EIS Medical Support for Modern Pentathlon

The English Institue of Sport (EIS) provides all of its services on a regional basis. Nominated WCP athletes can access Sports Medicine and Physiotherapy advice at any of the regional centres.

The EIS Sports Physicians come from a variety of medical backgrounds and all have qualifications in Sport and Exercise Medicine. Many of them have a role as GB team doctor to one of the Olympic Sports.

One of the key areas in which the EIS can excel is by using a multidisciplinary team of Sports Physicians, Physiotherapists, and Strength & Conditioning Coaches to optimise recovery from injury. Many sports injuries are relatively easy to diagnose; the difficulty is often in understanding the weakness or poor technique that caused the injury. The medical teams work with the S&C; coaches and the technical coaches to determine the cause of an injury and provide a sports specific training programme to prevent recurrence.

Good communication between doctors and therapists is an essential part of providing good medical support. The EIS uses an electronic medical records system Injury Zone which allows the records to be read and added to at any of the EIS sites. If an MP athlete is seen at one of the centre's I receive an e-mail advising me to check the medical record entry. Injury Zone is a secure system that can be accessed anywhere in the World. This means that as the doctor to the GB Team training in France for the recent Olympics I could access all the records on the system. When the athletes moved on to Athens the doctors had access to all of the medical records including my notes from the training camp.

As part of the injury prevention programme all funded athletes complete a medical questionnaire to help identify any potential medical or injury problems before the athletes progress to the high performance training group.

Physiotherapy

What is Physiotherapy?

Physiotherapists working in sport are primarily concerned with three issues. These are:

• Injury Prevention. The EIS Physiotherapists will work with both your own personal coach as well as your strength and conditioning specialist to identify areas of physical weakness that can be targeted to prevent injury.
• High quality injury assessment and diagnosis
• Individually tailored injury rehabilitation programmes geared to making as swift a return to your sport as possible so that you may maximise your athletic potential.

Should you need to see an EIS physiotherapist you can be assured that you will be seen by someone who has a large amount of sports injury experience and is committed to keeping up to date with all the recent advances in sports injury assessment and rehabilitation. Expect your appointment to last approximately one hour. The physiotherapist will be more than happy for your parents to sit in and listen during the appointment so please invite them and your coach (if you wish) to attend. This time will be split into about twenty minutes to talk to you about your injury for example why it came on (changes in training techniques and equipment); what has happened since the injury; any treatment that you may have had; any previous injuries as well as some questions related to your general health.

Following this the physiotherapist will actually perform a physical examination on you, assessing movement, strength and balance as well as some specific tests depending on which part of the body you have injured. This examination is made much easier if you wear shorts if you have a leg injury or a T-shirt if you have an arm injury. After the examination the physiotherapist should explain to you what has gone wrong and will then spend a further ten minutes or so demonstrating some basic exercises and advice on how to resolve your problem.

You should expect to leave the appointment understanding what has happened and what you need to do to improve. If you are confused please ask.

The type of treatment and rehabilitation that you receive from your physiotherapist is entirely dependent upon the type of injury that you have. You may be asked to come back to see the physiotherapist on several occasions for follow up treatment to your injury. All EIS physiotherapists (with your consent) will also always liaise with your coach, sports doctor and strength and conditioning coach to ensure that your rehabilitation program is allied as closely as possible to the type of training you are participating in at the time of injury.

The EIS structure has regional bases with physiotherapists in each of the nine regions. All medical records are now stored on a system known as Injury Zone. This ensures that should you need to move to another region for training or competition and require attention from a physiotherapist they will be able to access information on any previous treatment that you have had.

Strength & Conditioning

Strength & Conditioning is the physical and physiological development of athletes for elite sport performance. Its aim is to bridge the gap between the theory of training and applied training, helping athletes to get faster, stronger, more flexible and keep going longer so they perform better and steer clear of injuries.

The difference between strength & conditioning and sports specific coaching that the strength & conditioning coaches provide support for the sport specific coaches. A Strength & Conditioning coach will work alongside the main coach and help by designing a programme that will target the physical need as identified by the main coach and the S&C coach.

There are so many ways a well constructed programme can add to the rehabilitation, speed, agility, endurance and strength of an athlete. The aim is to identify what the athlete needs to produce a better performance. The strength & conditioning coach will structure a periodised programme that targets both strength and weakness. This insures that the athlete is working on the right area of training at the right time to produce the best possible performance.

