Coming Back from Near Death

Transcription

Coming Back from Near Death
HUMAN LIVES
|
Coming Back from Near Death:
Heart Attack in a Young, Fit Exercise Physiologist
In the latest of The Sport and Exercise Scientist (The SES) ‘human lives’ series, Dr Richard Godfrey,
a long standing and active member of BASES speaks about his recent health problems to Dr Garry Tew
I
n September 2007, at 45 years
of age, Dr Richard Godfrey
suddenly became a member
of a club that nobody ever wants
to join by suffering a heart attack.
Fortunately, he survived and is
presently in good health. Recently,
he kindly agreed to share his
experiences with The SES.
Richard with the British Olympic
Association in Canada
Dr Richard Godfrey is an experienced
sport and exercise scientist. In 2003, after
completing a PhD at Cranfield University,
he joined the teaching team at Brunel
University, where he is currently a senior
lecturer in sports coaching and human
performance. Before this, he worked for
12 years as a physiologist at the British
Olympic Medical Centre (BOMC), the
British Olympic Association’s department
of science and medicine. Between 1996
and 2003, he was Chief Physiologist of the
BOMC and was involved with organising
physiology service provision to elite sport
before the Home Country sports institutes
were operational. Richard’s main research
interests include growth hormone and
exercise, and the physiology of sports
performance. He has been a BASES
member for 20 years, an accredited
physiologist (support) for 15 years, served
on a BASES committee for five years and
has contributed many articles to The SES
and a number of its previous incarnations.
In 2007, he was runner-up in the voting
for BASES Chair-Elect.
COURTESY OF DR RICHARD GODFREY
Professional background
Health problems
swimming sessions in recent years (a
3,600 m interval session in just over 60
mins). However, his exercise session
before work the following morning was
much less successful. The intention was
to complete eight 30-second sprints on
the bike. By the fifth repetition, he felt very
fatigued with a strong burning sensation
in his chest. He was very annoyed that
he hadn’t completed what he’d set out
to do, but didn’t read too much into his
symptoms at that time. At work, later that
morning, the burning sensation intensified
until finally, in extreme pain, he asked a
colleague to take him to the local accident
and emergency department.
Richard’s heart attack occurred on 24
September 2007. There was little warning
of this event, but after swimming in a race
at Lake Annecy, France, he did feel “quite
unwell”, with symptoms of fatigue and
breathlessness. For two days afterwards
he experienced a burning sensation in
his chest and eating or drinking anything,
even water, made him feel very nauseous;
however, over the next couple of weeks,
nothing remarkable happened and he was
generally symptom free.
At the hospital, following a 12-lead
electrocardiogram, Richard found himself
surrounded by medical staff. A vein on
his right arm was cannulated so that
morphine could be administered for the
pain; his left arm was similarly cannulated
with a saline drip, and he wore an oxygen
mask and a pulse oximeter. Around this
time, he overheard the doctors talking
about ST-segment elevation and it was
confirmed he was in the middle of a heart
attack.
Throughout most of September 2007,
Richard experienced the occasional bout
of “chest burning”, which he thought was
indigestion. He continued to undertake
his usual exercise regime of swimming,
cycling and resistance training. On 23
September, the day before his heart
attack, he completed one of his best
The medical team worked hard to stabilise
the condition before transferring him by
road to a specialist cardiac unit three
miles away. Richard recalls being taken
outside to an ambulance in preparation
for this journey, but little after that, for
he suffered a ventricular fibrillation (VF)
arrest. VF is a potentially fatal condition
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| Issue 25 | Autumn 2010 | The Sport and Exercise Scientist
characterised by uncoordinated,
ineffective contractions of the ventricles.
This arrhythmia causes unconsciousness
in seconds, with death soon following
if untreated. Fortunately, after being
quickly brought back into the hospital,
Richard was successfully “cardioverted”
to sinus (normal) rhythm following three
defibrillator shocks.
He remembers being vaguely aware of
lights above him and of feeling anxious,
tense, and very angry. He describes it
as “like swimming through treacle with
an anchor tied to my feet and with every
muscle fibre tensed to 110%”. He also
remembers thinking that he would have
“done anything to get back to the light
[consciousness]”.
On being transferred to the specialist
cardiac unit, Richard underwent an
emergency coronary angiography. This
invasive procedure uses a special dye
(contrast material) and X-rays to identify
any obstruction to blood flow in the
coronary arteries. A catheter (a thin,
hollow tube) was inserted into his right
femoral artery and carefully moved up into
the heart before the dye was injected. The
images demonstrated a large intraluminal
thrombus (blood clot) in the right coronary
artery. Treatment involved removal of the
thrombus via aspiration, infusion of the
anticoagulant ReoPro©, and doses of
the vasodilators, adenosine and glyceryl
trinitrate.
After being closely monitored for three
days, he was discharged into the care
of his good friend Greg Whyte and his
family for a month as, initially, it was not
wise for him to be alone. Several drugs
were prescribed for the short-to-medium
term to reduce the risk of a further heart
attack, including anti-platelet agents
(Clopidogrel and Aspirin), a beta-blocker
(Bisoprolol), an angiotensin-converting
enzyme inhibitor (Ramipril), and a statin
(Simvastatin). This was based on the
assumption that the underlying cause was
a ruptured atherosclerotic plaque. In fact,
at this stage, the cause was unknown.
In May 2009, Richard repeatedly
experienced breathlessness and fatigue
whilst climbing stairs, both at home and
at work. The heart attack had made him
a bit more wary about such symptoms,
so he went to see his general practitioner.
He was told that it was probably an
upper-respiratory tract infection, for
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|
HUMAN LIVES
insight was gained. Cardiac magnetic
resonance quantified the myocardial
damage: Scar tissue now extended from
the base to the apex amounting to 16%
of the right ventricle (see Figure 2).
Thankfully, other tests showed essentially
normal cardiac structure and function,
and no evidence of atherosclerotic
vascular disease. Therefore, it appeared
that Richard was not a typical heart-attack
victim. So what caused his heart attack
and subsequent blood clots?
Figure 1. A: Overview of a heart and coronary artery showing damage (dead muscle) caused by a heart attack.
B: Cross-section of the coronary artery with plaque build-up and a thrombus (blood clot).
which he was prescribed antibiotics and
advised to take a week off from work. A
few days later, he awoke to find his right
thigh was aching profoundly and the
whole leg was warmer and more swollen
compared to the left one. Suspecting
deep vein thrombosis, he arranged an
emergency appointment with his general
practitioner. However, he never made it
to the appointment as, one hour before
it, he lost consciousness whilst going
downstairs. When he came round on his
hall carpet, he was hot, sweaty, confused
and very breathless and dizzy. He rang
for an ambulance, which came in due
course and he was admitted to hospital.
During the examination, a computerised
tomography scan identified blood clots
in his right leg and both lungs, and an
ultrasound scan demonstrated that the
right chambers of his heart were dilated.
Thrombolytic drugs were injected to help
dissolve the blood clots and Richard was
fortunate enough to survive.
What caused these health problems?
A heart attack, or myocardial infarction
(MI), is where heart tissue dies due to lack
of blood supply. Most heart attacks occur
when a thrombus forms on a ruptured
atherosclerotic plaque in a coronary
artery (see Figure 1). If a thrombus
becomes large enough, it can mostly or
completely block the flow of oxygen-rich
blood to the part of the heart muscle fed
by the artery. If the blockage isn’t treated
quickly, the heart muscle will begin to die
and be replaced by scar tissue. In fact,
some cardiac consultants use the phrase
‘time is muscle’. This heart damage can
either be minimal, having little effect on
function, or it can cause severe problems,
such as heart failure and life-threatening
arrhythmias.
In the months following Richard’s heart
attack, several investigations were
undertaken to try to determine the
underlying cause. Unfortunately, little
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Issue 25
Feedback from the treatment
Richard has mixed feelings about the
treatment he received for his health
problems. Indeed, although the treatment
of his heart attack was generally excellent,
some of the medical care he received
regarding his venous thromboemboli
was quite the opposite. For example, he
strongly believes that his most recent
health scare could have been avoided
if medical staff had checked for clots
in May 2009, when he presented with
breathlessness, dizziness, tachycardia and
a chesty cough. It is perhaps worrying that
he wasn’t screened, given that post-MI
patients have a 10–40% increased risk of
thromboembolism and that anyone with
an upper-respiratory tract infection has a
transient but significantly increased risk
(Smeeth et al., 2006).
