Human Performance, Performance | Feb 14, 2019
We explore attitudes and approaches in three elite high performance environments.

Do you have the nagging sense that you can be doing more to help your athletes recover?

By John Portch

While athletes may bemoan cryotherapy in post-game television interview or on social media, they fully understand the benefits and wholeheartedly trust the support staff who promote modalities that increase athlete availability and reduce injury risk.

Of recovery, Dr Phil Wagner of Sparta Science, an AI technology helping elite athletes reduce injury, says that recovery is: “Essential to keep up the body’s resilience, or the ability to recover quickly and protect itself against injury.

“Data from nearly a million Sparta scans shows that fatigue negatively impacts force production and movement mechanics, the foundation for performance in all sports, whether those movements are performed on the trapeze, on the court or on the bike.”

Its importance is paramount but athlete comprehension and acceptance cannot be developed over night. What are some of the most important considerations for coaches and support staff when looking for that buy-in? The Leaders Performance Institute asked the United States Tennis Association [USTA] and Ineos Team UK, as well as Cirque du Soleil.

Education and culture

You must tell the athlete from the off if you want them to understand the need for a recovery tool. As Director of Performance for the Player Development department at the USTA, Brent Salazar works closely with the aspiring teenagers that attend the organisation’s training camps in Orlando and beyond. “When it comes to recovery, we try to educate them with the basics,” he begins. “What does their sleep look like? What does their nutrition look like? Then what does their hydration protocol start to look like?”

The process of education in hydration and nutrition begins almost as soon as they breeze through the gates. “Their first meeting is going to be with a nutritionist,” he continues. “They set that up for each individual and from there we can make sure they start to understand those basics.”

By the time USTA graduates reach the professional ranks they are well-versed in the organisation’s culture of recovery. The artists employed by performance company Cirque du Soleil tend to be literate in modes of recovery too and, as Andrew Walker, the Senior Head Therapist at Cirque, explains, this has shaped the organisation’s approach to performance readiness and education around recovery.

He says: “We have protocols and recovery processes in place but the main thing about creating the right culture is education; it relates to the onboarding of artists and new people coming in, getting them to understand the environment and what we want from them, understanding what they need from us, and creating that two-way relationship.”

Not everyone can be in the building so Skype and PowerPoint presentations are common tools when Cirque reaches out to its artists and support staff situated across the globe. “Ours is a centric model. We also educate staff, artistic directors, nutritionists, pre-med staff, psychologists – all bought into our philosophy and culture. The communication is key and sometimes we’ve used translators to put messages across because I think we sometimes forget that people learn in different ways.”

Building relationships

First is education in recovery protocols, next comes understanding and, finally, trust. Cirque, as Walker tells the Leaders Performance Institute, tries to create a familial environment. He says: “We’ve got resident shows where it’s a family atmosphere and it’s important that we understand we’re a family, both worldwide and on each show. So that recovery process within that family is clear; people understand each other, people will be able to talk to people at different levels, and it’s also about a culture of openness, the trust, and individuals knowing where they can go to access specific modalities.

“I’ve learnt at Cirque that we’d sometimes forget this in sport; we’d actually group people in that aren’t particularly right in terms of their cultural differences and what they actually require.”

Similarly, Ineos Team UK draws upon a multinational line-up for every race and grand tour and trust is no less essential between riders and support staff. Take the Tour de France as an example: riders will climb off the bike in the early evening and be back in the saddle early the next morning during a gruelling three-week schedule. Yet cryotherapy is not an option, as Nathan Thomas, Physiotherapist at Ineos Team UK points out: “We can be changing hotel every day and have 20 hotels over the course of three weeks. You cover never use cutting edge recovery methods such as cryotherapy because it’s not feasible.”

Ineos Team UK make a concerted effort to control whatever aspects of recovery they can, whether it is compression boots on the team bus after the day’s action or carting each rider’s mattress and pillow from hotel to hotel as part of the emphasis placed on sleep hygiene. This all comes under Team Principal Dave Brailsford’s famous ‘marginal gains’ philosophy but equally significant are the team’s efforts to maximise their time in the evenings. Riders will come in for a massage, acupuncture, dry needling or high velocity thrust manipulation.

That rider-support staff relationship runs deep. “You will have already built that relationship prior to the race,” says Thomas. “Come race time everyone is dialled-in; they know what you’re doing, they know why you’re doing it, what you’re looking for, and why you’re looking for it. Then it becomes automatic for the race; the race should be as stress-free as possible and as time-efficient as possible because of that small window of opportunity. If they get back to the hotel at 7 o’clock at night they’ve got to eat, they’ve got to see me, and they’ve got to go to sleep.

“A conventional physio, osteo or chiropractor assessment can take up to an hour and a half if you did a thorough body, head to toe, assessment. I don’t have eight hours every night to see every rider so, knowing the rider, I’ll pick certain things they are susceptible to; one rider may get lower back stiffness and another may get hamstring stiffness; I make it very specific to the rider because I know that’s where they’re going to break down.

