A dormouse, a t-shirt made from bin liners and a jar of Nutella: Applying creative methodologies to understand athletes’ experiences of overtraining syndrome

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By Lindsay Woodford

Exceptional physical features, together with high commitment and motivation, are important attributes of high-performance athletes. However, when faced with frustrating setbacks, the same qualities of commitment and motivation that have elevated athletes above the pressures of competition can be their own worst enemies. It is not uncommon for elite athletes, especially young athletes to push themselves too far, to overreach and experience extreme tiredness on a regular basis and never reach their full potential because of excessive training load and insufficient recovery.

Unexplained underperformance and persistent fatigue – Exploring overtraining syndrome

Overtraining syndrome has been described as persistent fatigue and underperformance, which occurs following hard training and competition. The symptoms do not improve following two weeks rest and there is no other identifiable cause. It can be a devastating condition, as highly motivated athletes have to cope with the frustration of reduced performance and taking extended periods off training and competition to recover. Monitoring and treating a persistently fatigued athlete can be challenging, as the root cause of the fatigue is often not recognised until months of poor performance have passed. Accurate diagnosis is difficult as there are often numerous other medical and psychological conditions that present with similar symptoms. 

There is much debate in the sport science literature regarding the aetiology of overtraining syndrome. Various physiological mechanisms have been proposed to influence an athlete’s vulnerability to the overtraining state. These include low muscle glycogen, decreased glutamine, central fatigue, oxidative stress, an imbalance in the autonomic nervous system, hypothalamic dysfunction and elevated cytokine levels. However, no single marker can be taken as an indicator of impending overtraining syndrome. Until a definitive diagnostic tool for overtraining syndrome is developed, regular monitoring of a combination of performance, physiological, biochemical, immunological and psychological variables seem to be the best strategy to help identify athletes who are failing to recover properly.

Making the familiar unfamiliar – Using visual methods in applied psychological research

My passion for conducting research in the area of overtraining syndrome was inspired by my personal experience of the condition when I was competing as a national level lightweight rower. I understood first-hand what a debilitating condition it can be and the devastating impact it can have on an athletes’ career. I desperately wanted to help further our understanding of the condition so that sport science and medical practitioners could better support athletes like myself. There is a wealth of research that has examined the pathology of the overtraining syndrome, but no comprehensive understanding of the subjective experiences.

When I started my research, I was excited to conduct my first interview with a triathlete who had suffered with the condition for the last five years. I thought long and hard about the questions I was going to ask, and I was eager to hear his responses. But at the end of the interview I felt bitterly disappointed that the answers I received told me nothing I didn’t already know. I could not understand why. Perhaps he had difficulty accessing and communicating his experiences, maybe he was offering a rehearsed narrative, or was it that I was asking the wrong questions? 

I attended a seminar organised by my colleagues Victoria Clarke, Nicola Holt and Elizabeth Jenkinson from the psychology department at the University of the West of England, in collaboration with Cathy Randle Phillips and Catherine Butler. The seminar focused on exploring the potential for creative and arts-based methods for applied psychological research. Whilst feeling demotivated and dejected about my research it was following this seminar that I experienced what can only be described as an epiphany. I realised that the problem was that I was asking questions I already knew the answers to; overtraining syndrome had become too familiar – I needed to make it unfamiliar.

It has been suggested that by introducing a visual element to the process of data collection we can potentially provide different ways of knowing and understanding. Art can address atomization by forcing us to slow down our perception, to encourage us to linger for a while and to notice new things. Perhaps if I utilised visual methods in my research I could disrupt the athletes’ narratives and allow the unsayable to reveal itself? If I asked my participants to play with Lego, paint and take photographs would it provide a platform for exploring their world in more reflexive depth? 

