Optimizing Recovery for CF and COPD

Nov 4, 2019 | Blog

          The body is a remarkable system that takes time to recover. When you have chronic illness, such as CF or COPD, the recovery time the body needs will be a little different than for a healthier individual. This is due to decreased oxygen consumption and nutrient intake often seen for patients with CF and COPD. The amount of recovery needed to resupply the brain and muscles with the proper amount of fuel to improve exercise capacity increases for individuals with CF and COPD.


          Generally speaking, ACSM’s guidelines for recovery when an individual performs resistance training is 2-3 minutes in between sets (Riebe, Ehrman, Liguori, & Magal, 2018). This is all dependent on the type of training and the goals that an individual has. The general rule of thumb is; the more volume (volume= length x width x height) of work (work= force x distance) you do per set, the more time you’ll need between your sets and the more days you’ll need between your workouts. Within those workouts, exercises also require a certain amount of energy. Recovery is exercise specific and each exercise impacts neurological and muscular recharge differently. Optimizing how you recover between workouts is important if you want to see positive results.



Exercising has a multiphasic impact on the body and here is why. 



            When you are exercising there is an increase in neural activity. Your brain is sending your muscle messages to guide your body on how and when to facilitate the right muscle at the right time to create a gross movement pattern. As the intensity or difficulty of the exercise increases, so do the neurological responses to the muscles (Ollivier-Lanvin, Lemay, Tessler, & Burns, 1985). Not only is there an increase in neurological responses to the muscles, but there is an increase in neurological and physiological responses within the heart, lungs and other organ systems.


          In order for your body to create the movement you desire, the brain needs to have the ATP (energy) to accomplish that movement. The increase in demand increases the brains need for oxygen and glucose. Oxygen and glucose are two substrates that the brain utilizes to refuel and recharge. Think of these substrates as the fuel you put into your gas tank. Without the adequate amount of oxygen and glucose to fuel the exercise, the brain will decrease its neural responses to the muscles, causing muscle fatigue and muscle cramping to set in.


          On top of that, the heart and lungs are working at a higher rate in order to provide your brain with the proper amount of fuel, while also supplying the muscles with sufficient oxygen to facilitate the demands on the muscles and joints. As reps increase, the more oxygen you will need to perform a set. That is why you often hear that 15 reps work muscle endurance. The more repetitions you do, the more oxygen you will need in order to complete the set. 





           As you can see, there is a lot going on within the body that is required for you to complete a workout. Depending on the goal of the workout and the intensity at which you work, your body will need adequate time to not only recover between sets, but also between workouts. Research has shown that 24-72 hours after a workout is the time frame at which inflammation is at the highest concentration within the body (Pournot, Bieuzen, Louis, Mounier, Fillard, Barbiche, & Hausswirth, 2011), and is why you may feel tried later in the day after a workout or feel stiff the next day.


Have you ever been sore two days after a workout? This is what exercise professionals call “second day soreness.” This time frame is also when the body is at its highest demand for recover.


          The human body strives to create a homeostatic balance, this results in the body needing time to rebalance the system after having exhausted its fuel following a workout. When you have a pulmonary condition, it can be hard to facilitate the body’s abilities to reach optimal recovery, as the body is working harder to fight off infections, inflammation, and respiratory distress.




Here are some Tips to optimize your recovery between workouts to set you up for success.



Follow a harder intensity workout with a lighter intensity workout.

          You only have so much fuel in the tank each week. Harder workouts, or workouts that tax your body, will require more recovery over the course of a week. Try performing a harder workout and then follow it up with a lighter workout, such as stretching, foam rolling, or a light walk or bike ride. Keeping the intensity low and moving the body will help increase blood flow to the muscles that are trying to recover without taxing the brain. For example, have you ever woken up stiff or tight the day after a tough workout? But then you stood up, stretched, walked around and felt better? Standing up and stretching get the body moving and increase blood flow to the muscles at a low intensity. This rhythm of blood flow helps to pull bad waste product away from the muscles, and delivers quality nutrients and oxygen to the muscles for repair. Drinking a glass of water 30 minutes within waking up will also help decrease dehydration and facilitate in increased nutrients to the muscles and brain for recharge.




Simply put, drink water and move around when you feel stiff.



Active Recovery


          It doesn’t matter who you are, if you move often you tend to feel better. Exercise doesn’t always have to be in the gym. It doesn’t always have to be a structured exercise class. Getting outside and playing catch with your son or daughter, kicking the soccer ball around or messing around on the local jungle gym with the family is a form of active recovery. Exercising is too often connected with weight training, cardio blast classes or the new trend of the year class, such as “cold yoga.” Exercising can consist of moving the body in many different directions and different intensities. Spending at least 1-2 days a week of active recovery could be what your body is looking for.






Don’t Forget to Cool Down


          Integrating 5-10 minutes of exercises that down regulate your breathing and bring down your heart rate after your workout is very important for your recovery, especially the days after your workout. As we stated earlier, research has shown that the highest inflammation rate and need for recovery is around 48-72hours after the workout. Ending your workout with stretching, foam rolling, or just lying on a mat with your eyes closed and breathing, gives the body time to catch up and start the recovery process. No matter what, your body will have to start recovery sooner or later. Spending 5-10minutes at the end of your workout stretching and relaxing will kick start this process so you can recover at a more efficient rate.




