PRP, Dry Needling, and More: Decoding the Latest Trends in Sports Rehab

Sports rehabilitation has evolved dramatically beyond traditional rest, ice, and physical therapy. In 2025-2026, athletes have access to an expanding arsenal of innovative recovery modalities ranging from biological therapies like platelet-rich plasma to cutting-edge techniques like blood flow restriction training. This comprehensive guide examines the latest trends in sports rehabilitation, separating evidence-based treatments from hype, and providing practical guidance on which modalities deliver real results for athletes seeking faster, more complete recovery.

Platelet-Rich Plasma (PRP) Therapy: Harnessing Your Body’s Healing Power

What is PRP and How Does It Work?

Platelet-rich plasma therapy involves extracting a patient’s own blood, concentrating the platelets through centrifugation, and injecting this platelet-rich solution directly into injured tissues. The concentrated platelets release growth factors including platelet-derived growth factor (PDGF), transforming growth factor-beta (TGF-β), vascular endothelial growth factor (VEGF), and insulin-like growth factor (IGF), which accelerate natural healing processes.

The therapeutic mechanism works through multiple pathways. Growth factors stimulate cellular proliferation and tissue regeneration, platelets recruit stem cells to the injury site, the biological cascade reduces chronic inflammation without suppressing acute healing responses, and collagen synthesis increases for stronger tissue repair. Unlike corticosteroids that merely mask pain, PRP actively enhances the body’s natural healing capacity.

Clinical Effectiveness and Success Rates

Recent research from 2025 demonstrates that PRP therapy achieves clinically meaningful improvement in 50-70% of appropriately selected patients, with success rates highest when proper patient selection criteria are applied. A 2025 systematic review examining PRP use in athletes suggests that while PRP might aid in pain management, high-quality evidence is still developing.

Real-world clinical outcomes from sports medicine practices show impressive results. In a comprehensive study of 48 athletes receiving PRP for various sports injuries, 93.75% returned to pre-injury activity within 2-12 months. Athletes requiring only a single injection for acute lower-grade injuries returned to sports activity significantly earlier than those needing multiple injections for chronic conditions. These findings support early intervention with PRP for acute injuries rather than waiting for conditions to become chronic.​

Specific Injury Applications

Tendon Injuries: PRP demonstrates particular promise for tendinopathies that haven’t responded to conservative management. For Achilles tendinopathy, three athletes treated with a single PRP injection all returned to pre-injury activity with minimal pain. Tennis elbow, rotator cuff tendinopathy, and patellar tendinopathy show favorable responses to PRP treatment.

Muscle Strains: Grade I and II muscle strains (rectus femoris, rectus abdominis, pectoralis major) showed excellent outcomes when treated with single PRP injections combined with supervised strengthening programs, leading to early return to pre-injury activity. The key is catching these injuries early rather than allowing them to progress to chronic states.​

Ligament Injuries: PRP accelerates healing of partial ligament tears, though complete ruptures typically still require surgical intervention. The therapy works best as an adjunct to comprehensive rehabilitation programs.

Knee Osteoarthritis: Athletes dealing with osteoarthritis see major benefits from PRP therapy in 2025, with injections into arthritic joints reducing pain and potentially slowing cartilage loss progression. PRP demonstrates superior results compared to hyaluronic acid injections for mild to moderate osteoarthritis.

Treatment Protocols and Timeline

PRP protocols typically involve 1-3 injections spaced several weeks apart, depending on injury severity and chronicity. Acute injuries often require only a single injection, while chronic conditions may need multiple treatments. Athletes typically notice improvements gradually over weeks to months as natural healing processes are activated, rather than experiencing immediate relief.

Ultrasound guidance ensures precise injection placement directly into injured tissue, maximizing therapeutic effect. Following injection, brief activity modification (24-48 hours) is recommended, after which progressive rehabilitation exercises are initiated. The combination of PRP with supervised rehabilitation programs produces superior outcomes compared to PRP alone.​

Patient Satisfaction and Compliance

Patient satisfaction correlates strongly with several factors. Athletes with acute injuries report more favorable outcomes and higher satisfaction compared to those with chronic degenerative conditions. Single-injection protocols for appropriate injuries yield better satisfaction than multiple-injection scenarios. High compliance with post-PRP rehabilitation programs directly correlates with patient satisfaction and reduced pain scores.​

Limitations and Considerations

Not all injuries respond equally to PRP therapy. Success rates vary based on injury type, chronicity, patient age, and rehabilitation compliance. The quality and concentration of PRP preparation significantly impacts outcomes, with high-platelet preparations producing superior results. Insurance coverage remains inconsistent, often requiring significant out-of-pocket expenses. While promising, PRP should be viewed as an adjunct to comprehensive rehabilitation rather than a standalone cure.

