Category Archives: Caroline Heaney

Exercise: The miracle treatment for mental health?

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By Caroline Heaney

Campaigns and initiatives such as World Mental Health Day have helped to raise awareness of mental health difficulties (e.g., Norwich City FC video below). Mental health difficulties can affect anyone – it is estimated that 1 in 4 people experience a mental health problem each year, which means that most of us will be affected by a mental health condition at some point in our lives, either directly or through someone close to us. It is vital that once someone has taken the difficult step to disclose mental health difficulties they can access the right treatment and support, however, the NHS is struggling to meet the demand for mental health services. It is estimated that only 1 in 3 people with common mental health difficulties are getting the treatment they need. There are various treatment options available including talking therapies and medication, but medication is reported to be the most commonly used treatment for mental health problems. In recent years there has been a significant rise in the number of people taking antidepressant medication, which comes with a huge financial cost to the NHS, and it has been suggested that non-pharmacological treatments should be prioritised for those with mild to moderate depression. If only there was a low-cost treatment with few side effects and many additional health benefits. Well there is – exercise!

Exercise has long been recognised as an effective intervention in both the prevention and treatment of mental health conditions. For example, in their meta-analysis of the literature exploring exercise in the treatment of depression Heissel et al. (2023) found exercise to be an effective treatment for those with depression. Similarly, exercise has also been found to be an effective tool in the prevention of depression (Hu et al., 2020). The simple logic behind the link between exercise and mental health is that exercise can make us feel better. This means that exercise can benefit your mental health whether or not you have a diagnosed mental health problem. As well as combating diagnosed mental health conditions such as depression, exercise can enhance mood and reduce stress levels, thus allowing us to tackle daily challenges in a more positive, optimistic and constructive way. Up and down the country there are many people who are advocates for the beneficial role of exercise in preventing and treating mental health conditions. A few years ago I was lucky enough to meet a group of inspiring people who were referred to a scheme which involved prescribing exercise as part of a programme to tackle mental health conditions such as depression and anxiety. A clear message from these participants was that exercise was a powerful tool in helping them to combat mental health challenges. They described exercise as a far more positive treatment than medication.

Image by Moondance from Pixabay

Potentially, exercise can be used to treat mental health problems in place of or in addition to medication and other therapies, but in order for patients to benefit, medical professionals need to be confident in its role as a treatment and have access to suitable programmes to which they can refer their patients. In the past exercise referral for mental health reasons has been relatively uncommon, but in recent years there has been a drive to increase such ‘social prescribing’. For example, in 2022 a £12.7million scheme was launched in 11 local authorities for GPs to prescribe physical activity for those experiencing a range of physical and mental health conditions.

There lots of evidence to show that exercise can have a positive impact on mental health, but why is this the case? What is it about engaging in physical activity that leads to enhanced mental health? There is no one theory or hypothesis that has been universally accepted to explain the link between exercise and mental health. Instead, several different hypotheses have been proposed. These can be split into two categories: physical or psychological explanations (see Table 1). It may be that a combination of factors is causes improvements in mental health, rather than one factor alone. Additionally, because people differ greatly, explanations for improvements in mental health may vary according to the individual concerned.

Table 1: Examples of physical and psychological explanations for the relationship between exercise and improved mental health (adapted from Weinberg and Gould, 2015)

Physiological Explanations Psychological Explanations
  • Increases in cerebral blood flow
  • Changes in brain neurotransmitters (e.g., norepinephrine, endorphins, serotonin)
  • Increases in maximal oxygen consumption and delivery of oxygen to cerebral tissues
  • Reductions in muscle tension
  • Structural changes in the brain
  • Enhanced feeling of control
  • Feeling of competency and self-efficacy
  • Positive social interactions
  • Improved self-concept and self-esteem
  • Opportunities for fun and enjoyment

 

Conclusion

It would appear that exercise can be a highly effective tool in the prevention and treatment of mental health conditions. Exercise is a comparatively low cost treatment that can be used on its own or as an adjunct therapy and has virtually no side effects. In addition, it can tackle many other health conditions such as hypertension and heart disease. Surely prescribing exercise to treat mental health is a no brainer!

To find out more on this topic try our free OpenLearn course Exercise and Mental Health.

 

Reflecting on the complex legacy of Linford Christie

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By Caroline Heaney, Ben Oakley, Ola Fadoju and Jim Lusted

© BBC Photo – Photographer Jim Sharp

In July 2024 an impactful OU/BBC documentary ‘Linford‘ exploring Linford Christie’s (1992 Olympic 100m Champion) legacy aired on BBC1 just before the Paris Olympics. As well as charting the highs of his career, the documentary also addressed some of the lows such as racism and doping which were acknowledged in the media as being particularly powerful aspects of the programme. For example, The Guardian described the ‘racist fetishisation’ experienced by Linford as ‘heartbreaking’, whilst Athletics Weekly acknowledged the ‘painful’ sight of two of Linford’s children in tears after watching archive footage of their father facing the trivialisation of racism. In this article four #TeamOUsport staff members reflect on the documentary and the impact it had on them.

