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Abstract and Figures

Long-distance traveling is a concern for professional basketball coaches, players, and owners, as sport-based research has demonstrated that short-haul flights (≤6 h) increase injury risk and impede performance. However, examination of the impact of air travel on players’ health and performance specifically in the National Basketball Association of the United States of America (NBA) is scarce. Therefore, this chapter examines the literature pertaining to the influence of air travel on health and performance in team sport athletes with suggestions for future research directions in NBA basketball. Prominent empirical findings and practical recommendations are highlighted pertaining to sleep, nutrition, medication, recovery, and scheduling strategies to alleviate the negative effects of air travel on health and performance in elite basketball players.
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© ESSKA 2020
L. Laver et al. (eds.), Basketball Sports Medicine and Science,
Long-Distance Traveling
inBasketball: Practical
Applications Based onScientic
ThomasHuyghe andJulioCalleja-Gonzalez
74.1 Introduction
The National Basketball Association (NBA) is
the premier basketball league in the world [1, 2]
and in recent years a greater emphasis has been
placed on player safety [3, 4]. In regard to player
safety, there has been increased attention in the
areas of training load [3, 5] as well as schedule
and travel requirements [5]. In an attempt to
reduce the training load and schedule require-
ments of players, the NBA has modied the
preseason schedule. Prior to 2017, NBA teams
played eight preseason games across 3–4weeks
in preparation for the regular season [6, 7] Since
the 2017–2018 season, the NBA season has
consisted of four to six preseason games played
across 3–4weeks followed by an 82-game regu-
lar season played across 26 weeks (177 days).
During the regular season, each team plays two
to ve games per week (~3.2 games per week),
with games lasting an average duration of 2h and
15 min. NBA teams rarely practice during the
season, and practices that occur are typically less
than 1h [1, 2].
In response to teams resting players during
back-to-back (two games within a 2-day span)
games [8], the league extended the duration of
the regular season by 7days with the purpose of
scheduling fewer back-to-back games [6]. During
the 2017–2018 season, NBA teams played an
average of 14.4±0.9 back-to-back games, which
was the lowest on record compared to any pre-
vious season in the NBA [2]. Furthermore, the
2017–2018 NBA season marked the rst season
in NBA history in which no team played four
games in ve nights [6]. Despite adjustments to
the NBA schedule, air travel demands remain
high due to the geographical span of teams
across four time zones (eastern, central, moun-
tain, and western). In this regard, NBA players
spend more time above 30,000ft than athletes
competing in all other team sports in the United
States of America (USA) [7]. Consequently,
air travel requirements are a concern for NBA
coaches, players, and owners, as research has
demonstrated that short-haul ights (e.g., domes-
tic 6 h ights) increase injury risk [2, 913]
and impede performance [9, 1420] with more
regular or longer periods of travel (e.g., 6 h
international transfers) more likely to result in
negative responses [21, 22]. In this chapter, we
aim to provide a comprehensive summary of sci-
entic evidence about air traveling on ve criti-
cal aspects: (1) fatigue, (2) athletic performance,
(3) sleep, (4) health and injuries, and (5) mood
state alongside suggestions for future research
T. Huyghe (*)
BC Filou Oostende, Oostende, Belgium
J. Calleja-Gonzalez
Physical Education and Sport Department, University
of Basque Country (UPV-EHU),
Vitoria-Gasteiz, Spain
and real- world applications in professional bas-
ketball, particularly in the NBA.
74.2 The Inuence ofTraveling
74.2.1 Scientic Evidence
Frequent air travel can negatively affect hydra-
tion status, nutritional behaviors, sleep qual-
ity, and sleep quantity, thus extending the time
for sufcient recovery between games and/or
training in athletes [15]. As a result, air travel
should be considered as an additional stressor
imposed on NBA players in conjunction with
competition and training schedules [15], espe-
cially when less than 72h of rest is experienced
between games [23, 24].
Depending on the magnitude of air travel
exposure, traveling can result into a variety of
negative consequences (Fig. 74.1). One of the
main consequences associated with frequent air
travel exposure is “travel fatigue.” While jet lag
refers to the physiologic adaptations after a single
trip across one or more time zones, travel fatigue
is a more complex summation of physiological
and psychological consequences accumulating
over a longer period of time (e.g., competitive
season) which reduces the player’s ability to
recover and perform [18]. Hence, travel fatigue
is characterized by feelings of disorientation,
light- headedness, gastrointestinal disruption,
impatience, lack of energy, loss of motivation,
recurrent illness, changes in behavior, and gen-
eral discomfort following travel across time zones
[13, 18], while jet lag is mainly characterized by
gastrointestinal disturbance such as heartburn,
indigestion, diarrhea, sleep disturbance, intermit-
tent fatigue, loss of appetite, impaired concentra-
tion, and disruption of situational awareness [18,
25] (Fig.74.2).
Fig. 74.1 Characteristics of travel fatigue (chronic) versus jet lag (acute)
T. Huyghe and J. Calleja-Gonzalez
The magnitude of travel fatigue depends on
many factors such as regularity, duration, and con-
ditions of travel [13, 26] (Fig.74.1). Specic causes
of air-related travel fatigue include the following:
Prolonged exposure to mild hypoxia
[16, 27, 28].
Difculties in standing, walking, and moving
around due to limited room inside the air cabin.
Reduced air quality in the cabin, which may
impair immune function [12].
Dry cabin air and low hypobaric pressure
potentially causing dehydration [29].
Prolonged sitting in a cramped position reduc-
ing mobility and exibility [10, 16].
Disruption of routines (e.g., eating and sleep-
ing) [30].
Noise of plane and cabin (e.g., sleep distur-
bance) [16].
Formalities of air travel may induce negative
mood states [30].
A primary issue regarding air travel occurs
as a result of signicant reductions in oxygen
saturation, which has been found to decrease
signicantly from 97% at ground level to 93%
at cruising altitude (p<0.05) [28]. This nding
is signicant as oxygen saturation levels of 94%
or less may prompt physicians to administer sup-
plemental oxygen in hospital patients and thus
would slow muscle recovery [28]. Furthermore,
researchers examined markers of skeletal muscle
damage following trans-American jet travel, but
since a non-exercise control was not included in
this investigation, meaningful interpretations of
the data cannot be determined [32].
The regularity, duration, and direction of air
travel, combined with in-cabin conditions, likely
predispose NBA players to one or more symp-
toms of travel fatigue [13]. In turn, travel fatigue
can have deleterious effects on player recovery
and subsequent performance, particularly when
scheduled soon after practices or games. When
ying across two or more time zones, symptoms
of travel fatigue can remain up to 2–3days after
arrival [13]. Consequently, it is recommended
that recovery and practices administered before
and after air travel are modied to account for
Fig. 74.2 Potential underlying factors and negative consequences of long-distance traveling in NBA basketball
74 Long-Distance Traveling inBasketball: Practical Applications Based onScientic Evidence
travel fatigue, especially considering the travel
direction and ight duration experienced travel-
ing in NBA basketball players.
