High Performance programmes: are we putting the cart before the horse

Support programmes with the adage, ‘high performance’ are proliferating sport at all levels and targeted at a range of ages, some as young as eight if we consider academies attached to professional football clubs.  We see universities, schools, colleges, professional clubs and national governing bodies advertise roles for those with experience in high performance environments; what is less clear is whether these roles require those who occupy them to display high performance behaviours or whether the requirement relates to the athletes they will support.  It is worth discussing the relative merits and problems associated with high performance programmes for young athletes, particularly those under the age of 16.

Are we guilty of developing high performance programmes before appropriate athletes have been identified as warranting this level of support and coaching?  In some cases I think the answer to this question is yes, which results in coaches and practitioners charged with delivering performance outcomes with a group of athletes ill equipped to meet the demands, either as a result of commitment, technical proficiency or in some cases, both.  When this situation arises we may hear coaches and administrators admonish athletes, suggesting they don’t ‘deserve’ the support they have been given.  This begs the question; did they ask for or want the support in the first place?  I would suggest that enjoyment, in whatever guise that takes, is the single most important factor in ensuring young athletes remain active within their sport long enough to develop the skills required to compete at the highest level.  Introducing programmes that are overly structured and demanding before the athlete has developed an intrinsic love of the activity may begin to erode their desire to continue to practice and improve.  Unfortunately, structure and an almost formulaic approach are often hallmarks of high performance programmes and so called development pathways.  To use an example from my own discipline, few young footballers take up the game to improve their ‘movement competency’ however academies invest significant amounts of time trying to improve this quality and wonder why young players would rather ‘get the ball out’.  I am particularly concerned when I hear people take about the requirement to ‘earn the right to progress’ when we discuss the topic of athleticism; a stumbling block here surrounds the motivation levels of the player to improve in an activity they may not particularly enjoy.

Each year sporting organisations invest hundreds if not thousands of pounds in high performance programmes without athletes of a sufficient level to benefit from the support being offered.  Perhaps a new approach to the development of these programmes is required.  Firstly, there needs to be a group of athletes who can challenge each other.  These need not necessarily be the best of the best, rather individuals who, as we have discussed earlier, possess a deep rooted love of the activity and as such are willing to invest significant amounts of their time in both organised and self-guided practice.  There is a saying that suggests, choose a job you love and you will never have to work a day in your life (Confucius): no more so than in sport is this the case.  Without these vital ingredients I would suggest that any programme designed with the aim of achieving high performance are likely to fail, not least because the outcome will be more important to support staff than the athletes it has been established to serve.  Secondly, those responsible for providing support to the athletes need to be immersed in the sport, understanding the technical, tactical and physical demands that competition entails.  This cannot be learnt quickly and requires practitioners to combine formal qualifications with practical coaching skills in the sports that most interest them.  We cannot expect to make small yet meaningful changes to a discipline or sport in which you know only the broad outline.

The best way to produce athletes with the potential to win on the world stage is to get as many young people interested and regularly participating as possible.  This doesn’t require support systems it requires space, enthusiastic coaches and a challenging yet supportive environment (I should probably add willing and committed parents).  This should be the first priority for all sports.  Once this has been established it may be that a group of young athletes show sufficient promise that extra support and/or opportunities to practice seem warranted.  This potential is not assessed over a couple of weeks but over an extended period of time having witnessed their continued commitment to get better and enjoyment in doing so.  It is at this point that selecting the right individuals is key, a high performance programme by its very nature will be exclusive and include only a small number of people.  This is perhaps where programmes falter, as selection processes are not robust enough to withstand the interrogation from disgruntled parents and guardians who feel their children should have been selected.  High performance programmes are for those who are committed, as we discussed earlier we should have established these systems first, it is for those who are committed and show a propensity for outstanding achievement.  With this approach and small numbers a truly bespoke programme can be developed without the distraction of individuals who, for whatever reason, are not as committed (or talented).  This is perhaps a notion that doesn’t sit well with some organisations especially where public money is used to fund them, however if we really want to pursue high performance we need programmes that are exclusive and clear on what they expect and require of the athletes they select.  We should be immediately concerned if we hear of a performance programme laud how many athletes it has recruited; quality over quantity unless we are relying on probability and weight of numbers to create the next world champion, something countries with a small populations can ill afford.