Ben’s reflections

Image: Josep Maria Trias, CC BY-SA 4.0, via Wikimedia Commons

At the 1992 Olympics, for Linford’s 100m victory, I was in the Olympic village as part of the Team GB coaching team (windsurfing). That night many Brits crammed around the TV to watch him, aged 32, win the gold. It was one of those shared moments. We leaped around the room in celebration, proud that ‘one of us’ had won the blue-riband event. We all walked a bit taller. In a way it galvanised the GB team.

Watching how his personal story unfolded in ‘Linford’ I now understand that by defending his corner he was often perceived as tricky character by the media. For me, the greatest personal slight and racist trope having scaled the peak of Olympic sprinting history was for the very next day his achievement to be demeaned by the Sun newspaper. Their front page focused on his genitals rather than his supreme global victory. In the Olympic village we didn’t see the papers but now I better understand how racist stereotypes were at play. Would the same have happened to say, Andy Murray after his Wimbledon success or other world beating white athletes? For me, this type of framing of success can’t be dismissed as ‘banter’, it is abusive.

Ola’s reflections

Linford Christie was iconic – he was ‘the man’ who took the fight to the USA sprinters. The way he stood on the starting line, completely focused and dominating everybody in that 1991-93 period  made him the greatest in that era.  While watching the documentary it was great to see him being honoured but you can also see how much he was maligned by the British media.

I remember fuming in my Haringey bedsit  at the subtle racism and gaslighting at play as Linford was having to justify why he was wearing Lycra shorts on the Saint and Greavsie programme, so much so that I wrote a letter of complaint. The British mainstream media never gave Linford the platitudes or spoke about his supreme mental strength and great sprinting ability which contrasted to the positive coverage for white male athletes. The press just wanted to talk about his genitalia as if that was what all Linford was.

Image from Pixabay

He won a case against the Met police in the 1990s and interestingly things haven’t changed as two of the athletes that Linford coaches, Bianca Williams and Ricardo Dos Santos, also successfully took the Met police to court because they were unlawfully arrested and found to be racially profiled by officers in 2020. At the time Linford brought this to our attention on social media and was castigated by many people that he was a ‘race baiter’, rather than being praised for supporting his athletes.  How can it be that even now the Police are still racially profiling Black people in the UK?

Linford was the greatest sprinter this country has ever produced. His legacy should be celebrated.

Jim’s reflections

I had just turned 16 when Linford Christie won 100m gold in 1992 but I remember it like yesterday. I got the chills watching the race again via the documentary, aided by David Coleman’s famous commentary. He was one of my childhood sporting heroes – he came from London (like me), he was a sprinter (I liked to run fast too), he took on the brash, dominant North American athletes with all their privileges and beat them all (an easy narrative to get behind as an impressionable teenager).

Image by Steve Bidmead from Pixabay

Looking back now, I think I followed Linford’s career because of these simple personal connections. The racial politics associated with his career only really became apparent to me later as I began to take more of an interest in issues of ‘race’ and racism in sport during my studies and then through my academic career. For me, one of the most fascinating moments in the documentary was when Christie talked about wrapping himself in the union flag after his victory. He notes the controversy this caused, recalling a UK official telling him at the time that ‘this wasn’t something (Black) athletes should be doing’. But this simple gesture took on huge significance as it became an iconic moment well beyond sport; Christie’s flag wearing was an overt display of Black Britishness, one which helped to re-define national identity in late 20th Century Britain. In that respect, it is what Linford did straight after, rather than during, that race in Barcelona all those years ago that is arguably his greatest legacy.

Caroline’s reflections

Image by Claudio Bianchi from Pixabay

As someone who has been involved in athletics since the early 1990s and trained in a similar area of West London to Linford, I felt honoured to be an academic consultant on this documentary with Ben. As an athlete in that period Linford was a legend and it was always exciting when he trained at my track or was at the same competitions as me. To me and others in athletics he always came across as a nice guy, who took the time to speak to people and seemed very humble. It surprised me when others and elements of the media seemed to have a different opinion of him. That differing perspective continues to this day through his perceived legacy since retiring from competition. To those outside of athletics, Linford is perceived to be invisible and to have disappeared under a cloud of disgrace after his drugs ban. Those inside of athletics know that Linford is in fact still very visible, and his legacy has lived on through his role as a coach. Learning from the close partnership he had with his own coach Ron Roddan, Linford has gone on to successfully coach several athletes including Olympic medallists Darren Campbell and Katherine Merry and 2024 Olympian Bianca Williams. His coaching career, however, continues to be touched by issues of drugs and racism. His drugs ban means that he is not allowed accreditation as a coach at any Olympics and so his ability to support his athletes in hindered. Sports coaching as a profession continues to lack diversity with black people typically underrepresented and so Linford’s position as a successful black coach means that he continues to be an important role model and continues to challenge racial stereotypes – an important legacy.

 

The ‘Linford’ documentary has been instrumental in raising awareness of some of the darker sides of sport that not only affected Linford Christie’s competitive career in the 1980s and 90s, but sadly continue to affect athletes today. Let’s hope that this awareness can be a catalyst for change.

The ‘Linford’ documentary is an Open University (OU)/BBC co-production. You can watch it on BBC iPlayer.

Associated resources exploring why athletic performances continue to improve can also be found on the Open University Connect website.

Why would British athletes choose winter sports?