The 2025 Athlete Perspective

Professional and collegiate athletes increasingly incorporate PRP into their recovery strategies for accelerated healing from minor sports injuries that don’t require surgery. Instead of waiting weeks or months for rest and physical therapy alone, PRP delivers concentrated growth factors directly to injured areas, speeding natural healing and allowing safer, faster return to training and competition.

Dry Needling: Precision Treatment for Muscle Dysfunction

Understanding Dry Needling Technique

Dry needling involves inserting thin filiform needles directly into myofascial trigger points—taut bands of muscle tissue that cause pain and restrict movement. Unlike acupuncture, which is based on traditional Chinese medicine meridians, dry needling targets specific anatomical structures based on Western medicine principles of musculoskeletal anatomy and neuromuscular function.​

The therapeutic mechanism works through several pathways. Direct mechanical disruption breaks up trigger point tension, local twitch responses release muscle contraction, increased blood flow delivers oxygen and nutrients while removing metabolic waste, and neural modulation reduces pain signaling.

Evidence for Athletic Applications

A comprehensive 2025 systematic review incorporating 24 studies with 580 athletes across 13 sports provides crucial insights into dry needling effectiveness. The research encompassed predominantly talent/developmental and highly trained/national-level athletes, with interventions focused mainly on the lower limbs (58.3% of studies).​

Pain Management: Approximately 69% of studies reported pain perception outcomes, with dry needling generally showing more positive effects on pain than on athletic performance. Multiple studies confirmed pain reduction after athletes underwent dry needling following physical exertion.​

Functional Improvements: Six studies examined muscular strength, activity, and range of motion, with researchers discovering beneficial effects on range of motion in lower limb joints as well as strength of examined muscle groups following treatment. For instance, dry needling may facilitate improvements in muscle stiffness and motoneuron excitability of latent medial myofascial trigger points.​

Recovery Enhancement: Beyond injury treatment, dry needling proves beneficial for athletes in the recovery process after training, with studies noting positive impacts on pain intensity and muscle function following training periods.​

Clinical Trial Results

A 2024 randomized controlled trial comparing dry needling with stretching versus stretching alone for athletes with iliotibial band syndrome revealed significant findings. Three sessions of dry needling combined with stretching proved significantly more effective at reducing pain (p = 0.000) and enhancing iliotibial band functionality (p = 0.001) compared to stretching alone. Both Visual Analogue Scale (VAS) and Lower Extremity Functional Scale (LEFS) showed statistically greater improvements in the dry needling group.​

Treatment Protocols

Typical dry needling sessions last 15-30 minutes depending on the number of trigger points treated. Athletes may experience immediate relief or soreness initially with improvement over 24-48 hours. Treatment frequency varies from once weekly to twice weekly depending on condition severity and response. Most conditions require 3-6 sessions for optimal results, though some chronic issues need ongoing maintenance.​

Safety and Side Effects

Dry needling demonstrates excellent safety profiles with minimal adverse events reported in research literature. Common minor side effects include temporary soreness at needle sites, occasional bruising, brief muscle fatigue post-treatment, and rare vasovagal responses (feeling lightheaded). Serious complications are extremely rare when performed by properly trained practitioners.​

Best Candidates for Dry Needling

Athletes with myofascial trigger points causing pain or limiting performance benefit most from dry needling. Chronic muscle tightness not responding to stretching, specific sport-related muscle overuse patterns, rehabilitation following muscle strains, and performance plateaus related to muscle dysfunction all represent appropriate applications.

Blood Flow Restriction (BFR) Training: Game-Changing Rehabilitation Tool

The Science Behind BFR

Blood flow restriction training involves applying a specialized cuff or tourniquet to partially restrict blood flow to a limb during exercise. This restriction reduces oxygen supply to working muscles while allowing arterial inflow, creating a hypoxic environment that triggers powerful physiological adaptations.