The Dormouse – Recollections of a lightweight rower with overtraining syndrome

In my role as a practitioner I have been humbled and privileged to hear the stories of athletes I work with. I have shared in their joy and their sorrow, I have played a part in their journey of self-exploration – my role has been so much more than enhancing athletic performance. Yet in my research, to date, I have not allowed my participants to tell their stories. So, like all mad scientists I conducted a little experiment on myself! I got my camera out and started taking photographs of what overtraining syndrome meant to me. These are the images that represented my experience of living with the condition and some extracts from the story they inspired, told as part of The British Journal of Sports Medicine’s Patient Voices series this month.

Making weight was a challenge for me and my crew, the extreme and frankly ridiculous weight loss strategies we employed in the days leading up to the National Championships in 2000 seem incomprehensible now. I was not at race weight the night before the finals, so I severely restricted my food and drink intake, to the point of dehydration. I remember feeling so thirsty it was uncomfortable to swallow. The blissful sensation of sucking the moisture out of my toothbrush – I savoured that moment when the cool, minty water slid down my throat, it could have been champagne! It was July and I had set the central heating in the house to full blast, I had put on as many layers of clothing as I could, and I slept motionless, restrained from the weight of the blankets pinning me down. Despite subjecting my housemates to a night in a sauna, the next morning I was still 500g over race weight. In a last ditch attempt to be able to compete, I fashioned a t-shirt out of a bin liner, layered all my cold weather kit on top and ran a few laps round the housing estate. I remember darting behind a dustbin when I saw my coach drive past, I did not want him to know the shameful extent of my weight loss strategies. But to me it was normal, it was just part of being a lightweight rower, we all did it, I think our coach did know but he chose to ignore it. 

These strategies proved effective as I won a bronze medal at the Nationals, and later a coveted place on the England lightweight women’s rowing squad for the 2002 Commonwealth Games.Everything was going to plan, when one morning at 5.30am as I reached over to turn my alarm off, I felt my head begin to spin, my heart was pounding, and I felt violently sick. I threw up to ease the nausea, sipped some water, put on my kit and drove to the rowing club. I managed to complete the training session, but my legs felt like lead and my heart was racing. This was the start of a progressive decline in performance.

One of the most debilitating symptoms I experienced was the need to sleep. I became affectionally known as “The Dormouse” because I slept over 10 hours a night and during the day. When I stood up my heart rate would go through the roof and my blood pressure would drop, I felt constantly dizzy and sick. I caught cold after cold and I felt like I had a pair of golf balls permanently lodged in my throat. Despite these debilitating physiological symptoms, I was more motivated than ever to represent my country. 

It took me two years until I was well enough to do a full training session on the water with the rest of the squad. I had various relapses along the way, but none as severe as the first one. By the time I was fit enough to trial for the national team again I was completely burnt out. The sport that I loved more than anything else in the world, became something I despised and not long afterwards I quit (Woodford, 2019).

My current research has embraced some of the methods offered by the creative arts and has empowered my participants to shape its direction. I am excited about how this new approach can further our understanding of this debilitating condition and help us develop strategies to support those athletes with overtraining syndrome. 

Who is sport psychology for?

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By James Byron-Daniel and Manuela Teti (UWE MSc Sport and Exercise Psychology graduate)

What is sport psychology? 

Sport psychology is a broad subject, covering such things as the enhancement of athlete performance, dealing with pressure, enhancing focus, working with addiction and an infinite number of other issues. In terms of these services there has traditionally been a focus on athletes at the professional end of the sporting continuum, and there is a wealth of research which has shown very convincingly the efficacy and worth of these services for this group of athletes. All sport psychologists who work in practice have a smorgasbord of techniques they can bring to any given athlete or team, from psychological skills training (goal setting, visualization, relaxation techniques and self-talk) to more intensive therapeutic techniques (mindfulness, cognitive restructuring, REBT), all of which can be adapted and used collectively to address the issue or issues we face in applied sport psychology work.  

We can also say from our own experience, both from an applied sport psychology perspective and as a professional coach, that athletes and teams almost all believe in the importance of the mental side of their sport, regardless of what that sport is, and that despite an emphasis on the importance of this side of their training and performance in competition situations they do very little, and often feel they don’t have the opportunity, to enhance the psychological side of their game. 

