An elite endurance athlete's recovery from underperformance aided by a multidisciplinary sport science support team

Sex Differences in Self-Reported Causes, Symptoms, and Recovery Strategies Associated With Underperformance in Endurance Athletes

PURPOSE

This study investigated sex differences in self-reported causes, symptoms, and recovery strategies associated with underperformance in endurance athletes.

METHODS

A total of 82 athletes (40 women) meeting the inclusion criteria (performance level ≥tier 3, used training diaries, and experienced 1 or more periods of underperformance during their career) completed an online questionnaire. The questionnaire encompassed inquiries regarding load monitoring and experiences with underperformance, focusing on causes, symptoms, and recovery strategies.

RESULTS

The most frequently reported symptoms associated with underperformance included psychological (31%), physiological (23%), and health-related (12%) symptoms. Notably, female athletes were more likely to report psychological symptoms associated with underperformance (38% vs 25%, P = .01) compared with male athletes. The leading causes of underperformance comprised illness (21%), mental/emotional challenges (20%), training errors (12%), lack of recovery (10%), and nutritional challenges (5%). Female athletes reported nutritional challenges more frequently as the cause of underperformance compared with males (9% vs 1%, P = .01), whereas male athletes more often attributed underperformance to training errors (15% vs 9%, P = .03). Overall, 67% of athletes reported recovering from underperformance, with a tendency for more male than female athletes to recover (76% vs 58%, P = .07). Furthermore, a higher proportion of male than female athletes reported implementing changes in the training process as a recovery strategy (62% vs 35%, P = .02).

CONCLUSIONS

This study offers valuable insights into sex differences in experiences with underperformance in endurance athletes. The findings could inform coaches and athletes in both the prevention and treatment of such incidents.

Interdisciplinary practice in performance sport: A scoping review of evidence of collaboration

Performance support teams are increasingly comprised of sub-disciplines, bringing varied expertise to support an athlete or team in achieving the desired result. With more voices in the room, however, there is a need to investigate how these individuals can effectively work together collaboratively. Accordingly, the present study reviewed empirical articles that have examined interdisciplinary practice in performance sport. In total, 22 articles met the full inclusion criteria. We discuss the four key themes that emerged from the literature linked to these contexts: namely, Theoretical frameworks, Facilitative leadership and culture, Organisational and logistical structure and processes, and Personal and interpersonal qualities. To deepen the understanding in this intricate field, conducting future research such as longitudinal studies that follow team working practices over time and delve into the lived experiences of teams, as well as the perspectives of various stakeholders, would be beneficial.

The Psychology of Athletic Tapering in Sport: A Scoping Review

Taper is a common training strategy used to reduce fatigue and enhance athletic performance. However, currently, no review has summarised what psychological research has been conducted examining taper, what this research shows and what future research needs to be undertaken to extend the field. Consequently, a scoping review was conducted with three aims: (a) to determine the characteristics of psychological research examining taper, (b) to summarise psychological research collected during taper with adult athletes and coaches, and (c) to identify gaps in psychological research examining taper. Forty-eight articles were identified following an exhaustive search strategy and charted following scoping review guidelines. Results showed most research was quantitative, used a longitudinal design, was conducted in swimming, triathlon, cycling or across multiple sports, and used a university-, regional- or national-level male athlete sample. Eight themes were developed to summarise the research: Mood, Perception of Effort, Perceived Fatigue and Wellness, Recovery-Stress, Taper as a Stressor, Stress Tolerance, Psychological Preparation and Cognitive Functioning. Additionally, four research recommendations were identified: (a) conducting exploratory research that examines the impact taper has on athletes' and coaches' competition preparation and stress experience, (b) asking more advanced psychological questions and conducting multi-disciplinary research, (c) including a more diverse participant sample in studies and (d) examining the impact of psychological interventions during taper. Overall, this scoping review has highlighted the limited research examining the psychology of taper and the need for focused research that asks more complex questions across diverse populations.

The return from underperformance to sustainable world-class level: A case study of a male cross-country skier

