According to David Bishop’s (2008) Applied Research Model, sports science practitioners 'focus on optimising human performance by applying scientific principles'. This is not a new endeavour however, as understanding the scientific and medical principles underpinning sport can be witnessed as far back as the Ancient Greeks!
Yet, there are many challenges to this raison d’etre in the current sports science climate. One being the focus or to some, the excessive focus, on injuries. Footballers have accused us of robbing them of their robustness. While in the NBA, barely a month goes by without the so-called ‘load management problem’ garnering headlines. In this post, I’ll explore why there is a focus on injury and whether we can reframe our thinking to keep performance at the forefront.
Focusing on Injury Prevention
Given the overlap between sports science and sports medicine, injury has always been of interest. Indeed, several frameworks for sport science practices, in both research and applied practice, focus on injury prevention processes. These include van Mechelen’s early ‘sequence of prevention’ model (see this post for more on this seminal model), the Translating Research into Injury Prevention Practice (TRIPP) framework, or more recently, the Team-sport Injury Prevention (TIP) cycle, to name just a few.
Attention to injury risk mitigation is understandable and necessary, given the negative financial and performance effects of injury. One study, for example, estimated that Premier League teams lose an average of £45m due to injury-related decrements in performance per season (Eliakim et al., 2020). Given this was based on data from 2012 to 2017, this is now likely to be even higher.
More widely, research by an international insurance broker put injury costs to Europe’s top men’s clubs in the 2021/22 season at over £500m. Plus, injuries and therefore, reduced availability unsurprisingly impact team performance negatively, as we previously discuss here.
Injuries may be easier to quantify than performance itself, especially in team sports. This objectivity is not entirely without challenge, given the grey areas in injury and the lack of consensus on injury definitions (Clarsen and Bahr, 2014; Hulin, 2017). But generally speaking, injuries are a well-defined event, as Eyal Eliakim from Zone7 told me in one of our discussion pieces on injury risk forecasting.
Yet, reaching peak performance innately requires risk. Excessively mitigating risk can have negative effects on performance and may, in fact, lead to an increase in risk via reduced training exposure. For example, greater preseason participation has been associated with a reduction in odds of injury in the subsequent season (Ekstrand et al., 2020; Windt et al., 2016). Furthermore, developing physical capacities, such as aerobic fitness, strength, and repeated speed ability, can enhance performance whilst simultaneously decreasing injury risk (Malone et al., 2018; 2019).
Therefore, scientific support of athletes should not be viewed primarily through a risk averse lens of injury reduction, but as an integrated process of optimizing performance. With this in mind, how can we bring performance back into focus?
The Performance Cycle Framework
Given the need to keep performance as pre-eminent, here I present a performance-driven framework. The Performance Cycle (Figure 1) illustrates three overlapping and cyclical phases of the training process; Preparation, Competition, and Recovery. While there is overlap in these phases (i.e. there is no distinct time-point in which an athlete moves from recovery to preparation), it may be beneficial to consider them somewhat separately when exploring scientific support in each of these areas.
The context of each of these phases depends on the sport, time of season, and athlete in question. For an Olympic athlete, their foremost competition occurs at the culmination a quadrennial period. Meanwhile, team sport athletes are expected to perform consistently over much of the year, with multiple competitive fixtures each week. Ultimately, competition determines the performance demands and therefore, the subsequent preparation and recovery needs, while the relative importance of the phases may change at different points of the year.
The multidisciplinary nature of performance support is acknowledged, with each realm considered throughout this process. In fact, they are represented within the same area to highlight the desire for interdisciplinary support. While multidisciplinary support refers to knowledge of different disciplines that stay within their boundaries, interdisciplinary support synthesises links between disciplines into a coordinated and coherent approach (Choi and Pak et al., 2006).
This framework does not sidestep the importance of injury risk mitigation. Injury risk is intertwined throughout the Performance Cycle, with interventions underpining preparation, competition, and recovery directly influencing risk. However, with this cycle in mind the impact of interdisciplinary support can be re-focussed on promoting performance. Ultimately, the Performance Cycle can be used by organisations and individuals alike to plan, implement and review the multidisciplinary scientific support across preparation, competition, and recovery, all with a goal of improving athletic performance.
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