Other examples of sub-optimal care
arose during Richard’s time in hospital
and include failure to calibrate a blood
gas analyser prior to sampling, not using
enough transmission gel during an
ultrasound investigation (which resulted
in unnecessary and extensive bruising
of the ribcage), poor interpersonal skills
of several nurses and clinicians, lack
of care to minimise patient discomfort
during blood sampling and drug infusion
procedures and a seemingly long time (~7
hr) from diagnosis to treatment for a lifethreatening problem.
PTO
s
s
s
Figure 2. Cardiac magnetic resonance images of Dr Richard Godfrey’s heart highlighting inferior wall scar
tissue extending from the base to the apex of the right ventricle (white areas indicated by arrows).
Around 1–6% of heart attack patients
present with normal coronary arteries
on angiography (Raymond et al., 1988;
Widimsky et al., 2006). The mechanisms
underlying heart attacks in these
patients are not fully understood, but
might include a hypercoagulable state,
coronary endothelial dysfunction, coronary
thrombosis, cocaine abuse, and carbon
monoxide poisoning (Chandrasekaran
and Kurbaan, 2002; Robisek, 2002). In
Richard’s case, a hypercoagulable state
(i.e., a blood clotting disorder) seems the
most likely mechanism, because of his
history (two events in less than two years)
of thromboembolism in both arteries
and veins; however, to date, there is no
direct evidence of this. Nevertheless,
to minimise the risk of clotting, Richard
now takes Warfarin indefinitely, as well
as the cholesterol-lowering medicine
Rosuvastatin.
| Autumn 2010 | The Sport and Exercise Scientist | 17
HUMAN LIVES
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Coming Back from Near Death: Heart Attack in a Young, Fit Exercise Physiologist continued
Richard taking blood
that surfaced when he was 45 years of
age. Most of us are under pressure to
meet research and teaching targets or to
satisfy the demands of sports governing
bodies. This can very often displace the
appropriate weekly exercise targets for
health that we are all very familiar with.
Arguably, 30+ years of recorded exercise
and the fact he was well conditioned
at the time of the original heart attack
conferred additional “capacity” that
ensured survival.
COURTESY OF SALLY TRUSSLER
We would urge you to reflect on how
well you meet the current guidelines for
exercise and allow this story to convince
you that sacrificing exercise in favour of
career is not a good option. There is room
for both and there is a word that applies
to both...moderation! n
Perhaps most worryingly of all is that
Richard has felt unable to provide direct
feedback to the National Health Service
about these issues due to concerns that
this might negatively affect his treatment.
The present situation
Richard currently remains in good health
and exercises regularly. Although he
is now more sensitive to any unusual
feelings experienced, he is once again
swimming 3,000 m in <1 hr. His weekly
exercise also includes heavy resistance
training and 2–4 min repetitions on the
exercise bike at a heart rate around 95%
of maximum. His work life is also much
the same as before and he continues to
be published regularly; however, he now
manages work-related stress better and
has a healthier work–life balance.
Not having a definitive diagnosis
does cause some anxiety, but he is
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committed to leading a normal life;
although medication and regular general
practitioner and hospital appointments
will remain.
Richard is keen to share his experiences
and a case report explaining the clinical
aspects has already been published
(Whyte et al., 2009). There are also
plans to produce papers focusing on
the emotional and ethnographic aspects
of his experiences; Prof Andy Lane and
Dr Gary Armstrong will be working with
Richard on these articles, respectively.
A take-home message for sport and
exercise scientists
Heart attacks are more common in
males, but very rare in people <65 years
old. A blood clot, however, can happen
to anyone at anytime. In Richard’s
case, this appears to be the result of a
clotting disorder of autoimmune origin
| Issue 25 | Autumn 2010 | The Sport and Exercise Scientist
References
Chandrasekaran, B. & Kurbaan,
A. (2002). Myocardial infarction with
angiographically normal coronary arteries. Journal of
the Royal Society of Medicine, 95 (8), 398–400.
Raymond, R. et al. (1988). Acute
myocardial infarction and normal coronary
angiography: a 10 year clinical and risk analysis
of 74 patients. Journal of the American College of
Cardiology, 11, 471–477.
Robisek, F. (2002). Myocardial infarction
with angiographically normal coronary arteries.
Journal of the Royal Society of Medicine, 95 (10),
528.
Smeeth, L. et al. (2006). Risk of deep
vein thrombosis and pulmonary embolism after
acute infection in a community setting. Lancet, 367,
1075–1079.
Whyte, G. et al. (2009). Acute
myocardial infarction in the presence of normal
coronaries and the absence of risk factors in a young,
lifelong regular exerciser. BMJ Case Reports, 2009;
doi:10.1136/bcr.07.2008.0384.
Widimsky, P. et al. (2006). Prevalence
of normal coronary angiography in the acute phase
of suspected ST-elevation myocardial infarction:
Experience from the PRAGUE studies. Canadian
Journal of Cardiology, 22, 1147–1152.
Dr Garry Tew
Garry is a researcher in the area
of exercise and cardiovascular
health at Sheffield Hallam
University.
g.tew@shu.ac.uk
;
Dr Richard Godfrey
Richard is a Senior Lecturer
in Sports Coaching and Human
Performance at Brunel University.
richard.godfrey@brunel.ac.uk
;
www.bases.org.uk
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STRICTLY FOR STUDENTS
The Dissertation: The Culmination of
Your Undergraduate Experience
For many students the final-year dissertation is a task to be approached with trepidation;
Jayne Hastings and Alex Orton provide guidance from two different perspectives
Jayne
The main purpose of the final-year dissertation is to develop a
student’s ability to undertake a research project without close
supervision and present his or her findings in a written report. The
project will require an in-depth understanding of theory and current
knowledge of the chosen topic. It also provides a student with the
opportunity to enhance and/or utilise his or her practical ability and
organisational skills.
In my opinion, the components needed for the process to be
successful are as follows:
• A topic in an area of sport and exercise science that the student
is interested in.
• An appropriate research question investigated using appropriate
methods.
• Good experimental skills and experimental design; technical
skills and record keeping; interaction with subjects; ability to
work independently; good time management.
• Good data handling and analysis skills (e.g., interpretation,
presentation, recording, manipulation and reporting results, use
of statistics).
• Good communication skills (e.g., communication with subjects,
supervisors, technical staff; communication of results to a wider
audience, both written and orally).
My tips for students
• Get your subjects early and try and get a few extras in case of
dropouts.
• A good student–supervisor relationship is important. Have
regular meetings with your project supervisor booked in
advance and prepare for these meetings.
• Show enthusiasm – choosing a topic you’re interested in helps
with this.
• Show initiative – it is supposed to be a student-led project not
supervisor-led.
• Get organised – good time management is needed throughout
the whole process.
• Pick a topic that may help out with future career or plans.
Jayne Hastings
Jayne is the Associate Head of Department of Biomolecular and
Sport Sciences at Coventry University.
She has a PGCert in Learning and Teaching and is a BASES
Accredited Sport and Exercise Scientist.
Alex
As sport and exercise science students, the word “dissertation” strikes
the fear of God into many of us; it certainly increases adrenaline
levels and promotes hypertensive blood pressure. However, I’ve just
recently completed my dissertation study and I can honestly say, hand
on heart, that it was a truly great experience from start to finish.
Compared with the other disciplines of sport science that are covered
as part of the degree, I feel I’m most competent in the nutritionbased modules and, luckily, I have a genuine interest in this particular
area. Therefore, I decided to embark on a dissertation investigating
the effects of differing glycaemic index (GI) carbohydrate prior to
intermittent exercise on performance of the intermittent exercise task.
