Sports Drinks and how to make your own

With lockdown easing and the return of Grassroot sports, it is very important to keep hydrated. sports performance can be affected by dehydration, so it is important to be well hydrated…before, during and after activity.

Drinks can contain various amounts of carbohydrate & electrolytes (salts) that assist with rehydration or energy replacement. Choose a drink depending on whether you need to replace fluids or energy/carbohydrate (or both):

Water – will replace fluid losses but not provide energy – suitable for low intensity or short duration exercise (less than 45 minutes) – for longer activities (more than one hour) add a little sugar & salt to enhance absorption & fluid retention.

Hypotonic drinks – these contain low levels of carbohydrate (less than 3g/100ml) & some salt – they are absorbed into the body more quickly than water – they provide fluid but not much energy use these drinks to replace fluid quickly & when energy is not really required (if training lasts less than one hour & is low intensity).

Isotonic drinks – these contain carbohydrate (4-8g/100ml) – they are absorbed into the body as fast or faster than plain water – they provide fluid & some carbohydrate to fuel the muscles – these are the most effective drinks to use for rehydration during training & competition use these to replace fluids & for some energy (if training for more than one hour) – drink before, during & after exercise.

Hypertonic drinks – these have a higher carbohydrate content (more than 10g/100ml), including pure fruit juice, many canned drinks & energy drinks – they are absorbed more slowly than plain water – they replace lost energy rather than fluids & are therefore not an effective way to rehydrate use these when energy replacement is important (eg: when you are unable to get enough energy from food & need to top up your daily carbohydrate intake),

Stimulant drinks usually have a high carbohydrate content (which does not help with rehydration) & other additives (eg: caffeine, taurine), most of which have no beneficial effect on performance. These drinks should be avoided during sport.

Most people need 1.5-2L of fluid per day plus what is lost during exercise. Fluid includes all drinks, plus fluid in meals (like milk on cereal, or soup). Ideally, start activity fully hydrated by drinking about 500ml water, or suitable sports drink, about 2 hours before activity, plus another 150-350ml in the 10 minutes before starting activity. During activity drink small amounts frequently (150-200ml every 15-20 minutes). After activity, try to replace fluid losses within 2 hours, especially if training more than once a day. Do not wait until you feel thirsty (by then you will already be dehydrated).

Young athletes bodies are less able to cope with the stresses of activity because their bodies are not very efficient when coping with the heat activity generates, & the temperature & humidity of some pools do not help the situation. As a result young athletes are at greater risk of dehydration, as well as being more sensitive to its effects. Young athletes do not realise how much fluid they are losing during activity & they are not very good at replacing fluids voluntarily – therefore they should be reminded to drink during training (every 15-20 minutes). Children should be allowed to drink until their thirst is satisfied, then encouraged to drink some more (because their thirst mechanism is poorly developed). If young athletes are particularly irritable at the end of a training session they should be monitored to assess how much fluid they are habitually drinking. Water is an acceptable drink, but it may be necessary to provide a flavoured drink that is more appealing & provides some energy.

Fluid losses can be monitored by checking body weight before & after activity (1kg lost body weight = 1L fluid lost from the body). Dehydration can be checked by using a pee chart (right).


Generally, if training involves less than an hour of activity it is not necessary to refuel during activity. Good food & regular drinks before training will provide adequate energy & hydration for activity, and then good food & drink choices after activity will refuel & rehydrate the body.

Recipes for home-made sports drinks

Try different drinks during training to find one that you like. Drinks might taste different during & after exercise, so don’t decide on a drink when you are not exercising. Choose a drink that best matches your needs (fluid or energy). Salt in drinks enhances absorption & retention of fluid in the body.