The EIS structure has regional bases with strength & conditioning coaches in each of the nine regions. Each region has lead sports which they are responsible for. If any athlete is in another region the lead coach will contact the appropriate coach to implement the programme for that region. We are in constant communication with each other to ensure that all details of any programme are covered, so the athlete has consistency.

Sports Physiology

Physiological monitoring can be useful for:

• establishing base levels of fitness
• identifying strengths and weakness
• monitoring over-training
• predicting performance and potential
• prescribing training
• assessing progress

The more common tests include:

• O2max (direct and predicted)
• Lactate threshold
• Wingate for anaerobic power and capacity
• Lung function
• Body composition
• Blood pressure
• Strength Flexibility

Testing is usually followed up with an elaborate report, which includes an explanation of the test and terms used, interpretation and feedback of results, and individual recommendations for training.

Physiological support provides the athlete with an assessment of their current training status and is sensitive to any training adaptations. Physiological assessment also highlights the strengths and weaknesses of the athlete relative to the demands of their sport. Initially a meeting should be set up with the athlete and their coach. The long term and short-term training and competition goals are determined and a strategic plan for physiological assessment is drawn up. Physiological assessment is performed, on average three times per year however this is subject to change depending upon the sporting year for the said sport. Athletes receive feedback of the results in two ways. A written report is sent to the athlete which outlines the role of the tests performed and provides the athlete with training advice and a data summary sheet of their results. Athletes also receive verbal feedback of their results on the day the assessment is performed. This aspect of feedback works closely with the Strength and Conditioning support (outlined earlier).

Physiological support is multi-faceted and can be performed both in the more controlled environment of the laboratory or in the field which is more sports specific and environmentally suitable but less controllable. Both of the aforementioned tests should be used to augment each other and fit well into the athlete's schedule. The assessment is strictly controlled and monitored.

Sports Psychology

Being selected to the Modern Pentathlon World Class Programme is a significant step towards achieving your potential as a successful senior elite international. Taking full advantage of the opportunity you now have will involve working to enhance your technical, tactical, physical and mental abilities. An important aspect of getting the most from yourself will be about how well you work with the team around you. You will be responsible for taking action along with coaches and support services to maximise your potential as an athlete. Sport psychology is one of the support services available to help you maximise your potential.

Sport psychology support is the applied use of psychology principles in a sport setting. It employs a systematic approach which aims to help athletes use their thoughts, feelings and behaviour to maximum advantage in training and competition environments. Sport psychology support is a process ideally involving the athlete, coach and sport psychologist working in partnership to enhance performance. Successful use of mental skills and strategies will be your responsibility and achieved by committing the time and effort necessary to fully benefit from the support you receive.

Applied sport psychology support helps coaches and athletes to answer the following types of questions:

• What can I do to improve my mental toughness?
• How can I use mental relaxation exercises to maximise recovery?
• How can I prepare more effectively for major events?
• How do I maintain concentration or focus during training or at critical times?
• Why do I under perform in competition when training is going well?
• How do I control my nerves when they affect me negatively?
• What can I do to improve my confidence?

Using sport psychology support to achieve goals :

• Provides a resource within your programme to help you and your coach enhance performance and achieve potential
• Will develop your awareness enabling you to know and understand what does and doesn't work when performing at your best
• Aims to help you use your strengths consistently and effectively when it matters most
• Will support you in meeting the challenges you face
• Can help you to learn from the highs and cope positively with the lows of competitive sport
• Is about developing habits which enable you to be effective before, during and after training and competition
• In conjunction with Performance Lifestyle, is about effective self management where you have a healthy balance between your sport, your education/ work and personal life

What you can expect from sport psychology:

You can expect sport psychology to provide you with a service tailored to your needs either as an individual or as part of a squad or team. Becoming better (developing) is a process which will involve a series of steps.

• The key steps in the support process are:
• Finding out what is going to be most helpful to you (Needs analysis)
• Being clear about what you want to achieve with sport psychology (Identifying aims and objectives)
• Understanding how much time will be needed and how long the plan will take (Identifying a time frame)
• Identifying what you will be doing (Negotiating support programme content)
• Assessing how the plan is going (Monitoring/ evaluating progress)

You have an exciting opportunity to make the most of your ability and potential. Ultimately you are responsible for your success. Your mental game, whether you chose to use a sport psychologist or not will play a significant role in meeting and exceeding your sporting expectations and goals, be in control and use sport psychology to work for you.