Recovery methods in basketball: a systematic review

Posted by Fabio Forin on Ago 17, 2025 in Basket Lab, Integrazione |

Recovery methods in basketball: a systematic review

Basketball is a fast-paced sport, characterized by repetitive movements of varying intensity and duration and rapid changes in direction in both horizontal and vertical planes. During a basketball game, previous research has found that players cover an average of 4–5 km, of which just under 57% is spent walking, 34% running and jumping, and 9% standing still. Other researchers have found that basketball players tend to change the intensity or form of their movement every 2–3 seconds.

Although basketball is considered a mixed-energy sport, with both aerobic and anaerobic input, it is believed that anaerobic metabolism is the one basketball players primarily utilize during competition, in order to achieve rapid force production in a short period of time through repetitive movements of acceleration, deceleration, change of direction, and jumping.

Basketball performance, recovery, and fatigue are influenced by both physiological and psychological factors, and recovery from a decline in performance due to overexertion can take several days or even weeks. It is important to distinguish functional from nonfunctional overexertion: functional overexertion is short-term, resulting from increased training load that leads to a temporary decline in performance and improvement after rest (supercompensation); nonfunctional overexertion is characterized by a much greater decline in performance, with neuroendocrine and/or psychological symptoms, and the need for significantly greater rest to restore performance levels.

To monitor performance capabilities and perceived fatigue levels in basketball players, several indicators are used by sports coaches, such as sprint and vertical jump performance assessments, athlete self-assessment measures, heart rate indices, and biochemical markers.

Mladen Mihajlovic’s work, presented here, offers an in-depth overview of recovery methods used in basketball, analyzing the effectiveness of different strategies for improving athlete performance and reducing injury risk. The systematic review examines various approaches, highlighting the benefits and limitations of each, and seeks to provide athletes with guidelines on the most effective recovery methods for improving performance.

Mihajlovic refers to the classification of post-exercise recovery strategies as “primary” (e.g., sleep, nutrition, hydration) and “secondary” (e.g., ergogenic aids, cool-down strategies, manual therapy). Primary recovery strategies are those that should be prioritized and, if necessary, can be further integrated with secondary recovery strategies to maximize the effectiveness and efficiency of the overall recovery process and prepare athletes for the upcoming competitive demands on the field.

The recovery protocols analyzed in this systematic review were: sleep, nutrition, hydration, ergogenic aids, cold water immersion, compression garments, massage, acupuncture, tapering, mindfulness, and red light irradiation.

The most common variables used to quantify the fatigue-recovery process were jump height, levels of cortisol, testosterone, creatine kinase, hemoglobin, myoglobin, alanine transaminase, aspartate aminotransferase, maximal isometric voluntary contraction, RPE (Rate of Perceived Exertion), and muscle soreness. Additionally, the fatigue-recovery assessment included a 20-meter sprint, a repeated sprint test (6 × 20 meters), 5-0-5, a 300-yard shuttle run, reaction time, and a sit-and-reach test.

Here are some details on the publication’s content regarding the recovery methods analyzed:

SLEEP

Sleep is essential for athletic performance. Athletes require 7-9 hours of sleep, mostly at night, to meet physiological needs. Studies show that extended sleep (over 10 hours in bed) improves reaction times, shooting accuracy, and physical and mental well-being, reducing drowsiness and impaired alertness.

Late-night social media use is negatively correlated with athletic performance (fewer points and rebounds, more fouls and turnovers). Sleep deprivation increases heart rate and impairs endurance, muscle strength, and anaerobic performance, while sleeping more than 8 hours reduces the risk of injury and improves subjective well-being, with results confirmed across several sports.

NUTRITION

Well-planned nutrition is essential for recovery and optimal performance in athletes. Intense training, close matches, and travel can limit adequate nutrient intake, compromising recovery and performance.

Studies have shown that a high-protein diet improves recovery, cerebral oxygen saturation, and physical performance. For example, taking high-protein supplements increased cycling endurance by 16%, while supplementing with whey protein and carbohydrates improved hemoglobin levels and other blood parameters.