Sport psychology, in an applied sense, therefore fills this gap. Indeed the discipline as a whole has been developed and continues to evolve in order to provide a way to enhance and support athletes to be the best they can be. So, taking both the focus of sport psychology and the need and enthusiasm for it in sports in general then it seems rationale to assume sport psychology is widely available to all and that sport psychology services are integrated across all levels of all sports. This unfortunately isn’t necessarily the case. 

Who uses sport psychology? 

Sport psychology services (SPS) have traditionally been directed at professional athletes, perhaps not exclusively, however when one looks at any number of sport psych textbooks there tends to be a skew to this group, or at the very least when describing and discussing applied techniques the assumption often is that who you are working with has significant access to sport psychology and other resources. This may well be the case for professional or semi-pro athletes however this is almost universally not the case for the hundreds of thousands of us that play and compete outside this professional group. If one were to look at a current issue of a popular sport psychology academic journal (for example Journal of Applied sport psychology; The Sport Psychologist; Psychology of Sport and Exercise), there is a trend toward elite and professional levels of sport in academic research as well (not exclusive but certainly the focus tends to be on semi professional and professional sports women and men). There are undoubtedly many reasons for this focus however this shouldn’t lead us to conclude that sport psychology services have no place in amateur sport, be that competitive or non-competitive amateur sport. It is in the authors experience that far from not having a place there is in fact just as much demand for sport psychology support and that sport psychology interventions and support at this level can be just as effective. There is however a sub group of this already unrepresented group that have even less access to sport psychology services and are further under researched, and that is young (non-adult) non-elite athletes.

Sport psychology support for young amateur athletes 

Even less research and applied work has been dedicated to youth non-elite athletes, with a lack of guidance for Sport Psychologists working with young athletes which in recent years has sparked streams of research aimed at generating developmental frameworks and attempts at understanding young athletes’ progression in sport, from childhood to adolescence and into adulthood.  

Authors of the ‘International Olympic Committee (IOC) Consensus Statement on Youth Athletic Development’, reported an “urgency to address the culture of specific sports and youth sport in general, which have become disproportionately both adult and media centered”. The IOC recommendations advise on the need for widening the definition of success in youth sport, focusing on the development of young athletes in their whole and as “persons”, and committing to their psychological growth. The historical paucity of literature on developmental sport psychology is even more surprising when considering that young athletes are placed at the “ideal window of opportunity” for developing mental qualities and competencies. 

Many researchers agree on the need for developing comprehensive and holistic models and programs to support young athletes at a vital transitional period of physical and psychological development.  This is of course challenging for all sorts of reasons, perhaps one of the most important being the already existing challenges for young people, be they pre-adolescent or be they 12-18 years of age.  

Due to the high demands of competitive sport and more general life demands, young athletes are faced with the need to take ownership of their psychological growth: this often leads them to intuitively (through experience) and/or informally (taught by significant others) acquire a repertoire of mental skills necessary to cope with the pressures their sport places upon them. Consequently, young athletes may gain an implicit understanding of a range of psychological skills, albeit at various levels of awareness

Furthermore, the lack of easy-to-access sport psychology services to young athletes might drive them to spontaneously seek information, gain understanding and share experiences. In this context, in addition to relying on members of their support network, they might explore the internet and access online communication tools, such as social media platforms etc. However, a lot of this is assumed as so little work is done at this group, and it is in this context that we have conducted an initial investigation into sport psychology in youth amateur sport.  

Our research into sport psychology and young athletes 

The main purpose of our research was to investigate non-elite young athletes experiences by giving young athletes voice and an opportunity to express feelings and communicate thoughts in relation to their sporting engagement. The study revolved around three main research questions:  

  • What are young athletes’ perceptions of psychological needs and experiences of challenges?  
  • What is their understanding of the psychological dimensions of sport?  
  • What spontaneous ways do they resort to when seeking psychological support? 