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By Caroline Heaney

The British terrain and climate are not really designed for winter sports – there are few mountains suitable for skiing and our winters simply aren’t cold enough. Yet Team GB will be taking a 50-strong squad to the 2022 Winter Olympics in Beijing. So how do athletes from a green and pleasant land come to be involved in winter sports on snow and ice?

Paths into winter sports are varied and often quite different to the more conventional routes seen in summer Olympic sports. There is also a large variation between winter sports – bobsleigh, skiing, ice skating and snowboard athletes, for example, will all have come to their sport in different ways.

The majority of athletes have a background of junior participation, often having made their entry into the sport at a young age, but in some Winter Olympic sports this is not the case. It is very common for athletes in these sports to start late, having begun their sporting career elsewhere.

Take bobsleigh and skeleton for example: these are sports that you can only start as an adult – you just can’t do them as a child. This makes career paths into these sports very different. Olympic silver medallist Shelly Rudman didn’t try skeleton until the age of 21, which is very late compared to athletes from other Olympic sports. This contradicts some models of athletic development, which suggest that investment in a sport as a junior is a requirement for success.

Many athletes transfer from other sports and many are “spotted” as potential winter sport athletes through so called “talent transfer programmes”, such as UK Sport’s ‘Girls 4 Gold’ programme which started in 2008. Double Olympic gold medallist Lizzy Yarnold was a graduate from the Girls 4 Gold programme, having transferred into the sport from athletics.

The slide from athletics

Transition from athletics seems to be a common route into sliding sports: bobsleigh, skeleton and luge. Olympic skeleton medallists Alex Coomber (bronze in 2002) Shelly Rudman (silver in 2006), Amy Williams (gold in 2010) and Lizzy Yarnold (gold in 2014 and 2018) all had a background in athletics before switching to skeleton. The speed and power elements of athletics transfer well into the push start required in both skeleton and bobsleigh.

Bobsleigh has a long-established tradition of recruiting high calibre track and field athletes into its fold (e.g., British sprinters Mark Lewis-Francis, Craig Pickering, Joel Fearon, Allyn Condon and Marcus Adam have all been part of the British squad in the past). Current GB squad member and former British 100m record holder Montell Douglas is set to become Britain’s first female summer and winter Olympian in Beijing. She stated: “I’m over the moon to be representing women. There have been many male summer and winter Olympians, so I’m more thrilled about leaving a legacy like that behind than anything else.”

The transition from athletics to bobsleigh is not exclusive to the UK. For example, sprinter Alexandra Burghardt (Germany) who competed in the Tokyo Olympics last year will also be competing in the two-woman bobsleigh in Beijing, and previously track and field Olympic/World medallists Lauryn Williams (USA),  Lolo Jones (USA) and Jana Pittman (Australia) have transitioned to bobsleigh.

Live near a ski slope

Paths into winter sports are often dictated by opportunity. Facilities for winter sports participation are few and far between and so location plays an important part. If you live near an ice rink you are more likely to become involved in speed skating or figure skating.

Kate Summerhayes, who will be representing Team GB in freestyle skiing in her third Winter Olympics in Beijing, learned to ski when she was six at the Sheffield Ski Village, which was only ten minutes away from her home. There are certainly geographic patterns in team membership – for example the GB curling and Nordic skiing teams have traditionally been dominated by Scottish athletes. Is this connected to there being better facilities and infrastructure for these sports in Scotland? A lack of winter sport facilities in the UK could certainly be hindering our prospects and the types of facilities available may limit the range of our participation.

Interestingly, Team GB normally only enter athletes into the short track speed skating event and not the long track events. This could be a consequence of limited long track speed skating facilities.

Money and role models

Finance is also strongly related to opportunity – participation in winter sports often requires overseas travel and expensive equipment. At the upper ends lottery funding and sponsorship is available, but the financial aspects may prevent potential athletes starting a winter sport. Learning to ski as a child, for example, is a privilege largely reserved for children whose parents have the income to afford skiing holidays.

Finally, one of the most important factors influencing why an athlete might move into a winter sport is role models. Medals won in the past four Winter Olympics in skeleton have certainly boosted the profile of the sport and may encourage more athletes to consider taking it up.

Any British athletes gaining medal honours in Beijing will certainly be ambassadors for winter sports and have the potential to inspire a generation to take to the slopes, ice rink or track.

 

This article was first published on OpenLearn.

For more Winter Olympics and Paralympics related articles visit our hub on OpenLearn.

Tokyo 2020 in 2021: Do the best things come to those who wait?

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By Caroline Heaney

The life of an Olympic or Paralympic athlete is characterised by highly planned and structured 4-year cycles designed to lead to peak performance in Olympic/Paralympic year, but what happens when that cycle unexpectedly stretches to 5 years and is threaded with uncertainty?

Image by Gerhard G. from Pixabay

The COVID-19 pandemic created an unprecedented situation with Tokyo 2020 being the first Olympic/Paralympic Games to be cancelled or postponed since the Second World War. The postponed 2021 games will likely be a different experience to previous games with, for example, no spectators at most events (BBC, 2021) and a scaled down opening ceremony (Telegraph Sport, 2021). So, what effect does the postponement have on the athletes and their preparation? This article will explore some of the psychological and physiological impacts of this unusual situation.

What impact did the postponement have?