As a keen footballer, I was interested in looking at the pre-exercise
meal and the effects it has on metabolism and performance.
www.bases.org.uk
The first step I took was to phone friends who could be possible
subjects and most of the time I was forced to ‘make them an offer they
couldn’t refuse’, which would be a few beers if they agreed. I then
decided to start searching for useful journals and began my background
reading to help me become more familiar with the area. I honestly
didn’t realise how journal articles were obtained until this time!
The data collection period came around extremely fast; the first day
went smoothly, the first week went smoothly, but the second and third
weeks...not so smoothly. Some subjects let me down due to injury
or work commitments, then we had a day when the room we were
using was double booked so we had to find an alternative place at the
last minute, and the subjects complained about the low-GI meal of
lentils they had to consume. However, these setbacks were certainly
no match for the feeling I got whilst carrying out the experimental trials;
the feeling of conducting your own study and of being a real scientist.
When all the preliminary and experimental trials were complete, I felt
a real sense of achievement. A sense that was a little too short-lived as
it suddenly crossed my mind that I had a great deal of statistical analysis
to perform. However, it wasn’t as bad as I’d expected and I was really
looking forward to getting stuck into writing up the findings of the
study. I knew my study inside out and was interested in comparing
my findings with previous literature. I found that low-GI carbohydrate
improved endurance performance in comparison to the high-GI
carbohydrate intake, which supported my hypothesis. However, the
effects on substrate metabolism differed from previous literature,
which was slightly disappointing.
I had my project bound two days before the deadline. I felt a real
sense of pride and accomplishment, so much so that I wouldn’t let
anyone in my house read it for fear they would crease the pages or
spill something on it!
The dissertation can be a great way of putting theory into practice, and
gives us a great insight into scientific research.
Here are some practical recommendations I’d like to pass on
to fellow sport and exercise science students undertaking their
dissertations in the near future:
1.Be organised and manage time efficiently.
2.Prepare for setbacks and have alternatives.
3.Pick a topic of interest.
4.Ask more subjects than you need in case some drop out.
5.Confide in your supervisor.
6.Be confident and enjoy the experience.
Main value of the project
The dissertation allows the student to demonstrate his or her ability
to work independently, often under pressure and to use many
transferable skills, such as time management, initiative, problem
solving and, invariably, teamwork. Although these may not seem
of great importance to you at the outset of your research project,
these transferable skills are what enable you to work with people and
achieve a tangible output that employers will want you to be able to
demonstrate. As such, your dissertation may not only secure you a
quality degree, but also a job at the end of the process. n
Alex Orton
Alex is a third-year undergraduate in sport and exercise science
from Coventry University. Alex was supervised through his
dissertation by Jayne Hastings and would like to pursue a career
in teaching/lecturing, with hopes to complete a master’s in sports
nutrition in the near future.
Issue 25
| Autumn 2010 | The Sport and Exercise Scientist | 19
PROFESSIONAL DEVELOPMENT
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Developing a Successful Intern
Programme In-line with the BASES
Supervised Experience Pathway
Neil Gibson and Mark Ross give their perspectives on the internship programme run by Heriot-Watt University
T
he options available to graduates of sport and exercise
science are wide and varied; however, many wish to
pursue a career working with elite athletes. Having
seen the process of recruitment for such positions, one facet
consistently lacking in applications is relevant experience in
the field. As anyone working in performance sport will attest,
knowing the theory simply isn’t enough. In recent years, UK
Sport internships have bridged this gap, providing a steady
flow of highly qualified and experienced practitioners.
In the following sections, a supervisor and supervisee both
share their experiences of the programme, reflecting on the
challenges that delivering an applied programme of support has
posed.
The Supervisor’s View
Managing expectations
It is essential that initial contact between the interns and
coaches is a positive experience for both parties. Preparing
interns for this is an intense and challenging experience with
respect to managing their expectations and ambitions. Never
before has the phrase ‘Rome wasn’t built in a day’ been more
apt. It is vital they understand the requisite time-management
skills to balance their academic, intern and social commitments.
A major caveat of study-based intern programmes is that they
should not detract from academic development. In parallel, it is
important that coaches understand an intern’s level of expertise
and develop realistic expectations.
Interns’ commitment to the programme is enhanced when they
possess a good understanding of the skill-set being developed
over the year. Discussing and agreeing this before any support
work is delivered is certainly a beneficial strategy. With any
programme designed to facilitate an individual’s development,
there must be clear outcome goals (e.g., the preparation of
students to a standard commensurate with entry into the
Supervised Experience scheme). As such, the documented
competencies associated with this pathway are useful in rating
levels of expertise and tracking progress throughout the year.
This process allows students to continually self-evaluate and
provides a feed-forward loop for the supervisor.
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| Issue 25 | Autumn 2010 | The Sport and Exercise Scientist
COURTESY OF JOHN CURRIE
Over the past two years, Heriot-Watt University has strived
to provide a similar opportunity to students in their final year
of the sport and exercise science degree. A collaborative
approach between the School of Life Sciences and the Centre
for Sport and Exercise has seen students afforded the chance
to work with athletes from the University’s club performance
programme. The club performance programme was established
to give sports union clubs the requisite infrastructure and
ambition, and access to professional coaching and sport
science support services. Upon completion of the internship,
it is hoped that each intern will have facilitated his or her
academic development, gained valuable experience in the
planning, delivery and evaluation of sport science services
and, most importantly, built a portfolio of work that will support
future job applications and entry onto the BASES Supervised
Experience pathway.
Interpreting gas exchange data
Supervision
Using a guided-discovery approach to learning, aided by regular
feedback and progress meetings, is a worthwhile strategy.
Although time-consuming, we have found that students respond
positively to this approach and, in doing so, appear to develop
a much deeper understanding of the subject area. Offering
opinions on how things should be done, prior to students
developing their own action plans, should be avoided.
Students can then be challenged on the scientific rationale and
supportive evidence base for their recommendations. This is
facilitated further when support work interacts with the taught
academic content of their sport and exercise science course.
With respect to the delivery of practical sessions, students
should self-evaluate before receiving feedback. Providing
opportunities for interns to receive feedback and request advice
from practitioners other than their designated supervisor is vital
and ensures the experience is as diverse and challenging as
possible.
Personal thoughts
Supervising an intern has proved to be hugely rewarding, timeconsuming and challenging in equal measure. As is the case
with students, so it holds true with the supervisors that planning
the content and timescale of work undertaken is crucial.
The level of support work undertaken by students must be inline with, not only what they feel they can commit to, but also
that which the supervisor can realistically observe and provide
detailed feedback on. Working in parallel with the Supervised
Experience competencies gives an excellent yardstick by which
to guide development and assess progress.
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Of course, the success of the programme hinges largely on the
application and commitment of the students themselves. At
times throughout the year, you will be pleasantly surprised by
their progress, ingenuity and enthusiasm; at others, frustrated
at their development.
You will be required to enthuse and console in equal measure in
order to keep students motivated through what is an immensely
challenging experience. The reward, however, is more than
equal to the effort as you assist the development of a young
sport and exercise scientist in their chosen career.
PROFESSIONAL DEVELOPMENT
Researching applied work proved to be very time-consuming
and more problematic than the academic searches I was used
to. It also required me to rigorously critique the research and
assess its applicability to my work; something that was a real
challenge. The whole process ensured that when I met with the
coach, I felt confident in my understanding of the sport and my
ability to impact positively on the coaching process.
Physiological testing
COURTESY OF JOHN CURRIE
Physiologically assessing the athlete was one of the most
interesting aspects of the process,
due to my ability to transfer the skills
I was developing in my Honoursyear project. Although I had
performed tests on classmates, I had
never done so on an athlete. The
added pressure that this provided,
plus the requirement to deliver a
professional service, posed a real
challenge. Despite a lot of planning,
I was disappointed with the first
assessment, feeling that the process
could have run more smoothly. The
experience, however, allowed me to
plan and be better prepared for the
second assessment.
Practical experience in routine haematology
The Supervisee’s Experience
Introduction
When accepted onto the internship my main feeling was
one of excitement at the opportunity to work with experts
in the field and gain hands-on experience of applied sport
science. I was, however, concerned about whether I would
meet the expectations of the supervisor and be able to juggle
my academic and intern commitments as well as find time
to socialise. From early meetings it became clear that the
expectation was on me to manage my time effectively and set
realistic goals accordingly. This was difficult, especially around
coursework deadlines and exam time.
