In-Season Nutrition Strategies and Recovery Modalities to Enhance Recovery for Basketball Players: A Narrative Review

Basketball players face multiple challenges to in-season recovery. The purpose of this article is to review the literature on recovery modalities and nutritional strategies for basketball players and practical applications that can be incorporated throughout the season at various levels of competition. Sleep, protein, carbohydrate, and fluids should be the foundational components emphasized throughout the season for home and away games to promote recovery. Travel, whether by air or bus, poses nutritional and sleep challenges, therefore teams should be strategic about packing snacks and fluid options while on the road. Practitioners should also plan for meals at hotels and during air travel for their players. Basketball players should aim for a minimum of 8 h of sleep per night and be encouraged to get extra sleep during congested schedules since back-to back games, high workloads, and travel may negatively influence night-time sleep. Regular sleep monitoring, education, and feedback may aid in optimizing sleep in basketball players. In addition, incorporating consistent training times may be beneficial to reduce bed and wake time variability. Hydrotherapy, compression garments, and massage may also provide an effective recovery modality to incorporate post-competition. Future research, however, is warranted to understand the influence these modalities have on enhancing recovery in basketball players. Overall, a strategic well-rounded approach, encompassing both nutrition and recovery modality strategies, should be carefully considered and implemented with teams to support basketball players’ recovery for training and competition throughout the season.

Axilla versus Wrist as the Recipient Site in Vascularized Lymph Node Transfer for Breast Cancer-Related Lymphedema: A Systematic Review and Meta-Analysis

Background Vascularized lymph node transfers (VLNT) are being used with increasing frequency for the treatment of breast cancer-related lymphedema (BCRL). However, there is a lack of consensus in the surgical field as to which recipient site should be utilized. We, therefore, aim to assess the evidence comparing the wrist and axilla as recipient sites for VLNT in BCRL. Methods We conducted a systematic literature review to compare the wrist and axilla as recipient sites for VLNT in BCRL. Demographic data, as well as circumference reduction rate (CRR), excess volume reduction (EVR), postoperative decrease in infections per year, postoperative discontinuation of compression garments, and overall pooled complication rate were extracted from included studies. These were compared through a meta-analysis. Results A total of 37 studies met the inclusion criteria for a total of 689 patients. VLNTs to the wrist and axilla resulted in a decrease in CRR of 42.1 and 51.5%, and a decrease in EVR of 35.6 and 48.8%, respectively. However, our meta-analysis showed no significant differences between CRR or EVR and between wrist and axilla as recipient sites. Similarly, we found no differences in postoperative decrease in infections per year, postoperative discontinuation of compression garments, and overall pooled complication rate. Conclusion These data suggest noninferiority between the wrist and axilla as recipient sites for VLNT in the context of BCRL. In the absence of randomized, prospective data, we hope these results can be used as an evidence-based reference and facilitate future studies.

Putting the Squeeze on Compression Garments: Current Evidence and Recommendations for Future Research: A Systematic Scoping Review

Background Compression garments are regularly worn during exercise to improve physical performance, mitigate fatigue responses, and enhance recovery. However, evidence for their efficacy is varied and the methodological approaches and outcome measures used within the scientific literature are diverse. Objectives The aim of this scoping review is to provide a comprehensive overview of the effects of compression garments on commonly assessed outcome measures in response to exercise, including: performance, biomechanical, neuromuscular, cardiovascular, cardiorespiratory, muscle damage, thermoregulatory, and perceptual responses. Methods A systematic search of electronic databases (PubMed, SPORTDiscus, Web of Science and CINAHL Complete) was performed from the earliest record to 27 December, 2020. Results In total, 183 studies were identified for qualitative analysis with the following breakdown: performance and muscle function outcomes: 115 studies (63%), biomechanical and neuromuscular: 59 (32%), blood and saliva markers: 85 (46%), cardiovascular: 76 (42%), cardiorespiratory: 39 (21%), thermoregulatory: 19 (10%) and perceptual: 98 (54%). Approximately 85% (n = 156) of studies were published between 2010 and 2020. Conclusions Evidence is equivocal as to whether garments improve physical performance, with little evidence supporting improvements in kinetic or kinematic outcomes. Compression likely reduces muscle oscillatory properties and has a positive effect on sensorimotor systems. Findings suggest potential increases in arterial blood flow; however, it is unlikely that compression garments meaningfully change metabolic responses, blood pressure, heart rate, and cardiorespiratory measures. Compression garments increase localised skin temperature and may reduce perceptions of muscle soreness and pain following exercise; however, rating of perceived exertion during exercise is likely unchanged. It is unlikely that compression garments negatively influence exercise-related outcomes. Future research should assess wearer belief in compression garments, report pressure ranges at multiple sites as well as garment material, and finally examine individual responses and varying compression coverage areas.

