Perceptions and use of recovery strategies in water polo players and coaches: a worldwide survey

Article information

J Exerc Rehabil Vol. 20, No. 3, 112-123, June, 2024

Publication date (electronic) : 2024 June 30

doi : https://doi.org/10.12965/jer.2448214.107

Josu Barrenetxea-Garcia¹, Andrea Perazzetti², Sergi Nuell³, Juan Mielgo-Ayuso⁴, Eduardo Sáez de Villarreal⁵, Julio Calleja-González^6,7,

¹Water Polo Club Leioa Waterpolo, Leioa, Spain

²Department of Movement, Human and Health Sciences, University of Rome ‘Foro Italico’, Rome, Italy

³EUSES, Escola Universitària de la Salut i l’Esport, Universitat de Girona, Girona, Spain

⁴Department of Health Sciences, Faculty of Health Sciences, University of Burgos, Burgos, Spain

⁵Physical Performance Sports Research Center (PPSRC), Universidad Pablo de Olavide, Sevilla, Spain

⁶Department of Physical Education and Sport, Faculty of Education and Sport, University of the Basque Country (UPV/EHU), Vitoria, Spain

⁷Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia

^*Corresponding author: Julio Calleja-González, Department of Physical Education and Sport, Faculty of Education and Sport, University of the Basque Country, Portal de Lasarte, 71, Vitoria 01007, Spain, Email: julio.calleja.gonzalez@gmail.com

Received 2024 April 26; Revised 2024 May 10; Accepted 2024 May 30.

Abstract

INTRODUCTION

Periodization of the different training loads based on magnitude and specificity, seems to induce to a better improvement in performance (Kataoka et al., 2021; Miloski et al., 2016; Suchomel et al., 2018), however, accumulation of fatigue or incomplete recovery, influences negatively on performance as well (Alba-Jiménez et al., 2022). In team sports, players are exposed systematically to new stimuli (trainings or competitions) before they fully recover (Querido et al., 2022). Among team sports, water polo (WP) is a highly demanding water-based contact sport that requires intense bursts of sprint swimming, constant technical-tactical events (Perazzetti et al., 2023a; Perazzetti et al., 2023d) and frequent changes of direction, with incomplete recovery periods (Barrenetxea-García et al., 2023; Botonis et al., 2019). Therefore, optimal recovery strategies are essential to avoid long-term fatigue and adverse consequences such as poor performance or injury (Altarriba-Bartes et al., 2020). The most popular methods to improve recovery in team sports are ergo-nutrition, active recovery, hydrotherapy, massage techniques, compression garments, cryotherapy, foam rolling, sleep strategies, and psychological implements (Calleja-González et al., 2016; Querido et al., 2022; Rose et al., 2017; Wiewelhove et al., 2019). Nevertheless, in WP, there is still very scarce literature about that topic (Barrenetxea-García et al., 2022; Barrenetxea-García et al., 2023; Barrenetxea-García et al., 2024; Botonis et al., 2024; Botonis and Toubekis, 2023) and only a very limited number of studies have specifically analyzed the effectiveness of any recovery strategy throughout interventions in WP (Barrenetxea-García et al., 2022; Barrenetxea-García et al., 2024; Botonis and Toubekis, 2023). This reality turns it very difficult to make specific recommendations derived from scientific evidence, and generally the guidance of recovery is made by trends and sensations (Altarriba-Bartes et al., 2021; Simjanovic et al., 2009).

In soccer, team sports players, and in particular basketball, the most used recovery strategies have been already described (Altarriba-Bartes et al., 2021; Crowther et al., 2017; Pernigoni et al., 2022). In addition, the authors, identified a gap between scientific evidence regarding the effectiveness of the different strategies and the perceived effectiveness of these different strategies by the athletes and coaches. It seems that the selection of recovery strategy is made by its availability, the easy-to-implement and the athlete’s sensations rather than the evidence of its strategy, and there is no consensus on the protocols and the timings of their application (Altarriba-Bartes et al., 2021; Crowther et al., 2017). Consequently, the evaluation of recovery strategies in WP employed in different contexts could provide useful information to analyze and describe the reality, and help coaching staff to develop and make more evident recommendations in daily practice. Therefore, the main purpose of this descriptive international survey study was to assess recovery strategies and the perceived usefulness and limitations among WP players and coaches worldwide.

