The Psychological Effects of Chronic Injury in Elite Athletes

 Many athletes train in a constant state of pain or injury while meeting the demands of an elite level program.  It is hypothesized that the emotional distress experienced by athletes with chronic injuries is not inconsequential (Shuer, 1997).  Injury is often accompanied by depression, tension, anger and low self-esteem, particularly in competitive, seriously injured athletes.  Mood disturbance seems to relate to the athletes perceived progress in rehabilitation and has been shown to negatively relate to attendance at rehabilitation sessions (Smith, 1996).

 Interventions such as positive self-talk, relaxation, goal setting and healing imagery, seem appropriate to assist athletes in coping with injury.  Modeling interventions during injury rehabilitation have also been shown to have a positive effect on rehabilitation outcomes (Walker et al, 2007).  There has been quite a bit of focus on psychiatric intervention for acutely injured athletes or even those who have undergone surgical intervention. However, the psychological needs of athletes struggling with chronic "minor"  injuries appears to merit more consideration.

LCHF Diets for Sports Performance: Questionable method for trained athletes?

Multiple studies during the period of 1985-2005 examined the proposal that adaptation to a Low Carbohydrate High Fat (LCHF) diet to increase muscle fat utilization during exercise could enhance performance in trained individuals by reducing reliance on muscle glycogen.  As little as five days of training with a LCHF diet retools the muscle to enhance fat burning capacity with robust changes that persist despite acute strategies to restore carbohydrate availability(glycogen super-compensation), and a 2-3 week exposure to minimal Carbohydrate(<20g/day) intake achieves adaptation to high Blood Ketone concentrations(Hopkins et al, 1999); However, the failure to detect clear performance benefits during endurance/ultra endurance protocols, combined with evidence of impaired performance of high-intensity exercises via a down regulation of Carbohydrate metabolism has led to the skepticism of the LCHF diet creating enhanced performance outcomes in trained individuals.  

Sporting events last from seconds(jumps, throws) to weeks(Tour de France), with success being determined by a complex and often changing range of characteristics including power, strength, endurance, agility, skill, and decision making.  The role of training is to accumulate adaptations in the muscle and other body organs/systems to achieve specific characteristics that create success in the athletes event via a series of systematic and periodized stimuli, involving the interaction of nutrition and exercise(Hawley et al, 2011).

There has been a significant re-emergence of interest in LCHF diets, coupled with anecdotes of improved performance; However, the question that still needs to be answered today is, Does a Ketogenic LCHF diet create clear performance benefits during both endurance and high-intensity protocols for trained individuals?

Genetic Predisposition or Determinant: Is there a role of Genetic Influence on Athletic Performance specifically to young athletes?  A favorable genetic profile when combined with an optimal training environment, is important for elite Athletic Performance; However, few Genes are consistently associated with elite Athletic Performance and none are linked strongly enough to warrant their use in predicting athletic success (Guth et al, 2014)
Every sport has unique physical requirements and these requirements can be dramatically different between sports, so, genetic influence on performance must consider the performance components most appropriate for the specific sport of interest.
Considering the number of body systems, including; nervous, musculoskeletal, cardiovascular, respiratory, etc. that must interact, at heightened states, athletic performance is one of the most complex Human traits (Tucker 2012).
So, regardless of body Morphology, Endurance, Strength, and Power - which are factors underlying Athletic Performance; Does specific Genetic influence determine Athletic Performance? And, if so; How much of a role does it play?

Sport Performance

Sport Performance: Fundamentally, Athlete preparedness comes down to reconciling the effective with that which motivates. In valuable conversations, it became clear that a disconnect exists & generation gaps create information overload for Athletes. This is leading to coaches spending to much time creating passion for his athletes vs evaluating talent. In my day, passion was recognition from accomplishment. Today, far too many distractions exist that provide "real time" gratification of a quasi reckoning of success. However, this sacrifices real world success & longevity.