Hypotonic drink                                   Hypotonic drink

100ml fruit squash                               250ml fruit juice

900ml water                                        750ml water

1/5th teaspoon (1g) salt                        1/5th teaspoon (1g) salt


Isotonic drink

50-70g glucose or sugar

1L water or sugar-free squash

1/5th teaspoon (1g) salt

Dissolve the glucose or sugar & salt in 100ml warm water before adding them to the remaining 900ml cold water or sugar-free squash


Isotonic drink                                      Isotonic drink

500ml unsweetened fruit juice             150ml high juice squash

500ml water                                        850ml water

1/5th teaspoon (1g) salt                        1/5th teaspoon (1g) salt


Hypertonic drink

400ml squash

1L water

1/5th teaspoon (1g) salt



Sport Nutrition 3rd Edition 2019 Author: Asker Jeukendrup Michael Gleeson

Food for Sport: Eat Well, Perform Better Griffin, Jane (2001) Food for sport, Crowood Press;

Single leg hop for distance symmetry masks lower limb biomechanics:

Time to discuss Single Leg Hop distance as decision criteria for return to sport after #ACL reconstruction ?

A MUST read paper and not surprised after seeing the authors associated with the work

The study evaluated the lower limb status of athletes after anterior cruciate ligament reconstruction (ACLR) during the propulsion and landing phases of a single leg hop for distance (SLHD) task after they had been cleared to return to sport.

The Authors wanted to evaluate the biomechanical components of the involved (operated) and uninvolved legs of athletes with ACLR and compare these legs with those of uninjured athletes (controls).

For the full paper click on the link : bjsports-2020-103677.full


Anterior cruciate ligament injury: towards a gendered environmental approach


  1. Joanne L Parsons
  2. Stephanie E Coen
  3. Sheree Bekke

Anterior cruciate ligament injury: towards a gendered environmental approach | British Journal of Sports Medicine (

For all coaches out there, If you work with female athletes of any level in a coaching, clinical or performance role….. This is a must read.

The paper discusses the curious absence of gender as an influencer in the dialogue surrounding ACL injuries. the study proposes adding gender as a pervasive developmental environment as a new theoretical overlay to an established injury model to illustrate how gender can operate as an extrinsic determinant from the pre-sport, training and competition environments through to ACL injury and the treatment environment.


For a full read of the paper click here : bjsports-2020-103173.full


Hydration in Amateur Sport

After a year away from the sporting pitches and with the possible return to full training of Semi Professional and Amateur (Grass roots) sports in June, we must never forget the fundamental role that water plays in our body, cooling, nutrient transport, joint lubrication, digestion, and absorption.

Ref: EU Hydration institute.

The Human body is 60 or 70% made up of water, many of it is found in the blood and muscles. The amount of water in the body is limited, if the losses are not replaced there may be a decrease in heat transmission from the muscles to the skin, the consequence of which will be the increase in body temperature, favouring the risk of dehydration, the first signs are intense thirst, dry body, hot, dry skin and mucous membranes, cramps (sodium is lost due to perspiration), depletion by hydro-electrolytic imbalance (which manifests with dizziness, sweat, tachycardia, headache, paleness, etc.), heatstroke (decreased level of consciousness, neuromuscular un-coordination).

Dehydration causes a decrease in aerobic capacity, maximum aerobic potency, muscle endurance and the ability to develop physical work. In addition to the physical qualities mentioned, mental faculties, fine coordination and therefore it is essential to provide fluids during exercise, mainly when large water losses occur. The proper way to hydrate will depend on:

  • The goal to achieve (increase muscle mass, decrease adipose tissue, optimize performance, etc.)
  • The intensity, frequency, duration, etc. of the training to be performed
  • The weather (temperature and humidity)
  • Individual variations (there are people who sweat more than others) Having these factors present should opt for the right drink (water and / or sports drink) and rehydration strategies should be practiced during training. Recommendation: Never try a new strategy on match day, that is what training is for.


The goal is to ensure a state of euhydration (i.e. normal hydration) and prevent gastrointestinal discomfort. Avoid diuretic or gas drinks (alcohol, coffee, etc) and Drink between 300-600ml of water (without gas) in the pre-match time (preheating); and more if the temperature and/or humidity are high or if you are a “profuse sweater”.

