Athletics Weekly - - Performance - Dr Matt Long sits on the BMC coach­ing sub­com­mit­tee and is ed­i­tor of BMC News mag­a­zine

IN 2014, Mo Farah tripped and in­curred a heavy fall in Cen­tral Park, half­way through the New York City Half­marathon. He did just enough to hold off the chal­lenge of Kenyan Stephen Sambu to fin­ish sec­ond (61:07) be­hind even­tual win­ner Ge­of­frey Mu­tai, but soon af­ter col­lapsed and passed out. He was taken away in a wheel­chair be­fore mak­ing a speedy re­cov­ery, blam­ing not only his mid-race mishap, but the chilly weather in the Big Ap­ple. “I just tried so hard in the race. I’m all right. It’s not a big deal,” Farah said.

On that oc­ca­sion, the im­pli­ca­tions were not med­i­cally sig­nif­i­cant. But the sports medicine con­sul­tant Dr John Rogers, a for­mer North­ern Ire­land 800m and 1500m cham­pion, says that ath­letes of all lev­els should be aware that such oc­cur­rences might be a warn­ing sign of deeper prob­lems. Speak­ing at the

BMC Con­fer­ence re­cently, Rogers de­scribed how “the fine line” be­tween peak per­for­mance and ill­ness or in­jury in­clud­ing train­ing and life­style fac­tors which fa­cil­i­tate Adap­ta­tion (A) and that which re­sult in Mal­adap­ta­tion (M).

The dif­fer­ence be­tween th­ese two bi­na­ries is sum­marised in the ta­ble on the right. “Of course, train­ing in­duced fa­tigue and some­times func­tional over-reach­ing is healthy when at a train­ing camp for in­stance,” Rogers says.

“And part of our role as a sports sci­ence and medicine team, is to try to pre­vent or rec­tify the ap­proach of an ath­lete who is suf­fer­ing with non-func­tional over-reach­ing or who may be en­coun­ter­ing un­der­per­for­mance prob­lems or over­train­ing syn­drome (OTS).”

The pre­ven­tion of OTS

Rogers said there is no sin­gle marker to de­tect the early signs of OTS and em­pha­sised it is usu­ally the re­sult of a com­plex in­ter­play of fac­tors. “It’s a com­bi­na­tion of as­sess­ing per­for­mance, phys­i­ol­ogy, bio­chem­i­cal, im­munol­ogy and psy­cho­log­i­cal mark­ers,” he said. “Some of our work in­volves ad­dress­ing nu­tri­tional de­fi­cien­cies amongst ath­letes and typ­i­cal cul­prits in­clude rel­a­tive en­ergy de­fi­ciency in sport (RED-S), rron, vi­ta­min D, mag­ne­sium and pro­tein de­fi­cien­cies.” How­ever, the four-fold na­ture of com­mon train­ing er­rors can he stressed, be use­ful in help­ing ath­letes to self-re­flect.

Has the vol­ume of my train­ing sud­denly in­creased by more than 5% from one week to the next?

Has the in­ten­sity of my train­ing dra­mat­i­cally in­creased rather than it be­ing ef­fected in­cre­men­tally?

Is my train­ing too mo­not­o­nous and at risk of not help­ing me to achieve the pro­gres­sive over­load as­so­ci­ated with im­proved per­for­mance?

Am I in dan­ger of over­com­pet­ing and risk­ing a de­cline in my long-term per­for­mance?

Biome­chan­i­cal Over­load Syn­dromes

Of­ten, biome­chan­i­cal as­sess­ment is needed dur­ing re­ha­bil­i­ta­tion to pre­vent re­cur­rence of in­juries. Rogers, a Manch­ester-based con­sul­tant who now works as Chief Med­i­cal Of­fi­cer to Bri­tish Triathlon, ex­plained the preva­lence of biome­chan­i­cal over­load syn­dromes.

“Com­mon prob­lems we con­fronted with run­ners in­clude Patellofemoral Pain Syn­drome, Me­dial Tib­ial Stress Syn­drome, Ili­otib­ial Band Syn­drome and less com­monly Chronic Ex­er­tional Com­part­men­tal Syn­drome and ath­letic groin pain,” he said.

Un­like Mo Farah you may not have ready ac­cess to a sport sci­ence and medicine team, but you can chal­lenge your­self to ap­pro­pri­ately seek and draw on knowl­edge from phys­ios, doc­tors, nu­tri­tion­ists, phys­i­ol­o­gists and psy­chol­o­gists work­ing in sport. In other words, Rogers stressed: “You need to de­velop your own net­work of sup­port.”

Mo Farah: fell in the 2014 New York City Half-marathon and col­lapsed af­ter­wards

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