Obviously, there is variability in how athletes reacted to the postponement of the Olympics/Paralympics in 2020, but feelings of disappointment, frustration, confusion, and uncertainty seemed to be common (Taku and Arai, 2020). For example, in response to the announcement that the Olympics would be postponed British Olympic Taekwondo champion Jade Jones stated:

“I’m truly gutted – you give your heart and soul to something for four years, then for it not to go ahead is just horrible. Obviously, health comes first, […] but as an elite athlete, it is very demotivating and mentally tough. I’m a very positive person but the idea, right now, of having to devote myself to another year’s slog is a very difficult one” (BBC, 2020).

As well as the impact of the games being postponed, the lockdowns also had a significant impact on athletes and their preparations from both a psychological and physiological perspective. Lockdowns and the associated quarantine has been shown to have a negative impact on the mental health of the general population (Henssler et al., 2021) and elite athletes are not immune to this. Elite athletes were found to experience increased symptoms of mental health difficulties (e.g. depression) during COVID-19 lockdowns (Simons et al., 2021). As such the need for psychological intervention to support athletes is paramount (Reardon et al., 2021).

The impact on the training schedules of athletes was also significant. During the first UK lockdown, for example, many training venues were closed, and consequently many athletes lost face to face contact with their coaches and teammates and were forced to train alone in sub-optimal conditions. Research has shown that there was a reduction in the quality of training and sleep for many athletes (Mon-López et al., 2020), which could lead to a detraining effect and loss of fitness as well as an increased risk of injury (Sarto et al., 2020). To prevent these potential effects, athletes and coaches were required to be creative with their training sessions and develop innovative training programmes away from normal training venues.

Athletes who successfully managed to maintain their fitness ready to peak for a 2021 Olympics/Paralympics were faced with further difficulties when it came to qualifying for the games. Many qualifying tournaments and competitions were cancelled due to COVID-19 giving athletes far fewer opportunities to qualify.

For many, participating in an Olympic or Paralympic Games is a once in a lifetime opportunity and a postponed games may well make that opportunity unavailable for some, such as those who were at their peak in 2020, but injured or retired in 2021.

The ones who didn’t make it…

Postponing the Tokyo Olympics/Paralympics meant that some athletes who would have been there in 2020 didn’t make it to the 2021 Games. Retiring athletes are one example. It is common for athletes to retire after an Olympic/Paralympic Games and many athletes approaching the end of their career might having been looking at the 2020 games as their final swansong. The pandemic left these athletes with a difficult decision – hang on for one more year or bow out now. Some, such as Japanese volleyball player Risa Shinnabe and New Zealand cyclist Eddie Dawkins, chose to retire in 2020. Shinnabe said:

“That one year, to me, felt very long […] I could no longer imagine that I would be able to go through the same cycle for another year and maintain my condition” (Rowbottom, 2021).

The ones who hung on…

Those who decided to hang on include Olympic gymnastics champion Simone Biles who had originally planned to retire after the Olympics in 2020 but has decided to postpone her retirement. In fact, Biles is now considering continuing to the 2024 Olympics. She is not alone in this, with some athletes deciding that another three-year cycle is not as daunting as a four-year cycle. As Paralympic volleyball player Lora Webster puts it “three years seems like nothing when you look back on what these five years have felt like” (Radnofsky, 2021). These athletes seem to have benefited from the delay and they are not alone.

The ones who benefitted…

There are many athletes who appear to have benefitted from the postposed games. Take for example, an athlete who was injured in 2020 and would have missed the games, but now has the opportunity to compete. In many ways 2020 was the best time for an athlete to be injured as the entire world of sport effectively stopped for a while.

2020 also provided athletes with a unique opportunity to take a break from the physiological and psychological stresses of elite sport. This will likely have benefitted many athletes giving them a chance to recover and rejuvenate. The pandemic also allowed athletes to develop important skills such as resilience.

Tokyo: The games of the resilient athlete?

Resilience is considered to be an important quality in athletes, and those who have come through a pandemic and successfully qualified for the delayed games have certainly had the opportunity to demonstrate resilience. It will perhaps be the athletes who have the best skills in this area and have been able to adapt and thrive in this unprecedented situation that will rise to the top of the podium this year. Researchers exploring resilience have identified that the COVID-19 pandemic has created unexpected and novel adverse experiences for athletes and that resilience can help athletes to adapt positively (Gupta and McCarthy, 2021).

There has certainly been evidence of athletes demonstrating a positive approach. For example, in response to finding out that the games had been postponed, reigning Olympic champion swimmer Lily King posted on social media “Just one more year to get better #Tokyo2020” (Klosok and Church, 2020).

Let’s hope that such positivity and optimism will lead to a spectacular summer of Olympic and Paralympic performances.

References

BBC (2020) Tokyo 2020: How athletes reacted to Olympic Games postponement. Available at: https://www.bbc.co.uk/sport/olympics/52027542  (Accessed: 12 July 2021).

BBC (2021) Tokyo Olympics: Spectators largely barred as Covid emergency declared. Available at: https://www.bbc.co.uk/news/world-asia-57760883  (Accessed: 12 July 2021).

Gupta, S. and McCarthy, P. J. (2021) ‘Sporting Resilience During COVID-19: What Is the Nature of This Adversity and How Are Competitive Elite Athletes Adapting?’, Frontiers in Psychology, 12(374).

