phases and overload symptoms in athletes from different sport disciplines (Dupont et al., 2010; Ekstrand, Walden, & Hagglund, 2004; Main & Landers, 2012; Meyer, 2010). Increased training stimuli for a long period combined with insufficient recovery can lead to a performance stagnation or decrease and may even involve a chronic maladaptation. This is known as overtraining syndrome (Meeusen et al., 2013; Meeusen & De Pauw, 2018). Progressive fatigue and underperformance can be the result of a long-term underrecovery (Halson, 2014; Kellmann & Beck-mann, 2018a). However, the difficulty is to determine the exact point when conventional training turns from overreaching into non-functional overreaching.

Recovery and stress

Since the terms load and stress differ between scientific disciplines, it is necessary to define them.¹ Load defines the objectively quantifiable variables or factors that externally affect a person. Load is reflected in the subjective results and in the person’s perception of stress (Rohmert & Rutenfranz, 1975). To give an example from sports, different individuals respond differently (subjective stress; e.g., dependent on the training condition or the current state on the day) to an external load of 100 kg in bench press (objective load). Also, the same individual may respond differently to the same external load because of changes in their current physiological, emotional, and mental states. Therefore, the assessment of the mediating psychological processes associated with various perceptions (e.g., perceptions of load/effort/discomfort) are of great importance (Jerusalem, 1990; Lazarus, 1991). Athletes with the same performance level may react in different ways to an identical stimulus and show different stress states (Raglin, 1993). The same external absolute training load could lead to the desired training adaptions in one athlete, but chronic maladaptations in another athlete (O’Toole, 1998), or even the same athlete under different stress and recovery states. Therefore, there is a need to assess the emotional and mental states of an athlete and potential regeneration/recovery strategies to help them adapt to stress.

Kellmann, Bertollo, et al. (2018) recently defined the terms that are related to recovery in a consensus statement.

Recovery is regarded as a multifaceted (e.g., physiological, psychological) restorative process relative to time. In case an individual’s recovery status (i.e., his or her biopsychosocial balance) is disturbed by external or internal factors, fatigue as a condition of augmented tiredness due to physical and mental effort develops. Fatigue can be compensated with recovery, that is, the organismic allostatic balance is regained by reestablishing the invested resources on a physiological and psychological level.

(Kellmann, Bertollo, et al., 2018, p. 240)

Physiologically, recovery is mainly referred to as regeneration in sport and exercise contexts (Kellmann, Bertollo, et al., 2018). Ideally, regeneration follows physical fatigue that has been induced by training or competition. Nédélec et al. (2012) mentioned cold water immersion (CWI), nutrition/diet, and sleep as frequently used and scientifically evaluated regeneration methods. On a psychological level, cognitive coping strategies, resource activation, and psychological relaxation techniques (e.g., breathing, progressive muscle relaxation, systematic application of napping) help to reduce mental fatigue (Kellmann & Beck-mann, 2018b; Kellmann, Pelka, & Beckmann, 2018; Pelka & Kellmann, 2017).

A continuous physiological or psychological imbalance due to inadequate recovery and excessive demands can be the result of insufficient systematic and individualized recovery, which can further lead to a cascade of deleterious conditions. The first precursor of an overtraining syndrome can be a state of continuous underrecovery which has been identified as underrecovery syndrome (Kellmann, Bertollo, et al., 2018). This underrecovery syndrome is the consequence of an imbalance between daily life demands and recovery, and depicts the reaction to general stress (e.g., family, media) as a broader condition of insufficient recovery. Meeusen et al. (2013), on the other hand, define non-functional overreaching (NFO) as a more training-specific concept that results in negative psychological and hormonal alterations and decreased performance. Continuous underrecovery and NFO often serve as precursors to overtraining syndrome. An accumulation of insufficient recovery from daily life demands, in combination with a long-term NFO in training and competition, will inevitably lead to the overtraining syndrome. Despite a considerable overlap in symptoms between underrecovery and overtraining (e.g., fatigue, exhaustion), physical symptoms of an overtrained state include continuous muscle soreness, pain sensations, or clinical and/or endocrinological disturbances. The earlier potential intervention strategies are applied, the shorter the recovery period from overtraining will be. Compensation for underrecovery can be the systematic application of recovery strategies and rest periods, while recovering from overtraining requires a continuous restoration. This can only be achieved through long rest periods that might last from weeks to months. Recovery serves as the umbrella term, which can then be further characterized by different forms of recovery, such as regeneration or psychological recovery strategies. These strategies should be applied in a structured manner and they should be tailored to the individual needs of the athlete.

