When you ask any player they will tell you that the NBA season is a long haul. The rigors of a hectic travel schedule, altered sleep schedule, and back to back games at times puts a huge strain on the body and the mind as the season progresses.Playing a total of all 72 games is a huge feat by any player, and staying healthy during that whole time span is even more of a feat.
Last year the top 100 players minutes played averaged anywhere in between 28 to 37 minutes per game, so as you can probably imagine the toll that this puts on a players body is tremendous. Throw in a playoff schedule and the wear and tear is elongated. Although these fatigue factors are common with players, we know that their competitive nature makes them want to stay in the game and play as hard as they can every minute they are on the court. Proper recovery and rest is pertinent during the season, but it is always a question on whether players are doing the right things or if they are doing enough of it. Although the techniques listed here are not the only aspects of recovery that are out there, they are a good start to help player’s overall recovery needs.
Massage/Foam Rolling:
Everybody feels rejuvenated after a good massage. The same goes for athletes after a big bout of exercise. Soft tissue massage has been shown to increase circulation, clear waste products through the lymphatic system, reduce overall pain and discomfort, and maybe most importantly provide a calming effect. Numerous studies support this along with the notion that massage provides an overall healing effect on the body. Regular massages may not be feasible for everybody to get so learning a good self foam rolling program can provide the same benefits as a good massage, but the player is able to do it on their own. Whether doing a massage, foam rolling, massage stick, self massage gun, the key is consistency. The first time any soft tissue manipulation is done it can be uncomfortable due to initial tightness and tone that is in the muscle. This tone has to be worked out, and consistency in releasing these muscles makes the process better and easier the more you do it. This is a reason why we usually suggest to start performing a self foam rolling routine daily to help those overworked muscles on a regular basis.
Cryotherapy/Ice baths:
This form of recovery has been a tried and true method for recovery. I’m sure that everybody has seen an athlete sit in an ice tub after a workout for recovery, but what is the science behind this? An ice bath is believed to accomplish the following; facilitate recovery, decrease overall soreness, speed up overall recovery. A considerable amount of vasodilation to blood vessels and micro trauma to muscle happens after a heavy workout. As a result of this, immune cells rush to the area of the micro trauma and the result is inflammation to help the muscle, or damage area heal. Too much inflammation can lead to increased soreness and pain. Immersion in a cold bath can have numerous beneficial effects such as vasoconstriction of blood vessels to reduce muscle damage and swelling, bringing down an elevated body temperature. The effects of coming out of the ice bath are when some beneficial aspects happen as well. The vasodilation that occurs as the body warms up is when fresh oxygenated and nutrient rich blood rushes to the muscle helping out the overall recovery process.
But, what if time is a constraint for a player? The new cryotherapy chambers are an alternative method for whole body cryotherapy that has shown good usage in the last few years. The chamber can reach temperatures of minus 290 degrees fahrenheit, and thus only need about 3 minutes or less of application to have benefits. Regardless of the form used caution should be taken to not overdo it to cause damage to the skin by over icing. Remember there is a limit to anything, and doing extra doesn't make you better faster.
Many studies have shown only some minimal physical effects for ice or cold therapy for decreasing inflammation, so why still use it? One of the most important aspects of overall recovery is to mentally feel good, and at times this is what an ice bath does. Cold immersion therapy has shown to provide a major psychological benefit to the athlete by providing the mental aspect of feeling better. Mentally feeling better is just as, if not more important to overall recovery and performing at your optimal level. 10-15 minutes in an ice bath after a strenuous workout or game can help that mental and physical recovery afterwards.
Compression:
There are a number of ways to provide compression to the legs after heavy workouts or games. We all know that after those heavy workouts muscle soreness happens. Sometimes this soreness is tolerable and sometimes it puts a hindrance on subsequent workouts or activity. One of the major reasons for this is because of a build-up in blood lactate and other metabolites that occur after a heavy bout of exercise, and muscle damage that occurs afterwards. Although the body has a sufficient storage of glycogen to produce overall energy, it breaks down during strenuous exercise, and other metabolites build up. This muscle soreness is a protective response that the body uses to prevent further damage. Usually this response is present 24-72 hours after a strenuous exercise event, but in a competitive athletes world they don’t have the luxury of resting for 3 days after each game! Compression can help decrease muscle swelling and perceived pain along with helping with metabolite removal so that oxygen can be reintroduced to muscle and help the overall healing process The simplest way to do this is by wearing a pair of compression tights or socks. A more advanced way is to use a pair of Normatec Recovery Boots, or another form of pneumatic recovery system. These boots help sequentially compress the legs from the feet all the way up to the hips to help push metabolites out of the sore muscles and allow oxygen to flow in by dilating the aerial system and increasing the velocity of blood flow as well.
Hydration and Refueling:
As I mentioned before an athletes glycogen storage gets depleted during strenuous exercise, and that needs to be replenished so that energy can be again produced by the system. Many people may think that this is only done during games, but it is just as important to rehydrate after games so that glycogen storages can be replenished. A good combination of water and any carbohydrate rich energy drink can help do this. Including carbohydrates in any rehydration fluid can improve retention of water and help replenish sodium and glycogen storage which are essential building blocks needed for production of energy in the system. The addition of sodium can also aid in returning the heart rate to a more optimal level for recovery as well. The faster and more efficiently the body can return to a homeostatic point, the faster it can start recovering for the next bought of exercise.
Eating a meal fortified with proteins and carbohydrates can also help to repair muscle tissue that has been damaged and to again help fortify depleted energy reserves. It is always important to fuel the system with carbohydrates, proteins and healthy fat after a strenuous bout of activity to aid with the bodies natural repairing process.
Active Recovery Sessions:
An active recovery session is one of the best ways to recover. Rather than sitting around and doing nothing (and likely getting more stiff and sore with this method), performing a low load low intensity exercise can help flush out metabolites and toxins that can be associated with muscle fatigue and damage. An example of this can be a low intensity stationary bike ride. The act of increasing the blood flow in your lower extremities to help flush out the waste products, but not working so hard as to cause more muscle damage in the process as well. Light yoga or stretching, pool walking, or low level walking/jogging can also be considered in this category to help as well.
Sleep:
Perhaps the most important and often overlooked part of recovery is sleep. Sleep is where the body recovers as a whole. Without adequate rest the body does not have adequate time to replenish itself after intense exercise. Imagine a student saying up all night to study for an exam. They have accomplished the task of learning as much as they can to pass the test, but afterwards they are left exhausted with sore and acy muscles the rest of the day. This usually ends with the student sleeping until 1PM the next afternoon to replenish themselves. Unfortunately, this cant usually happen with the elite basketball player. It is important to replenish your overall storages with an adequate amount of sleep, especially during the season. Sleeping 7-10 hours per day should be a goal so that the athlete can continue to perform at their optimal level through the season.
Once again the success of a recovery program is measured by the effort put into the activity. The more effort that is put into adequately recovering, the more the overall effects will be seen over time. If a player wants to make sure that they are at the top of their game throughout the season, making sure that they properly recover is imperative to making sure that they will perform at their best.
Snehal Patel PT, MPT, SCS
Clinical Lead
Hospital for Special Surgery – Westside Sports Medicine Institute