Heart Rate Variability and What It Can Tell You About Recovery

There is a certain simplicity to HRV, or heart rate variability, despite the technical ring of the term. It is a matter of observing the minute time differences from one heartbeat to the next. A healthy system is not as regular as a metronome; rather, the nervous system will make its own adjustments and the spacing between beats will vary in response to what the body requires at any given moment.

By way of those small changes, you can gain some valuable perspective on how the body is coping with everything from exercise and sleep to stress and recovery. For anyone looking to be more attuned to their training and see how they are responding on a daily basis, HRV serves as a handy instrument.

Key Points About HRV

What You Should Know

What Does Heart Rate Variability Mean?

HRV describes the natural variation in timing between heartbeats. Even if your pulse is 60 beats per minute, those beats are not always exactly one second apart. That small variation is normal.

The autonomic nervous system is what drives this pattern, seeing to the body’s functions that require no conscious effort like digestion, breathing and heart rate. There are two sides to it: the sympathetic, which has a way of being associated with action or stress, and the parasympathetic for rest and recovery.

As a rule, if these systems are in balance and responsive you will see HRV run higher. Put the body under some strain, however, and it is not uncommon for HRV to fall.

Why HRV Matters for Active People

Those who put in the work with regular exercise, are in the process of an orthopedic recovery or putting in the hours for sports training might find HRV to be a useful measure of how the body is faring. It is not meant to supersede the advice of one’s care team, a physical exam or what you feel on any given day; rather it offers some further context for your daily decisions.

Take a dip in HRV below the norm as a possible sign that a lighter session is in order, or that more time for rest and sleep is called for. On the other hand, a trend that is improving or holding steady could be taken as evidence of sound adaptation to the training.

What Can Affect Your HRV?

There are a number of things that can put an influence on HRV. In some cases the variation is in keeping with actual changes in recovery, but at other times it is merely an artefact of the measurement. You should bear in mind that what a smartwatch or fitness tracker puts out is only an estimate; the make of the device and its algorithm, to say nothing of minor setup variations, will all have an effect on the numbers.

Then there is the matter of reliability. An irregular heart, frequent ectopic beats or a pacemaker can throw off thse readings. So can a bad sensor, or bad sensor contact And if symptoms are of concern, do not be swayed by an HRV figure that appears normal or better; seek medical attention.

• Sleep quality and sleep duration
• Physical training load and recovery time
• Emotional stress
• Illness or infection
• Hydration and nutrition
• Alcohol use
• Age and overall fitness
• Certain medications and medical conditions

Because so many factors affect HRV, one isolated reading usually does not mean much on its own. Looking at patterns over time is more useful than focusing on a single number.

Is Higher HRV Always Better?

Generally speaking, a higher HRV tends to point to a nervous system in good shape, one that is more adaptable and recovers well. But then again, HRV is an individual matter. A high figure is only as good as it is consistent with your own normal way of being.

Unusually high, erratic, or sudden changes are not automatically good. Such anomalies can be nothing more than an artifact of the measurement, or they may be indicative of an illness, rhythm irregularity, or simply overreaching. If you see the numbers change quickly it is worth taking a closer look at how you are feeling.

Since age, genetics, conditioning and overall health all play a part, there is considerable variation from one person to the next. Because of that you will find it more useful to have a handle on your own typical range and to be on the lookout for any changes.

How to Measure HRV

There are a number of ways to put HRV in numbers, from an electrocardiogram to the sort of wearables you might have on hand: a chest strap, smartwatch or fitness tracker will do. Remember that not all devices estimate HRV in the same way; for the sake of spotting trends it is best to stick with a particular device and routine.

Consistency is what really counts. Some will find their readings altered by even minor variations in body position or activity, depending on the wearable. Many people make a point of taking their HRV first thing in the morning to get a baseline reading.

How HRV Connects to Recovery and Orthopaedic Care

Those in the process of healing from an overtraining spell, a musculoskeletal injury or surgery can turn to HRV as a means of gauging how well the body is coping with stress. In the course of rehabilitation it is useful for keeping a proper day to day pace. Of course, it is best employed in conjunction with other indicators such as pain levels, swelling, strength and range of motion, as well as fatigue and sleep quality and functional gains, not to mention the input of one’s physical therapist or clinician.

Take the case where your HRV is running below normal and you are feeling more sore or run down than is typical; in that instance it makes sense to scale back. On the other hand, a steadier trend and good tolerance of therapy would be consistent with building up your activity a bit. But do not let HRV be the sole arbiter on when to get back to sport or the extent of post surgical progress.

What HRV Cannot Do

HRV can be helpful, but it has limits. It cannot tell you exactly why your body is stressed. It also cannot diagnose a heart condition, an injury problem, or another medical issue on its own.

• It does not replace a medical evaluation.
• It should not be used alone to push through warning signs or through pain.
• It is only one part of understanding your health and recovery.

When to Pay Closer Attention

If your HRV stays lower than usual for several days and you also feel unwell, overly fatigued, dizzy, or unable to bounce back from the day's activities, speak with a healthcare professional. This matters more if you have a pre-existing heart condition or are concerned about any other symptoms.

Seek medical care right away if you have

• Chest pain
• Fainting
• Trouble breathing
• A racing or irregular heartbeat with symptoms
• Severe weakness or dizziness

A Practical Way to Use HRV

Do not view HRV as a figure to be put on a pedestal; treat it more like a daily check in. When the readings are within your usual range and you are in good form, the body is likely primed for its normal routine. But should the numbers dip and you find yourself feeling sore or under stress, it is time to turn your attention to the fundamentals of recovery, sleep and hydration.

Active adults and athletes need not strive for perfection with these metrics. It is about understanding how one can make sounder choices. That can help lower the chance of burnout or setbacks.

Need Help Returning to Activity Safely?

When you find that staying active is a struggle due to pain, an injury, overtraining or simply a slow recovery, the orthopaedic specialists on our team are here to assist. We put in the time with our patients and athletes to assess how they move and determine the right course of treatment, all while formulating a plan for recovery in line with their objectives.

For those looking to put more confidence back into their exercise, sports or day to day routine, we invite you to set up an evaluation at Princeton Orthopaedic Associates.

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This blog post is meant to be informative and should not act as a self-diagnosis tool. If you’d like to see one of our doctors, please contact us here.