Recovery is Crucial for Health, Wellbeing, and Sustainable High Performance

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Recovery is an essential component to The Practices of the Healthcare Athlete.  High demand situations consume large amounts of physical, mental, emotional, and spiritual resources.  Without restoring these resources following the high demand event or task, we cannot expect to be able to perform to our fullest potential at the time of the next event and certainly are not able to perform at a high level in a sustainable fashion.  By emphasizing our recovery following high consequence situations and high demand events, we are putting ourselves in a better position to perform to our capability at the next event.

Typically, the components of recovery include mindset, sleep, physical activity, hydration, and nutrition.  An intentional and deliberate recovery routine incorporating elements of each of these categories is necessary in order to optimize recovery.  This is an active process.  An additional consideration within the paradigm of The Practices of the Healthcare Athlete is integration of technology to both promote and monitor recovery. 

In addition to the typical perspective of recovery, it is useful to apply the polyvagal informed paradigm.  From this lens, the purpose of the recovery can be considered to be development and optimization of ventral vagal activation as it is this component of the nervous system that promotes and allows for recovery and restoration.  Without sufficient ventral vagal activation, there is insufficient restoration which will not only lead to reduced performance but can also result in physical and psychological health ailments.

Mindset skills which are necessary for recovery include a recognition of the importance of recovery itself, as well as intentional practices of gratitude and optimism, development of a growth mindset, and training the skills of refocusing and calm, to name a few.  A common element underlying each of these skills is that they function to avoid utilizing mental resources on thoughts and resulting feelings and emotions that don’t align with our passion and purpose.  Such thoughts will be counterproductive to our ability to recover because they typically lead to increased stress and demand.  Therefore, training our minds to readily to reduce these thoughts and identify them when they arise and not be consumed by them is important.  By optimizing our thinking to promote our health and wellbeing and using our skill of awareness to identify counter-productive or destructive thoughts, we are better able to conserve and rebuild our resources following high demand situations.  From a polyvagal perspective, these skills serve to reduce cues of risk and threat and promote cues of safety and connection.  By increasing the predominance of cues of safety and connection, a ventral vagal state is more likely to result, thereby promoting recovery.

Sleep is another essential element of recovery.  It is widely recognized that the average human requires 7-8 hours of sleep per night.  Sleep is an active process that is required for numerous mental, psychological, emotional, and physical processes.  As examples, there is data indicating that insufficient sleep can decrease memory and concentration, impair decision making and reaction time, negatively impact mood, and result in numerous physical conditions, including altered glucose metabolism, increased risk of cardiovascular events, and potentially impact malignant tumor growth.  Without sufficient sleep, our mind and body is not able to recover and restore itself, thereby negatively impacting future performance. 

In addition to sleep, there is another type of rest, so called non-sleep deep relaxation, which is recommended as an adjunct to recovery.  It is believed that a regular non-sleep deep relaxation program, such as body scan, can reduce to a degree the number of hours of sleep necessary for sufficient recovery.  From a polyvagal perspective, sufficient sleep is necessary to allow for better access to the ventral vagal state through removal of cues of threat and risk.  For example, the mere existence of sleep deprivation is a cue of threat and subsequently a driver for sympathetic states.

Physical activity is widely understood to be an essential element of a healthy lifestyle.  It also is a contributor to recovery.  The physical activity needed for recovery does not need to be strenuous exercise and, in fact, most often is not a high exertion activity as this may cause further demand.  Rather, light physical activity is considered a component of recovery.  This type of movement assists with blood flow, mood, and cognition, may reduce the risk of overuse type injuries, all of which reduce cues of threat and promote cues of safety and connection.  In addition, from a polyvagal perspective, movement can be used to move up the performance hierarchy from dorsal vagal and sympathetic states and promote ventral vagal states.  This process directly assists with recovery and restoration.

Hydration and nutrition are also key factors in a recovery regimen.  High demand situations require consumption of metabolic resources and in order to replenish those resources, it is necessary to obtain sufficient hydration and nutrition.  Without sufficient nutrients, our cells are not able to perform their functions at an optimal level, thereby negatively impacting health, wellbeing, and performance.  From a polyvagal informed perspective, the additional importance of hydration and nutrition is that it removes a potential cue of threat.  In situations in which our body is dehydrated and/or malnourished, there is a significant cue of threat and risk detected by our neuroception.  By removing this cue, we are better able to promote a ventral vagal state for recovery and restoration.

Integration of technology is another important consideration in a recovery routine.  While these devices do not replace the skills discussed above, they can be a key supplement to our regimen.  There are two main categories of technologic devices that can be used for recovery.  The first type are those devices which promote recovery.  Of these there are those which promote physical recovery through increased bloodflow and those which promote recovery through parasympathetic activation.  The other main subtype of technology devices are those that monitor recovery, either through continuous metric measurement or periodic in-depth analysis.

From a polyvagal perspective, an active recovery routine begins following a high consequence task or high demand event by acknowledging without judgement the current physiological state.  The a priori developed skills of promoting safety for the nervous system are then utilized to promote a ventral vagal state to allow for recovery.  It is important for these skills to be developed in advance so that a level of proficiency is achieved in order to optimize recovery.  It is important to note that skill development is not a component of recovery.  Rather, training of skills and strategies is performed following recovery.  Through the utilization of these habits and skills, a ventral vagal state is promoted, thereby allowing for recovery and restoration of resources so that health, wellbeing, and sustainable high performance can be further pursued.

There are many components to a recovery routine.  This is an essential element of The Practices of the Healthcare Athlete.  Without sufficient recovery, we do not have sufficient physical, mental, emotional, and spiritual resources to pursue our best.  While recovery is not typically discussed, let alone emphasized, in traditional medical training and practice, it is an essential element of the daily routines of other high level performers, such as competitive athletes.  These individuals are seeking every competitive advantage they can acquire and one of the elements they pursue in this regard is recovery.  Given the crucial need for restoration of resources, it is necessary to implement an intentional and deliberate recovery routine in all our lives.

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