“It’s not the team with the best players that win. It’s the players with the best team.”
A holistic approach is the central tenet of effective, healthy and safe sports performance. In practice, this is a team of highly trained and experienced sports performance professionals working together in distinct but complementary roles, towards a joint goal – enabling the athlete to:
- maximise performance
- improve health
- prevent injury
- recover quickly
- rest effectively
- eat and drink smartly
- develop physically, mentally and psychologically
The greatest benefit of the holistic approach is a truly bespoke solution. You will get a personalised plan from each professional, tailored specifically to your body, mind and goals. In this article, we take a look at the holistic sports performance professionals, and how they can help you achieve your goals. Before you start, here is a summary of sports performance professionals and their key services:
|Category||Holistic sports professional||What they do|
|Training/Motivation/Tactics||Personal Trainers||– Help you achieve goals
– Personalised exercise plan
– Nutritional advice
– Improve technique
|Sports Coaches||– Improve motivation
– Tactical coaching
– Increase confidence
– Build character
|Physical Health||Physiotherapists & Sports Therapists||– Musculoskeletal experts
– Improve strength, posture and balance
– Some specialise in chest and cardiovascular therapy
|Podiatrists (Chiropodists)||– Foot and leg health e.g. gait and cadence|
|Chiropractors & Osteopaths||– Manipulation of joints and muscles to treat injury and improve performance|
|Diet & Nutrition||Nutritionists||– Make a bespoke dietary plan to achieve your individual goals|
|Mental Health & Wellbeing||Sports Psychologists & Counsellors||– Stress management
– Increase resilience
|Equipment & Aids||Orthotists||– Make and use aids, braces, splints, prosthesis to improve performance, prevent injury and aid recovery|
|Equipment Specialists||– Harmonise equipment and the athlete to improve performance|
Training, Motivation & Tactics
Personal trainers (PTs) are one of the most commonly encountered sports performance professionals by the general public. They have long been a feature at gyms, health and sports clubs and the fact that they are increasingly available in more integrated settings (such as our home and workplaces) is a testament to their effectiveness, importance and success within the holistic approach to sports performance.
PTs instruct and help people reach their performance goals. Possessing a broad and diverse knowledge of anatomy, exercise medicine and nutrition, they will design an individualised exercise and training plan for you (1). The vast majority of PTs have an exercise-related degree (2). Many PTs train alongside you and a number of studies have shown that PTs can help in particular with improving your technique, motivation and effecting positive behavioural change (3–5).
Behind every good athlete is a great sports coach. We have come to appreciate this increasingly over the last few years with many inspirational coaches enjoying as much credit and limelight as the athletes they have guided to success. Sports coaches truly embody the holistic approach to sports performance with their focus on the big-picture. They are the custodians for all aspects of overall performance and work closely with other members of the multi-disciplinary sports performance support team (6).
In particular, sports coaches deal with motivation, tactics, competition preparedness, behaviour modification, decision-making and competitor research (7). The notion that sports coaches are only reserved for elite athletes is now unfashionable and defunct. Their benefits are clearly seen at all levels of sporting pursuit and are well-established in the research literature (8).
Physiotherapists & Sports Therapists
Physiotherapy is a very well established domain within the multi-disciplinary clinical team. Working both in hospitals and (increasingly) within the community, physiotherapists use exercises, stretching and movement to help people with disability, injury or ill-health (9). Their role complements that of many other members of the holistic sports performance team such as coaches, nutritionists, podiatrists and osteopaths.
In sports performance, sports therapists’ expert understanding of bones, joints and muscles (the musculoskeletal system) enables them to help athletes maximise performance, whilst preventing injury. They will typically conduct regular checks of strength, posture and balance. They will prescribe a bespoke programme of exercises and stretches for your specific goals and needs. They are also trained in ‘manual therapy’, which is the use of hand pressure to reduce pain, stiffness and improve posture (10). Other treatments they can offer includes shock-wave and ultrasound therapy to reduce pain and relax muscles (11).
If an injury does occur, sports therapists’ are the central focus of the recovery process. Research recommends that timely physiotherapy programme delivered by a trained professional can prevent injury (12), reduce the need for surgery (13,14), decrease recovery time and reduce medicine usage (15).
There is even more to physiotherapy than the musculoskeletal system. Some physiotherapists (‘chest physiotherapists’) even have specialist qualifications to help people with lung problems such as asthma, emphysema and cystic fibrosis. This means they have expertise in improving oxygen levels, reducing carbon dioxide and increasing sputum clearance (16). Others specialise in the heart and blood vessels (‘cardiovascular physiotherapists’)(17). These skills are highly transferrable to sports performance, in which holistic sports therapists work with athletes to improve respiratory efficiency, posture and blood oxygen. All these factors enhance performance and prevent injury.
Podiatrists & Chiropodists
Podiatrists (previously more commonly known as chiropodists) look after your feet, legs and gait (how you walk and run)(18). This is a particularly important aspect of holistic sports performance because feet and legs are involved in almost every exercise and sport practiced by most athletes and many para-athletes. Many sports injuries such as knee, hip and back pain arise from incorrect foot posture, improper gait or inefficient cadence. Podiatrists will use their knowledge of biomechanics to assess your lower limb structure and function, diagnose any problems and make a detailed management plan. Interventions range from removal of callouses and corns (hard or dead skin) to using orthotics (aids such as insoles, specialist footwear and braces – see below) to improve leg and foot function and reduce injury (19).