For a sport with few options in terms of athletes who have the potential to succeed on the national, commonwealth or world stage resources may be better channeled into recreational, grass roots and participation initiatives.  This priority may expand over time to reflect a changing demographic and potential for success as a critical mass of those practicing and competing regularly is established.  This approach also ensures that sports only earmark resources for high performance programmes in instances when they have the personnel to pursue this goal with vigor.  A counterargument to this point is that without a high performance programme, or international competition schedule young athletes will be deterred from taking up the sport.  Whilst this seems plausible I am yet to see reliable evidence that it is true.  What is more likely to deter young athletes and their parents is a sport preoccupied with supporting athletes ill equipped to achieve the objectives set out for them whilst they nurse along a development system that is under funded and under valued.

The 2015 World Congress on Science and Football (WCSF)

Below are a collection of thoughts and, what I hope will prove, useful applied suggestions surrounding presentations made at the WCSF 2015 in Copenhagen.  The programme was too broad to comment on each session however what I have chosen below represents, for me, some of the highlights and contemporary issues.

Injury – based on sessions delivered by:

• ·      Jan Ekstrand, Injuries in top class football – coaches are more important than doctors?
• ·      Aaron Coutts, Training and performance characteristics of professional AFL players
• ·      Laura Bowen, Accumulated work loads and injury risk in elite youth football players using GPS technology

As might be expected, injury and reducing injury rates, was a popular topic.  It was suggested that the cost of one player being injured for a month at the top level was approximately €600,000.00, a cost much higher than robust and rigorous injury reduction programmes. Suggested strategies to reduce injury incidence can be distilled into three areas, the first may come as a surprise.

Communication - through a survey of practitioners working in football environments the most important component of injury reduction was clear and effective communication.  This, at first glance, may seem like common sense however facilitating effective communication is a problem facing many organisations both small and large; ironic given the proliferation of technologies designed to help us keep in touch. No easy answers to this problem other than a commitment by support staff to integrate with the coaching team and find ways of communicating in an effective manner.  We will pick up the issue of communication a little later when we look at recommendations for monitoring however perhaps the interpersonal skills associated with this area of the job are undervalued on many undergraduate and postgraduate courses.

Changing personnel and priorities – a bit of information that all fitness coaches will want to take note of; there is an increase in injuries when the fitness coach is changed during the season.  That should keep at least some of us in a job if we make it past July!  A similar, but less pronounced relationship was seen for coaches.  It was clear that when assessing player availability some coaches are more successful than others at developing a culture that keeps players ‘on the pitch’ (data taken from a champions league club over the past 14 years).  My interpretation of this is that although some coaches (fitness and technical) are better than others, none purposely design training to invoke injury.  More likely, some are better at assessing what is appropriate for the players they are responsible for.  In the same way that a teams technical ability will dictate how they intend to play, their physical prowess, injury history and training history will dictate what type (and how often it is administered) of training is most appropriate. 

We all like routine, and many of the popular periodisation models proffered today suggest a fairly standard approach to recovery and training.  Coaches and fitness coaches must recognise that it takes time and likely small incremental steps if the aim is to significantly increase training load.  This, in an ideal world would be done during the pre-season.  Periodisation could be described as the planned and progressive prescription of training; there is no greater necessity for heeding this advice as when changing a routine players have become used to.

Training – the first point to make is explicitly linked to the two above.  Where possible, avoid spikes in training volumes; weeks (and perhaps days) that are significantly different from the normal routine.  If you want to increase the external load, this must be done gradually and in a planned manner.  The issue is not that players cannot handle higher loads – more that they need time to adapt and develop a tolerance to the new stimulus. 

Strength is a commonly cited attribute necessary for success in all football codes.  There was a strong theme at the conference that eccentric training was often overlooked yet was critical in reducing injury rates, particularly around the hip, groin and hamstrings.  Undoubtedly, exercises that stress the muscles in this way are necessary however scheduling their use during the in-season may be difficult, requiring careful consideration of loads and the cost-risk ratio of their introduction.

