Co-ordinated approach is best to decide when an athlete can return to perform
One of the most frustrating parts of being an athlete is when injury or illness strikes at the most inopportune moment often resulting in the best laid plans being thrown into disarray. The nature of injuries and illness are that they can hit any time, and when they happen during a planned period of intense training it can set an athlete back weeks. It can also occur coming up to competition and that results in the final preparations and fine-tuning being adversely affected. If it happens at competition time then all the hard work over months can be put at risk.
Performing with injury is common
The frustration caused by injury or illness can lead to athletes being forced to take a chance by training or competing while not 100 per cent in order to maintain their programme or give themselves a chance of success. Most leisure athletes have experienced training with a slight injury or while suffering from something as minor as a cold, but they can be reassured that for elite athletes it is a similar situation. The idea of all athletes being in perfect condition every time they train or compete is a fallacy. The extent of the problem is outlined in Olympic athletes commonly compete with injuries by Dr. Dale Buchberger, who tells us that upwards on 95 per cent of athletes had some type of injury during the London Olympics. This could range from something minor that could be dealt with through tape, to something more serious that may have a significant impact on performance. The point is backed up in the article Managing the health of the elite athlete: a new integrated performance health management and coaching model which states:
The vast majority (80%) of the British Track and Field athletes selected to compete at the London 2012 Olympic Games had injuries or illnesses requiring management before, during and after the Games
When should an athlete return?
Despite the best efforts to prevent injury and illness, they will never be eradicated completely so when they do strike, the next challenge is to know exactly when an athlete should return to training or compete. Like everything else in sport, there are many variables and it is by no means an exact science. That is why efforts have been made to create guidelines which help athletes, coaches and medical staff make the correct decision that is in the best interests of the athlete in both the short and long term. One of the difficulties with knowing when an athlete should return to training or get back into competition is the fact that there are two different dynamics involved. The athlete and coach are determined to get back into action as quickly as possible – and may be under pressure to do so. On the other hand support staff may often err on the side of caution and prevent an athlete taking part on purely medical grounds.
Reaching a compromise
It is a dilemma addressed by David Joyce and Dan Lewindon in When is an Athlete Ready to Return to Action After an Injury? who point out that all factors must be carefully considered and that no risks should be taken as they state:
It is vital that we remove the guesswork, because if we get it wrong, the athlete may be spending even longer on the treatment couch. Although we cannot perfectly guarantee that an injury will not recur when the player steps out onto the pitch, there are a number of factors that, if taken into consideration when determining return to competition (RTC), can help determine whether the risk of playing is acceptable
The article points out that both a physical assessment (the state of repair of the injury), and functional assessment (the ability of the athlete to perform the tasks demanded by the sport) should be carried out, and he sees the key questions as follows:
- Is the athlete fit to play?
- Has the Athlete Returned to Baseline Measures?
- Does the Athlete Have to Be 100 Per Cent Fit?
- Is the Athlete Fit to Perform?
Athletes often want to return to full training and match/competition as soon as possible after suffering a concussion. The athlete and his parents/coaches need to be well informed about concussion and follow concussion guidelines and protocols. A Graduated Return To Play (GRTP) is recommended starting with Rest & Recovery moving onto Light aerobic exercise and gradually returning to full training and finally competition. Monitoring of symptoms and cognitive function forms an integral part of GRTP.
This idea of a compromise between the two different dynamics is also raised in Managing the health of the elite athlete: a new integrated performance health management and coaching model. The article makes the case for introducing guidelines for helping the athlete and medical staff make a fully informed decision by taking all factors into account before making the final call on returning to action.
It is therefore important to have a critical look at the organisation of medical support services to elite athletes, the process of decision-making in the elite sport environment and the best way to continuously manage athlete health. Athletes cannot do this in isolation and need the support of a well organised and integrated health and coaching team working in harmony towards common goals in a new Integrated Performance Health Management and Coaching model
The model would help ensure that decisions will be informed both the best medical evidence and the needs of the athlete, and this would ensure that the best interests of the athlete are being served in both the long term and the short term.
About Metrifit
Metrifit is an athlete monitoring system that gathers subjective and objective information from both coaches and athletes to drive behavior modification and improvement through insights modeled on descriptive and predictive analytics. It sounds complicated but Metrifit prides itself on its simple intuitive interface and advocates a simple effective approach that doesn’t overwhelm the athlete or the coaching/staff member. It has received high praise for its intuitive interface and it allows monitoring to be scaled for all levels of athletes and teams. Recent research by Anna Saw (Deakin University, Australia) has shown that use of Metrifit is associated with increased athlete sporting self-confidence. Metrifit is ‘athlete-centric’ helping to develop self-awareness, encourage creative thinking and emotional intelligence as well as developing ownership and responsibility within the athlete for their own success.
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References
Olympic athletes commonly compete with injuries by Dr. Dale Buchberger
When is an Athlete Ready to Return to Action After an Injury? – David Joyce and Dan Lewindon
Picture credit: Edward Morgan