Podiatry has been shown to be an effective intervention for common conditions in the sporting world such as plantar heel pain (20) and metatarsophalangeal arthritis (21). Sports podiatrists will help you condition your feet and ankles for your specific sporting needs. This will not only help you gain a competitive advantage, but also be able to enjoy your sport(s) without fear of injury or exacerbation.
Chiropractors & Osteopaths
These closely-related but distinctly different professionals both broadly use manipulation and adjustments of the body’s joints, bones and muscles to improve health and performance. A central focus of these treatments are to detect, treat and prevent ill-health without surgery or medicines (22).
Chiropractors focus mainly on treating muscle, bone and joint complaints. They do this mostly by manual (using their hand) adjustment of the joints (especially of the back and spine) and stretching muscles (23). There is a robust body of evidence in the medical literature supporting the efficacy of chiropractic for a range of musculoskeletal conditions including acute (24) and chronic (25) lower back pain. Most relevant to sports performance, chiropractic has been associated with decreased reaction time (26), improved balance (27) and increased jump-height (28).
Osteopaths aim to create an overall body wellbeing by harmonising the function of muscles, bones, joints, connective tissue and ligaments (22). They use a number of the same techniques as chiropractors, applied to the broader context of the whole body. They aim to detect and treat a wide range of issues (including non-musculoskeletal conditions such as gastro-oesophageal reflux and high blood pressure). Most relevant to holistic sports performance, osteopathic treatment is associated with reducing lower back pain (29), improved wound healing (30), improving nerve connections between brain and muscles (31), improving balance (32) and improving visual acuity (33).
Diet & Nutrition
A healthy balanced diet is undeniably one of the core principles of optimal sports, athletics and fitness (34). Studies suggest that athletes have limited knowledge about sports nutrition (35), so the need for professionals is clear. Accordingly, it is no surprise that nutritionists are a key part of holistic approach to sports performance. These are professionals trained in nutrition science, backed by a robust scientific evidence-base (36).
Catering to people on both ends of the body mass spectrum, and everyone in between, nutritionists will assess the nutritional value of your current diet, and design a bespoke nutrition plan for your specific goals. This includes (but is not limited to) weight loss, muscle gain, endurance, and recovery. Nutritionists can also identify specific elements (such as salts, vitamins and minerals) that you may be lacking and offer supplementation to achieve a healthy balanced diet for your needs.
Within sports performance, nutritionists work alongside other members of the holistic team such as coaches and physiotherapists to adjust and fine-tune the nutritional balance required for changing tactics, positions, exercise and recovery demands. Their interventions have been associated with faster return to play after injury (37) and a number of health benefits in recreational athletes (38). One of the greatest benefits of having a nutritionist as part of your holistic sports performance team is their ability to effect behaviour change, an area that is key to sustained sporting success (39).
Mental Health & Wellbeing
Sports Psychologists & Counsellors
The body and the mind work together to affect sporting performance. The fact that the demands and stresses of both recreational and competitive sports affect athletes’ psychological just as much as their physical wellbeing is increasingly appreciated. Sports psychologists are usually trained in general psychology before undertaking further training and experience in the sporting domain. This means that they have a detailed scientific understanding of how the mind is affected by training, success, failure and injury (40).
Sports psychologists and counsellors will help you unlock your sporting potential by understanding, reflecting upon and ultimately training your mind. This includes mood awareness, fatigue management, stress management, developing resilience under pressure and dealing with the personal and psychological consequences of injury and recovery. The benefits of sports psychology treatment is well researched (37,41) and has far-reaching applications even beyond the sporting world (42,43), which is a testament to its crucial importance.
Equipment & Aids
Orthotists & Prosthetists
Orthotists are specialists in the development and application of aids such as braces, splints, protheses etc. to improve performance, prevent and treat sporting injury (44). They are one of the key elements of holistic sports performance at all levels. They assess your movement for any deformity, injury or inefficiency and use orthotic aids to aid movement, relieve and recover (45).
Orthotists work closely with other members of the holistic sports performance team, especially podiatrists. Orthotics are helpful in conditions like plantar fasciitis (46) (highly common in running and other high impact sports), increasing functional activity (47), and reducing pain (48)
Sports Equipment Specialists
From running shoes to racquets and everything in between, you need the right tool for the job. The paradigm that harmony between the athlete and their equipment is key to optimising sporting performance is well-established at the elite level. Furthermore, using inappropriate equipment can risk performance decline and injury. Increasingly, these advances and lessons have filtered down through all athletes at all levels of sports. Sports equipment specialists combine their knowledge of sports with the latest technologies to assess your training and performance needs. This includes tailoring equipment to your body size, shape and physical attributes. Sports equipment specialists can also provide products for injury recovery and year-round training so you can keep your competitive edge during winter-months or off-season. Increasingly, smart devices and wearables within the sports performance sector can be used to track and improve your performance (49–52)
The holistic approach to sports performance relies on a diverse and complementary range of professionals devoted to optimising every aspect of athletic practice. From physical development to tactics, mental wellbeing to nutrition, there are myriad options available to achieve your sporting goals in a safe, healthy and fulfilling way – who will you choose to be on your team?
The content of this article does not constitute medical advice by a registered healthcare professional. Please consult your physician before starting any new diet, exercise or training programme.
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