Purpose: To determine the main factors associated with unexpected underperformance and prospectively describe the holistic process of returning to sustainable world-class level in a male cross-country skier. Methods: Longitudinal training data was retrospectively analyzed across nine seasons (2012-2013 to 2020-2021), and categorized into training forms (endurance, strength, and speed), intensities [low- (LIT), moderate- (MIT), and high-intensity training (HIT)], and modes (specific and non-specific). Performance data was obtained from the International Ski and Snowboard Federation. Following two seasons of unexpected underperformance (2019-2020 and 2020-2021), the participant was prospectively followed in the process of returning to sustainable world-class level (2021-2022). Day-to-day training data and physiological tests were analyzed, and interviews with the participant and the head coach conducted. Results: Longitudinal training data from 2012-2013 to 2018-2019 demonstrated a non-linear 30% increase in total training volume (from 772 to 1,002 h), mainly caused by increased volume of ski-specific endurance training without changes in intensity distribution. Coincidingly, the participant gradually reached a world-class performance level. After two seasons of unexpected underperformance with relatively similar training volumes and intensity distributions as in the preceding seasons, the possible contributing factors were identified: lack of training periodization, limited monitoring and intensity control, particularly in connection with a "extreme" regime of training with low carbohydrate availability and days including two MIT sessions, as well as lack of systematic technique training and follow-up by coaches on a daily basis. Consequently, the return to world-class level included the introduction of a clear micro-cycle periodization, more systematic physiological monitoring and testing, more accurate intensity control, increased carbohydrate intake during and between sessions, as well as increased emphasize on technique training and an assistant coach present during day-to-day training. Conclusion: These longitudinal data describe the main factors leading to unexpected underperformance, in addition to providing unique insights into the corresponding process of returning to sustainable world-class level in a male cross-country skier. The holistic approach described in this case study may serve as a theoretical framework for future studies and practical work with underperforming endurance athletes.

Relationships between Heart Rate Variability, Sleep Duration, Cortisol and Physical Training in Young Athletes

The aims of the current study were to examine the relationships between heart rate variability (HRV), salivary cortisol, sleep duration and training in young athletes. Eight athletes (16 ± 1 years) were monitored for 7 weeks during training and competition seasons. Subjects were training for endurance-based winter sports (cross-country skiing and biathlon). Training was divided into two zones (K1, easy training and K2, hard training). Heart rate and blood lactate during submaximal running tests (SRT), as well as cortisol, sleep duration and nocturnal HRV (RMSSD), were determined every other week. HRV and cortisol levels were correlated throughout the 7-week period (r = -0.552, P = 0.01), with the strongest correlation during week 7 (r = -0.879, P = 0.01). The relative changes in K1 and HRV showed a positive correlation from weeks 1-3 (r = 0.863, P = 0.006) and a negative correlation during weeks 3-5 (r = -0.760, P = 0.029). The relative change in sleep during weeks 1-3 were negatively correlated with cortisol (r = -0.762, P = 0.028) and K2 (r = -0.762, P = 0.028). In conclusion, HRV appears to reflect the recovery of young athletes during high loads of physical and/or physiological stress. Cortisol levels also reflected this recovery, but significant change required a longer period than HRV, suggesting that cortisol may be less sensitive to stress than HRV. Moreover, our results indicated that during the competition season, recovery for young endurance athletes increased in duration and additional sleep may be beneficial.

Diagnosing Overtraining Syndrome: A Scoping Review

Context:

Overtraining syndrome (OTS) is a condition characterized by a long-term performance decrement, which occurs after a persisting imbalance between training-related and nontraining-related load and recovery. Because of the lack of a gold standard diagnostic test, OTS remains a diagnosis of exclusion.

Objective:

To systematically review and map biomarkers and tools reported in the literature as potentially diagnostic for OTS.

Data Sources:

PubMed, Web of Science, and SPORTDiscus were searched from database inception to February 4, 2021, and results screened for eligibility. Backward and forward citation tracking on eligible records were used to complement results of database searching.

Study Selection:

Studies including athletes with a likely OTS diagnosis, as defined by the European College of Sport Science and the American College of Sports Medicine, and reporting at least 1 biomarker or tool potentially diagnostic for OTS were deemed eligible.

Study Design:

Scoping review following the guidelines of the Joanna Briggs Institute and PRISMA Extension for Scoping Reviews (PRISMA-ScR).

Level of Evidence:

Level 4.

Data Extraction:

Athletes’ population, criteria used to diagnose OTS, potentially diagnostic biomarkers and tools, as well as miscellaneous study characteristics were extracted.

Results:

The search yielded 5561 results, of which 39 met the eligibility criteria. Three diagnostic scores, namely the EROS-CLINICAL, EROS-SIMPLIFIED, and EROS-COMPLETE scores (EROS = Endocrine and Metabolic Responses on Overtraining Syndrome study), were identified. Additionally, basal hormone, neurotransmitter and other metabolite levels, hormonal responses to stimuli, psychological questionnaires, exercise tests, heart rate variability, electroencephalography, immunological and redox parameters, muscle structure, and body composition were reported as potentially diagnostic for OTS.

Conclusion:

Specific hormones, neurotransmitters, and metabolites, as well as psychological, electrocardiographic, electroencephalographic, and immunological patterns were identified as potentially diagnostic for OTS, reflecting its multisystemic nature. As exemplified by the EROS scores, combinations of these variables may be required to diagnose OTS. These scores must now be validated in larger samples and within female athletes.