Normal hydration status is defined the presumed condition of healthy individuals who maintain water balance. Evaluation of hydration status is not easy, as during daily activities or exercise, fluid compartments are constantly fluctuating and therefore the evaluation of a single body fluid compartment volume is insufficient to provide valid information about total body water (TBW) .

HYDRATION DURING (Matches/Training)

Players need to be educated regarding the benefits of fluid replacement to promote performance and safety and the potential risks of both hypohydration and hyperhydration on health and physical performance. Quantify sweat rates for physically active individuals during exercise in various environments. Work with individuals to develop fluid-replacement practices that promote sufficient but not excessive hydration before, during, and after physical activity.

The goal is to replenish sweat-lost water and provide an energy source, to delay glycogenic emptying and therefore fatigue.

With high-performance athletes, restricting dehydration to no more than 2% body mass loss helps to maintain the physiological, perceptual, and safety aspects of their exercise while aiding in exercise recovery and subsequent training sessions.

Dehydration is the process of water loss from the body and being in a dehydrated state means you no longer have sufficient fluid in your body to optimally function. Naturally, even at rest we lose fluid by as much as 1-3L per day.

In any training greater than 60 minutes long and high intensity, Water and/or sports drink, if possible, containing the necessary and sufficient nutrients such as sodium (to promote water absorption) and carbohydrates. The latter delay, but do not prevent, muscle fatigue; since the utilization rate is higher than the ability to eat carbohydrates during exercise.

Always have drinks during a pause in a game such as penalties, conversions, at half-time and, always when the referee allows you to… or between exercise sessions in the gym/field. Pay special attention to those who remain substitutes, they must rehydrate in the substitutes’ bench, to be prepared in case they have to enter the game.

If we are dehydrated our performance will NOT be optimal, with weight loss of 2% there is decreased athletic performance, 3% decrease in physical endurance 4% there is decreased muscle strength, thus having a personal plan and drinking a sufficient amount of fluid could be the difference between winning and losing.

You should not wait to be thirsty to drink liquid; at that moment you are already dehydrated!!

Other reasons for inadequate liquid intakes are lack of availability of liquids, unrespecting liquids, sports tradition, lack of awareness in the subject.


The volume of liquid lost depends on the intensity and duration of the activity, the temperature and ambient humidity, the clothing used, the acclimatization of the person to heat, the movement of air and solar radiation. The thirst mechanism is activated when a lot of fluid has already been lost, so it is important to control losses by comparing pre- and post-activity weight and urine color (the more yellow, the greater fluid loss, usually).

Example of how urine colour might vary with Hydration status:

Ref: EU Hydration Institute

The strategy to follow is: drink 1/2 litre of sports drink as soon as you finish training/playing and then you should consume up to 150% of the lost weight, within 2-3 hours. Example: 90Kg player with a dehydration of 2% lost 1.8Kg, the volume to consume would be 2.7 litres (2700ml): 1st half litre and then 2200ml.

As a rule, consume between 500-1000ml/hour of sports drink or mineral water (without gas), larger amounts may be necessary on days of high temperatures.

Although there is no exact answer for how much water you should consume as everyone may have different needs depending on individual and environmental factors, aim for approximately 35ml of fluid per kg body weight. That is just over 2 litres for a 60kg adult, or 2.8 litres for an 80kg adult. Active children should aim for 1-1.5 litres per day (approx. 4-6 glasses) and everyone should consume extra fluid if exercising.

All this is plannable and trainable!! Do not leave hydration released at random. Do not test these strategies for the first time in a match; but try to get used to drinking workouts every 15-20 minutes.

DEHYDRATION is one of the main 5 nutritional factors related to fatigue and decreased performance, along with the emptying of glycogen deposits (energy) in active muscles, decreased blood glucose (hypoglycemia), gastrointestinal discomfort, excess adipose mass (ballast). All is preventable with food education and “training” habits.