The internship involved working in conjunction with the sport
science support team at sportsactive, the University’s sport
science and sports medicine service provider, supporting
a student rower. This came as a huge surprise as I did not
think I would be given such responsibility so soon. Talk about
jumping into the deep end! However, through regular meetings
with my supervisor, what seemed like a daunting task became
an exciting challenge. My supervisor and I met regularly to
discuss my progress, which was great for building confidence to
communicate my thoughts to the athlete and coach.
Sport science support
www.bases.org.uk
Although challenging and, at times, frustrating (getting a
straight answer was very difficult), the process really enhanced
my understanding of applied sport science.
In addition to rowing, I was given the opportunity to work
with athletes from different sports, such as golf, football, and
triathlon. Coming from a rugby background, it was great to
become familiar with different disciplines and how sport science
can contribute to them. However, at times I felt out of place
and underqualified to support the athletes. I was reminded,
however, that the internship was meant to be a step in my
development rather than the final piece, which was nice to
hear, especially at times when I was feeling overwhelmed by the
experience.
Pitfalls
Although the internship was a great experience, we did
encounter difficulties throughout the year, predominantly with
athlete and coach adherence. As someone who is enthusiastic
about the positive impact of sport science on performance, it
struck me as odd that others in the support team were less so.
I now appreciate, however, that when athletes and coaches
are not full-time, the expectations of them must be tailored
around their other commitments if a programme of support
is to be successful. On reflection, I am glad these problems
arose and that I was able to tackle them under the guidance
of experienced practitioners. This would have been a much
more difficult experience had I been in a full-time working
environment and under pressure to solve problems
on my own.
PTO
s
s
s
As an eager intern, I was keen to begin work straightaway.
My supervisor, however, was quick to make sure I became
aware of the process of sport science support and spent time
investigating the sport and building a rapport with the athlete
and coach. Getting everybody together, however, was logistically
difficult and proved a regular source of frustration.
I was still relatively inexperienced
in analysing data collected from
physiological assessments and
disseminating the results to athletes
and coaches, so this was something
I was quite nervous about. I kept
thinking, “What if they don’t like what
they hear? How will I deal with the
situation?” To help me improve in
this area, I was asked to present the
results to my supervisor on a number
of occasions, each time receiving feedback and also some
questions regarding my rationale and thought process.
Issue 25
| Autumn 2010 | The Sport and Exercise Scientist | 21
PROFESSIONAL DEVELOPMENT
|
COURTESY OF JOHN CURRIE
Introducing blood handling and analysis techniques
Personal thoughts
The internship provided an excellent insight into the applied
setting of sport science, and was in stark contrast to the learning
environment of lecture rooms and teaching labs. What struck
me as the biggest barrier to successful sport science provision
is the development of systems that allow an organised delivery
approach. There is a wealth of athletes, coaches and support
staff; however, getting these people around the same table
and discussing important issues with regard to the athlete’s
development seems, at times, difficult.
The internship was also of benefit to my degree course as I was
able to transfer the knowledge to my coursework and exams.
The exposure I had to applied research also helped when I was
writing my dissertation; in terms of scientific writing, analysis
of data, dissemination of results and the development of
conclusions.
The internship proved very fulfilling in terms of the people I met,
confidence I gained and my enhanced interest in working with
athletes. Although it was not an easy ride, the programme met all
of my expectations and allowed me to develop a skill-set useful in
both applied and research roles.
Using the Supervised Experience competencies to monitor my
progress made me aware of the importance of the skill-set I was
developing and enabled me track my own progress, which was
great for motivation, especially at times when I felt I was not
progressing. Despite the pitfalls, I would have no hesitation in
recommending an internship to anyone who is serious about a
career in sport science.
Internship checklist
• Commitment: Ensure you have a committed client group; a
lack of client adherence can really jeopardise the success of the
scheme.
22
| Issue 25 | Autumn 2010 | The Sport and Exercise Scientist
• Goal-setting: Both the student and supervisor need to be
realistic about what they can fit into their diaries.
• Independent learning: Where possible, a guided learning
approach should be fostered to solve problems and design
interventions that work in the “real world”.
• Integration: Integrate internship tasks with taught academic
content. Utilising the theory taught in class to reinforce applied
skills will really enhance the experience.
• Skill-set: Give sufficient time to developing and refining
practical skills.
• Patience: Taking the time to plan and evaluate every aspect of
the support you offer is vital.
• Progress checks: A formal method of identifying areas for
development and tracking progress is crucial. n
Neil Gibson and Mark Ross
Neil is the Exercise Physiologist for the
Hearts Football Academy, situated at
Heriot-Watt University.
Mark is a postgraduate student at Waterford
Institute of Technology, currently undertaking
an MRes in Exercise Physiology.
www.bases.org.uk
|
ACCREDITATION
Needs Analysis and Reflective Practice:
Two Important Components of Case Studies
The realignment of BASES Accreditation has placed greater emphasis on two key skills; those of being able to undertake and describe a needs
analysis, and reflective practice. Dr Zoe Knowles and Prof John Saxton FBASES provide an insight into good practice for each
Background
The BASES Accreditation process was recently
realigned with a number of key changes being
made, in particular:
• the title awarded will be ‘Accredited Sport
and Exercise Scientist’
• members can be Accredited through
their work in scientific support, research or
pedagogy
• Supervised Experience is more closely
aligned with Accreditation
• those applying directly for Accreditation (or
those who have completed the old Supervised
Experience system) will need to complete the
Accreditation Competency Profile and submit
evidence to demonstrate how they meet the
competencies
• Re-Accreditation no longer requires the
submission of a case study; rather, applicants
have to reflect on their ongoing practice and
the professional development they have
undertaken to support this.
A case study is still required for new
Accreditation applications and this article
addresses the shortfalls in two key areas of
case studies that are frequently picked up
by expert reviewers and members of the
Accreditation Committee; namely the needs
analysis and reflective practice elements.
For all case studies, a comprehensive needs
analysis is necessary to address the gap
between the current performance level/state
of the athlete (or squad) and the requirements
necessary for improved performance.
Reflective practice, on the other hand, enables
the sport or exercise science practitioner to
achieve a better understanding of his or her
skills, competencies and knowledge. The aim
of this article is to provide those applying for
BASES Accreditation as a ‘Sport and Exercise
Scientist’, with some pointers for ensuring that
these processes are adequately addressed and
reported in case studies.
Needs analysis: A comprehensive needs
analysis should be one of the first procedures
undertaken as part of any scientific support
package. The needs analysis should be used
to assess both the specific demands of the
sport and the needs of the athlete. Frequently,
case studies include a thorough discussion
of the former, which can often resemble a
compact, fully referenced narrative review
of appropriate studies. Where applicants are
mindful of the 30-page case study limit, this
is highly appropriate, as it demonstrates a
thorough evidence-based understanding of key
dimensions of interventions that are necessary
for successful performance. It can also be used
to decide upon a battery of appropriate tests
www.bases.org.uk
(e.g., physiological tests, notational analysis
or psychometrics/interviews) to assess the
key dimensions of performance. However, a
frequently observed weakness of the needs
analysis lies in assessing the personal needs
and aspirations of the athlete. This should
take the form of in-depth discussions with
the athlete (and, ideally, the coach) about
perceived strengths, weakness and short- and
medium-term goals, and should provide
evidence of engaging clients in the design
of the intervention. This process is vital for
developing training objectives that are relevant
to individual aspirations and capabilities (taking
into account important issues, such as level
of physical maturity, previous experiences
with such interventions and so on); yet, it
is surprising how often this aspect of the
needs analysis is overlooked. In clinical
populations, where BASES Accreditation is
being sought for exercise science support
and the aspirations of clients are at the other
end of the human performance continuum,
the “personal consultation” dimension of
the needs analysis is especially important.
Here, it should be used to identify specific
problems/functional limitations that are
perceived by the patient, which can often
have a significant impact on quality of life, so
that an appropriate exercise rehabilitation
programme (perhaps incorporating additional
risk factor management) can be developed.