The mechanism creates metabolic stress through metabolite accumulation (lactate, hydrogen ions), earlier recruitment of type II muscle fibers due to faster fatigue, enhanced growth hormone and other anabolic hormone release, and cellular swelling that signals muscle growth pathways. Remarkably, these adaptations occur with low loads (20-40% of 1RM), making BFR invaluable when heavy loading is contraindicated.

Clinical Evidence and Effectiveness

A 2025 systematic review examining lower extremity BFR training in athletes reveals that 58% of studies showed significant improvements in strength-related outcomes compared to non-BFR control groups. More impressively, a 2025 meta-analysis investigating high-load resistance training combined with BFR (HL-BFRT) demonstrated significant improvements across multiple domains.

The meta-analysis results showed substantial improvements in muscle strength (SMD = 0.65), power (SMD = 0.45), speed (SMD = 0.78), and endurance (SMD = 0.90) following HL-BFRT interventions. These findings suggest that combining mechanical tension from heavy loads with BFR-induced metabolic stress overcomes biological limitations of unimodal training.​

Applications in Sports Medicine

Post-Surgical Rehabilitation: BFR allows early strength training when joint loading is restricted, preventing muscle atrophy during protected weight-bearing phases, maintaining strength with minimal stress on healing structures, and accelerating return to function compared to traditional low-load protocols.

Injury Prevention: Athletes can build and maintain muscle mass during deload periods, reduce training stress while maintaining adaptations, and address bilateral strength deficits that increase injury risk.​

Performance Enhancement: BFR integrated into standard training regimens enhances muscular development, particularly valuable during in-season maintenance when high-volume training is impractical. Research shows that BFR-trained runners experience enhanced running economy and time-to-exhaustion compared to non-BFR counterparts after just 4 weeks.

Practical Implementation Protocols

BFR Resistance Exercise (BFR-RE): Using low loads (20-40% 1RM), practitioners guide athletes through sets of 30-15-15-15 repetitions with controlled cuff pressure (typically 40-80% arterial occlusion pressure). This promotes muscular growth and strength when lifting heavy isn’t an option. Alternative methods include working to maximal fatigue in the first set followed by 3 additional sets to fatigue with 30-60 second recovery.​

Occlusion Pressure: Modern protocols use individualized arterial occlusion pressure (AOP) determined through Doppler ultrasound rather than arbitrary pressure settings. Higher occlusion pressures correlate with greater muscle activation, though comfort and safety must be balanced.​

Exercise Selection: Closed-chain multi-joint exercises (squats, leg press) produce superior results compared to open-chain single-joint movements (leg extensions), likely due to greater total muscle mass involvement. Sport-specific exercises can be modified to incorporate BFR for targeted adaptation.​

Safety Considerations

BFR training demonstrates excellent safety profiles when applied by trained professionals using appropriate equipment. Contraindications include active deep vein thrombosis or thrombosis history, peripheral vascular disease, uncontrolled hypertension, pregnancy, and recent surgery in the limb to be occluded. Athletes should be monitored for excessive discomfort, numbness or tingling beyond mild sensations, skin discoloration, and any concerning symptoms requiring immediate cuff removal.

The 2025 Clinical Consensus

Sports medicine practitioners increasingly view BFR as a game-changer in strength rehabilitation and recovery, particularly for load-compromised individuals. The ability to achieve muscular adaptations traditionally requiring heavy loads while using only 20-40% of maximum capacity revolutionizes rehabilitation for athletes with pain, post-surgical restrictions, or injuries preventing traditional strength training.

Extracorporeal Shockwave Therapy (ESWT): Acoustic Waves for Healing

Mechanism of Action

ESWT delivers high-energy acoustic waves to injured tissues, creating mechanical forces that stimulate biological healing responses. The pressure waves promote healing by stimulating blood flow and metabolism in poorly vascularized structures like tendons, mimicking forces experienced during trauma to promote tissue and bone regrowth, breaking down scar tissue and calcifications, and triggering release of growth factors and stem cell recruitment.

Clinical Applications and Effectiveness

A 2024 systematic review examining ESWT use in athletes and physically active individuals concluded that ESWT offers efficacious treatment alone or as an adjunct to concurrent exercise therapy in selected sports-related injuries without major adverse events. The therapy shows particular effectiveness for chronic tendon issues resistant to conservative treatment.