It is up to you to be hydrated.

Some ideas

1-2 hours before exercise – suitable foods include:

  • Milk shake or smoothie
  • Breakfast cereal with milk
  • Cereal bars
  • Fruit-flavoured yoghurt
  • Fruit

Less than 1 hour before exercise – suitable foods include:

  • Sports drinks
  • Squash drinks
  • Jelly sweets


Maintaining Euhydration Preserves Cognitive Performance, But Is Not Superior to Hypohydration Stephen P. J. Goodman, Ashleigh T. Moreland & Frank E. Marino Journal of Cognitive Enhancement volume 3, pages338–348(2019)

Eat Well, Feel Well: The Importance Of Hydration

National Athletic Trainers’ Association Position Statement: Fluid Replacement for the Physically Active J Athl Train. 2017 Sep; 52(9): 877–895.

Key tips on hydration Educational tool-measuring hydration status – European Hydration Institute



Game playing in Youth Rugby

It is a challenge and a great responsibility to play and train with young children. Because of their nature they are curious, they love  challenges, try things, new situations and discover the world around them for themselves.

The suggestion in the early years of schooling poses that the most important thing is not the teaching of motor skills, but you have to take seriously the needs of children in this area with actions such as climbing, jumping, spinning, spinning, playing with balance, looking for risky situations.

One of the most interesting proposals from World Rugby is the organization of training in seasons. Children choose more or less in the seasons, they can determine the degree of difficulty and learn from mistakes. Many children are able to assess their own risk. It should be noted that some  six-year-olds, for example, tend to have a developmental level for four-year-olds, while others develop eight-year-olds.

So, What would training could look like?

Creating a positive environment for the young player is crucial – develop players who can make correct decisions during a match, the (coaching) environment should be conditioned to allow players to practice recognising situations, work out solutions and then react accordingly.

It is here that coaches can make the most significant impact by encouraging Young players to try things and learn from their mistakes.

A training, encounter or game session with youth players can have various edges. The prerequisite for success is a good organisation. Drawings and photos are often better than long verbal explanations to help all participants who have to get used to new  tools and become more independent, with autonomy you do not lose the quality of the movement.

  • Always have a purpose / objective to your session
  • Question your players to check for understanding to ensure they are aware of:
    • What they are doing (the technical detail)
    • How it relates to the principles of play (the tactical detail)
    • What the effect of their actions will be on play

It is important, however, to remember that there is a lot of spontaneous motor activity (of movements) in children. Coaches should observe,  help when  needed, and/or  work  with children. Safety issues should not be forgotten.

  • Continually improve ALL players(not just the skilled ones)
  • Develop techniques into skills(by placing players into game situations)
  • Develop players’ game-sense’ (their ability to understand the game and the consequence of their actions)
  • See what is right and praise it
  • See what is wrong, recognise why it is wrong, and be able to correct it.

This is the optimal level for the acquisition of all motor skills, enabling many positive experiences of movement, and thus allowing the development of skills not only coordinative and conditional, but also cognitive, emotional, and even socialization.

  • Encourage skill learning for everyone (slow starters may be successful later)
  • Allow all players to experience every playing position – the prop of today could be the scrum half of tomorrow! Rugby is a late specialisation sport – so, no need to define players into position too early – if you do so you may be limiting their development!

Undoubtedly Modified games are extremely useful to help players to develop both their skills and game understanding for training ages is best for open, intensive teaching in terms of motor learning and several experiences.

World Rugby recommends coaches should ensure that they adopt a game-based approach to their coaching activities and actually coach through the game (focus on specifics, observe and analyse critically, correct errors, praise good practice and encourage learning) rather than manage the activity (e.g., commentating on play). This means providing specific feedback on both good practice and areas to develop, in relation to the aim set out at the start.

With Youth players It is important that the aim (e.g., tackle or pass technique) is maintained throughout the session as the tendency can be for the coach to fix other faults. This can result in the key message to the players be diluted through a focus on too much detail at once. distraction and loss of interest is common in young age groups.

