Performance of a lifetime

No wonder that, at the Olympic level, athletes train intensely for two main reasons: medal contention and injury prevention. For Bilodeau, ski-based training camps are usually three weeks on snow. Off-trail, his exercise regime diversifies into core training, bike intervals, trampoline sessions, water ramps, you name it. Then it’s back to snow and alternating gym sessions, all for about 11 months a year.

Shock absorbers

Health hazards — such as crash-landing an aerial manoeuvre — seem strikingly obvious. Yet it’s the repetitive nature of mogul skiing, like a pitcher throwing fastball after fastball, that’s potentially more damaging. Athletes train in specific motor patterns, says Richard DeMont, an associate professor in Concordia’s Department of Exercise Science. Golfers swing. Pitchers pitch. Mogul skiers absorb shocks. “Regardless of the sport, they get accustomed to patterns.” Unfortunately, athletes’ bodies may not adapt well to other forms of intense movement.

DeMont believes a diversification of pre- and post-injury exercises minimizes the risk of injury. “Professionals are a subset of athletes who train outrageously hard. It seems like they’ve got to practise all day long, seven days a week,” says DeMont, whose research at PERFORM deals with injury prevention. “The seasons tend to go far too long in my opinion.”

DeMont is keen to prove that variety is the spice of life when it comes to muscle strength and damage limitation to body parts. “What I hope to be able to show is that if athletes train in a variety of ways but specifically target some muscles geared toward joint-style injuries, like an ACL or a typical lateral ankle sprain, then maybe we can reduce those injuries.”

Fewer injuries mean less suffering. Therese Brisson, BSc 89, is no stranger to pain. A severe concussion in 2001 nearly cost her Olympic glory in Salt Lake City in 2002. Yet she led all Canadian defence in scoring, helping Canada win its first gold medal in women’s Olympic hockey.

A former team captain and winner of six world championships, Brisson was later sidelined by complications from a broken ankle she suffered just before the 2004 world championship in Halifax. She played anyway, underwent four surgeries, developed an infection and required further surgery. Yet Brisson, who later earned a PhD in Physical Activities Science from Université de Montréal, says her Olympic commitments to a “relentless pursuit of results” ultimately made her a better person.

Pain and gain

Better but banged up. “There are a lot of skills you learn as an athlete that make you a great business leader,” says Brisson, now working in marketing in Toronto. “The downside is that it comes with some leftovers of your career that you would rather do without.”

Indeed, the Montreal native still wonders about the long-term effects of her injuries. “There are some physical souvenirs that I would prefer not to have.” One is pain — a concept that fascinates Dover. “The research our lab attempts to answer is why some people feel more pain than others and how increased pain affects recovery and functions.”

Dover’s research also examines how injuries affect athletes’ sleep, as well as sleep’s role in recovery time. PERFORM researchers know that some people take longer than others to recover from illness and injury. What they don’t know — yet — is why. “We know sleep is essential for daily activities and functioning normally and it’s something we haven’t looked at enough in athletes,” says Dover. “We spend a lot of time and money on coaching, nutrition and performance enhancement, but we don’t look at sleep.”

Then there’s fear of pain, a factor with proven effects on patient recovery times. It is this deeper understanding of pain perception or pain-related fear that gets Dover up in the morning. Fear of pain and reinjury are well documented in general-population studies: recovering individuals either rehabilitate quickly or slowly, depending on their attitudes to pain. Dover wants to know how prevalent this is in athletes. “Everyone assumes athletes have a high pain tolerance and wouldn’t be affected by something like this, but it’s not true.”

Athletes, Dover adds, are affected by pain dysfunction as much as anyone. The difference between them and the rest of us is self-image. “If a regular person gets injured and they can’t do, say, the triathlon they wanted, it’s difficult because they like training,” he says. “It’s a completely different challenge when an athlete gets injured because it’s their identity — this is their life.”

In the mind

Olympians, like all elite athletes, acknowledge physical risks of competition. What of mental fitness? Mind games have played a huge role in Bilodeau’s ascent to medal podiums. Down the ski trail, the JMSB student mentally recites the words: ‘tall,’ ‘soft’ and ‘keep it.’ “It’s all about putting yourself in the right state of mind to deliver the best performance you can,” says Bilodeau, who works with eminent sports psychologist Wayne Halliwell. Bilodeau says the decade-long relationship has deepened his self-understanding. “I think I’m a better person. I know myself better and when you know yourself, you know how you’re going to react.”

This fits with Theresa Bianco’s definition of sports psychology. An assistant professor in the Department of Psychology, Bianco describes her work with Concordia athletes as a matter of self-awareness. “Performers don’t park their brain in a jar when they go out onto the field or arena or slopes,” Bianco stresses. “They need to be mentally prepared as well as physically prepared in order to perform well. We try to help the athletes figure out what works for them so that they can consistently perform their best under conditions of extreme pressure.”

So are sporting pinnacles reached by some kind of harmonic mind-body-spirit fusion in elite athletes? “At the highest level it is really 80 per cent mental and 20 per cent physical,” says Brisson, who has worked with psychologists on team tactics and distraction control. “I did a lot of imagery practice, rehearsing situations that the opponent would present so you can recognize cues early and make appropriate decisions quicker.”