Henssler, J., Stock, F., van Bohemen, J., Walter, H., Heinz, A. and Brandt, L. (2021) ‘Mental health effects of infection containment strategies: quarantine and isolation—a systematic review and meta-analysis’, European Archives of Psychiatry and Clinical Neuroscience, 271(2), pp. 223-234.

Klosok, A. and Church, B. (2020) Athletes come to terms with ‘heartbreaking’ Tokyo 2020 postponement. Available at: https://edition.cnn.com/2020/03/25/sport/athletes-reaction-tokyo-2020-olympics-postpone-spt-intl/index.html  (Accessed: 12 July 2021).

Mon-López, D., García-Aliaga, A., Ginés Bartolomé, A. and Muriarte Solana, D. (2020) ‘How has COVID-19 modified training and mood in professional and non-professional football players?’, Physiology & Behavior, 227, pp. 113148.

Radnofsky, L. (2021) ‘Athletes Who Waited for the Tokyo Olympics Are Asking: Why Not Stick Around for Paris 2024, Too? After a long wait for this summer’s Games, some old hands who had planned to retire are figuring they can also hang on another three years’, Wall Street Journal (Online), 04/11/2021 Apr 11. Available at: https://www.wsj.com/articles/simone-biles-will-push-on-to-2021probably-11585738819?mod=article_inline .

Reardon, C. L., Bindra, A., Blauwet, C., Budgett, R., Campriani, N., Currie, A., Gouttebarge, V., McDuff, D., Mountjoy, M., Purcell, R., Putukian, M., Rice, S. and Hainline, B. (2021) ‘Mental health management of elite athletes during COVID-19: a narrative review and recommendations’, British Journal of Sports Medicine, 55(11), pp. 608-615.

Rowbottom, M. (2021) A bridge too far – the athletes who retired instead of waiting for Tokyo. Available at: https://www.insidethegames.biz/articles/1109206/big-read-athlete-retirements-tokyo-2020  (Accessed: 12 July 2021).

Sarto, F., Impellizzeri, F. M., Spörri, J., Porcelli, S., Olmo, J., Requena, B., Suarez-Arrones, L., Arundale, A., Bilsborough, J., Buchheit, M., Clubb, J., Coutts, A., Nabhan, D., Torres-Ronda, L., Mendez-Villanueva, A., Mujika, I., Maffiuletti, N. A. and Franchi, M. V. (2020) ‘Impact of Potential Physiological Changes due to COVID-19 Home Confinement on Athlete Health Protection in Elite Sports: a Call for Awareness in Sports Programming’, Sports Medicine, 50(8), pp. 1417-1419.

Simons, C., Martin, L. A., Balcombe, L., Dunn, P. K. and Clark, R. A. (2021) ‘Mental health impact on at-risk high-level athletes during COVID-19 lockdown: A pre-, during and post-lockdown longitudinal cohort study of adjustment disorder’, Journal of Science and Medicine in Sport, 24(4), pp. 329-331.

Taku, K. and Arai, H. (2020) ‘Impact of COVID-19 on Athletes and Coaches, and Their Values in Japan: Repercussions of Postponing the Tokyo 2020 Olympic and Paralympic Games’, Journal of Loss and Trauma, 25(8), pp. 623-630.

Telegraph Sport (2021) Tokyo Olympics 2021 Opening Ceremony: when is it, what time does it start and how can I watch? Available at: https://www.telegraph.co.uk/olympics/0/tokyo-olympics-2021-opening-ceremony-time-does-start-can-watch/  (Accessed: 12 July 2021).

 

This article was originally posted on OpenLearn.

Why aren’t we educating those supporting injured players about mental health?

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By Caroline Heaney

Photo by Fancy Crave on Unsplash

Recently, The Independent reported that professional football clubs are failing to provide injured players with the psychological support they need (Lovett, 2019). The psychological impact of sport injury is well documented – for example, the IOC consensus statement on mental health in elite athletes (Reardon et al., 2019) recognises that sport injury can have a significant impact on mental health, and several sportsmen and women (e.g. footballer Danny Rose) have cited injury as a trigger for mental health difficulties. So why is it that the psychological aspects of sport injury are being ignored in professional football?

The article in The Independent, which explored a study conducted by Dr Misia Gervis, pointed towards a lack of education and training amongst medical staff treating injured players – an area that I have researched extensively with my colleagues at The Open University. My early work in this area (Heaney, 2006) investigated the attitudes and perceptions of physiotherapists working in professional football and identified that whilst physiotherapists recognised that injury had a psychological impact they largely did not have the education or training to be able to respond effectively. This was supported by our 2012 investigation into physiotherapy education in the UK (Heaney et al., 2012) which revealed great diversity in the provision of psychology education in physiotherapy programmes and an inconsistency between the reported importance of psychology and the demonstrated importance of psychology through its visibility within the curriculum.