The combination of protein and carbohydrates during high-intensity exercise promotes muscle recovery and maintains high performance. This highlights the importance of an appropriate nutritional regimen to support the needs of athletes in high-intensity sports like basketball.

HYDRATION

Hydration before and during exercise is crucial for optimal performance. Studies show that consuming beverages containing carbohydrates and electrolytes is more effective than water alone in maintaining hydration, improving cognitive function, and reducing fatigue.

Dehydration, even as little as 1-2%, can impair concentration, aerobic endurance, motor and cognitive performance, negatively impacting the ability to compete. Consuming carbohydrate-electrolyte beverages improves blood glucose levels, perceived energy, and time spent in moderate-intensity activity.

Rehydration with low-dose L-alanyl-L-glutamine (i.e., 1 g per 500 mL) has been shown to be beneficial in maintaining reaction time and increasing shooting accuracy in basketball, highlighting the importance of adequate hydration with the right balance of nutrients to prevent performance declines.

SUPPLEMENTATION

Still speaking of L-glutamine, it has proven effective not only for hydration but also as a supplement for improving recovery. Indeed, the micro-muscle injuries induced by an intermittent sport like basketball, with repeated accelerations, decelerations, jumps, and changes of direction at high intensity, have been shown to be attenuated by a 20-day supplementation of 6 g of L-glutamine per day.

Sodium bicarbonate has been shown to delay neuromuscular fatigue during high-intensity exercise, preserving muscle function, and branched-chain amino acids (BCAAs), particularly leucine, have been shown to improve the execution time of complex exercises and reduce central fatigue.

Supplementation with antioxidant vitamins (E, C, β-carotene) has been shown to reduce oxidative stress levels during periods of intense training, improving antioxidant defense.

COLD WATER IMMERSION

Cold water immersion (CWI) has been studied for its recovery benefits in basketball players. Below are the different CWI protocols covered in Mihajlovic’s publication, with which various authors have demonstrated the following:

Reduced perceived muscle soreness, as observed by Chaiyakul and Chaibal (15 min at 15°C) and Montgomery et al. (5 × 1 min at 11°C – Between each immersion, players rested passively at room temperature, approximately 23°C, for 2 minutes).

Improved physical performance (e.g., vertical jump 24 hours after exercise), as reported by Delextrat et al.

Decreased muscle damage markers (lactate dehydrogenase, creatine kinase) and blood lactate concentration, according to Seco-Calvo et al. and Pelana (7 min at 16°C).

Intermittent and continuous CWI have been shown to be more effective than static stretching or passive recovery in minimizing muscle stress and improving recovery. However, conflicting results, such as those by Peake et al., suggest that the effectiveness of CWI may vary by context, warranting further study.

COMPRESSION GARMENTS

Compression garments and cryotherapy have been evaluated as recovery methods in basketball players, with mixed results:

Compression garments:
- Atkins et al. found a significant reduction in perceived fatigue, muscle soreness, and improved sleep quality, but without significant differences in performance (sprinting, jumping, agility).
- Ballmann et al. observed an increase in mean anaerobic power and a reduction in RPE during the Wingate Anaerobic Test.
- Limited benefits for other sports, such as rugby, with a lesser impact on performance but a reduction in muscle soreness.
Compression cryotherapy:
- Fernández-Lázaro et al. documented a decrease in muscle damage markers (creatine kinase, transaminases) and a reduction in RPE in the experimental group compared to the control group.

In summary, both methods have been shown to be effective in improving recovery, especially in terms of reducing muscle soreness and perceived fatigue in basketball players.

MASSAGE

Massage, in various variations, has been studied as a recovery method for basketball players, showing significant benefits for managing fatigue and muscle soreness:

Effects on performance:
- Delextrat et al. observed improvements in vertical jump for men and a reduction in the decline in sprinting ability for women after a combined massage and stretching treatment. Both protocols improved the perception of fatigue and soreness
- Kaesaman & Eungpinichpong showed that a 10-minute traditional Thai massage can increase heart rate variability after exercise.
Other benefits:
- A systematic review found that massage improves flexibility and reduces delayed-onset muscle soreness, although the direct impact on sports performance is limited.
- The mechanical pressure of massage stimulates changes in parasympathetic activity and hormone levels, promoting a relaxation response and improving mood and reducing anxiety.