74.2.2 Practical Applications
Considering that skeletal muscle and connective
tissues become shortened during ights and may
stiffen, it is recommended for players to avoid
sitting the entire trip, and instead, walk around
the cabin every hour, unless they are asleep or
advised not to do so by ight staff [33]. With a
tentative agreement between the NBA and Delta
Airlines (Atlanta, GA, USA) charters, walking
inside the air cabin should be attainable, as most
NBA teams (27 out of 30 teams) y with private
jets of Delta Airlines (including Airbus 319s, and
Boeing 757-200s) with almost 50% more cabin
space than standard planes [34]. This cabin space
allows most NBA players, who possess an average
stature of 6feet and 7in, to have more freedom
to stand erect during air travel [34]. Additionally,
simple stretching exercises can be applied while
in the seat or in the cabin, which could help relax
muscles while increasing blood ow and deliver-
ing oxygen and other nutrients to muscles [31,
33]. As a result, stretching may reduce the nega-
tive effects of air travel on exibility and skeletal
muscle recovery. Consequently, future studies are
encouraged to examine the efcacy of these in-
ight travel strategies in NBA players.
74.2.3 Future Research
Despite recent schedule modications and an
increased awareness of the potential negative
consequences of air travel on the health and per-
formance of NBA players, there is still a need to
implement effective strategies to address issues
with travel fatigue to promote greater equity
across western and eastern teams. Future research
exploring various aspects of regularity, duration,
directions, and conditions of air travel [13] in
one or multiple NBA seasons can help identify
origins of fatigue in players. Consequently, a
holistic approach to future research (e.g., applied
chronobiology and jet lag research) is recom-
mended, with some potential topics of interest
encompassing descriptive and intervention-style
74.3 The Inuence ofTraveling
onAthletic Performance
74.3.1 Scientic Evidence Circadian Rhythm
Shifting a player’s circadian rhythm (body clock)
relative to real time in the destination has demon-
strated to be a major factor in sports performance.
Although peak performance times throughout the
day may vary among players [33], for most play-
ers, peak performance tends to appear between
4:00 and 10:00pm [33]. Proper planning of phys-
ical activities has the ability to support resynchro-
nization of the player’s circadian rhythm, which
in turn can lead into an increase of up to 10%
in endurance, physical strength, and mental func-
tion [19, 33]. Consequently, circadian variations
should be taken into account when scheduling
practices and physical activities before and after
air travel. In particular, strength and endurance
training tend to be optimally planned in the after-
noon or early evening while motor skill training
in the morning [35]. However, future research
studies are needed to validate these ndings in
the NBA as well as other professional basketball
leagues. Travel Direction
The direction of air travel should be considered
by NBA teams as traveling westward exacer-
bates reductions in performance [14, 23]. In a
sample of 8495 NBA games between 1987 and
1995, west coast teams scored four more points
per game (p < 0.05) when traveling to the east
coast than east coast teams scored when traveling
to the west coast [23]. Furthermore, NBA teams
traveling eastward had a winning percentage of
T. Huyghe and J. Calleja-Gonzalez
45.4% compared with 36.2% for teams traveling
westward (p < 0.001) between 2010 and 2015
[14]. The increased difculty of traveling west-
ward across the USA to compete has also been
reported in the National Football League and the
National Hockey League [14]. Westward travel is
likely more difcult since performance tends to
peak in the late afternoon, and players traveling
from west to east tend to play games closer to
their circadian peaks, given most NBA games are
played at night. Competition Schedule
The home court advantage during competition
has been reported in multiple team sports [14,
16, 19, 36] including the NBA [37, 38], suggest-
ing either a negative effect of travel or a circa-
dian advantage [39]. However, the magnitude
of the home court advantage may be mitigated
or enhanced depending on other external factors
such as the travel direction, tip-off time, oppo-
nents’ playing style, game/practice volume and
intensity, and travel duration. Therefore, a holis-
tic approach to scheduling and travel manage-
ment is recommended.
Another factor that plays a role into the home
court advantage is the quantity of rest NBA teams
attain prior to games [37]. In particular, a con-
sistent advantage was recorded when a team had
more than 1day of rest between games (the home
team’s score increased by 1.1 points per game and
the away team’s score increased by 1.6 points per
game) in a sample of 8495 regular season NBA
games between 1987 and 1995 [23]. Moreover,
average total scores (home and away teams) were
highest when 3 days of rest were encountered
between games with data collected from the 1987
to 1995 seasons [23]. Consequently, the negative
inuence of air travel during an NBA season may
be mitigated by incorporating supplemental days
to recover from games.
An optimal recovery window of 72h follow-
ing games and practices is needed for an athlete
or team to return to optimal levels of performance
[24]. Nevertheless, the NBA schedule dictates
condensed game schedules that necessitate com-
pressed training schedules, which may inhibit
access to active rest days to fully recover from
accumulated physical and psychological stress
induced by NBA games and practices. In this
way, NBA teams are often obligated to intervene
with various ergogenic practices in an attempt to
speed up the recovery process, such as whole-
body cryotherapy, compression tights, cold water
immersion, contrast water therapy, and soft tissue
massage [40].
74.3.2 Practical Applications
Although age and level of tness can inuence
the severity of symptoms associated with long-
distance traveling [41], air travel should be rec-
ognized and respected as an additional stressor
when planning physical activities before, during,
and after a travel period. Consequently, prac-
tices and workout sessions should be planned on
a chronobiological basis to ensure that perfor-
mance is not impaired during the trip and after
returning home [25]. In particular, it is recom-
mended to reduce the overall volume, intensity,
and frequency of endurance training sessions,
while strength training sessions (neuromuscular
work) tend to be less susceptible to the negative
consequences of long-distance traveling [18].
However, the benets should be weighed with
the potential risks. Hence, high-volume, high-
intensity, and even traditional strength routines
should not be assumed to be indispensable [18].
Additionally, the timing of practices and physical
activities should not be planned during the circa-
dian nadir (2–4PM and 2–4AM of the departure
time zone) until the players are fully adapted to
the new time zone [18].
74.3.3 Future Research
While these commonly employed recovery prac-
tices, including compression tights, [36] cold
water immersion, [42] and massage, [43] have
been investigated in various samples of basket-
ball players, no data are available specically in
74 Long-Distance Traveling inBasketball: Practical Applications Based onScientic Evidence
NBA players. Therefore, more research is needed
to ascertain if these recovery practices benet
NBA team and player performance, particularly
around intensive and extensive travel periods.
Furthermore, most of the studies that inves-
tigate performance decrements related to air
travel in team sport athletes have methodologi-
cal aws [33, 44] such as the absence of preight
assessments compared to postight assessments.
Therefore, it is recommended that future studies
take these issues into account when constructing
their research methodology.