To challenge players with realistic training activities, coaches should be creative in the tasks they set for their players to encourage them to solve problems and make decisions. Consider the following tips when designing the activities and always relate what you are asking the players to do in relation to the outcome of the session:

  • Condition the opposition in attack or defence to put players in decision making situations – by altering number in attack/defence, placing conditions on what they can or cannot do and giving some players specific roles
  • Utilise scoring zones and systems – the position and numbers of areas that can be scored in as well as what is required to score – relate to objective.
  • Alter the dimensions of playing area to maximise opportunity to practice (e.g. narrow for developing contact skills)
  • Allowing /disallowing some skills in certain zones (e.g. only 3 passes in the middle zone/ no kicking in own half etc.)

Coaching girls – considerations

When dealing with Youth players, coaches should take into consideration that just like boys, girls will develop at different rates and times.

Training programmes should take this into account and be tailored to the development stage of the player. For example, a ten-year-old girl may have been playing since she was six years of age and therefore has four years’ experience playing the game while a 12-year-old may just have taken up the sport and be in her first year of rugby.

Some key areas which are particularly useful to consider when coaching girls.

From World Rugby:

  • As girls can tend to be more people-orientated, how a coach engages and communicates with them is very important as this sets a foundation for their learning and encourages participation
  • Girls can respond more positively when their coach knows them as individuals and understands their personalities, motivations, and goals
  • Girls tend to ask more questions than boys as they usually need to understand the detail of an instruction before willingly completing it as the process is as important as the outcome
  • Be mindful of physical interaction. Physical touch needs to be appropriate. If it is required to demonstrate a particular skill, permission should be obtained from the player provided that it is within cultural norms. Coaches may need to use a full range of questioning and demonstration strategies (for example, use of experienced players to demonstrate, use of video)
  • Having females involved in managing or coaching is good practice
  • Physical differences between male and female children aged ten to twelve years of age are usually minimal.

World Rugby guide:


World Rugby Guidelines :  World Rugby Coaching : The home of Rugby coaching on the web : Coaching Children

I Coach Kids : iCoachKids: Home

International Safeguards for Children in Sport: org/en/toolkit/child-protection-and-safeguarding

Balyi, I. & Hamilton, A., 2004. Long Term Athletic Development: Trainability in Childhood and Adolescence. Victoria, British Columbia: National Coaching Institute and Advanced Training and Performance LTD



Too often, a “new” training or exercise method will emerge, and everyone will get in the cart and quickly incorporate exercise or change into the training method. This in my experience has been found to be prevalent at Grassroots and Amateur sport.

The attitude is, if this and the other is what the world record holder does, it must be good and therefore I will copy it. This is known as monkey sees, monkey do

The use of chains in weight training, using Ladders to improve agility are two examples that comes to mind. They are viable tools if they fit in. Before we incorporate something, we need to see how it is inscribed in the context of what is already being done and we need to carefully evaluate the context in which it was successful.

However, we must always keep an open mind and incorporate sensible innovations where appropriate.

Context is a key element of an S&C system. The context establishes the nature of the relationship of the various components of training within the system. What we do today in training must fit with what we did yesterday and should flow into what we are going to do tomorrow. Bringing something alien that is not proven or shown to be effective undermines the system.

The same is true for training components particularly in contact sports. Perhaps the biggest violation of the context principle is taking one of the components, for example, speed or strength training it to the exclusion of all other physical qualities. This is flawed. It is possible to design a program where a component is emphasized during one phase, but they must be taken into proportion to the other components and placed in the context of the total training plan.

If the context principle is not observed, then the training components will be disproportionate, and adaptation will not occur at the intended level. The best way to keep everything in context is to plan well and stick to the plan, explain to the athletes how does it work so they can buy into the Planning.