Those applying for BASES ‘Sport and Exercise
Scientist’ Accreditation are encouraged to pay
particular attention to this latter aspect of the
needs analysis.
Reflective practice is another aspect of case
studies that is frequently given scant attention
or is inappropriately reported. Reflective
practice is not something “from and for
psychologists”, but is widely acknowledged
as a learning technique across many diverse
professions. Reflective practice can be viewed
in many ways; however, it is more than the
common perception of simply thinking over
what has happened. Reflective practice is
a cognitive (thinking) process, which brings
together deliberate exploration of thoughts,
feelings and evaluations that are focused on
practitioner skills and outcomes. The outcome
of reflection is not always preparation
for change, or action based, but perhaps
confirmation/rejection of a theory or practice
skill option. For example, it may be that an
outcome of reflection is an understanding of
how a particular theory works in practice,
or you may uncover skills in communication
or presentation skills that you did not know
you had. Reflective practice is a process by
which we can generate an understanding of
Issue 25
self, focus on practice and the recipients of
support, and formulate new practice-based
(craft) knowledge.
A reflection guide or model might be useful to
facilitate the process of reflection, particularly
for the “novice” reflector. For example,
Gibbs’ (1988) six-staged cyclical model
poses questions designed to increase the
practitioner’s movement from a start point
of description through awareness of feelings,
evaluation/analysis, conclusion and formulation
of an action plan. Anderson, Knowles &
Gilbourne (2004) provide a linear model
of questions that offer greater structure to
engage in reflection. Within the Accreditation
submission, applicants are asked to provide
evidence of engagement in reflection.
Reflection may be conducted alone or with
others in written format or in conversation
(for a review see Telfer & Knowles, 2009).
The Accreditation review process would
expect to see evidence of such techniques
being embedded within practice, together
with reference to a process of reflection and
outcomes. n
References
Anderson, A., Knowles, Z. &
Gilbourne, D. (2004). Reflective practice: A
review of concepts, models, and practical implications for
enhancing the practice of applied sport psychologists. The
Sport Psychologist, 18 (2), 188–203.
Gibbs, G. (1988). Learning by Doing: A Guide to
Teaching and Learning Methods. Oxford Brookes University,
Oxford: Further Education Unit.
Telfer, H. & Knowles, Z. (2009). The
“how to” of reflection. In Exploring Sport and Fitness: WorkBased Practice (edited by C. Heaney, B. Oakley & S. Rea),
Oxford: Routledge.
Prof John Saxton FBASES
John is Prof of Clinical Exercise
Physiology in the Faculty of Health
at the University of East Anglia. He
is a Fellow of BASES and member of
the BASES Accreditation Committee.
His research is focused on the role
of exercise in the primary and
secondary prevention of chronic disease.
Dr Zoe Knowles
Zoe is a BASES Accredited Sport and
Exercise Scientist and BPS Chartered
sport and exercise psychologist
based at Liverpool JMU. She has
published articles and chapters
associated with reflective practice
in professional education fields and more recently her
attention has turned towards paediatric fields.
| Autumn 2010 | The Sport and Exercise Scientist | 23
RESEARCH
|
Dying Young: Is
Sport to Blame?
Prof Greg Whyte received a BASES International Conference Grant to
attend the 2010 American College of Sports Medicine Annual Meeting and
participate in the second in a series of four international symposia on ‘A
Global Perspective of Sudden Cardiac Death during Sports’
T
he sudden, unexpected death of a
young athlete is an uncommon
but regular event. When it does
happen the impact is significant and
wide reaching. When a high-profile
athlete dies suddenly, the impact may
often be felt internationally.
International
Conference Grant
Winner
The simple answer is “No”. The vast majority of sudden deaths in
sport occur due to undiagnosed heart conditions. In young athletes
(<35 years), inherited diseases of the heart muscle or electrical
conduction system, or congenital conditions affecting the structure
of the heart are the main culprits (in older athletes [>35 years],
the main problem is coronary artery disease). Participating in sport
increases the potential for an adverse event by about three times
that of rest; however, it is not sport that is to blame, rather the preexisting heart condition.
So, what can we do about it?
Because the majority of diseases associated with sudden cardiac
death in young athletes are inherited or congenital they can be
identified through cardiovascular screening. There has been
much debate surrounding the issue of screening; however, it is
now generally accepted that pre-participation screening should
be available for athletes. Unfortunately, it is not quite as simple as
it appears. What diagnostic tools do we use to screen? Who will
pay? Who do we screen? What do we do if we find an athlete
with a disease? These are all questions that remain under debate.
Recent research has provided answers to some of these questions;
i.e., in addition to physical examination and family history, a resting
electrocardiogram is crucial in the detection of cardiac disease in
young athletes. In contrast, we are still some way from establishing
the risk of an adverse event for athletes with specific diseases and
therefore what, if any, sanctions we should impose to limit their
participation.
What does the future hold?
Tragically, young athletes continue to die suddenly and unexpectedly
– as I write this article, the sudden death of the Swansea Football
Club first-team striker, Besian Idrizaj, aged just 22 years, has been
reported. We simply can not stand by and allow these catastrophic
events to continue. Whilst we have a good understanding of the
causes of such deaths, more research is required to enhance our
ability to identify athletes at risk and stratify the risk for disease
carriers. A global approach is needed to this global problem, and we
are now beginning to work hard with our international colleagues to
make sudden cardiac death in sport a dying trend. n
Prof Greg Whyte
Greg is the Prof of Applied Sport and
Exercise Science at the Research Institute
for Sport and Exercise Science at Liverpool
John Moores University.
His main area of research interest is
focused on cardiac structure and function
in health and disease.
24
| Issue 25 | Autumn 2010 | The Sport and Exercise Scientist
Kelly Marrin outlines the physiological significance
of melatonin in sporting competitions
International
Conference Grant
Winner
I
recently attended the 2010 American College
of Sports Medicine Annual Meeting in Baltimore, USA, to
deliver an oral presentation entitled ‘A positive relationship
between endogenous melatonin and core temperature
responses to exercise’. With my presentation in mind, my aim is
to outline the physiological significance of melatonin, especially
in an exercise context. One area where melatonin is relevant is
that of international travel.
What is melatonin?
Melatonin is a secretory product synthesised
by the pineal gland. It is a robust marker of
the timing of our body clock and has both
hypothermic and soporific properties.
What is its relevance to sport and
exercise?
Salivary melatonin assay
It is well established that many components
of sports performance vary with the time of day. Therefore, the
understanding of circadian rhythms is important for athletes and coaches,
especially when these circadian rhythms are disturbed as a consequence of
long-haul flights across multiple time zones.
Melatonin is secreted mostly at night and this timing is inversely related to
that of core body temperature. Melatonin secretion is inhibited by daylight;
however, there is always some melatonin secreted at night even if the
lights are on. Although there is a dearth of information on the hypothermic
effects of melatonin during sports performance, we recently conducted
a meta-analysis that suggested an acute dose of exogenous melatonin
can reduce core temperature by approximately 0.23ºC. This is a similar
reduction to that achieved via other pre-cooling mechanisms, and provides
a rationale for further research of this topic in an exercise context.
The role of melatonin in the timing of our body clock has implications for
travel across multiple time zones to competitions and training camps. The
consequential disruptions to our body clock can result in jet lag, which may
have negative effects on performance. Melatonin has been successfully
utilised to alleviate these symptoms; although, it is contentious whether
melatonin is helping the body clock directly to adjust or whether it is simply
improving sleep quality.
What are the implications for the Commonwealth Games?
British athletes and support staff travelling to Delhi, where environmental
temperatures in October may reach around 35ºC, will typically cross
multiple time zones and thus experience disturbances to their body clocks.
Furthermore, the schedule of events at the competition means that athletes
may have to compete at times of day that are not physiologically optimal.
Scientific support staff must attempt to minimise the impact of these factors
and, thus, an enhanced understanding of the physiological significance of
melatonin could be a key factor in optimising performance. n
Kelly Marrin
Kelly is a senior lecturer in sport and exercise
physiology at Edge Hill University and a parttime PhD student at Liverpool John Moores
University.