Laura Bowen of Southampton FC presented an interesting method for the quantification of training load.  Laura suggested that training load could be quantified as a percentage of the individuals match load, with, as I understood it, higher percentages of match load in training linked to injury.  This would seem like a novel and useful way of dealing with the application of load throughout the year.  Some questions associated with this approach;

• ·      How many matches should be used to infer ‘average’ demand and is it the average or most intense match load that should be used as the criterion measure?
• ·      How many false positives does this method yield?  For example, how many players are at risk of injury (according to their external load) but remain available for selection and are these same players the ones that progress to the first team?

In my experience of working with young professional players and in the absence of GPS data, if playing load exceeds 25% of the training load injury rates appear to increase.  Of course we can remedy this by playing the same number of games yet training more.  A more conservative approach to playing load prescription in young players is, I think, what is needed especially when they are eligible for selection in multiple squads.

A key message was that too little training could be as risky as too much, perhaps debunking the current preoccupation with recovery, time off feet and less is more.  There are likely individual variations in how players respond to the same external load however Aaron Coutts suggested the presence of a ‘goldilocks zone’ in terms of prescribed training that would allow adaptation to occur, prepare players for competition whilst limiting fatigue.  The take home message here along with some of the work being published from Australian Rugby League would seem to be don’t wrap the players in cotton wool.

Training, testing and monitoring – based on three sessions by:

• ·      Barry Drust, fitness training and testing of the top player
• ·      Aaron Coutts, Training and performance characteristics of professional AFL players
• ·      Robin Thorpe, Reliability of a range of fatigue variables in elite soccer players
• ·      Jens Bangsbo, training and testing in football
• ·      Tim Meyer, monitoring of stress and fatigue in football

Training

The key message in the training of top level players is that the stimulus and load must be individualised wherever possible and that in order to achieve this training time must be used effectively.  Additionally, there is a growing body of evidence that high intensity, anaerobic type efforts may be a useful and time effective modality for increasing soccer specific fitness.  A note of caution; data presented by Barry Drust showed an increase in the HR response with the addition of multiple 180 degree turns during shuttle running; not to mention the increased mechanical load associate with multiple accelerations and decelerations.

Sport scientists have a crucial role to play in the prescription and content of training however they must first understand implicitly what the coach is trying to achieve and what he wants his players to be able to do on the pitch.  This is often not an easy task and emphasises the importance, as discussed earlier, of clear and effective communication links.  Ask the question ‘what does the player need to do?’ rather than ‘what should they be able to do?’

Testing

The need to assess physical capacity was an area of debate with proponents and detractors.  Some of the key points focused on the following areas which sport scientists may want to consider when deciding if and when to test their players.

• ·      Is the assessment reliable and able to elucidate changes in performance (more of this in the section on monitoring).
• ·      Scheduling of tests and whether all players need to included.  For example is it only those with a low playing time or returning from injury.
• ·      Sub-maximal assessments and variations of the YoYo were suggested as being a useful addition to the assessment process.
• ·      If the assessment is maximal in nature, are the players giving a maximal effort and if not how does this affect the usefulness of the results?
• ·      If we don’t test how can we assess the effectiveness of our interventions?

Point four is perhaps the most important in that the fitness (or otherwise) of teams is not explicitly linked to performance if we consider the only outcome measure of note; winning or losing.

Monitoring

Monitoring of training load and the response of players to the stresses imposed on them is commonplace in football and there are a range of apps and technologies designed to help the practitioner deal with this type of large data set.  Given the time required to collect and analyse this data is it an effective use of practitioners time and resources?

Firstly, as with training, each player will respond to the stimulus and recover in an individual manner.  As such we need time to understand the requirements of each member of the squad and to be able to draw meaningful conclusions from the data.  For many applied practitioners time is not something they have a lot of and rely to a greater extent on intuition and experience.  This maybe unscientific however represents a vital component of the skill set required to work in sport; the ability to blend experience and evidence based practice.