How important is planning? Not planning is planning failure. So obviously I think it is important, but I have some questions about the concept of periodization that acquires popular acceptance. Where does it come from that focus on planning should be, long-term or short-term? I have concluded that the focus should be on short-term detailed planning, the real micro cycle, and the training session. I have found in recent years that the Meso Cycle plan demands constant adjustment particularly at levels other than elite.

Personally I used to put too many details into the plan and in the long run had to cut back or changing it anyway. The other aspect of planning that should require attention is planning the interaction between all components of the training. Is everything in context or is there something unexpected?

Ironically, some of the most productive training sessions I have had as a coach have come when I threw away the plan and followed my instincts because of unexpected variables. There are no secret programs or shortcuts to athletic excellence. Great training programs focus on fundamentals and build on the basics

Periodization is an art, moving forward and making more meaningful planning will require a major paradigm shift. Periodization in S & C follows in its current format follows linear reductionism (it’s the science that involves breaking things down into their smallest possible parts.), which has brought us to this point, but which prevents us from moving forward into the future.

Adaptive approach

Advances in Sports Science and coaching methodologies in the last 25 years has come in leaps and bounds, logically, this led us to an Adaptive approach to training planning (i.e., best optimal performance) The adaptive approach focuses on relationships and connections.

This framework integrates performance indicators such as training load measures, physiological constraints, and behaviour-change features like goal setting and self-monitoring. It provides a training plan, being adopted by the athlete, and its goal adapts to the athlete’s behaviour.  The framework for this adaptive approach is to have it personalized for athletes.

Adaptive Approach is to take advantage of these constantly changing connections and relationships. The one thing to avoid is overtraining, staleness, failure to develop transferable skills, psychological (e.g., decreased enjoyment, sense of failure) and social (e.g., limited social opportunities) particularly in young athletes or people just wanting to enjoy the sport.

(In terms of unpaid athletes, unplanned conditions such as overtime jobs, family issues and illness may intervene in the athlete’s plan. Reorganization of the training plan may be needed to cover these unpredictable issues to maintain or raise athlete’s performance as much as possible in the remaining time until competition day.)

The use of this training approach literally becomes a dance of discovery. It requires the coach to participate more actively in the follow-up of all aspects of the training. This is a significant deviation from focusing on the training parts (components) and goal setting also it assumes that the training parts will meet in a kind of reasonable useful set to work with.

The plan should constantly seek critical relationships that will allow the body to adapt to the stress of training. The body is a fully integrated system, to optimize the performance of this system you must have an approach to the planning and execution of training.


The Gambetta Method (2nd edition): Common Sense Training for Athletic Performance – Authors                James Radcliffe and Vern Gambetta

Science Articles:

A Conceptual Framework for the Generation of Adaptive Training Plans in Sports Coaching | SpringerLink

Planning a sports training program using Adaptive Particle Swarm Optimization with emphasis on physiological constraints | BMC Research Notes | Full Text (

Suicidal thoughts (ideation) among elite athletics (track and field) athletes:

This is an original research paper published in the British Journal of Sports Medicine first published in 2020.

A sobering paper on the current issues of suicide thoughts among Elite athletes, reading this paper it is also applicable to the lower tiers of sport including Amateur on Male and Female players in all sports where issues of suicide go unreported, National Bodies must take action.

The paper examined associations between suicidal ideation and sexual and physical abuse among active and recently retired elite athletics (track and field) in Sweden.
For the full paper click on the link :

Suicidal thoughts (ideation) among elite athletics (track and field) athletes: associations with sports participation, psychological resourcefulness and having been a victim of sexual and/or physical abuse



Recently I have been reading interviews of players mentioning the 4D’s of success. I have been researching the subject and how the four Ds served as a motivational tool for players.

No matter the level of play, (amateur, semi-professional or professional), age, sex, role within the team (coach, player, manager), or you are on or off the pitch; If you want to be successful, either as an individual or as part of a team, it is important to keep these four principles in mind. Some studies have shown that those players who are successful in their personal life (family, studies, businesses) are also successful on the playing field.