The Factorial Validity of the Norwegian Version of the Multicomponent Training Distress Scale (MTDS-N)

BACKGROUND

Athlete self-report measures (ASRM) are methods of athlete monitoring, which have gained considerable popularity in recent years. The Multicomponent Training Distress Scale (MTDS), consisting of 22 items, is a promising self-report measure to assess training distress among athletes. The present study aimed to investigate the factorial validity of the Norwegian version of MTDS (MTDS-N) among student-athletes (n = 632) attending the optional program subject "Top-Level Sports" in upper secondary schools in Norway.

METHODS

A confirmatory factor analysis (CFA) was conducted to assess the six-factor model proposed by Main and Grove (2009). McDonald's omega (ω) along with confidence intervals (CIs) were used to estimate scale reliability. After examining the fit of the CFA model in the total sample, covariates were included to investigate group differences in latent variables of MTDS-N, resulting in the multiple indicators multiple causes (MIMIC) model. Further, direct paths between the covariates and the factor indicators were included in an extended MIMIC model to investigate whether responses to items differed between groups, resulting in differential item functioning (DIF).

RESULTS

When modification indices (MIs) were taken into consideration, the alternative CFA model revealed that MTDS-N is an acceptable psychometric tool with a good fit index. The factors in MTDS-N all constituted high scale reliability with McDonald's ω ranging from 0.725-0.862. The results indicated statistically significant group differences in factor scores for gender, type of sport, hours of training per week, school program, and school level. Further, results showed that DIF occurred in 13 of the MTDS-N items. The student-athletes' reports of training distress were moderate.

CONCLUSION

The MTDS-N may be suitable for use in a Norwegian population to assess student-athletes' training distress in a reliable manner. The indications of group effects suggest that caution should be used if one is interested in making group comparisons when the MTDS-N is used among student-athletes in Norway until further research is conducted.

The Multidisciplinary Process Leading to Return From Underperformance and Sustainable Success in the World's Best Cross-Country Skier

PURPOSE

To investigate the factors associated with underperformance and the subsequent changes in training characteristics and supportive actions when returning to the world's best cross-country skier.

METHODS

The participant is the most decorated winter Olympian, with 8 Olympic gold medals, 18 World Championship titles, and 114 World Cup victories. Training data were categorized by training form (endurance, strength, and speed); intensity (low, moderate, and high); and mode (running, cycling, and skiing/roller skiing). In addition, test data were retrospectively analyzed, and interviews were performed with the participant and her support team.

RESULTS

After the competitive season, the participant had 8 weeks without systematic training and an evaluation process aiming to detect the factors contributing to underperformance. Here physiological, technical, and psychological challenges were detected. As a consequence, the participant included less high-intensity training (1.2 vs 2.1 sessions/wk, P = .011); more moderate-intensity training (0.9 vs 0.4 sessions/wk, P = .016); and more low-intensity training (6.9 vs 5.9 sessions/wk, P = .036) during the general preparation phase but with similar total endurance training load as previous season. In addition, more strength training (1.6 vs 1.1 h/wk, P = .036) and new ski-specific strength exercises were included. Finally, the athlete's autonomy when planning and adjusting training was increased, nontraining stressors were reduced, more frequent testing was included, systematic mental training was initiated, her nutritional strategy was adjusted, and her asthma treatment was optimized.

CONCLUSIONS

Overall, the current case study could be used as a framework for the holistic approach to treating an overtraining condition and for generation of new hypothesis in this exiting area.

Strategies for Maintaining the Coach-Analyst Relationship Within Professional Football Utilizing the COMPASS Model: The Performance Analyst's Perspective

There is a considerable body of research by that has investigated the coach–athlete relationship in sport. However, given the multi-disciplinary nature of modern elite coaching, there is a scarcity of research focusing on the relationship between coaches and other members of the coaching and support team. This study examined the perceptions of six elite professional football analyst’s relationships with their respective coaches. Semi structured interviews utilizing the COMPASS Framework were conducted focusing on Conflict, Openness, Motivation, Preventative Strategies, Assurance, Support, and Social Networks. The results verified that the COMPASS Model of relationship maintenance was applicable to this dyad. Content analysis indicated that there was 215 raw data units comprising of 16 higher order themes across the model which was further broken down into 29 lower order themes. All aspects of the model were found to contribute toward a positively maintained relationship. Having an open relationship underpinned by honesty and being able to provide an opinion was seen as the highest rated attribute that was closely followed by supporting the coach by understanding their requirements for successful coaching practice. Not meeting the coach’s expectations was found to cause conflict and was further highlighted by an inductive analysis that revealed the existence of a relationship that is fundamentally dictated by the coach. Implications of this investigation are that professionals which support elite performers need to set out clear expectations of working practice and hierarchies in order to minimize the chance of internal conflict that can impact on the service levels received by the performer.