MATERIALS AND METHODS

Design

A pilot version of the survey was administered to two coaches and two players who had solid experience in the sport before distribution (12 and 15 years, respectively). For data collection, a freely accessible online questionnaire was developed using Microsoft Forms with descriptive design (https://forms.office.com/r/BQCkk1NCv3) and different question options: combination of multiple choice, Likert scales, checkboxes and open-ended free-text responses. Subsequently, the survey was sent by email, telephone and social networks, in the same way as used by other authors (Calleja-González et al., 2021; Pernigoni et al., 2022; Perazzetti et al., 2023b) (Fig. 1). The survey was available online for 2 months (from 2 October to 2 December 2023) and was completed in a maximum of 8 min. The data obtained were treated with the utmost confidentiality and scientific rigor, their use being restricted by the guidelines for research projects following the required scientific method, complying with Organic Law 15/1999 on Personal Data Protection. The study was approved by the Human Research Ethics Committee of the University of Basque Country (Ref. M10_2023_192) and was adjusted to the Code of Ethics of the World Medical Association (2013).

Fig. 1

Worldwide survey procedure.

RESULTS

The majority of players (n=131, 56.7%) players surveyed were under 21 years of age; half of the respondents were female (n=119, 51.5%) and male (n=112, 48.5%); had sport experience between 5 and 10 years (n=99, 42%); were students (n=174, 75.3%); were from Europe (n=202, 87.4%); and were part of a first division team (n=108, 46.8%). In the case of the coaches, one-third were between 31 and 40 years of age (n=24, 31.6%); the majority were male (n=70, 2.71%); work experience between 5 and 10 years, and between 11 and 15 years for approximately one-third (n=20, 26.3%; n=18, 23.7%; respectively); were degrees in other disciplines (n=21, 27.6%); most were from Europe (n=63, 82.9%); work with male teams (n=54, 71.9%); and one-third were part of a territorial division team (n=28, 36.8%). Table 1 details the sociodemographic characteristics of the WP players and coaches.

Table 1

Sociodemographic characteristics of water polo players (n=231) and coaches (n=76)

The importance, objectives, frequency, timing, location and limitations of the use of recovery strategies in WP players and coaches are shown in Tables 2–4. The majority of players and coaches considered recovery strategies as very important (n=121, 52.4%; n=45, 59.2%; respectively). The most selected reasons to justify their use were to reduce the injury risk (n=200, 30.4%; n=62, 26.9%; respectively) and to improve the performance capability in the following training session or competition (n=162, 24.6%; n=57, 24.7%; respectively). The most prominent frequencies of use of recovery strategies were rarely (n=66, 28.6%) and occasionally (n=61, 26.4%) in players; and occasionally (n=23, 30.3%) and sometimes (n=14, 18.4%) in coaches. The most frequently used times were posttraining session (n=131, 28.1%; n=44, 26.5%; respectively) and post-game (n=126, 27%; n=43, 25.9%; respectively); and the most frequently used places were in the sports hall or in the gym (n=159, 49.7%; n=64, 57.1%; respectively) and at home (n=125, 39.1%; n=25, 21.3%; respectively). The most frequently observed limitations to the use of recovery strategies were that they are too time-consuming (n=132, 34.9%; n=40, 29%; respectively) and there are no available devices or facilities to implement those strategies (n=99, 26.2%; n=42, 30.4%; respectively).

Table 2

Importance, objectives, frequency, timing, location and limitations of the use of recovery strategies in water polo players (n=231)

Table 3

Importance, objectives, frequency, timing, location, and limitations of the use of recovery strategies in water polo coaches (n=76)

Table 4

Pearson correlations between the importance of the use of recovery strategies and the frequency of their use in water polo male and female players and coaches

The frequencies for perceived usefulness and actual use are shown in Fig. 2 (players) and Fig. 3 (coaches). In the case of the players, stretching (n=175, 12.7%), massage (n=152, 11.1%), active recovery (n=119, 8.7%), and cold baths (n=111, 8.1%) were the strategies perceived as most useful. The strategies most frequently used were stretching (n=178, 18.1%), active recovery (n=110, 11.2%), massage (n=107, 10.9%), and foam rolling (n=78, 8%). As for the coaches, active recovery (n=57, 11.2%), massage (n=48, 9.4%), stretching (n=45, 8.8%), and cold baths (n=31, 6.1%) were the strategies perceived as most useful. The strategies most frequently used were active recovery (n=51, 15%), stretching (n=47, 13.8%), pool recovery (n=37, 10.9%), and foam rolling (n=28, 8.2%).