Photo by Jesper Aggergaard on Unsplash

These findings indicate that UK physiotherapy training does not adequately prepare sports medicine staff for dealing with the psychological aspects of sport injury and that training in this area would be beneficial, but is this the case? To answer this question we conducted two further studies. The first (Heaney et al., 2017a) examined the sport psychology related attitudes and behaviours of ninety-four qualified sports injury rehabilitation professionals (physiotherapists and sports therapists) working in sport. These professionals were split into two groups – those who had been exposed to education on the psychological aspects of sport injury as part of their undergraduate or postgraduate studies and those who had not. It was found that those who had studied the psychological aspects of sport injury integrated significantly more sport psychology into their practice and referred more athletes to sport psychologists for further support than those who had not.

Photo by Hussain Ibrahim on Unsplash

The findings of this study suggest that sport psychology education is beneficial to sport injury rehabilitation professionals and the athletes they treat, but what about the professionals who aren’t lucky enough to receive sport injury psychology education as part of their undergraduate or postgraduate training? How can they access the benefits of sport injury psychology education? We wanted to know whether post-qualification continuing professional development (CPD) training on the topic can derive the same benefits and so we conducted a further study (Heaney et al., 2017b) exploring the impact of an online sport injury psychology education module on the attitudes and behaviours of ninety-five physiotherapists working in sport who had not been exposed to sport psychology education as part of their undergraduate or postgraduate training. The physiotherapists were randomly assigned to either an intervention group who studied an online CPD module titled ‘sport psychology for physiotherapists’ or a control group who studied an equivalent online CPD module on strength and conditioning which had no psychology content. Physiotherapists working in sport tend to be busy professionals who work unsociable hours and travel a lot (e.g. traveling to competitions across the country or the world) and therefore it was important that the CPD module was flexible, accessible and of a duration that would promote adherence. Consequently, an online format was adopted with a study duration of approximately 12 hours. The ‘sport psychology for physiotherapists’ module covered three main areas – (1) understanding the psychological impact of sport injury, (2) psychological skills and techniques for injured athletes, and (3) referral and professional boundaries. Attitudes and behaviours towards sport psychology were measured before the module and at three points after the module had been completed (immediately, 3 months and 6 months after). It was found that those who had studied the sport psychology module demonstrated an improvement in their attitudes towards sport psychology immediately following its completion that was significantly higher than those who had studied the control module. Use of sport psychology also increased following the sport psychology module, with significant differences seen between the intervention and control group indicating that those who had studied the sport psychology module were integrating more sport psychology techniques into their practice than those who had studied the control module.

Photo by Jesper Aggergaard on Unsplash

The findings of this study indicated that CPD courses can address the limitations that some physiotherapists and other members of the sports medicine team have in their understanding of the psychological aspects of sport injury, but it also uncovered another issue – a distinct lack of CPD offerings in this area in the UK. We have sought to address this by developing a free Badged Open Course Exploring the psychological aspects of sport injury, which we hope will contribute to bridging the gap, but more still needs to be done to ensure that sport psychology is properly integrated into undergraduate and postgraduate training so that injured players get both the physical and psychological support they need during sport injury.

Its not all doom and gloom when it comes to this topic and its important to note that some professional football clubs do utilise sport injury protocols that integrate psychological factors and use multidisciplinary sports medicine teams that include sport psychologists to support the injured athlete. Indeed, The Independent article gives the example of Queens Park Rangers where sport psychology is firmly embedded within the treatment room. Dr Misia Gervis suggests that for this to become more commonplace “a cultural shift of practice is needed by medics, physios and coaches.” It is my belief that educating sports medicine professionals is the first and key step to enabling this cultural shift.

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Please watch the video to find out more about the free Badged Open Course (BOC) Exploring the Psychological Aspects of Sport Injury

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Sport and Fitness Student Induction: Student Hub Live

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On Tuesday 26th September 2017, as part of our induction for sport and fitness students studying at the Open University, we held a live induction event through our Student Hub Live platform. If you missed the session you can watch the full video here on the link below or you can watch the individual videos of each session below.

Session 1: Sport and Fitness Qualification Overview (Caroline Heaney and Ben Oakley)

Session 2: Sport and Fitness Blog and Social Media (Helen Owton and Karen Howells)

Session 3: The Role of the Tutor (Helen Owton and Ola Fadoju)

Session 4: E117 App Demonstration (Ben Langdown and Caroline Heaney)

Session 5: The Student Journey (Jess Pinchbeck and Caroline Heaney)

Exercise: The miracle treatment for mental health?

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By Caroline Heaney

Recent campaigns such as Heads Together have helped to raise awareness of mental health difficulties. Mental health issues affect everyone – it is estimated that 1 in 4 people experience a mental health problem each year, which means that most of us will be affected by a mental health condition at some point in our lives, either directly or through someone close to us. It is vital that once someone has taken the difficult step to disclose mental health difficulties that they can access the right treatment and support, however, NHS funding for mental health services has been reduced whilst demand has increased. It is estimated that by 2030 there will be 2 million adults with a mental health problem, and an NHS funding shortfall of £44-54 billion over the next decade. There are various treatment options available including therapies and medication, but medication is reported to be the most commonly used treatment for mental health problems. This comes at a huge cost to the NHS who reportedly spend £285 million per year on antidepressant medications. If only there was a low-cost treatment with few side effects and many additional health benefits. Well there is – exercise!

