Managing the health of the elite athlete: a new integrated performance health management and coaching model

Abstract

Elite athletes endeavour to train and compete even when ill or injured. Their motivation may be intrinsic or due to coach and team pressures. The sports medicine physician plays an important role to risk-manage the health of the competing athlete in partnership with the coach and other members of the support team. The sports medicine physician needs to strike the right ethical and operational balance between health management and optimising performance. It is necessary to revisit the popular delivery model of sports medicine and science services to elite athletes based on the current reductionist multispecialist system lacking in practice an integrated approach and effective communication. Athlete and coach in isolation or with a member of the multidisciplinary support team, often not qualified or experienced to do so, decide on the utilisation of services and how to apply the recommendations. We propose a new Integrated Performance Health Management and Coaching model based on the UK Athletics experience in preparation for the London Olympic and Paralympic Games. The Medical and Coaching Teams are managed by qualified and experienced individuals operating in synergy towards a common performance goal, accountable to a Performance Director and ultimately to the Board of Directors. We describe the systems, processes and implementation strategies to assist the athlete, coach and support teams to continuously monitor and manage athlete health and performance. These systems facilitate a balanced approach to training and competing decisions, especially while the athlete is ill or injured. They take into account the best medical advice and athlete preference. This Integrated Performance Health Management and Coaching model underpinned the Track and Field Gold Medal performances at the London Olympic and Paralympic Games.

Asthma prevalence in Olympic summer athletes and the general population: An analysis of three European countries

“…As earlier studies have demonstrated that athletes have a very high degree of medical surveillance [16,30], risk estimates of doctor-diagnosed asthma modeled on the comparison of athletes and non-athletes might have been biased due to a differential misclassification of outcome. Further, based on the assumption that the athlete population has higher health awareness than the general population, a lower degree of recall bias in the assessment of asthma symptoms and medication use should be expected in the athlete population.…”

A new outlook on the evaluation of health state and physical capacity of skiers with disabilities as exemplified by a female Paralympic Champion

“…[19] stwierdza, że przy obecnej kumulacji klas startowych oraz określonym współczynniku (handicapie) V02max jest czynnikiem decydującym o wyniku sportowym zarówno w grupie zawodników startujących na stojąco jak i na siedząco. Podobnie, na podstawie brytyjskich doświadczeń z Igrzysk Olimpijskich i Paraolimpijskich w Londynie w 2012 roku, proponuje się w piśmiennictwie [40] model połączenia opieki medycznej z procesem szkoleniowym celem osiągnięcia etycznej oraz funkcjonalnej równowagi pomiędzy opieką medyczną, a optymalizacją sportowego wyczynu. Ponadto zwraca się uwagę na potrzebę zmiany kwalifikacji i roli lekarza pracującego ze sportowcami -"od lekarza "zainteresowanego sportem" do specjalisty medycyny sportowej" który, powinien być koordynatorem wielospecjalistycznego zespołu medycznego współpracujące-go w sposób zintegrowany ze sztabem trenerskim [40].…”

“…For instance, Bernardi et al [19] concluded that with the present cumulation of competition classes and a given coefficient, V02max is a decisive factor for sports result both in the group of athletes competing in a standing position and among those competing in a sitting position. Similarly, on the basis of British experiences from the Olympic and Paralympic Games in London in 2012, it is recommended in the literature [40] to implement the model of combining medical care with a training process in order to achieve ethical and functional balance between medical care and optimisation of sports performance. Moreover, attention is paid to the need of miast podobne stanowisko odnośnie sportowców z niepełnosprawnością zapowiedziane podczas IP w Soczi 2013 nie zostało dotychczas opublikowane [37].…”

“…changing the qualification and role of a doctor working with athletes from "the doctor interested in sport" to "sports medicine specialist" who should coordinate multi-specialist medical team cooperating in an integrated way with the coaches' team [40].…”

A phase of consolidation before moving forward again

“…[2] This occurred in the important area of managing players' wellbeing, in particular the management of their health, risk of injury and training status. This article was written by Paul Dijksra, [2] a South African who studied medicine at the University of Pretoria and sports medicine at the University of Cape Town. He was the chief medical officer of UK Athletics and is currently working in Qatar as the assistant chief of sports medicine for the Qatar Sports Medicine Department.…”