31. Are You Training Harder, But Feeling Worse?

You hit the gym, push your limits, and stay consistent, but if you're skipping recovery, you're actually holding yourself back. Overtraining doesn't just slow muscle growth; it ramps up inflammation, messes with your metabolism, and puts unnecessary stress on your heart. In today's episode of Extend, I'm breaking down why recovery is the missing piece in your fitness routine. We'll cover how overtraining wrecks your hormones, metabolism, and nervous system (and how to fix it), the science-backed "sweet spot" for exercise frequency that maximizes gains without burnout, seven next-level recovery strategies, like breathwork, sauna therapy, and sleep tracking, to speed up muscle repair and prevent injury, and why tracking HRV (Heart Rate Variability) and HRR (Heart Rate Recovery) can help you gauge whether you're actually recovering or just digging yourself into a hole. If you're constantly sore, exhausted, or stuck in a plateau, this episode is for you! More workouts aren't the answer, better recovery is. Tune in now to level up your training, recover faster, and stay strong for life. I also discuss: (00:03) Optimizing Fitness Recovery Protocols (04:56) The Science of Overtraining & Performance Plateaus (07:19) Cold Plunges, Sauna & Advanced Recovery Hacks (10:15) Maximizing Fitness Recovery Strategies (00:03) Optimizing Fitness Recovery Protocols (10:15) Maximizing Fitness Recovery Strategies Learn more about Dr. Shah: Website: https://www.drshah.com/ Clinic: https://www.next-health.com/ Instagram: https://www.instagram.com/darshanshahmd/

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:03Dr. Darshan Shah?

  Welcome to Extend with me, Dr. Darshan Shah, a podcast dedicated to cutting-edge science, research, tools, and protocols designed to help you extend your health span. Having become one of the youngest doctors in the country at the age of 21, and trained and board-certified at the Mayo Clinic, I've accumulated three decades of practice as a board-certified surgeon and longevity expert. Over that time, I've discovered that a mere 20% of health knowledge yields 80% of the results when it comes to your health span. We're living in a new era where we are creating a new healthcare system, no longer focused on disease management, but achieving optimal health and vitality. Join me as I interview world-renowned experts, offering you a step-by-step guide to proactively avoid disease, and most importantly, extend your health span.

• 0:49Dr. Darshan Shah?

  Welcome to today's episode of Extend. Today, I'm going to talk about an often overlooked aspect of fitness. I'm talking about the nebulous world of recovery. If you've ever pushed yourself hard to the gym or on the track, only to find out that your progress starts to plateau, or even worse, you're getting injured, you're going to want to hear this episode. What I was really surprised about when I was doing my research for this episode is about how essential it is to have a purposeful recovery protocol. You're going to need this to see gains in the gym, but also to prevent damage and to avoid injury. So here are three mechanisms that I think you should know about, where overtraining and not incorporating recovery can actually lead to more harm than good

• 1:33Dr. Darshan Shah?

  if you're working out without a recovery protocol. Number one, as we all know, we break down muscle during exercise. It's the point of doing sprints or lifting heavy weights. It's during the repair process that we actually gain more muscle. Repair involves a process of inflammation, which, if not allowed to resolve, can contribute to the same damaging inflammatory processes that lead to chronic inflammation from other sources in your body, like your gut, for example. This is why a lot of times I'll see in my patients advanced chronic disease. And I'm talking about my patients that are career athletes or people that run marathons. Every few months. Chronic inflammation is one of the root causes of chronic diseases like metabolic syndrome,

• 2:17Dr. Darshan Shah?

  heart disease, cognitive impairment, and many more. Intense physical activity also depletes your energy stores, which creates a net caloric deficit. This caloric deficit is a signal to your brain to consume more calories to maintain a hemostasis or a stable weight. So when you have this calorie deficit that leads to a hunger signal, you often overeat, and especially overeating carbohydrates or junk food. This can lead to an increase in your fat percentage and also an increase in metabolic syndrome. Finally, it's also a stress to your nervous system to overtrain. Our nervous system is always teetering between sympathetic and parasympathetic states. Sympathetic state is our flight or fight response.

• 3:02Dr. Darshan Shah?

  Parasympathetic state is our rest and digest response. These two systems, sympathetic and parasympathetic, live in harmony in our day-to-day routines in life. However, when we spend too much time in the overstimulated sympathetic state, we get the release of a hormone called cortisol. Cortisol, if secreted unchecked, can lead to damage in your metabolism. It leads to chronic stress responses like fat preservation and also poor sleep and many other issues. So as you can see, our physiology likes to be in balance. There was a publication in the Missouri Medical Journal in 2018 that described the Goldilocks zone for exercise. In this paper, the author showed a chart comparing the number of strenuous exercise

• 3:46Dr. Darshan Shah?

  sessions per week to the number of heart attacks someone suffered. It was a really large study group, over 100,000 people. The chart had a curve that is U-shaped, meaning that with no exercise, there is obviously a high risk of heart attacks. With one session a week, the heart attack risk actually dropped down to about 30% less. And then, when you do two to three sessions a week of strenuous exercise, you have the lowest incidence of heart attacks. This makes sense, right? Here's a surprise. When you go up to seven sessions a week, basically a strenuous session every single day, the incidence of cardiac Events goes up, forming this U-shaped curve. So this means it's important to take a day off a week for recovery to avoid this increased risk.

• 4:29Dr. Darshan Shah?