“I’ll try to keep it as time-efficient as possible and pick certain monitoring tools for that rider for that race. If I run a drop-in clinic for everyone then I have to be quite structured about how we do it because I may have 20-30 minutes with each rider so it has to be really on it in terms of communication – the last thing you want is riders being treated at midnight.”

Monitoring tools changing discussion

Thomas, Walker and Salazar also explain that the monitoring tools themselves have impacted on the quality of the discussions they are able to have with coaches and athletes. Walker, whose background includes time working in English soccer with Premier League side West Ham United and rugby union’s Premiership with Saracens, describes the shift for the Leaders Performance Institute. He says: “Over the last seven to ten years there’s more research to look at, more monitoring tools, more digital experiences – the way we’ve changed with monitoring apps – that’s changed our thought process.”

As Salazar explains, this is also true at the USTA: “I want to make sure we’re making the best use of the players’ time and so we start to determine what a physical practice is.” GPS technology has been a particular game-changer: “We can really quantify some of those numbers. Whereas in the past we’ve not been able to and would just use time. Coaches have got to use their eye and trust what they see because they’re pretty darn good at that and will say when they feel an athlete needs to cut down.

“Tennis is notorious for coaches saying ‘let me get 20-25 hours of court time during the week’ and so that’s why we need to educate the coaches and ask if this is really the best use of the players’ time. Are they better off going full speed that week or 16 hours of that week instead of going 65% or 70% for 25 hours of that week? What type of habits are we creating?

“Those are the things we don’t have the answers for and we’re working through them with our players right now and trying to explain the stress levels that they’re coming into, especially for the national camps, because they’re not always used to hitting with their peers; a lot of times they’re used to hitting by themselves with their coaches.”

When athletes and artists are empowered and armed with knowledge, they can be the ones to start the conversation. Thomas says: “I’m concerned with functional movement and we’ve started using an app to monitor certain body movements. I’ll collect data over the course of a ten-month season; data on hip movement, spinal movement or perhaps hamstring flexibility.

“You’re constantly showing the athlete what you’re doing and that’s massively important. Athletes like to have control and like to know what’s going on – at least I’ve found that with cyclists anyway. It’s that constant dialogue; I’ll tell them where there might be problem but I won’t tell them too much because we don’t want to overload them.

“So if their hamstring flexibility with 95 degrees and now it’s only 80, then he’s 15 degrees short of where he normally is; I’m going to focus my treatment on getting that hamstring back to normal. I’ll test, and if it’s up to 95, we’ll continue treatment and re-test. The dialogue keeps them happy, they’re doing something productive and it keeps them positive.”

Walker has enjoyed similar results at Cirque du Soleil. “Any monitoring tool is an adjunct, part of a wider process,” he observes. “What we’re trying to answer is if there is any space in training that’s affecting our artists; is there anything being red-flagged? Have our wellness questionnaires shown the quality of their sleep getting worse? Or it might be their mood and they’ve been stressed recently; we know that can affect performance and lead to injuries, so therefore we need to have a conversation with the artist. So for me, tech is a tool whereby we can then have a subjective conversation that we can put in place the right processes for that individual.”

Some artists can also serve as ‘barometers’ for the wider group that Walker and his colleagues can analyse. “They can help us make important decisions about a show itself; there might be six or seven artists who are theoretically our barometers with regard to training loads, recovery processes at a hotel, travel between cities. It allows us to analyse things in a more global way while looking at the individual and making informed decisions every day on what’s best for the artist group in terms of helping them to perform at their best at any given moment.”

Durability by Design

Recovery is ultimately a component of performance readiness and athlete/artist availability. With this in mind, we turn our attention to Cirque du Soleil’s Durability by Design initiative, which looks at the three pillars of prepare, perform and recover with a view to servicing their artists’ needs. “Each of them are interconnected,” explains Walker.

“So when we speak about recovery at Cirque, it’s also speaking about the preparation of how they’ve recovered; to prepare themselves properly because recovery is also part of their preparation and their performance.

“For us, it’s making sure that training regimes are correct, the recovery days and the active recovery in between sessions is properly put down and correct for me. Unlike in sports environments, at Cirque we can sometimes go from a one-show day to a two-show or three-show day and our performers will need different recovery processes.

“We try to understand our individuals but it’s also putting that education in place to start with and considering the artists’ needs; that might be nutrition, mental preparation, strength & conditioning – recovery within in all those aspects – even looking at facilities and equipment we travel with, the difference between arena shows, big top shows and resident shows. Within all of that we need to look at artists’ needs.”

And what of the future in recovery? Walker’s take echoes much of what is being said across the performance space: “In the next 18 months there will be a focus on mood and stress levels; there’s different parameters with regard to that such as people’s facial reactions and monitoring of mood swings.”

Mood measuring will not, however, be the greatest game changer in that time. “The biggest innovation over the next 18 months is going to be about making sure you’ve got the culture right and making sure you’ve got the buy-in of the artists on an individual level while also understanding the individual.”

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