The four Ds must exist together, if any are faulty it will not be possible to be successful. The four Ds as I see them are: Desire – Drive – Dedication – Discipline

 Desires: These are the dreams, goals or goals we all have, have you ever thought about what yours are? Do you really want to catch up with them? Yes! Anything is possible, “wanting is power”. There are no impossible. Desire to be the best, to win, to have success. How strong is your desire?

Drive: You have made the decision to make it possible, to make “something” happen. Never give up, you deserve the best. Visualize, think, feel, act positively Always move forward looking to achieve your goals, such as get 3 more reps; to force yourself during your training and not back down. That is Drive – no easy roads.

Dedication:  Stay true to yourself and your goals. Do not be dissuaded by “friends” and “concerned family members” who want to distract you, getting what you want takes time and effort. Practice will make it possible for you to get better. So, try again and again until you make it.

Discipline:  The last on the list is the most important.  This is the element that joins the previous three. It is the “internal force” that we all have and that pushes us to continue, continue to try, not to give up and not to lose sight of the ultimate goal.

To be successful is to achieve the goals, to achieve this you must have desires, drive, dedication and discipline. The four Ds of success.


The 4 Ds To Achieve Success: Desire, Determination, Dedication And Discipline ( – Afia Altaf

Article: Four D Words Are Needed To Be Successful ( Copyright 2005-2021 Gordon Bellows.

The Four “D’s” of Success | Ridgewood, NJ Patch

Sports Psychology in Action Copyright 1996 Richard Butler

Mental health in elite athletes: International Olympic Committee consensus statement (2019)

Claudia L Reardon,  Brian Hainline,  Cindy Miller Aron, David Baron, Antonia L Baum, Abhinav Bindra, Richard Budgett, Niccolo Campriani, João Mauricio Castaldelli-Maia, Alan Currie, Jeffrey Lee Derevensky, Ira D Glick, Paul Gorczynski, Vincent Gouttebarge, Michael A Grandner, Doug Hyun Han, David McDuff, Margo Mountjoy, Aslihan Polat, Rosemary Purcell, Margot Putukian, Simon Rice, Allen Sills,Todd Stull, Leslie Swartz, Li Jing Zhu, Lars Engebretsen
Reference: Claudia L Reardon et al. Br J Sports Med 2019;53:667-699


Mental health symptoms and disorders are common among elite athletes, may have sport related manifestations within this population and impair performance. Mental health cannot be separated from physical health, as evidenced by mental health symptoms and disorders increasing the risk of physical injury and delaying subsequent recovery. There are no evidence or consensus based guidelines for diagnosis and management of mental health symptoms and disorders in elite athletes. Diagnosis must differentiate character traits particular to elite athletes from psychosocial maladaptations.

Management strategies should address all contributors to mental health symptoms and consider biopsychosocial factors relevant to athletes to maximise benefit and minimise harm. Management must involve both treatment of affected individual athletes and optimising environments in which all elite athletes train and compete. To advance a more standardised, evidence based approach to mental health symptoms and disorders in elite athletes, an International Olympic Committee Consensus Work Group critically evaluated the current state of science and provided recommendations.

This is a very thorough and in depth study of Mental Health, a few things that stand out for me

The reported prevalence of mental health symptoms and disorders among male elite athletes from team sports (cricket, football, handball, ice hockey and rugby) varies from 5% for burnout and adverse alcohol use to nearly 45% for anxiety and depression.


The reported prevalence of mental health symptoms and disorders among male elite athletes from team sports (cricket, football, handball, ice hockey and rugby) varies from 5% for burnout and adverse alcohol use to nearly 45% for anxiety and depression.

Prospective studies have reported that mental health disorders occur in 5% to 35% of elite athletes over a follow-up period of up to 12 months.

