High Performance Medicine
High performance sports medicine is specifically focused upon high performance (’elite’) athletes. This is a system of health care that focuses on the support and achievement of optimal health of an athlete, which is allied to the athlete’s goals to achieve optimal sports performance.
HPSM can be described as the provision of an integrated model of medical care of the high performance athlete, focusing on the maintenance and optimisation of health, well being and competitive sporting performance under circumstances of high physiological and psychological stress (Br J Sports Med Feb 2011 Vol 45 No 2 p81-83).
A challenge is the protection of the health of high-performance athletes as they undertake substantial training loads that while aiming to optimize their performance, can in themselves induce ill health. HPSM is dependent on a multidisciplinary team working in an integrated,proactive and planned way. Thus ensuring there is a cohesive and unified approach, which involves both the medicine & science and performance teams, where the care and support of the athlete is key. The system includes preventative strategies, timely interventions and return to sports plans coordinated across the health care and athletic performance teams.
The provision of Medicine services is central to the role of Sport Ireland Institute. Sports medicine incorporates the total medical care of athletes from pre-participation medical screening through to management at consultant level of appropriate illnesses or injuries. The services include diagnosis, investigation, treatment and rehabilitation of injuries and illness occurring during or as a consequence oftraining and competition.
The support team needs to have an insight into and understanding of the nature of their specific sport and be trained and experienced in dealing with the specific physical, physiological and psychological demands that the sport imposes on an athlete. Rapid referral links to subspecialist services is a core component of any high performance medical support system. Sport Ireland Institute has established a rapid access referral system with the National Orthopaedic Hospital at Cappagh and with other centers for Specialist opinions and services.
The medical team at Sport Ireland Institute are committed to being recognised by our stakeholders as providing leading edge evidence based performance enhancing support to a community of elite high performing sports people, focused on excellence.
Chartered physiotherapists use their skills in treating injured athletes from the management of acute and ongoing injuries (rehabilitation), to the assessment and planning of an overall programme to prevent injury (prehabilitation). For optimal effect a physiotherapist does not work in isolation but relies on the expertise of the coach, the strength and conditioning coach and the sports medicine doctor. Through teamwork, an agreement is reached on the short, medium and ultimate long-term goals of the athlete and what support package is required to attain those goals.
The other facet of physiotherapy outside of performance optimization and injury prevention is injury management. Having a multi-disciplinary team under one roof allows for a prompt integrated response to injury management if required.
Sport Ireland Institute uses a network of chartered physiotherapists with vast experience in working with high performance athletes and sports. Currently Sport Ireland Institute are working with National Governing Bodies of sport (NGBs) in developing networks of sports specific physiotherapists to work with high performance athletes. In most sports a High Performance Lead Physiotherapist will be appointed to coordinate physiotherapy services in that sport. This will ensure that the highest quality of physiotherapy care is given to all athletes.
Specialist Medical Services
Sport Ireland Institute provides the following specialist medical services:
- Pre participation cardiac screening.
- High performance sportsmedical screening.
- Specialist sports medicine clinics.
- Blood testing – performance monitoring and diagnostic.
- Radiological imaging - Xray and MRI
- Rapid access specialist consultant medical referrals.
- Support for significant specialist interventions.
- Educational information.
Athlete Management System
Sport Ireland Institute has established a centralised electronic medical records system. The purpose of the system is similar to the medical records systems (charts) that are kept by a doctor or hospital for any patient that attends. The system records and stores demographic information, injury and illness histories and treatments of elite Irish athletes.
The AMS is an essential component to improving the quality of services to athletes through centralised, effective and efficient management of services. By providing a holistic view of athlete and service provider activities, athlete appointments and service provider schedules it will be easier to track and manage, creating the capacity for higher value activities. It will enable improved communication between service providers, sports, athletes, and between Sport Ireland Institute and Sport Ireland. Enhanced data capture will allow improved data analysis, reducing time and effort currently required to improve services.
The aim of the system is to improve the medical management of an athlete by enabling authorised medical staff to have access to an athlete's medical record and to communicate with one another while working both in Ireland and abroad.
The system is accessible via the web to authorised users only so that the doctor or physiotherapist can have access to up-to-date medical information about the athlete. The system also allows users to message one another thus improving communication between the medical staff. Information stored will include:
- Basic demographic data.
- Significant contact information.
- Injury and illness history.
- Medication and vaccination history.
- Treatment history.
- Performance related data e.g. physiological testing data, training workloads etc.
The data can only be accessed by authorised medical staff using unique usernames and passwords.
Athletes need to sign a consent form before their information will be entered into the system. If you do not sign the consent form your medical information will not be uploaded onto the system. Consent maybe withdrawn at any time or it can be withheld in respect of any part of the athlete's medical information. Withdrawal or withholding of consent will not affect the athlete's access to funding, medical care or access to other service provision. The athletes NGB high performance team will be informed of the decision.
The aim of Sport Ireland Institute blood bio marker performance program is to monitor each athlete’s training programme, nutritional status and general health to aid maintenance of optimal health to maximise performance. Blood profiling is seen as one of a number tools used to monitor athletes preparation and performance. They are a supplement to other methods of monitoring training load, nutritional intake and health, they are not a replacement of these monitoring tools. Blood profiling should integrate with other monitoring tools e.g. self monitoring using POMS, diary, resting heart rate, etc.
The blood service covers four distinct areas:
1. Screening: Identifying an unrecognised illness/condition in athletes without symptoms or signs.
2. Profiling: Tracking blood parameters longitudinally over season(s).
3. Illness investigation: Investigating in the presence of a suspected or confirmed illness.
4. Research: Gathering information which helps further blood service planning.
For athletes to avail of the blood screening or profiling programme they need to have:
- An integrated network of appropriate service providers (e.g. doctor, nutritionist, physiologist).
- A coach working with NGB of the sport.
- An agreed training, preparation and competition plan.
- Using tools of performance / training monitoring (e.g. diary, heart rate, POMS, etc).
Aims of Service:
- Performance enhancement.
- Illness / injury prevention.
- Screening tool.
- Guide / monitor to medicine and science input e.g. training load, nutrition…
- Feedback on medicine and science management strategies.
- Profile building.
- Part of MDT teamwork.