She is a BASES Accredited Sport and Exercise
Scientist.
www.bases.org.uk
COURTESY OF KELLY MARRIN
Is sport to blame?
Melatonin: How
Important is the Body
Clock for Athletes?
|
www.bases.org.uk
Issue 25
CAREER FOCUS
| Autumn 2010 | The Sport and Exercise Scientist | 25
APPLIED PRACTICE
|
Career Development Grant Winners
what was the rationale behind your
application for it?
At the conclusion of the 2008-09
season, I approached the manager of
Sporting Club Albion (SCA), which is
a female football team playing in the
Midlands Premier Division. The aim
was to complete a series of fitness tests
on the players and then use the data
in my dissertation. However, it was
proposed by the manager that I took on
the responsibilities of fitness coach for
the 2009-10 season. This Grant allowed
me to travel 210 miles every week for 46
weeks of the season and meant that I had
the opportunity to learn valuable skills
as a sport scientist that I would not have
been able to acquire in the classroom.
Q Did your studies and work with SCA
complement each other?
It gave me a great opportunity to apply
what I learned at University. It also had
a positive effect on my studies as I could
use my practical experiences as a sport
scientist to critically review articles and
theories. This experience has helped
me to get further placements, such as
at Liverpool Football Club Academy,
working alongside Mark Hulse. Gaining
added experience shows that you are
not just plodding along on an academic
treadmill and that you have the desire to
improve and succeed within the specific
role, whatever that may be. This role
helped develop my communication skills
for addressing female players. It also
improved creativity and adaptability when
designing practical sessions that did not
always go according to the intended plan.
Q What were your greatest challenges
and how did you deal with them?
Measuring the physical capacities of
the players was particularly difficult due
to there being so many players and a
limitation on specific equipment. In the
literature there are pros and cons between
laboratory-based testing and field-based
testing. During my time at SCA, the fieldbased approach was adopted, but lessons
were quickly learned of the issues around
validity and reliability. These issues need
to be considered when working with
teams rather than individuals.
Maintaining the players’ fitness was also
problematic because the time allotted
for the improvement of specific fitness
components was one hour per week.
One hour each day, over three days,
would have been an ideal situation to see
clear improvements; however, this was
26
Fitness coaching at Sporting Club Albion
not possible because the players are not
professionals and have no contractual
obligation to turn up to training, which
can also make it difficult to monitor their
progress. Therefore, it was essential
to give the players the opportunity to
conduct their own training outside of the
club. Encouraging them to “self-reflect”
and “take action” is a significant part
of empowerment, whereby the players
take ownership of their own training and
performances.
Q What has been your impact on
others?
Trust is a key component of being a
sport scientist, especially as a male who
is responsible for female players. This
was due to the fitness tests that were
carried out, which produced sensitive
information that the players may not even
have discussed with their partners or
family. In addition, students who attended
the University of Worcester were taken
on for work experience so it was my
responsibility to train them to a standard
that coincides with the BASES Code of
Conduct. It can be argued that creativity
is an essential part in the field of sport
science. However, it is important to take
on the advice of as many experienced
coaches, sport scientists and academics
as possible to successfully work within the
sport science environment, and then feed
it back into your own work.
Q How do you measure your success?
From a personal point of view, it is difficult
to measure success as I feel that I am
constantly working. With SCA, quantitative
and qualitative information could be
used to assess where the players were
at and where they wanted or needed to
be. For instance, by completing a series
of 20 m sprints at four points across the
season it could be determined whether
the players were improving their speed or
not. I also discussed with them, firstly, if
| Issue 25 | Autumn 2010 | The Sport and Exercise Scientist
they felt their results were good enough
to perform at a high level during matches
and, secondly, how they could improve
their results.
By getting the players to come up with
ideas to improve their speed, they are
more likely to do the necessary training
outside of the allotted training sessions.
The 2009-10 season was my first as
an applied sport scientist and I relied
very much on relevant literature and
University staff to guide me. This included
purchasing books, articles, DVDs, CDs
and newspapers to get ideas of exercises
and drills to use in my sessions.
Q On reflection, is there anything you
would have done differently?
In a practical sense, I would have pushed
the players harder to reach their potential
in fitness and lifestyle. What I mean by this
is that I would encourage the technical
coaches to adopt fitness-specific drills
into their sessions. Each player would
also be sat down individually to discuss
her lifestyle, workload and time available
for extra training. I would then keep
records for future discussions and action
plans. Due to it being my first season as a
sport scientist and working within female
football, it was a daunting first few weeks
because I did not know if the coaches and
players had pre-conceived expectations of
me. However, I quickly found out that they
appreciated my expertise and contribution
to the team. n
Will Patz
Will has just completed a BSc
in Sports Coaching Science at
the University of Worcester. He
works at Sporting Club Albion
as the Head of Sport Science,
overseeing the women and girls
football, basketball, disability
football and volleyball teams.
www.bases.org.uk
COURTESY OF CAROL PATZ
William Patz, winner of a BASES Career Development Grant, used his Grant to travel and work during the 2009-10 season
as the fitness coach for Sporting Club Albion, the non-professional organisation of West Bromwich Albion Football Club
Q Tell us about the Grant from BASES;
|
APPLIED PRACTICE
Trying to Stay Afloat
Jonathan Prichard, winner of a BASES Career Development Grant, provides insight into his work with Great British Rowing
I
COURTESY OF JONATHAN PRICHARD
’ve landed on my feet and got
experience to work with elite rowers
and their coaches so now all I have
to do is perform.
Prior to receiving the Grant I had been
providing physiological support for
over 18 months to a group of rowers,
including under-23s and junior Great
Britain athletes. This had been going
well but I wanted to provide a more
rounded support service while improving
my experience. The coach offered me
the opportunity to provide physiological
support during a training camp in Mantes,
France. I was overwhelmed; this is the
type of experience you dream of as a
student.
During the training camp
My role during the camp was to monitor
training through analysis of blood
lactate and keep check of the athletes’
recovery. This meant I had to put together
information about recovery, such as
useful and practical tips for the athletes.
To help me with this I consulted other
practitioners I knew regarding information
on the best practices.
I flew to France with one of the coaches
and five rowers, I’m not sure what I was
expecting, but the hotel was not five star!
The rooms were small with bunk beds
and everyone had to share. I enjoyed this
as I was able to get to know the athletes
much better, especially the one I was
Jonathan taking an earlobe sharing with.
blood lactate sample The days were long with two
or three training sessions
per day. They would start
with a 6 am rise for the
athletes to be on the water
for 7 am. This was followed
by breakfast and “down
time” until 12 pm when they
would train on the water
again, followed by lunch
and then recovery. A third
training session in the late
afternoon normally occurred
before dinner. The focus
of the camp was purely on
Before the training camp
training, refuelling and recovery and the
The camp was 10 days long and they
younger athletes did find this difficult to
wanted me to be there for the first five
accept, especially the importance of good
days. There would be two Great Britain
quality down time.
rowing coaches (one of whom I’d never
It was my job to educate them via an
met), and a range of different rowers,
initial discussion at the beginning of
female and male, lightweight and
the camp, then continuous monitoring
heavyweight as well as a range of different
using Total Quality Recovery, which is a
ages (from 14–22) attending the camp, of
useful tool that helps the athletes give
whom only half I knew.
their recovery a simple number and
All these different elements presented
shows them where their recovery may be
unique challenges. What was the new
faltering.
coach like? (I would have to quickly adapt
Other roles were to measure the athletes’
to his or her coaching style.) What were
mass before and after each training
the unique challenges of heavyweight
session to help monitor sweat loss and aid
rowers? (Prior to this I had only worked
fluid replacement, and to encourage the
with lightweight rowers.) What would be
athletes to take their morning heart rate.
my role? What would a camp be like day
During the day I would watch the athletes
to day?
closely, making notes about their recovery,
As the coaches wanted me to monitor
and then I would discuss any issues with
blood lactate levels during training,
them in the evening. This was especially
I borrowed a Biosen blood lactate
important with the younger athletes as
analyser and had to buy all the required
they would often forget to drink enough.
consumables.