Massage, while having a questionable impact on immediate physical performance, is ultimately effective in improving overall recovery, reducing fatigue, and promoting the psychological well-being of basketball players.

ACUPUNCTURE

Acupuncture, a traditional Chinese medicine technique, has been studied as a method to enhance muscle recovery and manage pain in basketball players, with the following key findings:

Physiological effects:
- Lin et al. [100] observed that acupuncture (points PC6 and ST36) reduced maximum heart rate, VO2 max, and blood lactate levels 30–60 minutes after exercise compared to the control group.
- Ma et al. [101] found a decrease in lactate, pyruvate, and citrate after intensive exercise, suggesting an improvement in recovery-fatigue status.
Muscle pain management:
- Lin and Yang [102] and Hubscher et al. [103] reported a significant reduction in exercise-induced muscle soreness 72 hours after treatment, although without effects on serum creatine kinase activity.

Acupuncture may therefore promote recovery in basketball players by reducing physiological parameters such as heart rate and blood lactate, as well as improving the perception of fatigue and muscle soreness. However, further research is needed to confirm these benefits.

TAPERING

Tapering is a strategy of gradually reducing training load, designed to reduce physiological and psychological stress and optimize athletic performance. Key findings from the literature include:

Effects on performance:
- Tapering can improve performance by approximately 3% on average.
- Svilar et al. showed that a reduction in training load three days before a match improved the recovery and readiness of professional basketball players.
- In team sports such as soccer and handball, a two-week tapering period (50–60% reduction in training volume) led to improvements in muscular power, acceleration, sprinting, and a reduction in perceived fatigue.
Exponential vs. linear tapering:
- Research on junior soccer players has shown that exponential tapering (a nonlinear reduction in load) is more effective than linear tapering for improving speed, power (vertical jump), and aerobic capacity (VO2 max).

In conclusion, tapering strategies, when implemented correctly, are effective for reducing fatigue and optimizing physical performance before competition. Combined with other recovery techniques, they can offer significant benefits for basketball players.

MINDFULNESS

Mindfulness is an emerging meditation practice in sports that helps athletes manage anxiety, improve cognitive function, and cope with challenges in both sports and everyday life.

Key benefits:

Stress reduction: Ten mindfulness sessions have been shown to progressively reduce stress in college basketball players.
Improved mental ability: Mindfulness training is associated with increased concentration, control, relaxation, and emotional intelligence.
Sleep quality and physical performance: Eight weeks of mindfulness improved sleep quality and athletic performance in a college rowing team.
Flow state: Amateur baseball players reported an increase in flow state after a mindfulness workshop.

Mental well-being: Mindfulness training reduced depressive symptoms, improved attention and working memory, and reduced the risk of injury.

Mindfulness has proven to be an effective tool for optimizing the mental health and performance of athletes, particularly useful for basketball players who face high levels of stress. Integrating sports psychology professionals to regularly implement this practice could create a positive team environment and improve the overall well-being of athletes.

RED LIGHT

Red light therapy, or red light irradiation, has shown potential benefits in the sports context, but available research is still limited and requires further studies to confirm its effectiveness.

A study by Zhao et al. found that exposure to red light for 30 minutes every night for two weeks improved the sleep quality of elite female basketball players and led to improvements in recovery and overall well-being. Additionally, the therapy increased serum melatonin levels and improved endurance performance, as evidenced in a running test.

Despite the potential benefits, using red light on the whole body could present logistical challenges, particularly for teams with intensive travel schedules.

In conclusion, Mihajlovic’s work provides a detailed analysis of various recovery methods in basketball, highlighting the importance of a combination of strategies to optimize athlete performance and well-being. The review calls for further research to better understand the effectiveness of each method and to develop personalized recovery protocols.

REFERENCE – ORIGINAL ARTICLE