Proven Applications: Plantar fasciitis, Achilles tendinopathy, lateral epicondylitis (tennis elbow), patellar tendinopathy (jumper’s knee), calcific shoulder tendinopathy, and shin splints all respond favorably to ESWT.​

Treatment Protocols and Outcomes

Most patients achieve long-term results after only three treatments, each taking approximately 15 minutes. Depending on the injury, patients can avoid invasive treatments such as steroid injections or surgery, as ESWT requires no incisions or downtime. Increased blood flow proves especially beneficial in tendons, which naturally receive limited blood supply and heal slowly.​

Advantages Over Traditional Treatments

ESWT provides non-invasive outpatient treatment, avoids steroid injections and their potential complications, addresses chronic conditions that failed conventional therapy, and requires minimal recovery time between sessions. The therapy targets the underlying pathology rather than merely masking symptoms.

Pneumatic Compression: NormaTec and Recovery Systems

Technology and Mechanism

NormaTec compression boots and similar pneumatic devices use sequential air compression to mimic the body’s natural muscle pump. The technology works through enhanced venous return and lymphatic drainage, removal of metabolic waste products (lactate, inflammatory mediators), reduced muscle edema and swelling, and improved tissue oxygenation for faster recovery.

Evidence Base

Multiple studies support pneumatic compression efficacy. A 2015 study in the Journal of Athletic Training demonstrated that intermittent pneumatic compression significantly reduced delayed onset muscle soreness (DOMS) in athletes. A 2017 study in the European Journal of Applied Physiology found that pneumatic compression boots improved recovery times and reduced muscle soreness following high-intensity training. A 2016 study in the Journal of Strength and Conditioning Research highlighted that athletes using intermittent pneumatic compression experienced improved blood flow and faster recovery compared to those without compression.​

Benefits for Athletes

Research confirms that NormaTec boots provide reducing muscle soreness by minimizing DOMS intensity, improving range of motion through reduced muscle tightness, speeding up recovery to enable more frequent high-intensity training, and enhancing circulation to deliver nutrients and remove waste products.

Optimal Usage Protocols

Duration: For short workouts (less than 1 hour), 20-30 minute sessions suffice for recovery. For long or intense workouts (over 1.5 hours), 30-45 minute sessions optimize recovery benefits. For very intense training or competition, 45-60 minute sessions provide comprehensive recovery.​

Frequency: Daily use after training sessions, particularly during intense training blocks or competition periods. Multiple sessions per day are safe for athletes in heavy training phases. Integration with other recovery modalities for synergistic benefits.​

Practical Considerations

NormaTec and similar systems have become staples in recovery routines of endurance athletes, particularly cyclists and runners. The devices provide convenient, passive recovery that can be performed while resting, working, or engaging in other activities. Home units allow consistent application without facility access requirements.​

Hyperbaric Oxygen Therapy (HBOT): Pressurized Healing

Therapeutic Mechanism

Hyperbaric oxygen therapy involves breathing 100% pure oxygen in a pressurized chamber (1.5-3x normal atmospheric pressure). This process supercharges oxygen delivery to damaged tissues, stimulates stem cell production for faster healing, reduces chronic inflammation, and enhances brain function and recovery.

Athletic Applications

HBOT proves particularly valuable for athletes with intense training schedules, post-surgery or injury recovery, chronic pain conditions, and fatigue-related issues. Research demonstrates that all athletes benefited from HBO treatment, presenting faster recovery rates. Studies suggest that lactic acid and ammonia are removed faster with HBO treatment, leading to shorter recovery periods.

Combining HBOT with Other Modalities

When combined with cryotherapy, HBOT creates synergistic recovery effects. HBOT delivers oxygen to rebuild muscles while cryotherapy reduces inflammation from intense training, resulting in faster bounce-back between sessions. The combination addresses both tissue healing and inflammation management comprehensively.​

Limitations

HBOT requires specialized facilities and equipment, involves significant time commitment (60-90 minute sessions), carries notable costs often not covered by insurance for sports applications, and has contraindications including certain lung conditions and claustrophobia.