The psychology behind laying claim to a gold medal is more about focusing on the process than on the goal, says Bianco, who works with 2008 Beijing Olympic Games wrestler Martine Dugrenier, BSc 02, GrDip 08. “You’re like a rock star when you’re at the Olympic Games. There is so much going on around you and it’s really easy to get caught up in all that excitement and start to lose a bit of your focus,” Bianco says. “We work on anticipating all the things that can be distractions. Athletes must feel in control.”

The Sochi Games will exact its price on athletes in several ways. The city on the Black Sea is nine hours ahead of North American east coast time. Those travelling from afar should be mindful of the perils of jet lag, warns Shimon Amir, professor in the Department of Psychology and director of Concordia’s Center for Studies in Behavioral Neurobiology. (For more on the centre, which celebrates its 30th anniversary this year, see “Sex, drugs and… rats” on page 37.)

An expert in circadian rhythms, Amir notes that maladjustment to time-zone changes could play havoc with athletes’ digestive systems, sleep and moods. “It’s very important to be exposed to light in the morning to reset the [body] clock,” Amir stresses. He adds: “Eating time is also very important. Food intake has a very strong effect on circadian clocks throughout the body.”

Athletes can control some factors, but not all. Sometimes there’s plain bad luck. Ironically, Brisson’s concussion happened during a selection camp six months before the Salt Lake City Olympics. Brisson was checked hard by another player, who then fell on top of her, slamming the back of her head into the ice, breaking her helmet.

The injury was a setback for Brisson, who found it challenging to deal with the long layoff. She followed a return-to-play protocol that progressed very slowly and with a lot of uncertainty. “When you’re lying on your friend’s deck in the middle of October, curled in the fetal position, trying not to vomit, you’re not even thinking about the Olympics, you’re just thinking about your health,” Brisson told the Toronto Star in 2002.

Heads up

Elite-level sport is hazardous. Head trauma is among the most talked-about sport injuries in Canada. Doctors recently dropped the gloves with National Hockey League owners, saying the outfit was too accepting of hockey violence. Two thirds of delegates at a Canadian Medical Association meeting in Calgary last August voted to “condemn the complacency of the NHL in regard to violence in hockey.”

The NHL expected that Rule 48 — implemented in the 2008-09 season — would reduce a rash of concussions from blindside hits because they would no longer be tolerated. It didn’t. Around that time, autopsies on former National Football League players Andre Waters and John Grimsley showed neurofibrillary tangles in parts of the brain that affect behaviour and memory. These tangles and other symptoms, commonly associated with early onset Alzheimer’s and Parkinson’s disease, can only be detected by autopsies. MRI and ultrasound cannot reveal any damage. Both Waters and Grimsley died prematurely. Bianco explains that the condition, called chronic traumatic encephalopathy (CTE), is caused by repetitive blows to the head. “CTE is nasty. Its symptoms may only show up 10 years later,” she says. “Concussions don’t affect everyone the same way,” explains DeMont. “The rehabilitation can be long and cumbersome.” Making contact-sport athletes more aware of imminent hits and strengthening their neck muscles to withstand greater forces might help, but DeMont doesn’t hold out much hope. “I am not sure that we have great data on that yet,” he says.

As certified athletic therapists and PERFORM members, Dover and DeMont are allied health care professionals. They get people back to activity and athletes back to action. “Where a physiotherapist might get you rehabbed to bathe yourself or eat, athletic therapists get people ready to hit a 200-pound running back,” says Dover. “Your goals in rehab are different.”

A return to action always carries an element of risk. Trauma won’t disappear from sport. The NFL had an official count of 217 concussions last year, up on the 190 it reported in 2011. The league instituted rule changes to eliminate hits to the head and neck, protect defenceless players, and prevent athletes who have had concussions from playing or practising until fully recovered. To boot, in 2012 the NFL reached a US$765 million settlement over concussion-related brain injuries among its 18,000 former players, agreeing to compensate sufferers, pay for medical exams and underwrite medical studies. “A lot of great research is coming from athletic therapists in the U.S. with regard to recognition of concussions,” says DeMont, stressing the role he and his associates play on the sidelines. His caveat: stronger headgear probably won’t offer any eureka moments in concussion breakthroughs. “Helmets are good for protecting against skull injuries but not necessarily good at protecting your brain from moving around inside your head,” he says. Which is why independent neurologists are now consulted before concussed NFL players can return to action.

Elite sport is the preserve of the world’s best. The Olympic Games is an ultimate test of mental and physical prowess. Olympians train long and hard for their special moments. They are tested in ways that few can imagine. As Brisson recalls, preparation is also about sacrifice and lifestyle choices. “When you’re an Olympic athlete, before every decision you make you ask yourself, ‘How will this affect the gold medal?’”

Two-time Olympian Bilodeau will compete for his second gold medal in Sochi. He’ll make decisions, too. “The only thing I want to replicate is the state of mind I was in in Vancouver,” he says. “Some things are out of my control and I am going to live with them. No regrets.”

— Scott McCulloch, BA (journ.) 90, is senior advisor, communications, Concordia’s Advancement and Alumni Relations.