It is certain that in sport and training science, the type of stimulus and the type of recovery interact with each other, depending on the respective activity (Kellmann, Bertollo, et al., 2018). A stimulus can, therefore, either lead to overload or, in combination with sufficient recovery, it can contribute to a training effect and an increased resilience to the training stimulus. Top athletic performance cannot only be accomplished through optimal training intensity and volume, but also through the compliance and facilitation of sufficient rest and recovery phases between training sessions (Hoffman, Epstein, Yarom, Zigel, & Ein-binder, 1999). Chronic negative consequences in the mental and physical domain, for example as an over-training syndrome, can be the result of neglected recovery (Kellmann, Bertollo, et al., 2018). Therefore, it is important to recognize an imbalance between the recovery-stress state as early as possible to avoid an unplanned reduction in performance (Brink, Visscher, Coutts, & Lemmink, 2012; Kellmann & Beckmann, 2018a). Standardized diagnostic methods can identify signs of overtraining with the help of the current biopsychosocial stress state to individually adapt the training regulation (Meeusen et al., 2013). Moreover, psychometric methods can support interdisciplinary cooperation between the coaches, medical team, and sport-psychological staff (Kellmann, Bertollo, et al., 2018). According to Hooper, Mackinnon, Howard, and Gordon (1995), the difficulty with physiological markers lies in distinguishing abnormal changes from normal reactions that result from intensive training stimuli. Often, overtraining syndromes are more effectively revealed with the help of psychological parameters than with objective tests (Kenttä & Hassmén, 1998; Raglin & Wilson, 2000; Saw, Main, & Gastin, 2016; Saw, Kellmann, Main, & Gastin, 2017).

Psychometric scales may well represent the most successful instrument in scientific studies to show recovery and stress (Heidari et al., 2019; Heidari, Kölling, Pelka, & Kellmann, 2018; Kellmann, Bertollo, et al., 2018; Meeusen et al., 2013; Nässi, Ferrauti, Meyer, Pfeiffer, & Kellmann, 2017b; Saw et al., 2016). One reason for this superiority could be assumed in the underlying global approach, as the gathered items assess several recovery and stress levels at the same time. The mental state, for instance, is constituted from different physical, mental, and emotional inputs that are processed by the central nervous system and hence influence the perception of the recovery-stress state, as well as the need for regeneration. By using psychometric methods, the individual biopsychosocial recovery-stress state can be measured economically and effectively and with as little impact as possible. In addition, performance control and training prescription can be supported (Meeusen et al., 2013). With regard to the monitoring of larger groups, using psychometric tools bears advantages due to the economy of implementation and the objectivity of evaluation (Kellmann & Beckmann, 2003). Furthermore, the recording of the athlete’s subjective perspective is crucial for an early identification of fatigue and stress signals (Meeusen et al., 2013; Meeusen & De Pauw, 2018). Constant monitoring is especially relevant, as athletes react differently and adapt individually to training stimuli (Coutts, Crowcroft, & Kempton, 2018; Hecksteden et al., 2017). It should be considered, though, that psychometric methods are generally transparent and are therefore easy to manipulate, as well. Hence, the use of the data and the benefit for an optimal training prescription must be explained to the athletes (Kellmann & Beckmann, 2003).

Assessing recovery and stress in sport

The following subjective measurements are mostly used in sport-scientific research and practice: Borg’s Rating of Perceived Exhaustion (Borg, 1998), Delayed-Onset Muscle Soreness (Ohnhaus & Adler, 1975), Profile of Mood States (McNair, Lorr, & Droppleman, 1992) and Recovery-Stress Questionnaire for Athletes (Kellmann & Kallus, 2001, 2016).

Borg’s Rating of Perceived Exhaustion (RPE; Borg, 1998) is a one-dimensional scale. The original version with a scale from 6 to 20 (very, very easy to very, very hard) measures the training intensity and the perceived exhaustion of an athlete at a certain time. Due to its shortness, the RPE has been used in many experimental studies (Noble & Robertson, 1996). Changes in the RPE scale in combination with blood lactate proved to be a reliable predictor for overtraining (Snyder, 1998; Snyder, Jeukendrup, Hesselink, Kuipers, & Foster, 1993). In a cohort study with more than 2,500 participants, the RPE turned out to be a convenient and valid instrument for emphasizing the training intensity independently from gender, age, and type of the implemented load (Scherr et al., 2013). Foster (1998) introduced a modification of the RPE (Session-RPE), which involves an athlete rating a whole training session with a global intensity. By multiplying the value (on a scale from 0 to 10) with the duration of the training session 30 minutes after completion, the individual training load can also be determined (Impellizzeri, Rampinini, Coutts, Sassi, & Marcora, 2004). However, a criticism of RPE scales is that the underlying reasons for changes in subjective effort across sessions for the same absolute training load remain unclear. Therefore, it is difficult to derive appropriate intervention measures based on the ratings alone (Mäetsu, Jürimäe, & Jürimäe, 2005). For example, athletes who were identified with overtraining syndrome showed only minor variation in RPE ratings (Urhausen & Kindermann, 2002). Kellmann (2002) has pointed out that by using a ‘one-item scale’, the multidimensional aspect of stress and recovery is neglected. Moreover, Kenttä and Hassmén (1998) argue that recovery, which they do not only characterize as the absence or reduction of stress, is completely disregarded.

In training and (sports-)medical or clinical settings, the visual analogue scale has been used to measure Delayed-Onset Muscle Soreness (DOMS; Ohnhaus & Adler, 1975). The athlete marks on a 10-cm line, ranging from no pain (left endpoint) to extreme pain (right endpoint), the appropriate position for his/her experienced pain intensity. The distance (in mm or cm) between the left endpoint and the respective mark represents the pain index. Consequently, the scale proves to be an economical and quickly implemented method, which is especially useful in experimental studies (Brown et al., 2017; Cleather & Guthrie, 2007; Nosaka, Newton, & Sacco, 2002; Page, Swan, & Patterson, 2017). Williamson and Hoggart (2005) observed a good sensitivity to...