Secondly, any measure you use must be reliable.  Robin Thorpe of Manchester United presented some interesting data on the reliability of a range of variables associated with assessing player wellness and readiness to train.  Subjective responses to training and wellness along with the CMJ were both deemed useful in the accurate assessment of recover however salivary IgA was not, or at least not in the sample sizes found in football clubs.  Aaron Coutts suggested that in his experience RPE was the most useful tool in tracking session intensity.  Perhaps we are coming full circle and swapping our laptops for the more traditional pen and paper.

Thirdly, and in this instance we find ourselves referring back to the first point concerning communication.  If we are going to ask players to fill in questionnaires each morning we have to be sure that we are able to use that information to inform the content of training sessions.  If players feel that their responses are no more than a sample set for the next research project they are unlikely to approach the task with any degree of accuracy or consideration.  This may have been the case in one data set presented where only poor correlations were found between physical performance and measures of ‘readiness to train’  (Jack Dowling presented some interesting data in this area).  Sport science should not be a checklist of practices that you utilise to satisfy the requirements of others.  Rather it is the knowledge of a range of practices and the ability to select and utilise the most appropriate to achieve the desired effect for the team you are working with.  It isn’t making a difference then don’t be afraid to try something else in its place.  Time in sport, at least at the top level, is something few of us will experience so use what you have effectively.

Research in high performance sport - a question of logistics not ethics

Finding good quality research that is of value to enhancing performance in sport is difficult, especially if we look for ecologically valid studies where participants are assembled from an elite group of athletes.  This poses a problem for applied practitioners who want to, as best they can, adopt an evidence based approach to their work.  In the relative absence of such data we find ourselves using research that is within the chosen area of interest however conducted with participants below the standard of athlete with whom we are working.  A common reason cited for the lack of scientific investigation within elite groups is an ethical one; exposing only half of the athletes to a potentially beneficial type of training or intervention may be deemed as unfair.  This of course is a significant deviation from what we consider to be a central tenet of sound scientific investigation, proving the null hypothesis to be true.

Whenever we are interested in the effect of a new treatment (for the purposes of this blog treatment encompasses a new training intervention/modality, nutritional aid or piece of equipment) we should start with the premise that it will be no better than what we currently have access to, representing the null hypothesis.  The aim of the investigation then is to prove this to be true.  Taking this approach turns the ethical question cited above on its head, as it infers no benefit of the new treatment.  If sufficient amounts of data are collected to disprove the null hypothesis then we conclude the alternative hypothesis to be true and can with confidence begin to prescribe the new treatment.  An example may serve to clarify this point.  We would all now accept that training with a reasonable level of volume and intensity is essential if we want to improve our VO2 max or lactate threshold.  This is the result of both anecdotal experience and scientific investigation revealing relatively high volumes of training to be effective in improving these variables.  Recent research however has suggested that intense yet brief efforts, equivalent of 2 minutes duration (4x30s efforts) may elicit similar responses.  This is an exciting finding, especially for those who have limited time to train.  As yet however there is insufficient evidence in elite level athletes to suggest that the null hypothesis (in this instance that brief high intensity training alone is better than high volume training) to be rejected.  As we do not yet know the potential benefits of this type of HIT training in athletes, withholding its use as part of a randomized control trial so that it can be compared to more traditional types of training should not be problematic.

We see similar problems in medical research investigating the effectiveness of drugs.  Ben Goldacre’s recent book ‘Bad Pharma’ highlights the problem with prescription medicines that have yet to be shown more effective than currently available remedies.  Some argue this in unfair as patients are being denied access to drugs that will potentially cure or alleviate their symptoms.  This however, as with our example from sport and exercise is not the case; since there is no evidence that the new drug is more effective patients are no worse off.