Fig. 2

Reported relative frequencies for perceived usefulness and actual use of recovery strategies in water polo players.

Fig. 3

Reported relative frequencies for perceived usefulness and actual use of recovery strategies in water polo coaches.

DISCUSSION

This global descriptive survey was designed to evaluate how recovery strategies are perceived, utilized, and constrained among WP players and WP coaches worldwide. The main findings of the study were that there is a notable inconsistency between participants’ perception of the importance of recovery strategies and their actual use, as well as a lack of knowledge on the topic based on the scientific literature.

Even if most participants acknowledged the significance of recovery strategies in WP, sometimes a considerable number of respondents demonstrated the utilization of outdated methods not aligned with the current scientific evidence. This confirms a lack of adherence to established recovery practices within this aquatic discipline (Barrenetxea-García et al., 2022). The participants’ primary reasons for using recovery strategies were mainly to minimize the risk of injuries and enhance performance capabilities in subsequent training sessions or competitions. These results align with early previous research in basketball (Pernigoni et al., 2022), where participants provided similar answers. In our study WP players exhibited infrequent utilization of recovery strategies, with rare occurrences being the most prevalent. Similarly, WP coaches reported occasional and sometimes usage. This kind of approach to recovery activities is not optimal for reaping the benefits of these strategies, given that several studies in other sports suggest that the use of recovery strategies and athlete monitoring should be consistently performed within the weekly microcycle (Padrón-Cabo et al., 2024; Wiewelhove et al., 2016; Wilke et al., 2020). Similarly, maintaining a daily and weekly record of player’s load is a crucial monitoring tool for coaches, allowing them to assess players’ stress levels and adaptive responses (Barrenetxea-García et al., 2024; Perazzetti et al., 2023c). These deficiencies in WP could be attributed to a lack of usefulness of scientific information, a limited number of coaches with a sports science background (Perazzetti et al., 2023b), and frequently inadequate training facilities (Reverter-Masía et al., 2012).

In the rare instances where recovery strategies are implemented by WP practitioners, our findings indicated that they were typically applied posttraining sessions and games. As previously showcased in various team sports (Calleja-González et al., 2018; Calleja-González et al., 2019; Nemčić and Calleja-González, 2021), the implementation of specific recovery strategies immediately posttraining brings about significant benefits for the players (Tessitore et al., 2007; Tessitore et al., 2008). Despite this, participants demonstrated a lack of habit to organize training sessions that included recovery strategies. A lack of specific knowledge on this topic indicates a deficiency in this area, particularly among coaches (Calleja-González et al., 2021). Indeed, several studies have emphasized the importance of using recovery modalities between training sessions (Barnett, 2006; Laborde et al., 2024).

Examining the pooled data, participants identified the following as the most useful recovery strategies among others: stretching; massage; active recovery; and cold baths. Regarding stretching, even if for long period of time scientific literature has consistently advocated it as a postexercise recovery method, last studies indicated there were not always positive effects associated with stretching in terms of postexercise recovery (Afonso et al., 2021; Dupuy et al., 2018; Herbert et al., 2011). This observation again indicates a lack of sufficient knowledge on this topic between both WP players and coaches. At the contrary, regarding massage strategy the participants’ answers were in line with scientific literature, which stated that is an advantageous method for perceptual measures of recovery (Delextrat et al., 2014) and for a better flexibility and evolution of muscle soreness (Davis et al., 2020). At once, active recovery, which is considered an excellent recovery strategy for the stimulation of reduction of blood lactate concentration and creatine kinase levels (Gu et al., 2021) and cold bath, which has been demonstrated to improve the level of perceived relaxation (Ahokas et al., 2019), appear to be well-known recovery strategies both by WP players (Barrenetxea-García et al., 2022) and coaches.