74.4 The Inuence ofTraveling
74.4.1 Scientic Evidence Desynchronization
oftheCircadian Rhythm
The physiological and perceptual stressors
associated with ying across one or more time
zones may alter sleep patterns in athletes [12],
especially when accumulated over an entire
season [18, 45]. In particular, short-haul air
travel has been reported to impair athletic per-
formance due to the development of an inef-
cient internally- driven circadian rhythm (i.e.,
sleep deprivation or disorientation between the
circadian system and the environment) [44].
Hence, the circadian rhythm plays a critical role
in sports performance [13, 19, 46, 47]. When an
athlete’s circadian rhythm is synchronized with
the environment, the athlete should achieve
optimal performance during late afternoons
and early evenings [19]. Contrary, a desynchro-
nized circadian rhythm impedes the ability for
muscles to accumulate protein synthesis (the
ability of skeletal muscle to adapt and repair),
which consequently may limit training adapta-
tions [48, 49]. This may be concerning during
the preseason period, given sleep disturbances
are present during higher training volumes [50].
Since sleep loss can also affect vigor, mood, and
perceptual awareness [30, 51], early training
sessions could cause reductions in motivation
and consequently reduce optimal training per-
formance and subsequent adaptations [52]. Time Zone Dierential
Considering air travel can cause an athlete’s cir-
cadian rhythm to become unsynchronized with
the environment, air travel may contribute to the
home court advantage in the NBA [53, 54] as the
body’s core temperature (an endogenous measure
of circadian rhythm) takes approximately 1day
for each time zone crossed to adapt completely
to the new time zone [13, 39]. Consequently,
the number of time zones traveled plays a criti-
cal role in the magnitude of potential disruptions
in the circadian rhythm of NBA players [13].
Hence, the greater the number of time zones
traveled, the more difcult it is for an athlete to
adapt to a new time zone. For example, a 2-h time
zone shift may cause marginal disruption to the
circadian rhythm, but a 3-h time zone shift (e.g.,
NBA players traveling coast to coast within the
USA) can cause a signicant desynchronization
of circadian rhythm [13]. Therefore, it is rec-
ommended that NBA players focus on physical
activity, eating, and social contact during daylight
in their new time zone in order to resynchronize
their circadian rhythm, especially when traveling
from coast to coast [13]. Travel Direction andSleep
One study examined the effects of air travel from
the east coast to the west coast of the USA on
physiological performance measures, sleep qual-
ity, and hormonal alterations [32]. However, it is
important to note the following: participants used
in this investigation were not athletes, a simulated
sporting event most closely related to demands
experienced during soccer was administered,
and a non-exercise (control) group was absent.
However, air travel-induced jet lag symptoms,
which resulted in decreased sleep quality and was
paired with signicantly increased melatonin lev-
els on ight days (travel from east to west coast
and travel from west to east coast) [32].
Finally, ying eastwards requires a phase
delay of the player’s circadian rhythm, while
T. Huyghe and J. Calleja-Gonzalez
traveling westwards requires a phase advance
of the players’ circadian rhythm. Typically, the
body adjusts more efciently to a phase delay
compared to a phase advance because the stan-
dard duration of circadian rhythm is approxi-
mately 24.5h (in sync with environmental factors
such as light, temperature, food intake, physical
and social factors) [25]. Hence, it is easier to fall
asleep when days are becoming longer rather
than days becoming shorter.
74.4.2 Practical Applications
Implementing a brief data collection procedure
pertaining to each player’s sleep history during
the initial medical screening process as well as
a month’s worth of sleep logs could help iden-
tify which player is more susceptible to jet lag
or travel fatigue before the ofcial start of the
season. In particular, it is recommended that
sleep quality in team sport athletes is monitored
through actigraphy as well as the Pittsburgh
Sleep Quality Index, Likert scale, Liverpool Jet-
Lag Questionnaire, and RESTQ [55]. However,
more studies are needed to verify their efcacy in
professional basketball teams.
NBA schedule-makers and teams may suc-
ceed in mitigating the negative effects of air travel
from coast to coast on sleep by implementing
up-to-date, evidence-based strategies applied in
other professional sports such as the ingestion of
more frequent and smaller meals [18]. In particu-
lar, a high-carbohydrate, low-protein meal in the
evening is recommended to enhance serotonin
production and subsequently promote drowsi-
ness and sleep [19, 33], while the ingestion of a
high-protein, low-carbohydrate meal is recom-
mended in the morning to induce the uptake of
tyrosine and its conversion to adrenaline, which
elevates arousal and promotes alertness [33, 56].
However, future studies are required to evaluate
the efcacy of the abovementioned strategies in
NBA players.
Besides the implementation of specic travel
management strategies, basic education and
awareness programs on behavioral management
for staff and players to recognize the causes,
symptoms, and solutions of cumulative travel
fatigue and sleep disturbances in professional
basketball players is strongly recommended [18,
47]. For example, prior to long-distance ights
(>6 h), high-performance support staff should
advise their teams to adopt the timing of train-
ing sessions to the destination time zone to help
synchronizing the circadian rhythm of their play-
ers prior to arrival [18]. Furthermore, an evening
ight is recommended for eastward travel (e.g.,
United States to Europe) [18]. During the ight,
eyeshades and earplugs are recommended to
help relaxation and mitigate the noise and over-
stimulation. Furthermore, on-board meals should
be consumed according to the destination time
[18]. Perhaps, having the players bring their own
meals may be helpful in this regard. Additionally,
players should also adapt their watch to the desti-
nation time as soon as boarding the plane, main-
tain proper hydration, and sleep according to the
destination time [18]. Moreover, to aid with a
rapid circadian adaptation to the new destination
immediately after a long-distance ight, high-
performance support staff and their players are
recommended to strategically plan their activities
according to the new time zone. Strategic use of
naps, caffeine, melatonin, light exposure, light
avoidance, and physical activity may all help
with accelerating (or decelerating) the adaptation
process, especially for those who tend to be more
susceptible to travel fatigue compared to others
[18, 5759]. Finally, in the current age of “social
media” consumption and late-night tweeting in
the NBA, players should also be advised to mini-
mize tablet usage or any other form of blue light
exposure before heading to bed as this has dem-
onstrated to sabotage sleep quantity and next-day
game performance [60].
74.4.3 Future Research
Considering frequent time zone transitions often
disrupt the circadian rhythm in athletes [15, 16,
19, 30, 61, 62], future studies may focus on
monitoring both exogenous and endogenous
74 Long-Distance Traveling inBasketball: Practical Applications Based onScientic Evidence
parameters, such as the measurement of salivary
melatonin onset, adrenaline concentrations, and
body temperature as these are critical biomark-
ers of circadian rhythm [19, 63]. Measurement
of these biomarkers would provide insight into
how each player individually adapts to air travel
throughout the NBA season. Consequently,
NBA performance support staff may then apply
individualized approaches to training and game
preparation to combat the negative impact of air
Furthermore, examination of various ergo-
genic aids will provide a better understanding
of practices that may enhance physiological and
perceptual responses to air travel in NBA play-
ers. For instance, nutrition and hydration are fun-
damental aspects underpinning circadian rhythm
[64]. Therefore, analyzing and comparing the
hormonal responses of NBA players adopting
different diets may provide NBA coaches and
support staff with further insight into benecial
nutritional strategies for coping with air travel in
the NBA.
