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Managing health to sustain champion performance

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Summary of an article reporting on inteviews with elite long-distance runners on how they manage health and injuries to sustain excellent performance over their athletic career.


12 (6 females, 6 males) elite champion long-distance runners aged 20-29 years (from 4 countries).


In-depth semi-structured interviews and thematic analysis

Outcome measures

  • 3 most recent injuries and illnesses that impacted on workout and competition plan.

  • injury and illness management from a career perspective

  • strategies to sustain performance and health in the long run

Main results

  • Two tactics used to deal with injury:

    • educated flexibility (ability to rapidly change training and competition schedules in response to the injury or illness)
      • precisely planning when to “go all out” and staying on the “safe side” for the majority of the time.
      • running through pain was considered pushing yourself when running through muscle soreness, but running through pain indicating injury should not be a rule
    • exigency (pressing situation or urgent need)
      • exposing oneself to a risk of an injury or illness, acting with a short-term goal in mind. For example: competing even though it carried a risk of worsening injury or illness.
  • The same two tactics (educated flexibility, exigency) were used to stay well through the running career. The choice between the two strategies comes down to a constantly balancing a risk of an overuse injury, and social and economic pressures of being an elite level athlete. Stiving for balance was characterized by:

    • constant concern about health
    • worrying about injuries leading to earning less and reduction in access to qualified sports medical support which could lead to a higher risk of overuse injury.
    • athletes believed that environmental strain, sports performance, and ill health were all connected. This led to amplified worrying about minor health complaints and change of behavior in their training.
    • Athletes felt that responsibility for their long-term health and career was on the athlete themself.

Take home message

For a clinician & coach
Elite long-distance runners constantly try to balance risk of overuse injury and their performance goals to stay well and competitive. They use their experience and support of sports medical team to manage their health. When injured, they mainly use two tactics: either change training and competition plans or sacrifice health to reach strategic short-term performance goals.
For a parent
Constant focus on health was key to reaching and staying at the elite champion level in long-distance runners.
For an athlete
Elite champion long-distance runners constantly pay attention to their health and adjust their training accordingly.

Original article

Bargoria V, Timpka T, Jacobsson J, Halje K, Andersson C, Andersson G, Bermon S. Running for your life: A qualitative study of champion long-distance runners’ strategies to sustain excellence in performance and health. Journal of Science and Medicine in Sport. 2020; 23(8):715-720.

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