Regarding the usage, players predominantly answered to most utilize stretching, active recovery, massage, and foam rolling, whereas coaches most frequently employed stretching, active recovery, pool recovery, and foam rolling. Team sport players of all competition levels frequently use stretching, which can be attributed to several factors such as its self-administered nature, accessibility and ease of use and widespread use in the fitness and sports industries (Nuzzo, 2020). In addition, stretching may be done in a small space and doesn’t require any complex equipment. This could explain the reason why the majority part of WP participants answered to use this strategy more than other. On the other hand, the great use of active recovery indicated by the respondents is a positive trend in line with previous studies demonstrated that following exercise, wellbeing status and muscle discomfort may benefit from active recovery (Ortiz et al., 2019).

Concerning massage, it seems to be also used at international level by elite athletes (Crowther et al., 2017). Clearly, this strategy could be used only by elite level of WP practitioners since it implies the presence of a massage therapist or physiotherapist in the staff or a wide budget from the club to send players to an external professional. This is maybe the reason why WP coaches didn’t include this method as the most used during their job. Instead, WP coaches indicated pool recovery as one of the most used strategies for recovery, which, according to our knowledge, was not present in previous research on WP. Among the most intriguing findings of our study, it was observed that both WP coaches and players identified the use of foam rolling as one of the most employed recovery methodologies. This is notable finding, considering that it was not perceived as important in the previous question of the current survey and in a previous study conducted by Barrenetxea-García et al. (2024), it has been demonstrated that it does not impact the recovery of WP athletes more than a passive recovery, but rather exclusively influences players’ joint range of motion, preventing injury risks. Unfortunately, in line with previous study on basketball (Pernigoni et al., 2022), although recovery methods that are costly and need specialized facilities are frequently seen to be beneficial, even though there is no scientific proof to justify some of these strategies, it was anticipated that they would be employed infrequently by WP practitioners.

Our research suggests a degree of discrepancy between the scientific literature and the research participants’ perceptions and usages of recovery methods, as other authors observed (Altarriba-Bartes et al., 2021; Crowther et al., 2017; Field et al., 2021; Pernigoni et al., 2022). This study could be useful especially for WP coaches, since they may influence those WP players who eventually become coaches and strength and conditioning coaches in the future. Previous research has demonstrated that coaches’ perception of recovery strategies may be influenced by previous knowledge, based on their personal experiences as players (Simjanovic et al., 2009). Therefore, it is crucial to reduce the gap between scientific evidence and coaches’ perceptions to improve player recovery and performance, and to share validated information. For this purpose, the coaching staff should rely on scientific research to offer effective recovery strategies to their players, as well as maintain close and collaborative communication between the different agents involved (Crowther et al., 2017; Field et al., 2021; Németh et al., 2024; Pernigoni et al., 2022). It has also been shown that the practice of sports coaching education is related to the level of popularity of a sport (Németh et al., 2024), consequently, the professionalization of sports coaching should be enhanced (Németh et al., 2024). Further research should be conducted to increase knowledge, to develop accessible and easy instruments to provide general protocols for sport teams, and to promote players education on this topic (Altarriba-Bartes et al., 2021; Pernigoni et al., 2022).

The study also presents certain limitations. While descriptive statistics illustrate the study results categorized by WP players and coaches, these variables were not thoroughly examined for more in-depth statistical analysis to confirm or refute differences both groups. Additionally, distinctions in responses between male and female participants were not considered. Moreover, the survey does not take into account the training diary of the players with their respective rest days per week. Nevertheless, to our knowledge, it is the first study on this topic in WP, involving a large number of participants around the world, different performance levels, and both genders. Future research could explore the same inquiries exclusively within teams that include an athletic trainer on the coaching staff, as described in football (Calleja-González et al., 2021), considering that they typically adopt a more professional and specialized approach compared to head coaches. Nevertheless, further research is essential in the realm of recovery within the WP, enabling coaches and WP practitioners to develop more specific and practical recommendations.

In summary, the study showed that the importance of tailoring interventions to address specific challenges and preferences within the diverse landscape of WP players and coaching staff. Participants demonstrated an inconsistency between their perception of the importance of recovery strategies and the frequency of their utilization. Particularly noteworthy are the results provided by coaches, as they play a crucial role in instructing and leading WP players towards a better understanding of this important topic. Indeed, a limited understanding of recovery strategies by coaches could result in the adoption of incorrect approaches, elevating the risk of overtraining and injuries in WP players and imparting inaccurate knowledge to them.

SUPPLEMENTARY MATERIAL

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