Verbal Encouragement and Between-Day Reliability During High-Intensity Functional Strength and Endurance Performance Testing

As verbal encouragement (VE) is used in high intensity functional exercise testing, this randomized controlled crossover study aimed at investigating whether VE affects high intensity functional strength and endurance performance testing. We further examined between-day variability of high intensity functional strength and endurance performance testing with and without VE. Nineteen experienced athletes (seven females and 12 males, age: 23.7 ± 4.3 years) performed a standardized one repetition maximum (1 RM) squat test and a 12-min high-intensity functional training (HIFT) workout [as many repetitions as possible (AMRAP)] on four different days over a 2-week period. Athletes randomly performed each test twice, either with VE or without (CON), with a minimum of 72 h rest between tests. Very good to excellent relative between-day reliability with slightly better values for strength testing (ICC: 0.99; CV: 3.5–4.1%) compared to endurance testing (ICC 0.87–0.95; CV: 3.9–7.3%) were observed. Interestingly, VE led to higher reliability during endurance testing. Mean squat strength depicted higher strength values with VE (107 ± 33 kg) compared to CON (105 ± 33 kg; p = 0.009, Cohen’s d: 0.06). AMRAP in the endurance test showed negligible differences between VE (182 ± 33 AMRAP) and CON (181 ± 35 AMRAP; p = 0.71, Cohen’s d: 0.03). In conclusion, the effects of VE do not notably exceed day-to-day variability during high intensity functional strength (CV: 3.5–4.1%) and endurance (CV: 3.9–7.3%) testing. However, high intensity functional strength and endurance testing with VE seems to be slightly more reliable, particularly during endurance testing.

Factors that influence fatigue status in Canadian university swimmers

The overall purpose of this two-part study was to examine factors that influenced fatigue status in university level swimmers. Participants were 25 swimmers (14 male, 11 female) from one university swim team. A mixed methods approach was used. Quantitative data were collected using an orthostatic heart rate test and self-report questionnaire at multiple time points throughout a competitive season. Qualitative data were collected via focus groups conducted at the end of the season. Analysis of the quantitative data indicated high levels of accumulated physiological and psychological fatigue that improved with increased recovery. Specifically, heart rate indices, form, feeling, and energy level improved during taper periods and worsened during and immediately after intensive training blocks. Analysis of the qualitative data revealed that one factor (flexible structure of training programme) had a positive influence on athletes' fatigue while two factors (teammate expectations and balancing school, work, and sleep) had a negative influence on athletes' fatigue.

Overtraining syndrome: a practical guide

CONTEXT

Fatigue and underperformance are common in athletes. Understanding overtraining syndrome (OTS) is helpful in the evaluation, management, and education of athletes.

EVIDENCE ACQUISITION

Relevant articles in English were searched with OVID (1948-2011) and PubMed using the following keywords: overtraining syndrome, overtraining, overreaching, unexplained underperformance, staleness, pathophysiology, management, treatment, evaluation. Bibliographies were reviewed for additional resources.

RESULTS

OTS appears to be a maladapted response to excessive exercise without adequate rest, resulting in perturbations of multiple body systems (neurologic, endocrinologic, immunologic) coupled with mood changes. Many hypotheses of OTS pathogenesis are reviewed, and a clinical approach to athletes with possible OTS (including history, testing, and prevention) is presented.

CONCLUSIONS

OTS remains a clinical diagnosis with arbitrary definitions per the European College of Sports Science's position statement. History and, in most situations, limited serologies are helpful. However, much remains to be learned given that most past research has been on athletes with overreaching rather than OTS.

Perceived tiredness and heart rate variability in relation to overload during a field hockey World Cup

The aim of the study was to examine the utility of perceived tiredness to predict cardiac autonomic response to overload among field hockey players during the 2006 World Cup. The French Society for Sports Medicine (SFMS) questionnaire was administered at the start of the Cup to evaluate perception of tiredness. Autonomic function was assessed nine days later at the semifinal match by time and frequency domain analysis of heart rate variability. An anxiety questionnaire was administered so that the effect of precompetitive anxiety on heart rate variability could be controlled. Results showed a negative correlation between perceived tiredness scores and time domain indexes, and a positive correlation of perceived tiredness scores and the high frequency component ratio (LF/HF ratio) of heart rate variability. Anxiety did not influence the precompetitive cardiac response despite somatic anxiety's correlation with sympathetic response (LF/HF ratio) and tiredness scores. Perceived tiredness predicted the autonomic cardiac response to competitive overload. Thus, the perceived tiredness assessment would be a good early marker of fatigue and overload states during competition.