Light therapy, light avoidance, and pharma-
cological techniques have demonstrated to help
shift the circadian phase to optimal time zones
before, during, and after ights [58]. However,
practical recommendations pertaining to this
type of intervention remain difcult due to
interindividual and intraindividual differences
in response to these interventions alongside the
lack of research on light therapy in team sport
environments in general. Future studies have
an opportunity to validate the impact of light
avoidance (e.g., light-blocking glasses), blue
light exposure, chronobiotics (circadian phase
shifters), and chronohypnotics (sleep induc-
ers) on the sleep quantity and quality of NBA
players during one or multiple periods of the
Finally, more studies are needed to establish
a denition of parameters inferred by actig-
raphy as well as consistency in sleep quality
algorithms, and the validation of self-perceived
sleep questionnaires, particularly in team sport
athletes [55].
74.5 The Inuence ofTraveling
onPlayer Health andInjury
74.5.1 Scientic Evidence Competition Schedule
Competing in away games has been reported to
signicantly increase regular season injury risk
in a sample of 1443 NBA players between 2012
and 2015 [9]. Specically, 54% of regular season
injuries occurred in players playing games away
from home, which was signicantly greater than
the expected injury rate for away games of 50%
(p<0.05) [9]. Playing Time andInjuries
Another factor to consider in reducing injury
risk in the NBA is the total amount of in-game
minutes accrued by each player. While coaches
have presumed withdrawing high-minute play-
ers from entire games may reduce injury risk
and enhance performance, a tactic which is
often seen nearing the conclusion of the regular
season, data to support this approach is lacking.
In fact, existing data revealed the average min-
utes played per game did not inuence injury
risk (p < 0.001) in 811 NBA players compet-
ing between 2000 and 2015 [8, 9]. However,
it should be noted these data are not reec-
tive of performance and injury risk in players
who were rested for entire games but rather
are indicative of players completing reduced
game minutes. Subsequently, future studies are
needed to examine the consequences and con-
rm the efcacy of resting high-minute players
for entire games in the NBA. Air Travel andImmune
System Suppression
One of the main concerns with long-distance
air traveling (e.g., transcontinental ights) is
the disturbance of sleep. Subsequently, this
may cause a suppression of the immune system
of the athlete when sleeping 1h less than usual
T. Huyghe and J. Calleja-Gonzalez
[65]. This can be exacerbated by dry pressur-
ized air cabin conditions during the ight due to
uid loss, abnormalities in breathing, dry nose
and throat, similar to responses on acute expo-
sure to altitude [25]. Consequently, diuretics
such as caffeine and alcohol should be avoided
during long-distance ights to mitigate these
symptoms [48]. Air Travel andDeep-Vein
A potential negative consequence of prolonged
sitting within the cabin of the airplane is “venous
thromboembolism” [66] (e.g., career-ending
diagnosis of NBA-champion Chris Bosh), often
referred to as “travelers thromboses,” which is a
condition that occurs when a blood clot (throm-
bus) forms in one or more of the deep veins in
the body, usually in the lower limbs. Deep vein
thrombosis can cause leg pain or swelling, but
might occur without any symptoms. On a large
scale, this condition has been reported as a
major health problem with at least 201,000 cases
reported each year in the United States in which
25% of these patients die within 7days [67]. The
risk for venous thromboembolism can remain up
to 2weeks after a long-haul ight. Additionally,
the annual risk of being diagnosed with this condi-
tion increases with 12% if one long-haul ight is
taken yearly [66]. Although no studies have been
published on this regard within the NBA eco-
system, NBA physicians and high- performance
support staff should be well-aware of the poten-
tial risks associated with long- distance traveling
(e.g., during preseason transcontinental NBA
global games) and advise players and staff with
customized travel management strategies as well
as prophylaxis based on other individual risk
factors associated with deep-vein thrombosis
[68]. For example, FlightFit is an iOS applica-
tion which introduces basic stretching techniques
to air travelers in an interactive way [69], which
may help blood circulation, oxygen, and nutrient
supply to the muscles, bones, and connective tis-
sues, and ultimately mitigate the risk for travel-
ers’ thromboses.
74.5.2 Practical Applications
In order to mitigate the negative consequences on
players’ health and injury propensity of air travel-
ing, it is recommended for players to drink more
than usual during ights, approximately 200 ml
extra in 12-h ight [25]. Furthermore, to mitigate
the risk of travelers’ thromboses, it is recom-
mended to implement a comprehensive assess-
ment prior to the competition period to identify
potential high-risk prole players. Additionally,
keeping the body active through in- ight ex-
ibility exercises may also help in reducing joint
stiffness and pooling of blood in the legs [25].
For example, through the mobile application
“FlightFit,” players can stretch different muscle
groups by following an interactive infographic
system and instructions visually and acousti-
cally as well as customizing their own stretching
plans based on their individual characteristics and
needs [69]. FlightFit also includes the possibility
to implement notication reminders and in-ight
tips which may help with educating and cultivat-
ing healthy travel behaviors. Another educational
opportunity might be considered through the form
of a meeting or workshop with the team or players
individually prior to traveling. In this case, keep-
ing the information brief and to-the-point (e.g.,
infographic or summary table) would help players
to comprehend and apply the given recommenda-
tions. Each player should also be advised on an
individual basis as a difference exists in peak core
body temperature and ability to fall asleep or arise
between morning type, intermediate type, and
evening type of players [25].
Consequently, the player’s chronotype should
be taken into consideration when providing
guidelines. Finally, high-performance support
staff who travel with the team should also con-
sider their age as a subsequent factor in the abil-
ity to shift in circadian rhythms because a phase
advance (tendency toward morning-type behav-
ior) might be favored once reaching the age of
47years [25]. Finally, in order to mitigate the sup-
pression of the immune system, special attention
should also be given toward proper food hygiene
74 Long-Distance Traveling inBasketball: Practical Applications Based onScientic Evidence
(e.g., avoiding uncooked foods) and ensuring at
least 8h of high-quality sleep before, during, and
after trips [65].
74.5.3 Future Research
In order to mitigate the potential consequences of
air travel on NBA players’ health state and injury
risk, each player’s external and internal work-
load should be monitored and carefully managed
throughout the season. However, future research
should investigate new metrics or biomarkers
that reect a player’s immune system and injury
risk prole. For example, researchers may focus
on salivary cortisol and salivary immunoglobulin
A (SIgA) as demonstrated in a previous study on
monitoring stress tolerance in basketball players
[70] or vitamin D status, cortisol, testosterone, pro-
inammatory cytokines (e.g., TNF-Į and INF-Û),
and anti-inammatory cytokines (e.g., IL-4 and
IL-10) [71, 72]. Additionally, future studies should
approach a holistic mindset to gain a complete
picture about each player. For example, ratings of
perceived exertion (training load) and pyschomet-
ric questionnaires can be included and compared
with other insightful metrics as well. Once this
information has been collected over a longer period
of time (e.g., 4-week period), multiple microcycle
stereotypes could then be identied based upon
the NBA season schedule (e.g., home week, road
week, split week, 3-game week, 2-game week).