Image courtesy of nenetus at FreeDigitalPhotos.net

Exercise has long been recognised as an effective intervention in both the prevention and treatment of mental health conditions. For example, in their meta-analysis of the literature exploring exercise in the treatment of depression Josefsson, Lindwall and Archer (2014), found exercise to be an effective treatment in those with mild and moderate depression, with the potential to be effective with those with more severe depression. Similarly, exercise has also been found to be an effective tool in the prevention of depression (Mammen and Faulkner, 2013). The simple logic behind the link between exercise and mental health is that exercise can make us feel better. This means that exercise can benefit your mental health whether or not you have a diagnosed mental health problem. As well as combating diagnosed mental health conditions such as depression, exercise can enhance mood and reduce stress levels, thus allowing us to tackle daily challenges in a more positive, optimistic and constructive way.

BBC 1’s Mind Over Marathon showed the power of exercise as it charted the experience of a group of people with mental health conditions as they prepared to run the 2017 London Marathon. The people in this programme were not unique in their experience of finding exercise therapeutic in their fight against mental health conditions. Up and down the country there are many people who are advocates for the beneficial role of exercise in preventing and treating mental health conditions. A few years ago I was lucky enough to meet a group of inspiring people in Essex who were referred to a Healthy Lifestyle Programme which involved prescribing exercise as part of a programme to tackle mental health conditions such as depression and anxiety. A clear message from these participants was that exercise was a powerful tool in helping them to combat mental health challenges. They described exercise as a far more positive treatment than medication.

Potentially, exercise can be used to treat mental health problems in place of or in addition to medication and other therapies, but in order for patients to benefit, medical professionals need to be confident in its role as a treatment and have access to suitable programmes to which they can refer their patients. Data from the Mental Health Foundation suggests that whilst more than half of the GPs they surveyed recognised exercise as an effective treatment for mild to moderate depression, only 21% would actually refer a patient to a supervised exercise programme. This could however be due, in part, to a lack of access as 40% of the GPs surveyed said that they didn’t have access to an exercise referral scheme.

There lots of evidence to show that exercise can have a positive impact on mental health, but why is this the case? What is it about engaging in physical activity that leads to enhanced mental health? There is no one theory or hypothesis that has been universally accepted to explain the link between exercise and mental health. Instead, several different hypotheses have been proposed. These can be split into two categories: physical or psychological explanations (see table 1). It may be that a combination of factors is causes improvements in mental health, rather than one factor alone. Additionally, because people differ greatly, explanations for improvements in mental health may vary according to the individual concerned.

Table 1: Examples of physical and psychological explanations for the relationship between exercise and improved mental health (adapted from Weinberg and Gould, 2015)

Physiological Explanations Psychological Explanations
  • Increases in cerebral blood flow
  • Changes in brain neurotransmitters (e.g., norepinephrine, endorphins, serotonin)
  • Increases in maximal oxygen consumption and delivery of oxygen to cerebral tissues
  • Reductions in muscle tension
  • Structural changes in the brain
  • Enhanced feeling of control
  • Feeling of competency and self-efficacy
  • Positive social interactions
  • Improved self-concept and self-esteem
  • Opportunities for fun and enjoyment

 

Conclusion

It would appear that exercise can be a highly effective tool in the prevention and treatment of mental health conditions. Exercise is a comparatively low cost treatment that can be used on its own or as an adjunct therapy and has virtually no side effects. In addition, it can tackle many other health conditions such as hypertension and heart disease. Surely prescribing exercise to treat mental health is a no brainer!

To find out more on this topic try our free course Exercise and Mental Health.

 

Life after the Olympics: retirement

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By Caroline Heaney

The close of the 2016 Olympics bought with them the prospect of the retirement of some of the leading names in sport. Usain Bolt, Jessica Ennis-Hill and Michael Phelps, for example, will all be notable absences from the 2020 Olympics, but how will these athletes cope with life after elite sport?

After the thrill of the Olympics many athletes experience a post-Olympic come down and some can even experience depression. It seems logical that after the four-year build-up and the excitement of the event, many athletes are left asking themselves the question of ‘what next’ once the games are over. When an athlete feels that they’ve achieved all that they can achieve in the Olympic environment the answer to that question might be retirement.

Retirement from sport is not an easy transition for any athlete to make. Elite athletes who have dedicated their whole life to their sport and tend to have a strong athletic identity, where being an athlete is a large part of their perception of their identity. To have that part of their identity taken away can be traumatic and lead to an identity crisis. Several high profile athletes have admitted to struggling with retirement and career termination (retirement) is considered to be a significant potential cause of depression and anxiety amongst athletes. Of course, retirement from sport doesn’t have to be a negative experience – some may view it as a ‘rebirth’ rather than a ‘death’. How an athlete copes with retirement can depend on a multitude of factors such as their general resilience, whether they have made plans for life after sport, whether they have fulfilled their potential, and whether their retirement is planned or forced (e.g. a career ending injury).

Let’s examine the case of three Olympic medallists who are reaching the end of their careers and are contemplating retirement in the not too distant future – Usain Bolt, Jessica Ennis-Hill and Michael Phelps.

