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Injury Prevention

What Is Performance Therapy?


What Is Performance Therapy?

Our post this week comes from West London Track and Field Performance Therapist Gareth Degg. Gareth achieved a master of osteopathy degree from the British School of Osteopathy and also has a keen interest in biomechanics and human function. Gareth is trackside on a weekly basis and works with the other therapists and coaches to ensure athlete movement is optimal.

Performance therapy team in action at Lee Valley earlier this year

Performance therapy team in action at Lee Valley earlier this year

As competition season has sprung into action, the role of a therapist will be as equally important as the off-season time. The role of a Performance Therapist is a position that has become more noticed and more popular over the last 5 years. Especially considering the work done at Altis and British Athletics who employ therapists from a number of different professions as performance therapists. People have different views about the responsibilities of performance therapy and the pros and cons of the whole process, but I will only give my opinion in this short article about performance therapy and then more specific competition therapy.

What is Performance Therapy?

The initial role of a therapist, whether that is an Osteopath like myself or any other profession, is to consider the health of the patient. In that respect the role is no different than if you are in a clinic and a member of the general public walks in and seeks treatment for an ailment.

In a sports setting the chances of seeing injuries are quite high and these are what we spend a large portion of our time dealing with, whether that be a hamstring issue or a shoulder complaint for example.

However, everything previously mentioned is what happens in a normal clinic setting and the question of where does ‘performance’ come into the role arises. I feel that Performance Therapy is where you go beyond injury and pain as your measuring tool for success. The responsibility has to shift to you having an appreciation and understanding of the function and movements required in the athletes’ event and knowing what should be happening and what should not. Then you may choose to make a therapy intervention to improve a movement pattern or action, which then theoretically leads to an improvement in performance.

This is why a performance therapist needs to be present at training, competitions and forge a good open relationship with both athlete and coach. All three elements need to be communicating and be on the same page with the same goals in mind.

Head sprints and hurdles coach Laura Turner-Alleyne with Altis head coach Dan Pfaff in Phoenix

Head sprints and hurdles coach Laura Turner-Alleyne with Altis head coach Dan Pfaff in Phoenix

Competition Therapy

On the day of competition it is my belief that the therapy team play a different role to normal training days. On normal training days often the therapy team will spend most of their time with athletes that are either recovering from injury or have some specific issues that need attention. Competition day is all about the athletes that are competing on that day and this is all about maximizing an athlete’s performance; performance therapy in its truest form.

What happens on competition day?

By the time an athlete gets to competition they should be free of injury and fit enough to compete first and foremost. So the focus then is aimed at maximizing their body to its potential. A basic outlook of a competition day for a therapist will be as follows:

-          Set-up and make your athletes and coaches know where you are

-          Find out what time your athletes are competing and what time their call room is.

-          Find out what time athletes plan to start warm-up

-          Plan what athletes you want to assess prior to warm-up

-          Watch warm-up and drills where possible

-          Therapy intervention where indicated

-          Repeat throughout the competition

How is competition different from training?

The stress of competition will affect each athlete differently and sometimes this can become an issue. Due to stress or performance anxiety the athletes mind can play tricks on them and they can present all kinds of symptoms or potential injuries that are often perfectly fine. In this situation your role is to reassure the athlete and give them the confidence to compete.

On the flip side you may have an athlete that is too aroused for the competition and they are “bouncing of the walls” and it may be your responsibility to bring them back down a little before they mentally fatigue themselves before competition.

How much therapy work should be done on competition day?

Simply put, it depends.

There are a few things to consider on the day:

Time – There may only be a 5-minute window during an athlete’s warm-up for a short intervention. It has to be meaningful.

Individual athlete – Some athletes require more attention than others from both a biomechanical point of view and an emotional one.

Goal/aim – Athletes are preparing to compete so the interventions have to be geared towards the end goal.

Our performance therapy team are trackside on a weekly basis

Our performance therapy team are trackside on a weekly basis

Things that I avoid on competition day

Again, this is only my personal opinion and other therapists may do things differently, but there are a number of things I try not to do prior to competing:

Treatment Time – I believe on competition day that therapy interventions should be short, concise and outcome driven. If an athlete is requiring masses of treatment before they are about to compete then the question needs to be asked, “Are they fit enough to compete?”