Cupping Therapy: Ancient Practice Meets Modern Science

Mechanism and Application

Cupping therapy involves placing cups on the skin to create suction, drawing blood to the surface and creating the characteristic circular marks. The proposed mechanisms include increased blood flow to affected areas, myofascial release and reduced muscle tension, pain modulation through counter-irritation, and enhanced recovery through improved circulation.

Current Evidence

Research on cupping effectiveness shows mixed results. A comprehensive analysis concluded that cupping therapy has low to moderate evidence in musculoskeletal and sports rehabilitation but might be used as a useful intervention because it decreases pain levels and improves blood flow with low adverse effects. A 2018 review examining cupping in amateur and professional athletes concluded that no explicit recommendation for or against the use of cupping can be made, with more studies necessary for conclusive judgment.

Recent Research Findings

A 2025 study on university baseball players examined cupping effects across different training phases. Results showed that cupping during preseason conditioning improved post-exercise recovery of autonomic activity and notably enhanced daytime function and sleep quality. During in-season conditioning, cupping improved recovery of sympathetic activity following intense exercise. However, cupping showed no significant effects on upper-extremity function, peak power, peak oxygen consumption, or anaerobic threshold during either phase.​

Another 2021 study found a time effect of cupping therapy for reducing muscle fatigue, with the delayed effect (24 hours after exercise) being significant while the initial effect was not. This suggests cupping may provide benefits through mechanisms that take time to manifest rather than immediate effects.​

Clinical Perspective

While cupping gained tremendous visibility during the 2016 Olympics when elite athletes displayed the characteristic circular marks, scientific evidence remains limited. The therapy appears safe with minimal adverse effects, may provide subjective benefits through placebo or relaxation effects, shows potential for pain reduction and recovery enhancement though mechanisms remain unclear, and requires more rigorous research to establish definitive effectiveness.

Low-Level Laser Therapy (LLLT): Photobiomodulation for Recovery

Technology and Mechanism

LLLT (also called photobiomodulation) involves applying specific wavelengths of light to tissues to modulate cellular metabolism, reduce inflammation, and accelerate healing. The proposed mechanisms include enhanced mitochondrial function and ATP production, modulation of inflammatory pathways, increased blood flow to treated areas, and stimulation of cellular repair processes.

Evidence for Athletic Applications

A comprehensive 2024 review examining LLLT for acute tissue injury and sport performance recovery revealed nuanced findings. Surface Lesions and Wound Healing: Studies show LLLT holds promise in accelerating wound healing for body surface structures. Athletic Performance and Recovery: LLLT typically delivered pre-exercise reveals beneficial effects on exertion recovery, improvements in muscle strength and endurance, and reduced fatigue. Acute Deep Tissue Injuries: Evidence is less convincing for acute deep tissue injury models, where most studies do not report significant benefits for functional outcomes over conventional therapeutic modalities.

Clinical Applications

Pre-Exercise Application: Delivered before training or competition to precondition muscles, reduce fatigue onset, and enhance performance capacity. Post-Exercise Recovery: Applied after exertion to accelerate recovery, reduce muscle soreness, and prepare for subsequent training. Wound Healing: Shows promise for abrasions, lacerations, and surface injuries common in contact sports.

Limitations and Considerations

Significant variability exists in LLLT delivery parameters across studies (wavelength, power density, duration, frequency), making standardized recommendations difficult. Technical properties of laser light delivery differ materially from LED devices, affecting penetration and efficacy. Evidence remains questionable for accelerating repair of deeper musculoskeletal structures in acute/subacute injury settings. The lack of clear treatment guidelines limits widespread clinical adoption.

Emerging Trends for 2025-2026

Data-Driven Return to Play

Wearable technology integration provides real-time monitoring of athletes’ recovery progress, essential for phased and informed reintroduction to training. Fourteen percent of sports practitioners expect more focused approaches to improve and create faster return-to-play plans through data integration. Video analysis combined with wearable data offers comprehensive assessment of athletes’ recovery and precise evaluation of return-to-play readiness.​

Personalized Treatment Plans

Advanced analytics and AI enable customized rehabilitation protocols based on individual athlete characteristics, injury patterns, and recovery trajectories. Sports medicine in 2025 increasingly focuses on individualized training programs tailored to each athlete’s specific needs and responses.