The sports with the highest general substance use/misuse rates across all substances for men’s elite sports are lacrosse, ice hockey, football, rugby, baseball, soccer, wrestling, weightlifting, skiing, biathlon, bobsleigh and swimming, and lowest for track, tennis and basketball.


For women’s elite sports, the highest rates occur in ice hockey, gymnastics, lacrosse, softball, swimming, and rowing, and lowest in track, tennis, basketball and golf.

As women continue to engage in elite sport opportunities, their participation has led to varying degrees of cultural acceptance.

Women competing in sports traditionally considered ‘male’ may face being marginalised and stereotyped and may experience unequal training opportunities and resources.

Sexualisation, traditional gender roles, religion and ethnic beliefs all influence opportunities for women.

Tension may also exist between what is functionally optimal for women elite athletes to be wearing and what is culturally deemed acceptable. Gender stereotyping in the media may influence how women athletes view themselves.

Women athletes may be stereotyped as ‘lesbian’ to keep them from playing certain sports, or from playing for certain coaches or with certain teams. Some professional women athletes must train outside their native countries and may struggle to find a support network and cultural understanding from teammates in their new location

Summary on Male and Female

In general, those who participate in team sports are more likely to use or misuse substances than athletes in individual sports.

Common risk factors for use include: sport context and culture (eg, normative beliefs about heavy peer drinking or illicit drug use); situational temptation (eg, drinking games); permissive on attitudes among athletes, coaches and parents; male sex; use of performance enhancing substances or tobacco; identification as lesbian, gay, bisexual, transgender or queer; party lifestyle or drinking game participation; sensation seeking; overestimating peer use; achievement orientation; lower use of protective measures (eg, avoiding serious intoxication, using a designated driver); leadership position; fraternity/sorority membership; problem gambling; and injury.


The IOC has committed to improve the mental health of elite athletes, recognising that doing so will reduce suffering and improve quality of life in elite athletes and serve as a model for society at large. The IOC hopes that all involved in sport will increasingly recognise that mental health symptoms and disorders should be viewed in a similar light as other medical illnesses and musculoskeletal injuries; all can be severe and disabling, and nearly all can be managed properly by well informed medical providers, coaches and other stakeholders. Mental health is an integral dimension of elite athlete wellbeing and performance and cannot be separated from physical health.

Mental health assessment and management in elite athletes should be as commonplace and accessible as their other medical care; ideally elite athletes should have access to the best interdisciplinary care. To advance a more unified, evidence informed approach to mental health assessment and management in elite athletes, the IOC Consensus Group has critically evaluated the current state of the science and practice of mental health in elite athletes.

Click on the link for the full report: Report


Sleep and the Athlete: Narrative Review and 2021 expert consensus recommendations

AUTHORS: Neil P Walsh1, Shona L Halson2, Charli Sargent3, Gregory D Roach3, Mathieu Nédélec4, Luke Gupta5, Jonathan Leeder6, Hugh H Fullagar7, Aaron J Coutts7, Ben J Edwards1, Samuel A Pullinger1,8, Colin M Robertson9, Jatin G Burniston1, Michele Lastella3, Yann Le Meur4, Christophe Hausswirth10, Amy M Bender11, Michael A Grandner12, Charles H Samuels13


Elite athletes are particularly susceptible to sleep inadequacies, characterised by habitual short sleep (<7 hours/night) and poor sleep quality (eg, sleep fragmentation). Athletic performance is reduced by a night or more without sleep, but the influence on performance of partial sleep restriction over 1–3 nights, a more real-world scenario, remains unclear.

Studies investigating sleep in athletes often suffer from inadequate experimental control, a lack of females and questions concerning the validity of the chosen sleep assessment tools. Research only scratches the surface on how sleep influences athlete health.

For example, athlete sleep is influenced by sport-specific factors (relating to training, travel, and competition) and non-sport factors (eg, female gender, stress and anxiety).

The study recommends an individualised approach that should consider the athlete’s perceived sleep needs. Research is needed into the benefits of napping and sleep extension (eg, banking sleep).

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