An online survey, including quantitative and qualitative data collection and qualitative semi-structured interviews were conducted in a sample of 13-19 year old girls and boys who regularly engaged in extracurricular sporting activities (outside of school and within clubs, associations, organisations), involved in a number of sports (including multi-sport engagements), at any level of training and competition, but not included in any talent development programs or professional level sport structures.  

Through these interviews what the participants said clearly showed the discrepancies between young athletes’ needs and their sporting realities. The young athletes’ all desired sport psychology support, specifically access to independent sport psychology professionals and availability of ‘in-house’ and ‘easy-to-access’ services consistently integrated in their ‘ideal sporting world’. Participants sometimes resorted to Screen-Based Media (SBM) as a spontaneous way to seek psychological support: however, the young athletes were favourable to online communication technology to get that support as well as face to face support with a sport psychology specialist. (This work is currently being prepared for publication, as well as a follow-on study to this initial work.) 

So what does this mean and where do we go from here? 

In summary, it certainly seems that there is a need for a greater understanding of how sport psychology services could be used to benefit young athletes, and that irrespective of level of athlete this support is desired and sought out. Our work with these young athletes clearly shows that demand and perhaps points to a way we can get sport psychology into amateur club and team settings (through screen-based media and social media being one possibility). The lack of research into this group also needs to be addressed, specifically deepening our understanding of how sport psychology can be integrated within a young athletes life, and what the subsequent benefit for future engagement and performance might be. We believe that integrating sport psychology into youth sport has the potential to reap huge benefits for youth sport and the sport psychology profession in general, and we hope in the years to come a greater focus on this group of athletes will lead to not only to the next generation of elite levels sports women and men but perhaps more importantly a much greater engagement with all sports across all age groups at all levels. 

Introducing our new lecturer, Dr Gamze Arman!

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By Gamze Arman

My name is Gamze Arman, and I have recently joined the UWE Department of Health and Social Sciences as a Lecturer in Occupational Psychology.

I received my undergraduate and master’s degrees from the most prestigious universities of Turkey (Bogazici University and Koc University, respectively) and my Ph.D. degree in Industrial/Organisational Psychology from DePaul University in Chicago – IL, USA. Prior to joining UWE, I worked as an assistant professor at MEF University (Turkey) for two years, with a joint appointment in the psychology and business administration departments.

At UWE, I will be primarily teaching at the masters’ program specialized in Occupational Psychology, and I will be involved in the modules such as training and development, and psychological assessment, in addition to the undergraduate module on research design and analysis.

My research is relevant to the “Optimising Performance and Engagement” theme of PSRG and focuses on two key areas: 1) diversity and interpersonal relationships in organizations as determinants of the task and 2) contextual performance in the work context. Within the broad scope of diversity, I am interested in gender and culture as the critical bases, and in my research so far, I have specifically focused on the following topics:

  • Career development of female employees (What is the role of senior female managers on career development of junior women? How does involvement in Women in Business student clubs impact the career perceptions of female university students?)
  • Expatriates and high skilled immigrants (How do host country nationals perceive and treat expatriates from different cultural backgrounds? What are the factors facilitating or hindering female expatriates’ career development in a given cultural context?)
  • Functioning of multinational teams (How does subgroup formation take place in teams consisting of members from several national backgrounds? How does it impact team functioning?)

Within the area of interpersonal relationships in organizations, I am primarily interested in:

  • Abusive supervision and the dark side of leadership (What is the role of third-party observers in abusive supervision cases? Which factors impact their perceptions and willingness to help the victims?)
  • Relational energy among employees (How do people in a work context impact each other’s mood and motivation?)

Although my priority is research, I am a proponent of the scientist-practitioner model of occupational psychology. In my experience as a practitioner, I worked for human resources departments of multinational companies such as Accenture, and I engaged in consulting projects in the USA and Turkey. I look for opportunities for collaboration with practitioners since I believe consulting and delivering training programs to professionals provide valuable inspiration for my research via the interaction with people working at different organizations.