Combination Therapies

Prolozone therapy (combining PRP/prolotherapy with ozone therapy) gains national recognition for joint and soft tissue injuries. The powerful natural oxidant reduces inflammation and accelerates tissue healing when combined with regenerative injections. Practitioners increasingly combine multiple modalities—such as PRP with exercise therapy, BFR with traditional rehabilitation, or HBOT with cryotherapy—to create synergistic healing effects.

Evidence-Based Recommendations: What Actually Works?

Strong Evidence (Recommended)

PRP for Tendinopathy: Particularly effective for chronic tendon issues not responding to conservative treatment, with 50-70% success rates in appropriate candidates. BFR Training: Excellent evidence for maintaining/building strength when high loads are contraindicated, with 58% of studies showing significant improvements. ESWT for Chronic Tendon Issues: Effective treatment for plantar fasciitis, Achilles tendinopathy, and tennis elbow resistant to other therapies. Pneumatic Compression for Recovery: Well-supported evidence for reducing DOMS and accelerating recovery between training sessions.

Moderate Evidence (Consider with Appropriate Selection)

Dry Needling for Trigger Points: Shows positive effects on pain and function, particularly when combined with other therapies. HBOT for Recovery: Benefits demonstrated but requires significant resource investment and facility access. LLLT for Pre-Exercise and Superficial Healing: Promising for performance enhancement and wound healing, less convincing for deep tissue injuries.

Limited Evidence (Use with Caution)

Cupping Therapy: Low to moderate evidence with potential benefits for pain and recovery, but mechanisms unclear and results inconsistent. Athletes report subjective benefits, but objective performance improvements remain unproven.

Practical Integration: Building Your Rehab Protocol

Phase 1: Acute Injury (0-72 Hours)

Focus on PEACE protocol principles while considering early PRP intervention for appropriate injuries. Apply compression and elevation as tolerated. Consider LLLT for surface wounds if available. Avoid aggressive anti-inflammatory modalities that suppress healing.

Phase 2: Early Rehabilitation (Week 1-4)

Incorporate dry needling for persistent muscle guarding or trigger points limiting range of motion. Initiate BFR training if traditional loading is contraindicated. Consider ESWT for chronic tendon issues not responding to initial treatment. Use pneumatic compression for recovery between rehabilitation sessions.

Phase 3: Progressive Loading (Week 4-8)

Continue BFR training while progressively increasing loads. Apply ESWT for stubborn tendinopathies. Use LLLT pre-exercise to enhance training capacity. Implement pneumatic compression for recovery management.

Phase 4: Return to Sport Preparation (Week 8+)

Combine high-load training with BFR for maximal strength adaptations. Continue any modalities showing individual benefit. Emphasize data-driven return-to-play criteria over arbitrary timelines. Maintain recovery protocols including compression therapy.

Cost-Benefit Considerations

Athletes and practitioners must weigh potential benefits against financial and time investments. High-Value Interventions: BFR training (requires only cuff equipment, integrates into existing rehabilitation), PRP for appropriate acute injuries (may prevent need for surgery), and pneumatic compression (one-time equipment investment for ongoing benefits).

Moderate-Value Interventions: Dry needling (relatively inexpensive per session, cumulative costs moderate), ESWT (higher per-session costs but limited sessions required), and LLLT (equipment costs high but per-use costs low).

High-Investment Interventions: HBOT (requires specialized facilities, significant per-session costs) and cupping (low individual costs but questionable evidence).

The Bottom Line

The landscape of sports rehabilitation in 2025-2026 offers unprecedented options for athletes seeking optimal recovery. PRP therapy, blood flow restriction training, extracorporeal shockwave therapy, and pneumatic compression demonstrate strong evidence bases and should be considered for appropriate applications. Dry needling, hyperbaric oxygen, and low-level laser therapy show promise with moderate evidence supporting their use in specific contexts.

The most effective rehabilitation protocols integrate multiple evidence-based modalities with comprehensive exercise-based rehabilitation, recognizing that no single treatment provides a magic solution. Athletes should work with knowledgeable sports medicine professionals to select appropriate interventions based on injury type, chronicity, individual response, resource availability, and evidence quality.

As research continues evolving, practitioners and athletes must stay informed about emerging evidence while maintaining healthy skepticism toward trends lacking rigorous scientific support. The future of sports rehabilitation lies in personalized, data-driven protocols combining the best of biological therapies, innovative training methods, and traditional rehabilitation principles to optimize recovery and performance.