Subsequently, this data would allow researchers
to identify the impact of air traveling on player’s
immune system and injury risk and identify which
microcycle might be at higher risk compared to
others. Consequently, this would support more ef-
cient and effective travel management strategies for
NBA players and high-performance support staff.
74.6 The Inuence ofTraveling
onMood State
74.6.1 Scientic Evidence
In addition to sleep disturbances, fatigue, detri-
mental performance, and increased risk of injury,
traveling can result in an impaired mood state
[18, 73, 74] and loss of motivation all of which
can affect recovery [18]. If a player’s motiva-
tion declines, their training intensity and volume
during subsequent practices may decline equiva-
lently, [30] and consequently their performance
as well [74]. In particular, westward travel across
six time zones demonstrated altered mood states
for up to 24h post-travel [74]. Furthermore, sleep
disruption and desynchronized circadian rhythm
induced by long-distance traveling may further
exacerbate these uctuations in mood states [44].
However, these ndings often remain inconsis-
tent in the literature [35, 74] and have yet to be
determined in professional basketball players in
74.6.2 Practical Applications
Although it can be difcult for NBA coaches
to make the most appropriate decisions toward
their training and recovery protocols of the
competition schedule for the entire team, espe-
cially the day after a game, it is important
to consider the type of treatments, timing of
practices and activities, and recovery interven-
tions as all these factors can either induce or
reduce mood disturbances caused by frequent
In order to mitigate the negative impact of
air travel on mood state, it is recommended
that each player’s psychological and psycho-
sociological reactions to air travel should be
monitored during the season. For instance,
comprehensive psychometric questionnaires
such as the Acute Recovery and Stress Scale
(ARSS) [75] and the REST-Q Sport [76] have
been established as logical, practical, and ver-
satile tools to measure self-perceived travel
fatigue in professional team sports [75, 76].
Considering the time constraints in the NBA,
shorter customized versions of these question-
naires can be completed on a daily basis [77],
which have been reported to be valid and reli-
able in elite Australian Rules Football [78].
However, further research is necessary to pro-
vide normative standards, especially with a
T. Huyghe and J. Calleja-Gonzalez
focus on individual interpretations, recommen-
dations, and compliance in NBA players.
Furthermore, a systematic exercise regime
(even away from home) should be considered as
physical activities have demonstrated to improve
mood state in athletes [79] and immediately after
arriving to the athletes’ new destination [41].
However, the timing of these exercise regimes
should be carefully planned by high-performance
support staff with consideration to the changes in
the athletes’ body temperature as a symptom of
adapting to their new time zone [41].
Unnecessary psychological stress should
be avoided by approaching travel with a pro-
active mindset. For example, players should
be advised to adjust their watch and phone to
the local time of their upcoming destination as
soon as boarding the aircraft [33]. Additionally,
if the budget allows, travel managers should
incorporate 1day of adjustment time for each
time zone crossed [33]. Moreover, family and
friends should be informed about the time dif-
ferences during each travel period to avoid
phone calls at night or during times that may
interfere with sleep [33].
Finally, extending sleep over a period of 3
weeks with a mean addition of 110min per night
has demonstrated to improve shooting accuracy,
energy, mood state, and mental preparedness for
competition in basketball players [80]. However,
benets only occurred in non-sleep deprived
players, which means that sleep extension should
only be considered when players suffer from sig-
nicant less total sleep time [80]. Nevertheless,
more research is needed pertaining to this par-
ticular strategy.
74.6.3 Future Research
More research is needed on the acute and chronic
effects of cumulative travel (e.g., over a season)
on psychological and physiological recovery
parameters of professional team-sport athletes.
Future research has the opportunity to validate
proactive interventions (e.g., light therapy, day-
time nap scheduling) and reactive interventions
(e.g., oxygenation therapy).
Take-Home Message
The NBA travel schedule induces mis-
alignments in circadian rhythm that cannot
be avoided. Hence, air travel across three
time zones has been reported to induce
susceptibility to travel fatigue [18, 44, 56,
61, 62], increase injury risk [13, 44, 81],
disrupt sleep patterns [12, 18], disturb an
optimal mood state [18, 74], and reduce
game performance [13, 14, 17, 44, 53].
First, it is important to understand the
impact of air travel on NBA players at an
individual level, given that each NBA player
adapts to the demands of long- distance
travel differently. Therefore, a well-struc-
tured travel management plan, taking into
account both travel conditions and players’
individual needs, is the rst step in estab-
lishing an effective approach to mitigating
the negative consequences of frequent air
travel. Therefore, adopting a preight, in-
ight, and postight model [47] and incor-
porating a travel fatigue monitoring system
would help NBA high- performance support
personnel to identify problems, limit nega-
tive symptoms induced by traveling, and
subsequently improve players’ health and
performance. Nevertheless, future studies
in collaboration with multiple NBA stake-
holders are needed to identify the impact
of current travel management practices and
approaches implemented by NBA teams
across one or more NBA seasons.
The following recommendations
(Table 74.1) are based on the literature
reviewed within this chapter as well as
empirical ndings from research on air
travel in elite team sports. It should be
noted that there remains a scarcity in
research in long-distance traveling in bas-
ketball. Nonetheless, there tends to be little
risk involved and much (potential) ben-
et in applying these recommendations.
Most importantly, these recommendations
should be tailored toward individual differ-
ences between players.
