Ischaemic pre-conditioning improves workload, fatigue and recovery in team sport: A randomized, double-blind, placebo-controlled crossover trial

Ischaemic preconditioning (IPC) is reported to improve performance, fatigue and recovery, yet evidence in team-sport settings remains limited. We examined the effects of repeated IPC on external workload, perceptual strain and recovery during ecologically valid Gaelic football training. In a randomized, double-blind, placebo controlled crossover design, 13 male players completed two identical pitch sessions following IPC (3 × 5 min 220 mmHg occlusions; 48 h, 24 h and 30 min pre-session) or placebo. Global positioning system-quantified external load, and perceptual outcomes (fatigue, soreness, differential RPE [overall, cognitive/technical, breathing, leg muscle]) were obtained pre- and 0, 24 and 48 h post-exercise. Countermovement and drop jumps were assessed pre-, post- and 48 h post-exercise. Participants were naïve to both conditions. IPC resulted in larger very-high-speed running distance versus placebo (210.6 ± 220.9 vs. 81.6 ± 65.7 m; P = 0.046; effect size [ES] = 0.62; Bayes factor [BF10] = 1.71). Bayesian evidence also modestly supported greater sprint distance, high-speed running and moderate-intensity accelerations (BF10 = 0.38–0.41). Despite increased external loads, IPC lowered perceptual strain, namely physical fatigue, muscle soreness and cognitive effort (ES ≈ 0.20–0.40; BF10 = 0.28–0.49 [P > 0.05]). IPC also improved recovery, evidenced by significantly better countermovement jump outcomes (BF10 1.53–3.21; P = 0.017–0.042). Other non-significant outcomes were directionally consistent. This study provides evidence that repeated IPC can improve (i) on-field workload, (ii) acute perceptual and physical strain/fatigue, and (iii) postexercise recovery in team-sport athletes. Nevertheless, similar to other recovery interventions (e.g., ice baths), a theoretical risk of blunting fatigue/inflammation, and their subsequent adaptive signalling potential, implicates that application may be best periodized for phases prioritizing acute workload and/or recovery over physiological adaptation (e.g., in-season, before important matches).