Changing the process of prescribing to procuring lymphoedema compression garments: a service evaluation

Compression garments are the mainstay of lymphoedema treatment, yet the process of obtaining by prescription is lengthy, governed by funding, involves numerous professionals with little patient value and often involes copious inaccuracies, delays and errors. This service evaluation estimates the potential impact of changing the way compression garments are accessed from a prescription to a procurement process. The main objective was to estimate the impact and costs of altering the process within the NHS Wales setting. A service evaluation was formally supported by Medicine Management and Lymphoedema Wales Strategy Board to compare the prescription process to a new procuring route. A form was devised so that data was could be collected over 12 months by lymphoedema therapists on each compression garment issued to patients attending two lymphoedema services in NHS Wales. The data collected included information on the garment ordered, costs (prescribed compared to procured), timing between garment ordered and received plus a comparison of the processes. All non-patient identifiable data was entered into a database and comparison analysis was completed to identify any correlations between the variables collected. The project was ratified by research and development as service evaluation. There was a total of 5392 completed patient data forms were included, which when compared to the processes indicated that using a prescription route is overwhelmingly more costly than procuring. Overall costs suggest the potential for substantial savings to NHS Wales (£71.10 per patient) were statistically significant (P<0.001). Potential for improved patient outcomes was observed as garments were provided directly on appointment instead of significant delays promoting value-based healthcare.

Advances in surgical treatment of lymphedema

An estimated 250 million people worldwide suffer from lymphedema. In the past, the firstline option for treatment was nonsurgical management, either in the form of compression garments or wrapping, or comprehensive decongestive therapy, with debulking surgery reserved for the more advanced cases. However, with improvements in microsurgical techniques and imaging modalities, surgical intervention is increasingly being utilized. This review highlights recent advancements in the surgical treatment of lymphedema, specifically focusing on improvements in imaging, surgical techniques, and prevention of lymphedema.

The Prevalence of Use of Various Post-Exercise Recovery Methods after Training among Elite Endurance Athletes

There is now compelling evidence of the effectiveness of a range of post-exercise recovery techniques, including extended nights of sleep, cold water immersion, massage, and compression garments. Currently, limited information is available on post-exercise recovery methods used by elite endurance athletes. Therefore, this study investigated the actual methods of recovery used in this group of athletes. Google Forms were used to collect information on the recovery methods used by elite endurance track and field athletes (n = 153, 61.4% men, 38.6% women; average age: 22.7 ± 4.6 years). The most used methods of recovery were sauna bathing (96.7%), massage (86.9%), daytime nap (81.0%), and long night sleep (at least 9h) (61.4%). Recovery methods with proven effectiveness such as cold water immersion and compression garments were rarely used (15.0% and 7.8%, respectively). Overall, recovery methods were used more often when the tiers of the track and field athletes were higher. Massage and sauna bathing were the most used methods of post-exercise recovery among Russian endurance track and field athletes. In most cases, they were used in conjunction with short daytime nap and long night sleep. Higher tier athletes were more likely to use sauna bathing, massage, long night sleep, and daytime nap but not cold water immersion and compression garments as recovery methods; however, all these methods except for cold water immersion were widely used among elite-tier athletes.

Effects of 24 h Compression Interventions with Different Garments on Recovery Markers during Running

Compression and temperature manipulation are discussed as strategies to improve performance markers and recovery in sports. Here, we investigate the effects of compression stockings made with fabric, either combined or not with heating and cooling substances, on variables related to running performance and recovery. Ten trained runners (mean ± standard deviation age 45 ± 9 years old, body mass 69 ± 7 kg, height 166 ± 4 cm) with no experience of using compression garments performed an intense running session of 10 km, then wore a stocking for 24 h (randomized; without compression, compression, compression with camphor, and compression with menthol), and were evaluated on the following day, after running 5 km. The different types of compression stockings used 24 h before exercise did not affect running kinematics (p > 0.14), skin temperature (p > 0.05), heart rate (p > 0.12; mean value of maximal heart rate 156 bpm), comfort perception (p = 0.13; mean value of 7/10 points), or perception of recovery (p = 0.13; mean value of 7/10 points). In general, there were no effects of 24 h pre-exercise lower leg compression, including those treated with menthol and camphor applications on running kinematics, skin temperature, heart rate, or recovery perception in athletes undertaking consecutive running exercises.