Keeping UK athletes fit for Sydney

Kay Brennan meets the team that provides medical services to élite Olympic athletes

A tall, toned man appears at the door in a tracksuit. He wipes his sweaty palms over the shiny blue bottoms and smiles broadly, disguising his labrador pant. "That was great," he puffs, tumbling into a large black chair with a sweaty squelch, "much faster than last time." He has survived the treadmill from hell.

The scene is the recovery lounge at the British Olympic Medical Centre (BOMC). The athlete, a young sprinter, is bidding to be part of the British team at the Olympic Games in Sydney, only a few weeks away. He is a "gold passport holder" for the centre and can use the facilities as often as he likes, free of charge. "It's brilliant here," he says between mouthfuls of a banana, "this is my third time this year."

Set up in 1987, the BOMC is the British Olympic Association's (BOA) department of sports medicine and sports science, based in Northwick Park Hospital in north west London. It provides medical services to élite Olympic athletes.

The centre offers a multidisciplinary team of experts who can meet the demands of world class performers. This includes a full time team of physiologists, six sports medicine doctors, two physiotherapists, a sports dietician, and now a sports psychologist. As it is based at the largest district general hospital in Britain, sports injury clinics and orthopaedic surgeons are readily available, and there is quick access to blood tests, x ray examinations, bone scans, ultrasonography, and general physicians.

I was taken to the centre's testing laboratory by Dr Richard Budgett, BOA's chief med- ical officer and a sports medicine consultant at the centre. He is an expert on the needs and demands of today's top athletes, having rowed for Britain and won a gold medal in the 1984 Los Angeles Olympics.

Centre sees 4000 people a year

He has been at the centre since it was set up. "There were only a few physiologists and doctors then, but we have evolved into a centre of excellence providing a fantastic range of services for over 4000 visitors a year. The joy of this place comes from the way the experts work together to provide the optimum service to individual athletes."

A teenage athlete in matching bra and cycling shorts is just breaking into a gentle jog on the treadmill. A multicoloured mass of wires from a 12-lead electrocardiogram, chest pulse monitor, and turbine mask with elephant trunk attachment are connected to a computer which will test her overall fitness in the next 20 minutes. She is carefully watched and encouraged by a physiologist, who is slowly increasing the speed.

Laboratory testing on running machines, rowing machines, or bikes is carried out on all athletes who visit the centre. To ensure consistency, the same protocols, equipment, and staff are used on each test and retest. This enables the centre to track the athletes' progress, measure the effectiveness of their training schedule, and, if they are injured, plot their return to fitness.

Dr Budgett boasts about the medical services at the centre. "All our doctors hold the Diploma in Sports Medicine and have a wide range of sports specific involvement from Olympic competitors to team doctors with major Olympic sports teams."

Advice given on diet to maximize performance

The team congregates in the feedback room to eat a low fat, high carbohydrate lunch. A can of coke sparks a debate on caffeine - how many cans constitute an overdose? The current doping scandals in the British team means that everyone is twitchy about the subject, and heads turn to Jacqueline Boorman, the resident sports dietician. She provides advice and education programmes to help coaches and athletes develop a diet which will maximise their performance in training and competition.

A recent recruit to the team is Britt Tajet-Foxell, a sports psychologist, who aims to boost both body and mind. After lunch she invites me to join her on the comfortable couch in her consulting room.

"A positive attitude is fundamentally important to a top performance," she said. Britt is also the psychologist to the Royal Ballet Company. "I help athletes focus their minds positively on training and competing and also help them deal with the unavoidable pressures in sport today, such as the media attention." She hopes that teaching the athletes to focus their minds in this way will also help them to cope with injury and nagging doubts experienced during the recovery period.

Some coaches and athletes are resistant Not everyone is receptive to the centre and its services, Richard Godfrey, chief physiologist told me. "Some coaches and athletes believe we are undermining their work. We had resistance from one of the swimming coaches for years. We try to reassure them that we are only the medical backup. Coaching and good facilities are the two main systems to success and we are careful not to upset these dynamics. But at this top level it is the backup that picks the winners from the losers."

I flick through the visitors' book. Rower Steve Redgrave, four times an Olympic gold medallist, regularly attends, as well as many track and field stars. They benefit from the dynamic yet friendly atmosphere at the centre. Using a holistic approach, calling on the knowledge and skills of all the team, means that athletes have a one-stop shop guaranteed to produce the best from them in training and competition.

Dr Budgett said, "There are no heads in books here; we are all practitioners or therapists with years of experience, who take the science of sport and use it in a way the athlete can understand."

Kay Brennan, third year medical student, University of Leeds
Email: Kaybrennan@hotmail.com


studentBMJ 2000;08:347-394 October ISSN 0966-6494