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Considered in the appraisal was the impact on risk of injury and illness from rapid changes in training and competition load, an over-packed competition calendar, psychological load and travel. Practical guidelines were produced, which are useful for both elite and recreational athletes.
This article is a brief summary of some findings from the consensus statements, with a focus on the nutritional elements of illness prevention.
Training volume and intensity is pushed to the limit in both elite and developing athletes, in order to elicit maximal adaptation in an attempt to improve performance. Evidence is mixed regarding injury risk and training loads in athletes, in that high loads can have either positive or negative influences on injury risk.
However, an imbalance between loading and recovery may lead to chronic fatigue and abnormal responses to training, thus increasing the risk of both illness and injury.
The J-shaped curve relationship between absolute training load and risk of illness is well established in recreational and sub-elite athletes (i.e. both low and very high training loads being associated with higher risk of illness). However, evidence suggests that increased illness risk with higher training loads may not be applicable to the elite-level athlete, perhaps due to inherent self-selection.
Large and rapid week-by-week changes in training load may place an athlete at risk of injury. If the program allows athletes to reach high training loads in a gradual and regulated manner, then hard training appears to offer protection against injuries due to development of robust physical qualities.
In terms of the relationship between risk of illness and changes in training load, only a few studies have been conducted. These suggest that increases in training volume or intensity increased the risk of illness, but it was not possible to quantify the amount of training load increase relative to the risk of a specific illness in a given sport.
Competition, which is a high acute load, can place greater demands on the athlete than their usual training blocks. Injury rates across sports are typically found to be higher in competition compared to training. Calendar congestion – many events over a shorter period than usual – can increase acute load and may increase injury risk.
Participation in single or multiple competitions is associated with increased risk of illness, but data is too sparse to quantify the risk. Several studies have demonstrated an increased risk of illness during the pre-competition and competition period.
Data from several Olympic games and international competitions across a variety of sports reveals that in shorter-duration international games (less than 4 weeks) 6-17% of registered athletes are likely to experience an episode of illness. 50% of all acute illness in athletes during competition affects the respiratory tract.
Competition, a high acute load, can place greater demands on the athlete than their usual training blocks. Injury rates across sports are typically found to be higher in competition compared to training.
Despite the sparse number of studies, it is recognised that frequent long-distance air travel across several time zones, leading to travel fatigue and jet lag, can negatively influence performance and increase risk of illness. However, no link has been found with injury risk.
In elite rugby union players competing in a 16-week tournament, travelling across more than 4 time zones was associated with a 2-3x increased risk of illness.
Several psychological factors may influence injury risk, such as life event stressors, anxiety and type A behaviours. Other variables, such as lack of sleep or severe psychosocial stress, may impact immunity and also increase risk of illness.
Regular athlete monitoring is fundamental to assessing the relationship between load and risk of injury and illness. A variety of methods can be used, such as recording training load, mood profiles, RPE (exercise intensity) and psychological screening. Subjective load measures have been found to be particularly beneficial.
A well-executed illness prevention strategy can have a significant impact. For example, an illness prevention program in the Norwegian Olympic Winter Games reduced illness rate from 17.3% of athletes competing in Turin to 5.1%, which may have contributed to the improved performance and overall results.
Outlined below are some of the nutrition and hygiene strategies that are recommended from the IOC document to help prevent illness in athletes:
Nothing beats a healthy, balanced diet to provide all the nutrients we need. But when this isn’t possible supplements can help. This article isn’t intended to replace
medical advice. Please consult your healthcare professional before trying supplements or herbal medicines.
1Soligard T, et al. (2016) How much is too much (Part 1) International Olympic Committee consensus statement on load in sport and risk of injury, British Journal of Sports Medicine 50, 1030-1041
2Schwellnus M, et al. (2016) How much is too much (Part 2) International Olympic Committee consensus statement on load in sport and risk of illness, British Journal of Sports Medicine 50, 1030-1041
The full article from the IOC can be found here.