CASE Study: Mark ROHAN

M Rohan

MULTIDISCIPLINARY TEAMS

Teams of specialised service providers are at the heart of the Institute’s performance-focused services. These teams aim to maximise the athlete’s performance potential by optimising preparation both physical and psychological, monitoring training load and rapid diagnosis and management of injury or illness. These teams works in conjunction with the athletes and sports performance team (coaches, performance directors and managers). The service providers work in an interdisciplinary manner ensuring close coordination between all parties in the management of any case.

Preparing for the London Paralympic Games was the focus for double World Champion Hand-cyclist Mark Rohan and his coach Brian Nugent. Mark’s gold medal success in London was the culmination of more than three years of support to Mark and Brian by a multi-disciplinary team of service providers, focused on providing individualised support tailored to Mark’s specific needs.

        Coach | Brian Nugent

        Physiology | Toni Rossiter

        Nutrition | Sharon Madigan

        Lifestyle management | Darragh Sheridan

        Physiotherapy | Fintan O’Donnell, Jon Faulkner, Sinead Murphy

        Performance Analysis | Alan Swanton

        Medical | Dr Joe Conway ,Dr Eimear Smyth (CRC).

In the two years leading up to the London Games Mark was working hard to maximise weight loss while optimising his performance. This involved regular consultation with the nutritionist Sharon Madigan to fine-tune his nutritional plan. Mark also worked with Daragh Sheridan to balance his work and lifestyle needs. Due to Mark’s spinal injury his heart rate was not a completely accurate system of monitoring his recovery and physiological state. Under the guidance of Dr. Joe Conway and Dr. Eimear Smith blood test profile parameters were measured, health reporting was routinely carried out and a variety of use tools such as the smartphone app Restwise. Mark also had an experience team of physiotherapists around him, including Fintan O’Donnell, Jon Faulkner and Sinead Murphy who helped him with his injury rehabilitation and provided him with guidance on injury prevention strategies.

Once Mark addressed lifestyle issues, missed training days were reduced dramatically. However he was still susceptible to illness and this appeared to be more frequent during periods of high training load. To address this issue, an online system where Mark inputted information regarding his well-being and training daily was developed. This was a crucial step as it allowed for the remote monitoring of Mark by the physiologist Toni Rossiter. She could then report back to Brian if she noticed any worrying trends. This allowed Toni to present greater objective feedback on recovery, thus helping to prevent fatigue and illness. 

Toni also monitored Mark’s physiological response to many key training sessions. This along with physiological testing in the lab, provided crucial information to Brian regarding Mark’s progress. It was also important in educating Mark on the importance of training quality and helped him gain a better understanding of the importance of adhering to prescribed training. According to Mark;

“Without these tests and the feedback from Toni I would have stuck to the old fashioned approach to flogging myself every time I trained, resulting in a catch 22 situation in my case, train-fatigue-train-fatigue- burn out and injury”.

Alan Swanton also provided support to Mark and Brian, specifically around the survey of the time trial and road race course in Brands Hatch which took place 11 weeks before Mark’s first event. This involved overlaying power meter data and video footage of Mark on the course. The survey delivered a clear profile of the course as follows:

        8km course was broken into parts (defined by the coach) and average power, cadences, speed on specific parts of the course were identified

        Max power, cadence and speed could also be identified at specific sections of the course

        Footage was used during specific monitoring sessions which replicated the time trial course

Information was given to Mark, Brian and physiologist Toni so that so that course specific sessions could be created and monitored to ensure that training was as specific as possible. This allowed a more comprehensive development of race tactics, building Marks’ confidence that preparation was tailored to the course.

The support given by the team was very much question-led by the Brian. This allowed the support team to work together to identify novel ways of tailoring support specific to Mark’s needs. I really believe that this could not have been done without the significant prior relationship with Brian and Mark that has been built up over the last three years.

Alan Swanton, Performance Analyst.