I was asked to measure lactates to help
The hardest job was arranging the correct
monitor the athletes’ training but the
box and padding for the analyser. I was
analyser decided not to work! This was
so worried about this expensive piece of
extremely frustrating and despite my
kit that it travelled everywhere with me,
best efforts I couldn’t get it to function.
including as my hand luggage during the
In an ideal world I would have brought a
flight.
back-up, but the added cost made this
www.bases.org.uk
Issue 25
impossible. This did make me feel slightly
redundant but I aimed to stay positive
and help in any way I could; for example,
videoing training as well as basic jobs,
such as filling water bottles, liaising
with the restaurant and helping in the
boathouse.
What I have learned from my
experiences with rowing
• Always have back-up plans; even if you
can’t perform your main role, embrace
your other roles, stay positive and help out
in any way you can. Remember, you are
part of a team.
• I now better understand the coach–
physiologist relationship. Don’t assume
you know it all, have your answers ready if
the coaches ask and build rapport. Trying
to achieve/change things takes time and
trust. For example, I suggested that one
athlete should sit out of training as they
seemed under-recovered; although, the
coach took this on board, the athlete
trained anyway.
• I have gained a better understanding
of the needs of athletes during intense
training periods. For example, often there
was not enough food at meal times and
the athletes would then buy extra. I made
a point of going with them to make sure
they didn’t make poor food choices.
• I better understand the importance
of down time and recovery in intensive
training phases. For example, I
encouraged the athletes to snooze
during the day, but for no longer than 40
minutes.
• I appreciate the importance of the
athlete as an individual. Everyone
reacts differently, be it physiologically or
psychologically, and understanding this
helps you make the right decision.
This is where experience with the athlete
is key. When I suggested the athlete
should sit out of the session, the coach’s
experience with the athlete meant he
knew this wasn’t required.
I’ve just been given a year’s part-time
contract with Great British Rowing to
provide physiological support to their
athletes in the north-east, enabling me to
apply some of the lessons I learnt during
the camp. n
Jonathan Prichard
Jonathan is a a technician/
sport scientist at Northumbria
University and is studying for a
part-time PhD in prior exercise
on sports performance. He is
also close to completing his
BASES Supervised Experience.
| Autumn 2010 | The Sport and Exercise Scientist | 27
BOOK RE
REVIEWS
|
The Masters Athlete: Understanding the
Role of Sport and Exercise in Optimizing
Aging (2009)
9
Editors: Baker, J., Horton, S. and Weir, P.
Publisher: Routledge ISBN: 978-0-415-47657-7
An informative and extremely well put together book, with
breadth, depth and an accessible style. This book fills a previously
unfilled niche (as far as I’m aware) and is divided into four
sections: “Introduction to Masters sport and the study of older
athletes”; “Aging, performance and the role of continued
involvement”; “Psychosocial issues in Masters sport”; and “Toward
a comprehensive model of lifespan physical activity, health and
performance”.
Current knowledge and evidence is presented on the effects of advancing age
on cognitive skills, motor skills and physiological capabilities. This academic book
would be of interest to sport scientists and health practitioners and is suitable
for postgraduates, undergraduates and anyone else with a specialist interest in
Masters athletes and aging well. A question of interest for many (particularly
those of us over a certain age) is whether sports and exercise can minimise the
effects of aging and this book certainly presents convincing evidence to support
the argument that Masters athletes are a model of healthy aging. It concludes
that, although there is more research needed before categorical assertions
are made, there are many reported benefits and, remarkably, few adverse
consequences of participating in Masters athlete competitions. The book draws
upon international research and each chapter is presented by leaders in the
field. There is a slight bias towards Canadian statistics in some places, which
is not surprising as the lead editor is based in Canada, but in no way did I feel
that this made the content irrelevant to me as a Brit. I would have liked to see
more included on biomechanics, but I think that this is perhaps due to more
of a dearth in the research literature rather than an oversight by the editors. I
found reading the book inspiring as well as academically relevant, challenging
and interesting to me in the field of sport and exercise science, so I would
recommend it to students and colleagues alike.
Alison Carlisle, Roehampton University
28
| Issue 25 | Autumn 2010 | The Sport and Exercise Scientist
Soft Tissue Release: Hands-on
Guide for Therapists (2009)
7
Author: Johnson, J.
Publisher: Human Kinetics ISBN: 978-0-736-07712-5
This book gives a sound introduction to soft tissue
release (STR) with revision of the mechanism behind
it, and is structured in a way that introduces the
modality, in terms of physiology, and then progresses
to different techniques and hand positioning (holds).
The book is supported by numerous photographs as well
as end-of-chapter quizzes and case studies. The author’s
method of writing first helps the reader appreciate the
principles and then explains how these are applied in a
practical/clinical setting. The simple layman-style examples
could also help explain and demonstrate this to clients.
“Soft Tissue Release” aims to be relevant for a wide audience
and would appeal to either individuals starting out in STR
or the experienced practitioner as more of a reference
guide. Although written by a physiotherapist, the author’s
background does not come across in a biased way. The
photographs are clear and well sized and the thumbnails with
anatomical landmarks make quick and easy reference points
for the practical application of STR.
The book is, generally, a very useful tool for a wide variety
of clinicians who work in the musculoskeletal discipline as
well as those who work in the teaching arena (lecturing/
placement-based teaching). There are no accompanying
resources; although, the addition of a DVD/CD-ROM with
video demonstrations of the techniques would be very useful
for the novice STR practitioner. One accepts that this resource
would not replace teaching or supervision in the first instance,
but could act as a good aide-memoire.
Matthew Fitzpatrick,
Greenwich Teaching Primary Care Trust
www.bases.org.uk
VIEWS
Exercise and Cognitive
Function (2009)
9
Editors: McMorris, T., Tomporowski P. and Audiffren, M.
Publisher: Wiley-Blackwell ISBN: 978-0-470-51660-7
This excellent, postgraduate text offers extensive
and detailed coverage of a topic relevant to academics,
teachers and coaches who are interested in how cognitive
performance might be influenced by aspects of exercise
physiology and nutrition. It is intellectually stimulating
and sufficiently challenging to deter the faint-hearted.
It does cover some of the same topics as the 2008 book “Exercise
and its Mediating Effects on Cognition” by Sirduso, Poon and
Chodzko-Zajko (eds), produced by Human Kinetics, but this
resource is sufficiently different in focus and approach to be worthy
of in-depth scrutiny. As a reference source in its own right, I would
certainly recommend it.
The book contains 16 papers reflecting the contributions of
22 authors from the United Kingdom, mainland Europe and
the United States. It is split into three main parts, which deal
with theoretical and methodological issues, acute and chronic
exercise and their effects on cognition. There is a final discussion
chapter that summarises the current picture as well as offering
suggestions in which future research and theoretical approaches
may be developed. The majority of the book, 11 papers in total, is
contained in the middle two sections.
The approaches utilised include neuro-endocrinal and cognitivecognitive energetic as well as evaluating possible effects of nutrition
and (de)hydration. Several different populations are used as foci for
application of theory and subsequent evaluation. These include the
elderly, those with certain disease states, children and people with
development disabilities.
The only disappointment with this book is that all of the references
are at the end of the book and do not follow the relevant chapters.
Dr Ron Butterly, Leeds Metropolitan University
www.bases.org.uk
|
REVIEWS
Performance Psychology in Action: A Casebook
for Working with Athletes, Performing Artists,
Business Leaders, and Professionals
in High-Risk Occupations (2009)
8.5
Editor: Hays, K. Publisher: American Psychological
Association ISBN: 978-1-4338-0443-4
This book provides a unique and interesting insight into the
workings of a professional psychologist, in the areas of sport, art
and business. There are fascinating accounts of how psychological
strategies are employed and adapted in the applied field, with
refreshing perspectives that indicate how they can be used to
enhance performance.