  The sweet spot of how many events per week or how many intense sessions per week is three to five intense exercise sessions per week for most people. Too much exercise can also lead to what is known as overtraining syndrome, which is a syndrome characterized by a combination of daily fatigue, increases in injury, and even hormonal imbalances. Studies on endurance athletes and strength trainers alike highlight the dangers of ignoring recovery. Overtraining syndrome can manifest as chronic fatigue syndrome, decreases in performance, and even mood disturbances and depression. In addition, you can also see a blunting of your gains in the gym and plateaus in your workout. Remember, muscles grow during recovery, not during the workout itself. So skipping recovery means you're stalling your progress rather than accelerating it.

• 5:14Dr. Darshan Shah?

  So what are some of the best recovery strategies for the active individual? Here's seven science-backed methods to use and to add to your routine to create a good recovery protocol. Number one, splitting training and rest days. Avoid working the same muscle groups intensely two days in a row. Every other day for muscle groups allows for more recovery and repair. Next is breath work and parasympathetic activation. Practices like box breathing, which is breathing in for a count of four, holding for a count of four, then breathing out for a count of four, and then holding again for a count of four and repeating is one of my favorites. It's easy to do, and you can even do it in between sets of the gym. Other methods include four, seven, eight breathing or alternate nostril breathing.

• 5:59Dr. Darshan Shah?

  These breathing patterns shift your nervous system into a recovery mode after a workout, which is your parasympathetic state. This reduces stress hormones and sympathetic activity. Next, let's talk about sauna and heat therapy. Saunas have been shown to increase heat shock proteins in your serum, which aids in cellular repair and inflammation reduction. A study done in 2022 in the Biology of Sport showed improved performance and better HRV for people using a sauna session after every workout.

• 6:30Dr. Darshan Shah?

  Next, let's talk about massage and compression therapy. This includes things like foam rolling, massage therapy, or compression boots to enhance blood flow and speed up waste removal from muscles. This can also be very powerful, especially in post-workout soreness recovery. Sleep is also incredibly important. The most powerful recovery tool is actually deep restorative sleep. You want to aim for seven to nine hours, and I'm a big fan of tracking your sleep so you can prioritize REM and deep sleep cycles. Next, you should try to look at deloading weeks. This is where every four to six weeks, you reduce your workout intensity. This allows your tendons, ligaments, and your nervous system to reset and adapt. A deload week is usually about one or two weeks where you deload and go back on your

• 7:14Dr. Darshan Shah?

  weights, and then after you're done with this week, you go back up to achieving one rep max. Finally, let's talk about cold plunges and just heat contrast therapy in general. Alternating between cold water immersion and cryotherapy and heat therapy can also improve your circulation and decrease inflammation. However, there is research showing that cold plunging or cryotherapy after a strength training session can actually blunt the effect of that strength training session. So you want to try to do this on a different day, perhaps your recovery day. Remember, you don't have to do all of these methods simultaneously. You should experiment with what works for you. I always talk about on this podcast that you're the best candidate for N of one experiments using these various methodologies.

• 7:57Dr. Darshan Shah?

  It's important to try one or two, track your changes in your physiology, and stick to what works. So how do you track your recovery? Other than tracking how you feel, which is probably the most important metric to utilize, there's a couple of objective measures out there that can be helpful. These are heart rate variability, or HRV, and heart rate recovery. Heart rate variability is the time in between heartbeats. This is just a few milliseconds, but it actually changes beat by beat, depending on how sympathetically or parasympathetically active you are. A higher HRV generally indicates better parasympathetic activation and switching between sympathetic and parasympathetic. This indicates better recovery. A consistently low HRV

• 8:40Dr. Darshan Shah?

  Means your body's under a lot of stress and has too much sympathetic activity going on. A large study published in 2019 and 9,500 plus participants showed a nighttime HRV of less than 29 led to a higher risk of all causes of mortality in people. And then another recent meta-analysis done in 2022 of 32 studies and 38,000 participants confirmed this result. So it's important to track your HRV and what improves it. One important fact about HRV is that everyone's baseline HRV is different. So there's really no goal HRV or competition about HRV levels. You want it to be at least 25 and continually work to improve your HIV with all the various recovery methods that we talked about earlier.

• 9:24Dr. Darshan Shah?

  Next, let's talk about heart rate recovery, or HRR. After a workout, the faster your heart rate drops back down to normal, the better your cardiovascular fitness and recovery capacity is. If your heart rate drops by 20 beats per minute in the first minute post-exercise, that's a pretty decent recovery. A drop of 30 to 40 within 60 seconds or one minute is considered excellent. Lastly, listen to your body. Listening to your body is the ultimate guide of your recovery. If you're sick, exhausted, or sleep deprived, don't force a high-intensity session. If you're feeling rundown from travel, stress, or poor nutrition, opt for a recovery day or a self-care day instead. Low-impact activities like yoga, stretching, walking, or sauna sessions keep you active

• 10:08Dr. Darshan Shah?

  without overtaxing your system. Some final thoughts on recovery. Recovery isn't just about preventing injury. It's about maximizing your fitness gains and longevity. Training breaks you down. Recovery builds you back up, stronger and more resilient than before. So next time you're tempted to push through exhaustion, remember, train smarter, not harder. Thanks for tuning in. If you found this helpful, please be sure to subscribe, give me a review, and share this episode with a friend who needs to hear this. Until next time, keep training with consistency and add in some smart recovery. Thank you.

• 10:46Dr. Darshan Shah?

  Thank you so much for listening to the podcast today. Please remember to subscribe if you liked this episode and give us a good review and share a link with your friends. It really helps to support all of our efforts. I also want to remind you that the information shared on this podcast is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Please consult with your healthcare provider or physician before making any decisions or taking any action based on what you hear today, especially if you have any underlying health conditions or on any medications. Your doctor knows your personal health situation the best and it's always important to seek their guidance.