          Everyone’s recovery will be different, but everyone needs quality recovery. The key is to optimize how you recover. Creating self-awareness on how your body feels in-between sets, in-between workouts, and multiple days after your workouts will put you at an advantage. Recovery comes in all shapes and sizes. Your muscles need to recover just like your heart, lungs, and brain need to recover. If you feel like a zombie after a workout or the next day, your body is letting you know that it needs to recharge. If you are feeling stiff, sore, and/or stressed, your body is telling you it is in the recovery phase of your training. Understanding how your body is recovering between workouts gives you an opportunity to improve your training which will ultimately put you at an advantage to improve your strength, endurance, and potentially your lung function. Performance gains are not developed in the weight room, they are developed during your recovery (sleep, hydration, nutrition). Align your exercise goals with proper recovery and great things will happen.









Ollivier-Lanvin, K., Lemay, M. A., Tessler, A., & Burns, A. S. (2009). Neuromuscular  transmission failure and muscle fatigue in ankle muscles of the adult rat after spinal cord  injury. Journal of Applied Physiology107(4), 1190–1194.




Pournot, H., Bieuzen, F., Louis, J., Mounier, R., Fillard, J. R., Barbiche, E., & Hausswirth, C.   (2011). Correction: Time-Course of changes in inflammatory response after whole-body  cryotherapy multi exposures following Severe Exercise. PLoS ONE, 6(11)




Riebe, D., Ehrman, K. J., Liguori, G., & Magal, M. (2018). ACSMs Guidelines for exercise testing and prescription: American college of sports medicine. Philadelphia (PA): Wolters Kluwer.







For more exercises check out our YouTube Channel: Cystic Fibrosis Fitness Institute 

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Intrinsic motivation is something that develops over time. Kids don’t yet have the cognitive abilities to grasp the concept that, “exercising is good for physical and mental health.” The understanding that by “doing something good for your body now, your future self will thank you,” is far too abstract. Kids don’t live for the future, they live for the here and now.

By the time children are in high school and/or go through puberty, those high order thinking cognitive processes begin to develop. However, social obligations and a sense of figuring out one’s own identify often trump the desire to be consistently active for one’s own physical and/or mental health purposes.

Sports certainly help, as they play a role in encouraging healthy competitiveness within oneself and others, as well as promotes team building and social opportunities that child and young adults actively seek out. However, not every kid plays a sport or has the health opportunities to actively participate in one. So, how do we encourage motivating?


There are two types of motivation: intrinsic motivation and extrinsic motivation. Some will say, intrinsic motivation is ideal because it creates long lasting effects on one’s drive and purpose to reach a goal. The definition of intrinsic motivation is, “behavior that is driven by internal rewards.” Extrinsic motivation is the opposite. Extrinsic motivation is defined as, “behavior that is motivated to perform an activity to receive an award or avoid punishment.”


When starting to increase your child’s motivation to exercise, extrinsic motivation is the “easiest” way to go. When young, a child/teen is beginning to develop his/her own sense of motivation and enjoyment from exercising, something that is not going to happen overnight. Fortunately, exercising regularly will naturally contribute to developing intrinsic motivation, as it increases the feel-good happy chemicals in your brain (serotonin, dopamine, endorphins). But, habits do take time, so here are three tips to increase your child’s motivation to exercise!

  1. Reward System

There are often mixed reactions to implementing a reward system. However, a reward system is not something to frown about when working on establishing a foundation for positive behaviors. Research has shown that children respond better to positive reinforcements than they do to negative reinforcements.

How to begin a behavior reinforcement plan:

  • For children ages 7-12: Make a personalized goal tracker with your child. For example, if want your kid to do something physically active 3x a week, create a page with three boxes per week to check off after each workout (e.g., can use stickers, a drawing, a penny, etc.)
  • For children 13 and older: they can often keep rack on their own, and independence is key for teenagers and young adults.
    • Each workout = 1 point.
      • It is up to you to decide how often a reward occurs and what the reward will be.
      • Reward types: with your child’s help, create a list of 5 items/things that might be motivating to earn. For example, 30 minutes of a favorite show, a new toy or “surprise box,” staying up later one night a week, choice of a favorite meal for dinner, a new book, etc. The possibilities are endless!
  1. Social Opportunity

As an adult, performing 15 reps, 4x on one exercise is manageable. Our attention is longer. We enjoy isolation more. We have intrinsic motivation or tangible goals set for ourselves, like losing weight. However, children and young adults are heavily socially dependent with shorter attention spans. Their worlds thrive around social opportunities, So, make physical exercise a social experience. Workout with your child, put on a YouTube video and together and complete 30 minutes. Put on your child’s favorite music on in the background and encourage your child to work out for 20 minutes (set a timer). One time a week (or more) invite a friend or sibling, make it an event that can be done inside or outside, and make it fun.

  1. Bring back Play

Which brings us to our third tip: Bring back play! Even if you have a teenager or young adult, play is important to developing a positive attitude towards physical exercise. Play can consist of hiking with friends or family, trying a new activity in your community, and generally, reducing the strict structure around exercise that children and young adults often try to escape as they build independence and autonomy. A majority of the time, exercising can consist of structured exercises catered around a specific goal, however, a few times a month it’s important to switch it up and encourage exploring of physical exercise through unstructured (play) opportunities.



















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