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Bu hafta blog yazımda her direnç (ağırlık) antrenmanı yapan hemen herkesin sıklıkla deneyimlediği kas hasarı fenomenini tartışalım. Egzersiz sonrası geç dönemde (24-48 saat sonra) ortaya çıkan kas hasarı nedir? Neden önemlidir? Kas gelişimi için gerekli midir? Ağrı ne kadar çok ise o kadar iyi midir (ağrı yok gelişim yok)? Gelin beraber bu soruları bilimsel temelde yanıtlamaya çalışalım.
Egzersiz kaynaklı gecikmiş kas hasarı fenomeni, bir egzersiz sonrası ertesi gün (24 saat sonra) veya daha uzun süreler (48-72 saat) sonra ortaya çıkan lokal veya genel ağrıyı temsil etmektedir (ACSM). Egzersiz kaynaklı gecikmiş kas hasarı büyük oranda kişinin egzersiz geçmişi, güncel fitness seviyesi, uygulanan egzersizin türü, egzersiz süresi ve yoğunluğu gibi faktörlere bağlı olarak farklılaşabilmektedir. Bilimsel açıdan, egzersiz kaynaklı gecikmiş kas hasarı semptomları aşağıdaki gibidir:
- Dokunmaya duyarlı kas ağrısı
- Hareket sırasında ağrı, sertlik ve hareket kabiliyetinde (mobilite) azalma
- Etkilenen kaslarda şişkinlik
- Etkilenen kaslarda lokal ve genel yorgunluk
- Kuvvet ve güç kaybı
Egzersiz kaynaklı gecikmiş kas ağrısı genel olarak neden gelişir? Muhtemel mekanizmaları nelerdir? Bilimsel literatür, yüksek yoğunluklu, alışılmadık veya eksantrik temelli egzersizlerin kas fiberlerinde mikroskobik yırtılmalara veya travmalara neden olabileceğini ifade etmektedir. İnsan organizması kas fiberlerinde oluşan bu mikroskobik yırtılmalara inflamasyon yanıtı geliştirmektedir. İlgili kaslarda gelişen İnflamasyon yanıtını egzersiz kaynaklı gecikmiş kas ağrısı fenomeni takip etmektedir. Literatür açısından genel kabul, eksantrik fazın uzaması kas hasarı düzeyini arttıran en önemli potansiyeldir. Örneğin, Biseps curl hareketi sırasında barın aşağıya doğru salınması sırasında Biseps braki kasınızın veya yokuş aşağı koşu sırasında kuadriseps kaslarınızın eksantrik fazda olduğunu düşünürsek bu ve benzer koşullarda egzersiz yapmanın daha yüksek kas hasarı geliştirme potansiyelleri olacağı bilinmelidir.
Egzersiz sonrası gelişen gecikmiş kas ağrısı uzun dönem laktat birikimi ile ilişkilendirilmiş ve kas hasarı ile laktat arasındaki bağlantı anlaşılmaya çalışılmıştır. Ancak, laktat akümülasyonu ve atım süreleri dikkate alındığında (biriken laktatın egzersiz sonrası 2 saat içine başlangıç düzeyine geri geldiği keşfedilmiştir) ertesi gün yaşanan kas ağrısı ile bağlantısı çürütülmüştür. Bu bağlamda, üzerinde düşünmemiz gereken konulardan biri de egzersiz sonrası gelişen gecikmiş kas ağrısını kimler deneyimlemektedir? Bu sorunun yanıtı aslında çok net seçkin sporculardan yeni başlayanlara veya uzun süredir egzersiz yapmamış kişilere kadar hemen herkes egzersiz kaynaklı kas hasarını deneyimleyebilir. Bu nedenle, fitness seviyeniz ne olursa olsun, egzersiz yüklenme yoğunluğunuzu artırdığınızda, eksantrik egzersizler yaptığınızda veya vücudunuzun alışık olmadığı yeni bir egzersiz türünü denediğinizde kas hasarını yaşarsınız. Burada bir diğer konuda kas gelişimi için egzersiz sonrası kas hasarını her zaman yaşamak mı gerekir? Aslında bu soruya yanıt hayır olacaktır. Çünkü, yeni bir egzersiz rutinine başladığınızda veya sınırlarınızı zorladığınızda ağrınız daha olasıdır. Ama siz çalışmaya devam ettikçe vücudunuz buna uyum sağlayacaktır. Antrenman sıklığınız arttıkça daha az ağrı hissedebilirsiniz, ancak bu hiçbir şekilde yeterince çalışmadığınız veya bu antrenmanlardan elde ettiğiniz fitness kazanımlarını kaybettiğiniz anlamına gelmeyecektir. Size tavsiyem fitness kazanımlarınızı optimize etmek için antrenman rutinlerinizi her 4-6 haftalık dönemler arasında revize etmeniz. Bu strateji vücudunuzun adaptasyon süreci için optimal bir zaman dilimi oluşturmanız ve devamında yeni limitlerinizi belirleyip yeni koşullara adaptasyon geliştirebilmenize yardımcı olacaktır. Aksi durumda “plato ya da kararlı denge fenomeni” gerçekleşecektir (plato ya da kararlı denge fenomenini başka bir hafta tartışalım).