74 Long-Distance Traveling inBasketball: Practical Applications Based onScientic Evidence
Table 74.1 Practical recommendations to mitigate the negative consequences with long-distance traveling for basket-
ball players, coaches, and high-performance support staff
Long distance traveling in basketball
Scientic evidence Practical applications Future research
Fatigue Flying reduces
oxygen saturation
which slows down
muscle recovery
Air travel likely
predisposes NBA
players to one or
more symptoms of
travel fatigue, which
in turn disrupts player
recovery and
particularly when
scheduled soon after
practices or games
When ying across
two or more time
zones, symptoms of
travel fatigue can
remain up to 2–3days
after arrival
Incorporate educational sessions with
players and staff about the potential
increments in stiffness and self-
perceived fatigue after ying, and how
they can mitigate these negative
consequences before, during, and after
Maintain extra hydration before,
during, and after ights
Avoid sitting the entire trip, but
instead, walk around the cabin every
hour and perform simple seated or
standing stretches (e.g., FlightFit
application), unless you are asleep or
advised not stand up by the on-board
ight crew
If traveling across 3time zones in
eastward direction or traveling across
4time zones in westward direction,
consider the following:
Ultra short-acting as well as
medium-acting and medium
half-life hypnotic;
Intake smaller, more frequent, and
recovery content meals according
to the destination schedule;
If traveling across 3time zones in
eastward direction or 4zones in
westward direction, consider the
Reduce training 2–4days
Intake 3–5mg melatonin 30min
before bed
Effective strategies to
address issues with
travel fatigue to
promote greater equity
across western and
eastern teams
The regularity,
duration, directions,
and conditions of air
travel across one or
multiple NBA seasons
to identify the origins
of “travel fatigue” in
A holistic approach to
future research is
recommended, with
some potential topics
of interest (e.g.,
applied chronobiology)
encompassing both
descriptive and
T. Huyghe and J. Calleja-Gonzalez
Long distance traveling in basketball
Scientic evidence Practical applications Future research
Traveling westward
reduces performance,
particularly winning
percentage and points
per game
NBA players who
travel from west to
east tend to play
games closer to their
circadian peaks
NBA teams perform
signicantly worse in
away games
compared to home
An optimal recovery
window of 72h
following games and
practices is needed
for an athlete or team
to return to optimal
levels of performance
For most athletes,
peak performance
tends to appear
between 4:00 and
Proper planning of
physical activities
during travel can
improve endurance,
physical strength, and
mental function in
athletes up to 10%
training tend to be
less susceptible to
consequences of long
distance traveling
compared to
high-volume work
Maintain extra hydration before,
during, and after ights
Reduce training frequency, volume,
and/or intensity 2–4days postight if
traveling across 3time zones in
eastward direction or 4time zones
in westward direction
If possible, plan motor skill training
sessions in the morning, and strength
and endurance sessions in the evening
Consider ergogenic modalities such as
cryotherapy, compression tights, cold
water immersion, contrast water
therapy, and soft tissue massage
If possible, plan individual practices
or workout sessions based upon the
player’s chronobiological prole
If arriving to a new time zone, avoid
planning practices or workout
sessions during the circadian nadir
(2–4PM and 2–4AM at the departure
time) until players are fully adapted to
the new time zone
Validity and reliability
of recovery practices
during traveling in
NBA players across
one or multiple
seasons, encompassing
both behavioral and
Longitudinal studies
on travel fatigue in
preight, in-ight and
postight assessments
Table 74.1 (continued)
74 Long-Distance Traveling inBasketball: Practical Applications Based onScientic Evidence
Long distance traveling in basketball
Scientic evidence Practical applications Future research
Sleep Frequent air traveling
may induce sleep
deprivation or
between the circadian
system and the
A desynchronized
circadian rhythm
impedes the ability
for muscles to
accumulate protein
synthesis, and thus
the ability of skeletal
muscle to adapt and
The body’s core
temperature takes
approximately 1day
for each time zone
crossed to adapt
completely to the new
time zone
The greater the
number of time zones
traveled, the more
difcult it is for an
athlete to adapt to a
new time zone
Air travel increases
melatonin levels on
ight days in
regardless of the
travel direction
High-volume training
may exacerbate sleep
disturbance (e.g.,
preseason period)
It tends to be easier to
adjust to a circadian
phase delay (e.g.,
eastwards travel) than
a phase advance (e.g.,
westwards travel) as
the standard duration
of the circadian
rhythm is
approximately 24.5h
Late-night social
media use negatively
impacts next-day
performance in NBA
Include sleep history and a month’s
worth of sleep logs in the preseason
test battery as well as a month’s worth
of sleep logs to identify players who
are at high risk for sleep issues
Monitor sleep through actigraphy as
well as valid surveys such as the
Pittsburgh Sleep Quality Index, Likert
scale, Liverpool Jet-Lag
Questionnaire or RESTQ
Prior to long-distance travel,
educational sessions should be
considered to communicate effective
strategies moving forward
For example, the coaching staff
should be advised to adopt the
timing of their practice sessions to
the time zone of the prospective
destination. Additionally, an
evening ight should be advised
when traveling in eastward
Consider the following in-ight
strategies to promote relaxation:
Eyeshades and earplugs;
On-board meal intake according to
the destination time;
Bring custom meals;
Modify the time on personal watch
or phone to the destination time as
soon as boarding the plane;
Consume a high-carbohydrate,
low-protein meal in the evening
Consume of a high-protein, low-
carbohydrate meal in the morning
If traveling seems to disturb your
sleep, consider taking 20–30min naps
during the circadian nadir of the
departure time
If traveling across 3time zones in
eastward direction or traveling across
4time zones in westward direction,
seek or avoid light according to a jet
leg calculator
Focus on physical activity, eating, and
social contact during daylight time in
the new time zone
Avoid late-night tablet use or any
form of blue light exposure before bed
Include exogenous and
endogenous parameters
to measure the
circadian rhythms in
NBA players, such as
salivary melatonin,
adrenaline, light
exposure, and body
Standardized protocols
for the usage of
wearable devices and
progressive strategies
to help with sleep
disturbances induced
by traveling, such as
light-blocking glasses,
exercise regimes,
caffeine consumption,
food intake, melatonin
prescriptions, as well
as the use of other
chronobiotics and
Denition of
parameters inferred by
polysomnography, as
well as consistency in
algorithms and
self-perceived sleep
Table 74.1 (continued)
T. Huyghe and J. Calleja-Gonzalez
Long distance traveling in basketball
Scientic evidence Practical applications Future research
Competing in away
games increases
regular season injury
risk in the NBA
Reducing minutes
played per game does
not inuence risk of
injury in NBA players
When sleeping <8h,
the immune system
becomes suppressed
Dry pressurized air
cabin conditions
during the ight or
acute exposure to
altitude may
exacerbate a
suppressed immune
Prolonged sitting
increases the risk for
The annual risk of
deep vein
thromboembolism in
non-athletes increases
with 12% if one
long-haul ight is
taken yearly. This
increased risk may
remain up to 2weeks
after a long-haul
Avoid caffeine and alcohol during the
ight to mitigate uid loss and the
suppression of the immune system.
Instead, drink other beverages,
approximately 200ml extra in a 12-h
Include a baseline assessment during
the preseason medical screening to
gain insight into the risk for deep vein
thromboembolism in each player and
staff member
Perform exibility exercises (e.g.,
FitFlight) during ights (when awake)
Advise players on an individual basis
according to their chronotype, age,
and level of tness
Ensure 8h of quality sleep before,
during, and after trips
Ensure proper food hygiene, and
avoid uncooked foods
Explore which
biomarkers indicate an
increased risk for
injury or health
problems in basketball.
