Athlete History Intake on an Olympic hopeful

While the title of this next post is not exactly a shocking title that draws a person in, it was written with the intention that a thorough client history can drastically improve your exercise prescription. The audience reading this most might be personal trainers, physiologists, strength coaches, or new personal trainers in the field that are wanting to be more thorough in their assessment of athletes and clients, and more thoughtful in their assessment, athlete history, and intake process. I wanted to make a post about the different components of an intake of a specific athlete I worked with in the past, how to divide up your client's history and highlight red flags while doing such an assessment. This type of assessment has helped me become a better CEP (Certified Exercise Physiologist), and I hope to continue to improve it. For those who are reading this that do not work in the industry, hopefully it opens your eyes to what your health care providers are reviewing when asking you basic interview-style questions during your first visit to the gym.

Section 1 – Subject Characteristics

• 23 year old female on the International (travel) group for Dino’s Swimming

• 172.0cm and 66.3kg (BMI 22.3kg/m2), Waist Circumference ~80cm

• Resting BP 100/60mmHg and Resting Heart Rate of 48bpm

The current cutoffs for resting heart rate and blood pressure in Canada (as of January 2019) are

• 100bpm or higher is too high for a resting heart rate to safely participate in exercise

• 160/90mmHg or higher is too high for a resting blood pressure to safely participate in exercise

Her main events in Swimming

• 100m Breast Stroke

• 50m Breast Stroke (at Worlds)

• 200m Breast Stroke (at Olympics)

Why is this section important? Outlining that this athlete is a "swimmer" vs a "breast stroker" could vastly impact the program design based on the likelihood of injury in breast stroke vs other strokes, and this will impact the exercise selection we choose to specifically target her strengths and weaknesses.

Goals

• Finals at the Olympics in Rio 2016 (place top 8)

• Finals at Worlds (first week of August 2015) in Russia (place top 8)

• Make the time for Olympic Trials at the end of July in Santa Clara (needs to swim under 1:07.85)

• Needs to qualify for worlds (can start now/this month)

• Was off by 0.15 seconds at her last trials but was sick

• “Wants to” lose 10lbs of fat mass by August (3 months to accomplish goal)

Injury history

• Long history of shoulder injury

• Infraspinatus in bad shape (MRI confirmed previous tearing)

• Long head of biceps giving her issues lately with pain

• Started from bad technique and continued to get worse until she fixed her form and now it is a chronic injury

• Prone to impingement due to overuse (biceps tendon is where she tends to feel the pain, or around medial fibers of the deltoid)

• Prone to groin injury due to breaststroke

• Things that make it worse: biking makes hip flexors too tight, a lot of kicking workouts in the pool

• Things that make it better: massages (weekly, mostly with a focus on legs and groin region), and stretching helps

Before workout physio exercises she adheres to

• 3-4 exercises (one set of 8-10 reps)

• External rotation of the shoulder with therabands

• Banded rows

• Abducted external rotations

• Straight arm lateral raises

• Plus current dryland “warm up” before every swim

• Clamshell 2x6

• Rolling plank

• Side lying external rotation

• Prone incline trap 3 raise (lower fibers of the trap)

• Barbell mobility (weight room warm up only)

Motivations

• Has wanted to go to the Olympics since she was 12 years old

• Wants to make family and loved-ones proud

• Has a very competitive nature and always wants to win

• This is evident in the weight room, she is always trying to lift as much as the guys on the team

This section is always interesting to get an idea into the athlete's psyche.

Section 2 – Schedule

• Athlete is finishing her 3rd year of Kinesiology at University of Calgary

• School work is manageable during the Fall and Winter semesters but during the summer, training is her full time job

• Most of her summer is spent travelling around the world to competitions, but one trip back home to Ireland will be planned throughout her summer as well.

• Next competitions will be in June, May will be used as a GSP, followed by power and rate of force development block

This is a good time to get the athletes currently weekly training schedule, or future proposed training schedule, if different.

Section 3 – Strength&Conditioning Components

• Motor patterns are addressed in the FMS screen (which can be found at http://www.functionalmovement.com/)

• Athlete’s strengths are in her flexibility, her attention to detail in the weight room (hint of perfectionist) and her lower body strength (this is all based on the athlete's perception, not necessarily on assessments the S&C coach has made at this point)

• Her weaknesses lie in her adductors due to the nature of the breast stroke, and many shoulder injuries caused from repetitive use from swimming

• Mentally, she is struggling with new timing of her dolphin kick that she just adapted since January. The motor patterns still sometimes breakdown still in practice because the pattern is so new.

• Qualities required to reach goal: qualify for Worlds and continue to swim faster. Keeping her injuries minimized (shoulder and adductor) are important for realizing her training goals.

• What is missing from her program is currently individualizing a program for her rather than for the team as a whole. She could use more individualized warm up, and more core work to address her instabilities pointed out by her FMS screen.

• It would be of value to focus more time to her shoulder strength so that we can minimize the chance of reinjuring it.

Section 4 – Other Considerations

• Access to resources is good (UofC pool, as well as access at other facilities in Calgary)

• The athlete is from Ireland, and compared to her resources there, she has many more opportunities than back home

• In Ireland she didn’t have access to weekly massages, training groups her age (the motivation has helped her here in Canada), and anthropometrics so often (monthly) at CSI

• Athlete wants to start engaging in sport psych this year, as she thinks it will aid some of her mental blocks related to competition

Once we have a full athlete history, it is important to take these considerations into the assessment, the programming, and any further referrals that need to be made. The follow up to this session with the athlete, would be starting by designing the testing battery that is appropriate for evaluation of their current abilities (strengths and weaknesses; sport specific), followed further by a detailed yearly training plan (YTP) outlining the year's upcoming competitions. Stay tuned for subsequent posts on how to program a YTP, how to take these considerations into the design of the specific macrocycles, mesocycles, and microcycles within an athlete's program, and feel free to reach out via my "contact" page if you have any questions! Happy programming :)