Şimdi biraz da egzersiz sonrası gelişen gecikmiş kas ağrısını yönetmede nasıl stratejiler izlemeliyiz? sorusunu irdeleyelim. Egzersiz sonrası gelişen gecikmiş kas ağrısı büyük oranda kaslarda gerginlik ve ağrı artışına beraberinde ise hareketlilik minimizasyonu ile karakterizedir. Tipik bir şekilde hareket etme veya egzersiz yapma isteğinde azalma meydana gelmektedir. Bu bağlamda izlenmesi gereken en önemli noktalar, eğer ağrı seviyeniz yüksek ise (görsel ağrı skoru açısından 10 üzerinden 7’den fazla ise, kabaca 0 düşük ağrı, 10 dayanılmaz ağrıyı temsil eder) dinlenmek akılcı olacaktır. Çünkü, yüksek kas ağrısı durumunda dinlenmek kasların onarımı ve yenilenmesi için efektif olacaktır. Ancak, eğer ağrı hissiniz 6’dan düşük ise hareketlilik düzeyinizi arttırmak egzersiz sonrası gelişen gecikmiş kas ağrısını uzaklaştırmada daha faydalı olacaktır. Ancak, düşük veya yüksek düzeyde egzersiz sonrası gelişen gecikmiş kas ağrınız varsa yüksek yoğunluklu egzersizlerden ve patlayıcılık gerektiren işlerden uzak durmalısınız. Ayrıca, split rutin çalışma yöntemini benimseyenler bir kas grubunu çalıştıktan sonra ertesi gün veya yakın günlerde tekrar aynı kas grubunu çalıştırmamaya özen göstermelidir. Eğer egzersiz sonrası gelişen gecikmiş kas ağrınız düşük ve orta düzeyde ise gün boyunca düşük-orta yoğunlukta bir hareketlilik düzeyi benimseyebilirsiniz. Bu strateji kaslarınızın restorasyon ve toparlanma potansiyelini azaltabilir (bu iddia tartışmalıdır), ancak hissettiğiniz ağrı düzeyini azaltabilir. Bu bağlamda, kullanabileceğiniz seçenekler kaslarınızı rahatlatmak için hafif yoga yapmak veya düşük-orta yoğunlukta yürüyüşler, bisiklete binmek veya yüzmek olabilir (bu yöntemler bilimsel açıdan tartışmalıdır. Ancak, hareketsizlikten daha iyi sonuç verebilir).
Sonuç olarak, egzersiz sonrası gelişen gecikmiş kas ağrısı egzersiz ekosisteminin temel yapılarından biridir. Hemen herkesin deneyimlediği bir olgudur. Fitness kazanımları için de son derece kritiktir. Egzersiz sonrası gelişen gecikmiş kas ağrısını önlemek veya ortadan kaldırmak için kullanabileceğimiz stratejiler sınırlı ve tartışmalıdır. Ancak yine de egzersiz kaynaklı kas ağrısını hafiflemede kullanabileceğimiz bazı stratejiler bugün de yoğun bir şekilde araştırılmaktadır. Literatürde, egzersiz sonrası gelişen gecikmiş kas ağrısını hafifletmede kullanılabilecek yöntemleri sizin için sıralıyorum.
Hareketliliği Artırmak: Yürüyüş yapmak, bisiklete binmek, kürek çekmek, yüzmek, yoga yapmak, mobilite egzersizleri yapmak (SMR ve stretching)
Su Tüketimine Dikkat Etmet: Egzersiz öncesi, sırası ve sonrası yeterli su tüketmek (1).
Isınma ve Soğuma Yapmak: Egzersiz öncesi ve sonrası ilgili kaslara yeterli ve efektif ısınma ve soğuma stratejileri uygulamak (2).
Progresif Olmak: egzersiz programını kademeli olarak zorlaştırmak ve uygulamak
Anti-inflamatuar Yiyecekler Tüketmek: Polifenoller, omega-3 yağları, kafein ve taurin (3).
Soğuk Uygulamalar Yapmak: 10-15 dk boyunca 10-15 derece su ile duş almak veya suda beklemek (4).
Sıcak Uygulamalar Yapmak: Vücudun bir bölümünü içine alan sıcaklık torbaları veya giysilerini kullanmak (5).
Masaj Uygulamalarını Denemek: Kalf, kalça, uyluk omuz ve kollara masaj uygulamak (6).
Topikal Analjezikler: Mentol içeren topikal analjezikler kullanmak (7)
Ağrı Kesiciler: İbuprofen gibi steroid içermeyen anti-inflamatuar ilaçlar kullanmak (8).
“Hayat bir öğrenmedir. Öğrenmede esas olan gelişmek, değişmek ve ilerlemektir. M.E.KAFKAS”
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