For example:
Internal load
vitamin D, cortisol,
and anti-
External variables:
Type of schedule,
travel duration,
travel direction, and
The magnitude of
inuence by the NBA
ecosystem on the risk
of its athletes and
employees to being
diagnosed with venous
The analysis of
preight, in-ight, and
postight interventions
(e.g., FlightFit) and
how these interventions
play a role on the
immune system,
hydration status, and
blood circulation of
NBA players and
employees who travel
with the team
Table 74.1 (continued)
74 Long-Distance Traveling inBasketball: Practical Applications Based onScientic Evidence
Long distance traveling in basketball
Scientic evidence Practical applications Future research
Mood state Traveling tends to
impair mood and loss
of motivation all of
which can affect
Altered mood states
after ying may
remain up to 24h
after the ight
Sleep disruption may
further exacerbate any
mood uctuations
Physical activity has
demonstrated to
improve mood state
in athletes
immediately after
Extending sleep over
a 3-week period may
improve energy,
mood state, and
mental preparedness,
especially in
basketball players
Monitor subjective loads during travel
periods based on evidence-based
surveys such as the Acute Recovery
and Stress Scale (ARSS) and the
REST-Q Sport.
If traveling across 3time zones in
eastward direction or 4time zones
in westward direction, consider
intaking 50–200mg of caffeine as
If traveling across 3time zones in
eastward direction, or traveling across
4time zones in westward direction,
consider intaking 50–200mg of
caffeine in late afternoons and in the
minutes before a nap
Avoid unnecessary psychological
stress by applying a proactive
mindset, such as adjusting your watch
as soon as boarding, and if the budget
allows, travel managers should
incorporate 1day of adjustment
period for each time zone crossed.
Additionally, inform family and
friends about the time difference to
avoid calls during inappropriate times
Validity and reliability
of pyschometric
surveys specically in
professional basketball
and during travel
The effectiveness of
intervention strategies
on mood state
disturbances in NBA
players induced by
traveling, such as
napping and sleep
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Background Sleep quality is an essential component of athlete’s recovery. However, a better understanding of the parameters to adequately quantify sleep quality in team sport athletes is clearly warranted. Objective To identify which parameters to use for sleep quality monitoring in team sport athletes. Methods Systematic searches for articles reporting the qualitative markers related to sleep in team sport athletes were conducted in PubMed, Scopus, SPORTDiscus and Web of Science online databases. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. For the meta-analysis, effect sizes with 95% CI were calculated and heterogeneity was assessed using a random-effects model. The coefficient of variation (CV) with 95% CI was also calculated to assess the level of instability of each parameter. Results In general, 30 measuring instruments were used for monitoring sleep quality. A meta-analysis was undertaken on 15 of these parameters. Four objective parameters inferred by actigraphy had significant results (sleep efficiency with small CV and sleep latency, wake episodes and total wake episode duration with large CV). Six subjective parameters obtained from questionnaires and scales also had meaningful results (Pittsburgh Sleep Quality Index (sleep efficiency), Likert scale (Hooper), Likert scale (no reference), Liverpool Jet-Lag Questionnaire, Liverpool Jet-Lag Questionnaire (sleep rating) and RESTQ (sleep quality)). Conclusions These data suggest that sleep efficiency using actigraphy, Pittsburgh Sleep Quality Index, Likert scale, Liverpool Jet-Lag Questionnaire and RESTQ are indicated to monitor sleep quality in team sport athletes. PROSPERO registration number CRD42018083941.
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Objectives: In sports, decreased sleep duration is generally associated with poorer performance compared to adequate or enhanced sleep duration. Yet, these findings have primarily been taken from small numbers of athletes performing outside of real games or competitions. It remains unknown how acute decreased sleep duration impacts real-game performance among professional athletes. Here, we merged 2 publicly available datasets to jointly measure late-night social media activity (a proxy for sleep deprivation) and next-day game performance. Setting: Professional basketball competition. Participants: 112 players from the National Basketball Association. Measurements: Time-stamped social media activity and in-game individual performance statistics. Results: Late-night tweeting (compared to not late-night tweeting) is associated with within-person reductions in next-day game performance, including fewer points scored and fewer rebounds. However, we also observe less time played per game following late-night tweets and decreases in the negative outputs of turnovers and personal fouls. The critical measure of shooting accuracy – which is not time dependent – provides the clearest evidence of a performance penalty following late-night tweeting activity (between 11:00 PM and 7:00 AM); players successfully make shots at a rate 1.7 percentage points less following late-night tweeting. Conclusions: Our findings suggest that acute sleep deprivation, as measured via late-night Twitter activity, is associated with changes in next-day game performance among professional National Basketball Association athletes. More broadly, the use of late-night social media activity may serve as a useful general proxy for sleep deprivation in other social, occupational, and physical performance-based contexts.
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Context: National Basketball Association (NBA) athletes experience a high rate of injuries. Injury prevention requires identifying observable and controllable risk factors. Objective: To examine the relationship among game load, fatigue, and injuries in NBA athletes. Design: Cross-sectional study. Setting: Game statistics and injury reports over 3 NBA seasons (2012-2015). Patients or other participants: Data represented 627 players (height = 200.7 ± 8.9 cm, mass = 100.6 ± 12.1 kg, NBA experience = 4.8 ± 4.2 years, pre-NBA experience = 3.2 ± 1.9 years), 73 209 games, and 1663 injury events. Main outcome measure(s): An injury event was defined as a player missing or leaving a game due to injury. Logistic multilevel regression was used to predict injuries from time-lagged fatigue and game load with between-subjects differences explained by demographic variables. Results: The odds of injury increased by 2.87% ( P < .001) for each 96 minutes played and decreased by 15.96% ( P < .001) for each day of rest. Increases in game load increased injury odds by 8.23% ( P < .001) for every additional 3 rebounds and 9.87% ( P < .001) for every additional 3 field-goal attempts. When fatigue and game load were held constant, injury odds increased by 3.03% ( P = .04) for each year of NBA experience and 10.59% ( P = .02) for a 6-cm decrease in height. I observed variability in the intercepts ( P < .001) and the slopes for minutes, rest, field goal attempts, and rebounds (all P < .001). Conclusions: Injuries were associated with greater fatigue and game load, more years of NBA experience, and being shorter than average. Both baseline injury risk and the magnitude of the load-injury and fatigue-injury associations varied across individuals. Researchers should explore the nature of these relationships.
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Currently, very little is known about the impact of short- or long-haul air travel on the sleep and wellbeing of wheelchair basketball athletes. Eleven national wheelchair basketball athletes wore actigraphy monitors prior, during, and after air travel to the United Kingdom. Upon arrival, participants rated their subjective jet-lag, fatigue, and vigor. Individuals traveled to the United Kingdom from different locations in Australia, the United States, and Europe and were categorised according to travel length [LONG (up to 30.2 h) or SHORT (up to 6.5 h)]. Linear mixed models determined effects of travel length on sleep and subjective ratings of jet-lag, fatigue, and vigor. During competition, subjective fatigue and jet-lag were substantially higher (ES = 0.73; ±0.77) and (ES = 0.57; ±0.60), subjective vigor was lower (ES = 1.94; ±0.72), and get-up time was earlier (ES = 0.57; ±0.60) for LONG when compared to SHORT. Travelling greater distances by airplane had a larger effect on subjective ratings of jet-lag, fatigue and vigor, rather than sleep. Irrespective of travel group, sleep and subjective responses were compromised, reflecting the travel requirements, competition-mediated influences, and/or due to a change in environment.