The book also provides examples of how approaches from sport
may be implemented in other fields through knowledge gained from
research studies, and contains five parts: Part I “Mental Attributes for Peak
Performance” contains four chapters covering psychological and emotional
factors that influence performance and mental skills designed to enhance
performance; Part II “Performance Challenges” has four chapters that provide
insights into the positive and negative effects that anxiety, perfectionism
and competition can have on performance and other outcomes; Part III
“Performance-Related Consequences” has three chapters that relate to some
of the negative experiences high performers may be confronted with, such
as eating disorders, isolation and burnout; and Part IV “The Consultant and
the System” also has three chapters that consider various systemic issues
that influence performers, including family systems, teams and leadership
issues, and organisational systems. In the concluding chapter, which is Part V
“The Consultant as a Performer”, the focus is on the role of consultants and
various ways to enhance their abilities to perform as practitioners.
This resource is suitable for postgraduate students, practitioners and
researchers who are interested in performance enhancement in the areas
of sport, arts, and business. Additionally, the text provides an interesting and
enjoyable read for anyone interested in how psychological factors relate to
performance in an applied setting.
Sunghee Park and Stuart Flint, Aberystwyth University n
Issue 25
| Autumn 2010 | The Sport and Exercise Scientist | 29
BASES Winter 2010/2011 Workshop Programme
Unless otherwise indicated, workshops are at an intermediate level
(for those with limited knowledge and experience of the workshop area).
Combined Supervisor/Reviewer Workshop
Wednesday 29 September, 10.00am–4.00pm
Loughborough University
Kate Yule and Dr Sarah Rowell FBASES
Single-Case Research in Sport and Exercise
Wednesday 6 October, 9.30am–4.00pm
Staffordshire University
Dr Jamie Barker, Dr Paul McCarthy, Dr Stephen Mellalieu and
Dr Marc Jones
The Scientific Application of Music in Sport
and Exercise
Wednesday 13 October, 9.30am–4.00pm
Brunel University
Dr Costas Karageorghis and Dr Daniel Bishop
Applied Physiological Support to the High
Performance Athlete: Perspectives from
Athletics, Cycling, Canoeing and Rowing
Saturday 20 November, 9.30am–4.00pm
Loughborough University
Dr Steve Ingham, Dr Scott Gardner, Sarah Hardman,
Dr Jamie Pringle and Dr Barry Fudge
Cognitive Behavioural Therapy (CBT)
Interventions for the Sports Psychologist –
An Applied Workshop
Wednesday 24 November, 9.30am–4.00pm
University of Salford
David Knight and Mike Davison
Physical Activity in Children
Wednesday 1 December, 9.30am–4.00pm
University of Glasgow
Victoria Penpraze and Dr Graham Baker
Applied Strength and Conditioning
Saturday 16 October, 8.30am–5.00pm
Liverpool John Moores University
Colin Robertson, Neil Parsley and Dave Rydings
Strength and Power Diagnostics
Using Problem-Based Learning (PBL) in Sport
and Exercise Sciences
Wednesday 3 November, 9.30am–4.00pm
Coventry University
Dr Mike Duncan, Mike Smith, Kathryn Cook, Mark Lyons
and Prof Maggie Savin-Baden
Wednesday 15 December, 9.30am–4.30pm
University of Salford
Dr Phil Graham-Smith, Paul Jones and Paul Comfort
Physical Activity and Bone Health
Programme Design and Periodisation: A
Critical Review and Real World Application
Wednesday 10 November, 9.30am–4.30pm
University of Salford
Paul Comfort, Dr Phil Graham-Smith and Paul Jones
Get the Party Started: Getting to Grips with
Lecturing in Sport and Exercise Science
Thursday 20 January 2011, 9.30am–4.00pm
Loughborough University
Dr Katherine Brooke-Wavell
Core Workshops for
Supervised Experience
will be added to the
website when the dates
are confirmed.
Wednesday 17 November, 9.30am–4.15pm
Coventry University
Dr Mike Price, Mike Smith, Kathryn Cook and Dr Val Cox
To book a place, please go to;
�www.bases.org.uk/Workshops or go to
the Events tab on the website, or
30
� 0113 812 6163/62/64 for further details
| Issue 25 | Autumn 2010 | The Sport and Exercise Scientist
www.bases.org.uk
Help
Blog
The
|HELP BLOG & CALENDAR
Calendar of Events
With Dr Edwin D. Bayard
BSc (Hons), PGCE, MSc,
FBASES (pending)
September
21-23|Leisure Industry Week Conference
NEC Birmingham
; www.liw.co.uk/page.cfm/link=8/GoSection=1
26–30|23rd Scientific Meeting of the International Society
of Hypertension
Vancouver, Canada
; www.vancouverhypertension2010.com/
October
1|BASES High Performance Sport Accreditation submission and Supervised Experience submission deadline
28–31|20th Annual Meeting of the International Association for
Dance Medicine and Science (IADMS)
Birmingham Hippodrome
; www.iadms.org
November
2 4–27|UKSEM 2010 – The British Association of Sport and
Exercise Medicine Annual Conference
(BASES members eligible for same delegate rate as BASEM members)
ExCel, Docklands, London
; www.uksem.org/default.php
December
INGRAM PUBLISHING
Hello all, welcome back to my
world; and I have to say, it is so
gratifying that my words of wisdom
in the last issue of The Sport and Exercise Scientist
touched so many of you. Thank you for all of your
feedback – and yes, Ms T., I do think that being given 20 hours’
contact time per week is a tad on the high side, even if you do
enjoy what you do and are able to make use of the lecture notes
left over from last year.
Now, on to things new and, in particular, an e-mail that I received
from the delightful Mrs A., who, having found her son’s copy of
The Sport and Exercise Scientist during the summer, tucked under
the bedding among the debris that is a young man’s bedroom,
writes for advice regarding his future career.
Mike, the aforementioned young man, is about to enter the third
year of his undergraduate sport and exercise science degree. He
has decided that his future career rests in serving and bettering
our elite Olympic and Paralympic athletes. Mrs A. writes for advice
regarding where young Mike should seek to pursue his masters
degree to maximise his future career goals.
What a telling question, and one to which my sage advice might, at
first, seem contrary given my own sound academic standing and
position. I will begin, therefore, with a helpful analogy.
Consider the position of a high-powered lawyer, a female one
perhaps, who, on a day-today basis has to communicate
with learned peers with indepth knowledge, insight and
appropriate “lawyer speak”. When
our hypothetical lawyer returns
home in the evening she has to
change. She has to “unlearn”
her lawyerly intellectual way of
thinking and speaking; unwinding
much of what she has learnt, to
reset her vocabulary calibration at
an appropriate level to be able to
communicate in a way that makes
sense to her family.
So you will find it is the case with
athletes and all too often coaches,
who are perplexed by our fine academic traditions and the finite
details of the “why” of our research. They care primarily for the
“what” and “how”, even when it is not fully supported by the
sacrosanct, statistically significant, peer-accepted research.
Therefore, a discord often exists between academia and athletes.
Take my own Head of School, Prof G., a man of esteemed
academic standing, but one who sends me searching for the
dictionary every time he speaks, given the depth and complexity of
his words and the papers he can quote from. He, however, keeps
schtum about his previous forays into applied athletic support,
for he did not bring revelation and improved performance, only
puzzlement and frustration.
So, Mrs A., back to your son and hopefully you can see the
relevance – he is best advised not to seek a course that pursues,
exclusively, the rigor of academic excellence, even if this means
looking beyond some of those that you mentioned in your letter.
Rather, he should look for one which helps him re-calibrate, one
which provides him with the patience and understanding required
to work successfully with athletes and coaches. This, in my
experience, is a skill-set sadly lacking within many of those who
inhabit our learned spires (myself excepted, of course).
Anyone wishing to send a dilemma or question for Dr Bayard
can do so via
EBayard@bases.org.uk n
Some key events to watch out for this Autumn
9-10|The British Psychological Society Division of Sport and
Exercise Psychology Conference 2010
Holiday Inn London, Camden Lock
; www.bps.org.uk/conferences-and-events/eventlisting
15-17|The Physiological Society Cross Themed Meeting
Durham University
; www.physoc.org/site/cms/contentEventViewEvent
;
www.bases.org.uk
Issue 25
| Autumn 2010 | The Sport and Exercise Scientist | 31
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32
| Issue 25 | Autumn 2010 | The Sport and Exercise Scientist
www.bases.org.uk