CASE STUDY: PEP PARTNERSHIP WITH AN GARDA SÍOCHÁNA TRAINING COLLEGE

The Pursuit of Excellence Programme has developed a close collaboration with the An Garda Siochana Training College in Templemore over the past two years which has facilitated a new approach to high performance coach development in Ireland. The collaboration that has taken place has allowed for two innovative workshops to take place in the past two years which have received exceptional feedback.

In addition to being able to provide highly experienced trainers in areas such as team dynamics, leadership, problem solving, conflict management and practical activities such as simulators for fire arms the programme has benefitted hugely from the experienced trainers the centre has. New recruits to the Gardai are trained using a problem solving approach which PEP has built on in delivering cutting edge workshops.

The unique facilities in Templemore allow for coaching based scenarios to be acted out by  experienced educators whilst being recorded live. PEP coaches work in groups and each participant can observe the rest of the group and their own scenario enactment before going into carefully facilitated feedback sessions where the coaches evaluate their own performance against carefully developed problem solving models.

This has enabled some very realistic, yet potentially destructive situations to be played out which has proved the most powerful and effective development tool employed on the scheme. Once the coaches have self reflected, had peer feedback and external evaluation from the Garda trainers they also then receive DVD copies of both the scenarios they were involved in and the feedback session. This is done to facilitate further reflection and capturing of the learning tool.

The feedback on the workshop run in Templemore in 2012 received a universally positive rating. Dr. Julie Norris is an expert in the Problem Based Learning Approach (PBL) and has worked closely with the programme to help initiate the development of a competency model along with supporting development of the scenarios and problem based learning approach. Julie paid tribute to the approach undertaken.

The innovative approach taken by PEP has put it on a strategic and integrative footing because it is implementing across the different competency strands that are emerging as key in high performance coaching. To integrate these individual strands allows each coach to work on developing their individual needs against their own competency profile. It is very clear that you can already see and hear the impact that the approach is having based on the feedback from the sessions we have hosted”.

Given the feedback generated from all sources, the PEP programme will work hard to build on the relationship with the Garda College in developing high performance athletes in the future.

Additional Programmes

    Building a Service Provider Community

The Institute held its first event for the service provider community who were involved with the preparation of Olympic and Paralympic athletes. 27 sports science and medical service providers attended a post-Games debrief in November designed to help them unpack and refocus after their Games experience.

    Professional Quality Assurance Programme and Trainee Scheme

This Institute continues to run its Professional Quality Assurance Programme which now accredited over 60 service providers, along with a trainee scheme which saw 7 trainees receive mentoring from 6 experiences and accredited service providers.

    Research

Two applied research projects were carried out in the areas of sports psychology and nutrition supplementation.


The Medical Case Conference Process - Casestudy

One of the key strategies in Performance Medicine is the establishment of multidisciplinary support teams that provide medicine and science support working proactively with the athletes performance support team. The significance of this is most clearly seen in the management of complex difficult injuries where difference experts need to work closely together and this is where we use a Medical Case Conference process.

In these situations the Institute medical team lead and manage a case conference whereby the athlete, coach, performance director and every service provider working on the case meet with a solution based focus, to clarify the problem and agree a management with practical outcomes.

The Sport Ireland Institute has led a number of cases with athletes who have had long-term injuries and illnesses. Not uncommonly this is the first time that all the service providers have spoken together, allowing each if them to get a better understanding of all the issues and this influence their input to the athlete’s management. For example, in assessing the case of an athlete with recurrent bone injuries over a number of years this process led to the realisation of the athlete that poor sleep pattern since a young age (never before mentioned to anyone) was a contributing factor to the recurrent injuries (bone adaptation after heavy exercise is helped by proper sleep). The management of this case then needed the input of a psychologist and athlete lifestyle manager to help with a very physical problem.

Complex or difficult cases require a team of experts working in close collaboration to accurately diagnose and treat the problem. The case conference process is one example of how the Institute is actively pursuing best practice in the care of our athletes.