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Background There has been speculation that rest during the regular season for players in the National Basketball Association (NBA) improves player performance in the postseason. Purpose To determine whether there is a correlation between the amount of regular-season rest among NBA players and playoff performance and injury risk in the same season. Study Design Cohort study; Level of evidence, 3. Methods The Basketball Reference and Pro Sports Transactions archives were searched from the 2005 to 2015 seasons. Data were collected on players who missed fewer than 5 regular-season games because of rest (group A) and 5 to 9 regular-season games because of rest (group B) during each season. Inclusion criteria consisted of players who played a minimum of 20 minutes per game and made the playoffs that season. Players were excluded if they missed ≥10 games because of rest or suspension or missed ≥20 games in a season for any reason. Matched pairs were formed between the groups based on the following criteria: position, mean age at the start of the season within 2 years, regular-season minutes per game within 5 minutes, same playoff seeding, and player efficiency rating (PER) within 2 points. The following data from the playoffs were collected and compared between matched pairs at each position (point guard, shooting guard, forward/center): points per game, assists per game, PER, true shooting percentage, blocks, steals, and number of playoff games missed because of injury. Results A total of 811 players met the inclusion and exclusion criteria (group A: n = 744 players; group B: n = 67 players). Among all eligible players, 27 matched pairs were formed. Within these matched pairs, players in group B missed significantly more regular-season games because of rest than players in group A (6.0 games vs 1.3 games, respectively; P < .0001). There were no significant differences between the groups at any position in terms of points per game, assists per game, PER, true shooting percentage, blocks, steals, or number of playoff games missed because of injury. Conclusion Rest during the NBA regular season does not improve playoff performance or affect the injury risk during the playoffs in the same season.
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Purpose: Determine the recovery timeline of sleep, subjective jet-lag and fatigue, and team-sport physical performance following east and west long-haul travel. Methods: Ten, physically-trained males underwent testing at 09:00 (AM) and 17:00 (PM) local time on four consecutive days two weeks prior to outbound travel (BASE), and the first four days following 21 h of outbound (WEST) and return (EAST) air travel across eight time-zones between Australia and Qatar. Data collection included performance (countermovement jump [CMJ], 20-m sprint and Yo-Yo Intermittent Recovery level 1 [YYIR1] test) and perceptual (jet-lag, motivation, perceived exertion and physical feeling) measures. In addition, sleep was measured via wrist activity monitors and self-report diaries throughout the aforementioned data collection periods. Results: Compared to the corresponding day at BASE, the reduction in YYIR1 distance following EAST was significantly different to the increase WEST on day 1 post-travel (p<0.001). On day 2, significantly slower 20-m sprint times were detected in EAST compared to WEST (p=0.03), with large effect sizes also indicating a greater reduction in YYIR1 distance in EAST compared to WEST (d=1.06). Mean sleep onset and offset were significantly later and mean time in bed and sleep duration were significantly reduced across the four days in EAST compared to BASE and WEST (p<0.05). Lastly, mean jet-lag, fatigue and motivation ratings across the four days were significantly worse in EAST compared to BASE and WEST (p<0.05), and WEST compared to BASE (p<0.05). Conclusions: Long-haul transmeridian travel can impede team-sport physical performance. Specifically, travel east has a greater detrimental effect on sleep, subjective jet-lag, fatigue and motivation. Consequently, maximal- and intermittent-sprint performance is also reduced following travel east, particularly within 72 h following arrival.
The National Basketball Association (NBA) has an extremely demanding competition schedule, requiring its athletes to compete in 82 regular-season games over a 6-mo period (~ 3.4 games/wk). Despite the demanding schedule and high value of athletes, there is little public information on the specific game and training demands required to compete in the NBA. While provisions in the NBA collective bargaining agreement allow for research designed to improve player health and broaden medical knowledge, such information is sparse in the available literature. In relation to the physical demands of the NBA, the current lack of information likely results from multiple factors including limited understanding of (basketball-related) emerging technologies, impact of specific league rules, and steps taken to protect players in the age of Big Data. This article explores current limitations in describing specific game/training demands in the NBA and provides perspectives on how some of these challenges may be overcome. The authors propose that future collaborations between league entities, NBA clubs, commercial partners, and outside research institutions will enhance understanding of the physical demands in the NBA (and other health- and performance-related areas). More detailed understanding of physical demands (eg, games, practices, travel) and other health-related areas can augment player-centered decision making, leading to enhanced player care, increased availability, and improved physical performance.
Objectives: To investigate the practices and attitudes of professional basketball head coaches towards injury prevention. Design: Survey Setting: Elite-level basketball. Participants: Head coaches of all 366 German professional teams. Main outcome measures: Use of injury risk screening methods, rated importance of different musculoskeletal injuries and rated effectiveness of preventive interventions. Results: Eighty-three of 366 invited coaches (23%) responded to the survey. No non-response bias was detected. Only one of three teams conducts systematic injury screenings. The most commonly used test was the functional movement screen (73.1% of users), while balance and strength testing (both 38.5%) were least prevalent. Top-rated preventive interventions included balance and strength training, training of functional movement patterns, and stretching. In contrast, passive interventions, e.g. the use of orthoses, were not considered effective. The involvement of a health professional (e.g. physiotherapist) was associated with the performance of injury screening, but not with the choice of specific tests or preventive strategies. Conclusions: The methods applied to conduct injury screening and prevent musculoskeletal disorders in German professional basketball teams seem only partially backed by scientific evidence. Although not correlated with the tests and interventions used, the involvement of health-related stakeholders might help to identify players at increased injury risk.
We investigated the effects of a circadian disadvantage (i.e. playing in a different time zone) on the winning percentages in three major sport leagues in North America: the National Basketball Association, the National Hockey League and the National Football League. We reviewed 5 years of regular season games in the National Basketball Association, National Hockey League and National Football League, and noted the winning percentage of the visiting team depending on the direction of travel (west, east, and same time zone) and game time (day and evening games). T-tests and analysis of variance were performed to evaluate the effects of the circadian disadvantage, its direction, the number of time zones travelled, and the game time on winning percentages in each major league. The results showed an association between the winning percentages and the number of time zones traveled for the away evening games, with a clear disadvantage for the teams travelling westward. There was a significant difference in the teams' winning percentages depending on the travelling direction in the National Basketball Association (F2,5908 = 16.12, P < 0.0001) and the National Hockey League (F2,5639 = 4.48, P = 0.011), and a trend was found in the National Football League (F2,1279 = 2.86, P = 0.058). The effect of the circadian disadvantage transcends the type of sport and needs to be addressed for greater equity among the western and eastern teams in professional sports. These results also highlight the importance of circadian rhythms in sport performance and athletic competitions.