Bolt: The man with a plan

After he achieved the unprecedented ‘triple triple’ (Olympic gold medals in the 100m, 200m and 4x100m in 2008, 2012 and 2016) Usain Bolt announced that Rio would be his last Olympics. This comes as no surprise as Bolt had identified this as his plan long before the Rio Olympics. Bolt is not retiring just yet and is planning to compete in the World Athletics Championships in London next year. This ‘phased retirement’ may help Bolt with the transition into retirement that many athletes struggle with. The difference between Bolt and some athletes who find retirement difficult is the fact that Usain has achieved everything he possibly could in his sport and is exiting on his terms (a ‘planned’ retirement) – for Usain there will be no unfinished business. This will give Usain a strong sense of control over his retirement. Despite this, retirement must still be a difficult decision for Bolt, particularly when he is viewed by many as the saviour of athletics – a pressure indeed and his absence from the sport will no doubt be felt when his retirement does come.

Ennis-Hill: A decision to be made

Whilst Bolt has a clear plan for his future Jessica Ennis-Hill, after achieving a heptathlon silver medal in Rio, following her Gold in 2012, is taking some time to contemplate her future. After her event she stated “It’s going to be a tough decision, I’m going to go away and think about it… it’s a big decision.” Like Bolt, Ennis-Hill has given a clear message that she will not be at the 2020 Olympics, but has yet to decide whether to draw a line under her career now or at a later date. A home World Championships for the reigning World Champion might be a temptation for a final swansong, but will it live up to a home Olympics? Preparing for a heptathlon competition is no easy task and having twice before won the World Championships Ennis-Hill may decide that the incentive just isn’t great enough. Maybe what Jess needs is a new challenge, such as joining the exclusive 7000-point heptathlon club. Taking her time to reflect on her future and not rushing into a decision in flurry of post-Olympics emotion is a sensible approach as effective retirement decision making can be a complex process. Whatever decision she makes Ennis-Hill has been a fantastic ambassador for her sport and as one of the few women in sport to become a household name her role as female athletic role model should not be underestimated.

Phelps: The comeback king

Michael Phelps, the most decorated Olympian in history (28 Olympic medals over 5 games), is an example of an athlete who retired, but then came back to swimming. Returning to sport after retirement is often associated with a compulsion to compete and an inability to cope with the sense of loss that occurs following retirement. This appears to have been the case with Phelps who stated that he experienced a tremendous low point after his retirement. Phelps has made no secret of the mental health challenges he has experienced in his life and in sharing these he has helped to overcome the stigma of athletes experiencing mental health conditions such as depression. Having learnt important lessons from his first retirement Phelps felt that he had ‘unfinished business’. His response to his imminent second retirement has been very positive:

“‘I feel fulfilled. It was what I wanted. I was able to dedicate myself to this last comeback and that was it. One last hurrah. Looking back, it happened exactly how I wanted it to and exactly how it should have. Now I can hang up my suit and be happy with retiring. During the medal ceremonies, I was more emotional than I ever was before. I think that’s just because I was truly happy with where I am and how everything went.”

Bolt, Ennis-Hill and Phelps have all left their mark in Olympic history and as they move towards new chapters in their lives they face new challenges which they will hopefully take on with the mental strength of an Olympian.

Reflections on the Student Hub Live Olympics Special

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On Friday 19th Aust 2016 members of the OU sport and fitness team (Simon Rea, Karen Howells and Caroline Heaney) took part in the Student Hub Live Olympics Special. This was our first experience of a live streamed event, but we all thoroughly enjoyed it. We were joined by Kath Woodward and Elizabeth Silva and the session was expertly hosted by Karen Foley.

imageOn our arrival we were delighted to see that the green room was well stocked with tasty treats, possibly as an incentive to take a green room selfie!

We then participated in a short Facebook live video talking about what we would cover in the session. This helped us to overcome some of our nerves about the main event and we were impressed how many students watched the video. This filled us with excitement about what was to come and the amount of student interaction that was possible.

imageThe session kicked off at noon and Simon Rea was up first discussing the history of the Olympics. He also shared his experience of racing 1980 Olympic 100m champion Alan Wells!

 

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Simon was followed by Elizabeth Silva, Professor of Sociology, who examined some of the economical and political aspects of the Olympics, and gave some interesting insight.

 

 

 

 

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Karen Howells was up next discussing the coach-athlete relationship and the role of sport psychology. This session highlighted the importance of the team behind the athlete.

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Karen was followed by Caroline Heaney who discussed the links between mental health and sport and exercise. As well as looking at exercise as a treatment for mental health conditions, the session looked at the incidence of depression in elite athletes.

 

imageThe session concluded with an interesting discussion about gender and the Olympics with Kath Woodward who challenged the audience to consider whether traditional views of gender are too narrow.

The Student Hub Live Olympics Special provided us with a great opportunity to interact with students and share our knowledge on sports related topics. We hope that those who engaged with the session found it interesting.

If you missed the session it will be available through the catch-up link on this page, or you can watch the video below.

If you are interested in studying sport and fitness at the OU please click here to find out more.

Video: What sporting future? Risks and rewards

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So far in the 2016 Rio Olympics we have seen several world records (e.g. Ayana in the 10,000m, Peaty in 100m breaststroke, Wlodarczyk in the hammer,  Qingquan in weightlifting). In this video Michael Johnson, who yesterday lost his 400m world record to Wayde van Niekerk reflects on the future of sport in an age when technology is advancing rapidly.

Note: This video is also available in the OpenLearn Chasing Perfection video collection