Over the last decade, NBA players are enjoying longer successful careers, and this could be attributable to Trainers and Physical Therapists now being proactive instead of reactive — focusing on monitoring fatigue, reducing injuries, and recovery.
"The game is faster now, and more explosive athletes like basketball players need more recovery time because there's more muscle damage, so it's what players do between games — when they travel, when they train — that has the biggest impact."
—Dr Andrew Barr, who served as the New York Knicks' director of performance and rehabilitation from 2009-2015 straitstimes.com
Every professional that you ask will recommend a slightly different combination of a recovery protocol elements, but each still require the contribution of the body's natural regeneration systems.
Although the heart is very good at pumping blood to the muscles to supply them for maximal performance, it is not effective at returning that blood to flush the by — products of exercise (i.e. lactic acid, carbon dioxide, water, and other metabolic waste. Left alone, this flush requires time, but if these by-products are not cleared quickly enough after exercise, they block oxygen and nutrients from replenishing the muscles and facilitating micro-tear repair, causing soreness the day or two after. This Delayed Onset Muscle Soreness is called DOMS, and is what makes athletes wish their toilets were taller after squat days.
Recovery methods like ice, compression, and elevation have been traditionally popular to boost this naturally slow blood return. Especially ice baths are used commonly to constrict blood vessels and flush waste, then the following thaw to rev circulation and speed up the healing process. However, recent research studies have shown that icing muscles actually suppresses the metabolic processes required for muscle gains, including inflammation and muscle fiber regeneration. There is also evidence that "ice really isn't going to do much for recovery from DOMS."
As a result, Passive Recovery such as RICE (Rest Ice Compression Elevation) is becoming old questionable science and is being replaced by Active Recovery philosophies that include walking, low intensity swimming or cycling, self myofacial release such as foam rolling, yoga, and "stim" (NMES). However, although using the muscles during these activities will cause an increase in blood flow and flushing of waste, activity is the opposite of rest, and it can contribute to muscle fatigue.
When the body is fatigued or experiencing DOMS following a workout, it is at its highest risk of injury because the body is focused on repair instead of performance and self-preservation.
"Decreases in the muscles strength and neural firing rate may also be detrimental to the players´ motor control abilities, with consequences to overall motor control. For example, the decrease in joint position sense throughout the game will most likely be detrimental to the reflexive (and often protective) response…responsible for an increased likelihood of a traumatic joint injury, such as the anterior cruciate ligament (ACL) rupture."
Overuse injuries and overtraining are also very common with single-sport athletes, and can be avoided with a focus on sufficient recovery as well as supplementing with cross-training. Overtraining syndrome is a very serious medical condition presenting with many symptoms, and can lead to additional injuries that take an athlete out of their sport:
Recovery is becoming a focus for trainers for good reason — ensuring that players are available and healthy, as well as performing at the top of their game even with tight schedule constraints. Regardless of specific recovery strategy, it is imperative to improve blood flow so the muscles can accelerate their own repair process.
Interestingly, success with Deep Vein Thrombosis therapy methods that stimulate the peroneal nerve in the lower leg has given athletes a new option that minimizes muscle fatigue while maximizing circulatory benefits of both Passive and Active Recovery. Fortunately for aging NBA players, this form of nerve stimulation can be done between games and when they travel to accelerate recovery and shorten down time.
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