Treatment type – I personally do little to no massage style soft tissue work prior to competing. I will do soft tissue release work often on the day, but this will not be in the form of the long stroke massage techniques as I feel this will not optimise the muscle for what we are about to ask it to do. Simply put, a massage helps to relax the muscles, creates a parasympathetic response in the body and often gives the body a feeling of rest. This is great post competition to aide recovery and regeneration.

Prior to competition the body needs to be alert, aware, activated and primed for what is about to happen.

That is a brief overview of my feelings towards competition-based therapy. The key point that I need to reinforce is that most importantly you have to have both a sound understanding of the athlete and their chosen event in order to make good choices when deciding whether a therapy intervention is needed and what to do.



Challenges For Developing Athletes

Whilst away on warm weather training in Barcelona, we took the time to sit down with Commonwealth Games silver medallist Laura Edwards and ask her a few questions about what she thinks makes an elite level athlete.

Hi Laura, thanks for talking with us today. Firstly, what do you think athletes can do to engage with their coach more and what are your views on communication between athlete and coach?

I think in order for an athlete to engage with their coach they need to be willing to give more than what is expected of them. As an athlete you need to ensure you are focused during sessions and taking on board what the coach is telling you. Turning up unprepared or late can also show the coach you aren't organised or ready to work hard. You have to be accountable for what you are doing. Asking questions if you don't understand can also show the coach you want to learn and progress. This can all help you as an athlete show the coach you are serious about being an athlete and willing to commit to working hard. I also do think a good coach-athlete relationship is extremely important and can significantly impact an athlete’s performance. Athletes should be confident in their coach and having good communication between the two is key to it I think. Having a mutual trust and respect for each other can be so important and I think without that it can be difficult for an athlete to reach their full potential.

What do you think is important for athletes to consider when responding to feedback?

I think athletes need to understand that the feedback their coaches are giving them is to help improve their performance. It is beneficial to their growth as an athlete. When your coach gives you feedback you should acknowledge it as a challenge and a learning opportunity. You also have to make sure you act on what they are saying. I think you need to consider the fact that they aren't telling you something for you to just accept it and move on. As an athlete you need to do something with that feedback by being able to make the necessary changes in order to enhance your performance. It's also important to not take their feedback negatively as you have to consider that they are trying to make you into the best athlete you can be and they only want the best for you. By listening, accepting and acting on feedback athletes can learn from their mistakes and use it to better themselves.

Gymnastics, like pole vault, is an individual sport where athletes train in groups. Do you think it’s important for athletes to be their own person and be an individual whilst appreciating the support of the group?

Yes definitely. Participating in an individual sport means as an athlete you need to take ownership of your career. You need to take responsibility for performances and seeking ways to improve during both training/ competitions as well as your lifestyle. At the same time, I believe having great support from your team mates is second to none and vital in your success as an athlete. Having good teammates around you can help you become a better athlete as you can all work together bettering each other and creating a great environment to train in. It helps everyone as you are all pushing towards similar goals and understand what each other is going through.

Given the high performance environments that you’ve trained in, do you see a difference between what high level athletes are posting on social media and what they’re doing behind closed doors when training?

Yes 100%.  I guess everything isn't always as perfect as it seems on social media. It's nice that social media allows more experienced athletes to broadcast aspects of their training to younger/ less experienced athletes. However, I think people just need to be aware it is only aspects and they don't show absolutely everything. Behind closed doors can be very different to what is actually shown. They may go through a lot and will only tend to post the positive or more exciting parts of what is going on. Basically, what you see on social media isn't everything there is to the life of a world class athlete.

What do you think separates those that go on to perform at an elite level and those that don’t make it and is it always the most physically talented athletes that go on to perform at elite level?

In my experiences within gymnastics there was often the physically naturally talented athletes winning at a younger age however, it was often the gymnasts who were always around but never quite there working hard, never giving up who came out on top. They weren't necessarily the most naturally talented to start with but from their committed, hardworking approach and mind set they eventually got to where they wanted to be. I think the athletes that perform at an elite level are very motivated and committed. They don't give up when things get hard, instead they use their failures to fuel them to do better and succeed. I think having the self-determination and mental toughness is a key factor to reaching a high level in sports. Training long hours and dedicating yourself to a sport can sometimes be draining and extremely tough at times but making it through those tough times is what makes achieving so great, especially in sports like gymnastics and pole vault. If it was easy, it would be boring. So, I think what separates those that make it to an elite level is the desire and passion they have to consistently work hard by doing what others aren't willing to do.

Thank you for taking the time to talk to us today Laura and all the best with the upcoming season!