Adopting an evidence based approach to sport science provision is difficult, not least because of the dearth of data compiled and collected within this heterogeneous group.  Performing research within elite groups however should not pose an ethical conundrum to the practitioner, instead it represents an opportunity to understand with greater clarity the effect of different and perhaps more effective treatments.  Yes of course there are logistical considerations; however with sound planning and organisation these can be overcome as can the issue of timeframe and competitive advantage.  Institutes and professional teams may not want to publish their data whilst opponents can gain a competitive advantage.  This is understandable however building in a ‘publication threshold’ may solve the problem.  For commonwealth and Olympic sports this may be at the end of the training cycle (every 4 years).  If sport science is to continue as a ‘science’ it must extend the same rigor that exists in academic circles to the applied environment and commit to examining the effectiveness of each type of treatment it adopts to impact upon performance.

So where does this leave us when attempting to innovate within sport science?  Firstly all parties who engage in the physical and mental preparation of elite athletes should commit to performing and publishing research.  In doing this we can start to understand how different treatments work amongst this specific group of people.  We should also feel comfortable with utilising control groups when working with elite athletes enabling the assessment of new treatments against what is currently available or being used.  This approach should ensure we feel comfortable in the veracity of our practices whilst not falling foul of the many gadgets and fads marketed at giving our athletes the ‘edge’ they desire.

Understanding 'impact' in sport and exercise.

Every year students approaching the end of their sport and exercise science degree sit down to a general exam.  This is an examination that requires students to assimilate the information they have learnt over their 3 year degree (or 4 for students in Scotland) and identify its usefulness and applicability within an applied setting.  This seems to be a task that many students struggle with; describing what they have learnt is familiar territory however the necessity to put this information to use in a practical setting is clearly not.  The fact that students struggle with this skill however should not be surprising; many sport scientists are caught in the vicious cycle of collecting data for data’s sake with no real avenue for this information to be utilised by the coach.  More worryingly however is that unless we provide students with the sort of modules that teach these skills, should the opportunity arise to utilise the data they have collected, will they know what to do?

In a recent conversation with a friend who works in the finance world he told me that when researching a new investment opportunity there really is no limit to the amount of information you can gather in order to fully understand the sector.  The trick of course (unless 100 hour working weeks are what you aspire to) is to know when you have enough information to make an informed decision.  The same is true in sport (and exercise) science.  Given recent advances in technology there are now very few physiological markers which cannot be tracked on an almost daily basis; these include metres covered via GPS, training heart rate, resting heart rate, heart rate variability, subjective responses, markers of neuromuscular fatigue and haematological markers.  What is worth remembering however is that it is not the numbers per se that are important, rather, their ability to enable us to make informed and accurate decisions about how athletes are responding to the training load and how their program should look moving forward.  This is the ‘application’ that so many students (and possibly practitioners struggle with).

So how do we redress this balance?  Firstly we need to move away from the current silo approach that separates the composite disciplines of sport and exercise science, a move that has already been made by BASES in the accreditation of its practitioners as sport and exercise scientists.  Students must understand how these disciplines interact and the capacity they have when utilised in unison to enhance the provision of support services to athletic groups.  Take for example the physiologist who undertakes an assessment with an athlete; how this information is reported can have as big an impact as the numbers themselves (probably more so) which requires an understanding of the client’s psychology and how they respond to this kind of information.  Thought should also be given to how best to communicate the findings to the coach.  This is in addition to considering aspects such as accuracy, real change and equipment reliability.  Conversely the psychologist must understand that no amount of mental skills training will enhance performance if the requisite physical qualities have not been developed to a sufficient standard.  Perhaps asking students to identify practical uses for the information presented to them would help, in addition to developing skills in producing coach and athlete focused synopsis’ for recent and relevant research articles. 

Clearly this is a complicated skill set and one which has to be developed over time through exposure to different situations, sports and client groups coupled with a commitment to reflective practise.  It is also something that practitioners will learn to a large extent ‘on the job’, a positive consequence of the proliferation of internships within the industry over recent years.  To accelerate this learning curve however University courses should develop modules that encourage students to identify the practical implications of any data they collect and how best the key messages might be delivered in d within different scenarios.  This is likely to be a difficult challenge however if the UK are to continue to excel on the world’ sporting stages it is paramount that each new generation of practitioners learn to work as ‘applied practitioners’ as early as possible in their careers.