Stress and Championship Swim Meets

Championship season brings a whole new environment for swimmers.  One important question is how does the body respond differently to the stress of a championship event and the pressure building up to the event?  Any competitor knows that championships feel different.  Championships even look different with more people in the stands and maybe some TV cameras present.  But what’s really going on inside the body when we step behind the blocks for a championship race?

Alan Goldberg describes what happens when we succumb to mental demons under the pressure of key races…..

First, your level of NERVOUSNESS will INCREASE. Second, when you get nervous, your MUSCLE TENSION will automatically INCREASE. Third, the amount of NEGATIVE THINKING and SELF-DOUBTS bopping around inside your cranium will increase. And Fourth, when you're flooded with negativity and doubts, your SELF-CONFIDENCE will DO A NOSE DIVE!!!! And finally, and a result of all of these above, your RACE PERFORMANCE will go down the proverbial tubes!!!!

Fortunately, with sound mental strategies such as ones taught by Dr. Goldberg, swimmers can overcome the mental demons and have the best chance of swimming to their potentials.  On the other hand, many other swimmers bring the right mindset to championship season but find their bodies betraying them at the worst possible time due to illness or injury.  Far too many swimmers find themselves nursing colds or more serious maladies despite hitting all their practice goal times and having a successful pre-championship season.   Often the trigger into illness or poor performance is a misunderstanding of stress management before and during big competitions. 


Moreira (2013) studied elite male volleyball players and compared various stress markers between a regular season match and a championship match.  Markers included rating of perceived exertion (RPE), salivary cortisol (SC), and salivary immunoglobulin (SIgA).  Results indicated higher stress in the championship match, as indicated by greater RPE, increased SC, and reduced SIgA. In other words, tasks seemed harder, overall stress was elevated, and immunity decreased. Filaire (2001) found similar results with judo athletes, noting that cortisol increased at an interregional competition as compared with a regional competition.  However, immunity was not significantly affected in this study, though many theorize that immunity may be indirectly affected by changes to these other stress markers.

In short, by simply attaching more importance to any result, our stress levels increase.  Added stress also increases vulnerability to illness, injury, and poor performance. These risk factors only multiply for championships when you factor in travel, midterms, and the next phase of life for high school and college seniors and even middle schoolers heading to high school.    

A similar trend emerges in studies comparing simulated competition with actual competition.  Moreira (2012) compared simulated basketball games with actual games and found increased RPE and SC levels in young elite males, but no change in immunity.  Another Moreira (2012) study looked at Brazilian Jiu Jitsu fighters and noted an increase in cortisol levels when comparing interregional competition (a higher level) with regional competition, but again no decrease in immunity.  Unlike other studies, RPE was not part of this analysis. 

CONCLUSION
Let’s not forget that higher stress may be a good thing when managed properly. Stress is part of the body’s fight or flight mechanisms and may stimulate career best performances.  Problems occur when stress lasts too long and when training inputs are incongruent with the body’s needs given the present stress levels. Coaches must recognize that stress is a tangible physiological phenomenon that can be harnessed for peak performance or alternatively trigger athletes into disappointment or breakdown. Though saliva samples are unrealistic for most teams, the research has validated other methods such as RPE that coaches can use to track athlete readiness during a potentially stressful championship season.    

REFERENCES

  1. Moreira ACrewther BFreitas CGArruda AFCosta ECAoki MS.  Session RPE and salivary immune-endocrine responses to simulated and official basketball matches in eliteyoung male athletes.  J Sports Med Phys Fitness. 2012 Dec;52(6):682-7.
  2. Filaire ESagnol MFerrand CMaso FLac G.  Psychophysiological stress in judo athletes during competitions.  J Sports Med Phys Fitness. 2001 Jun;41(2):263-8.
  3. Moreira AFreitas CGNakamura FYDrago GDrago MAoki MS. Effect of match importance on salivary cortisol and immunoglobulin a responses in elite young volleyball players. J Strength Cond Res. 2013 Jan;27(1):202-7. doi: 10.1519/JSC.0b013e31825183d9.
  4. Moreira AFranchini Ede Freitas CGSchultz de Arruda AFde Moura NRCosta ECAoki MS. Salivary cortisol and immunoglobulin A responses to simulated and official Jiu-Jitsu matches.  J Strength Cond Res. 2012 Aug;26(8):2185-91. doi: 10.1519/JSC.0b013e31823b8702.
By Allan Phillips. Allan and his wife Katherine are heavily involved in the strength and conditioning community, for more information refer to Pike Athletics.

Immune System and Elite Swimmers: Part II

After last week's post on Immune System and Elite Swimmers, one of our readers posted an excellent question:

I understand that this gives you ideas of how to spot the likelihood of the upper respiratory infections, but what suggestions exist for minimizing or eliminating them? Is there a dietary or vitamin plan?

First things first: Many illnesses are within our control even if they seem like random luck.  Yes, there are cases in which you do everything right and you turn up with a cold at the wrong time, just as there are other outliers who take poor care of their bodies but avoid immune system setbacks.  But if you challenge the organism when it’s in a depressed state (regardless of WHY it’s in that state), the body is more vulnerable to immune system setbacks .  Revisit what you are doing in the water; otherwise special meal plans and supplements are just figurative band-aids for immunity problems caused by ineffective training and deficient diets. 

Monitoring is also important.  Several weeks ago we addressed ways to assess autonomic nervous system readiness.  We don’t know if the body is vulnerable unless we actually check its state daily.  If you don’t assess, it’s just a guess!    

Building the immune system is like a cyclist learning to handle a bike.  You always wear a helmet on the bike, but you must learn to learn how to avoid crashes and not need your helmet.  Search for any deficiencies first before choosing supplementation or modifying diet beyond normal athlete recommendations.  Once we establish that our training is not causing any more stress than necessary for adaption, we can explore ways to fortify the immune system.  But as with training, it’s most important to identify deficits first.  
"Ensuring adequate energy, carbohydrate and protein intake and avoiding deficiencies of micronutrients are key to maintaining immune health." (Walls 2011)

In one recent study, Mestre-Alfaro (2011) studied the effect of phytoestrogen supplementation in female swimmers.  A control group received a supplement with vitamins C and E, while the experimental group received the same beverage but also with phytoestrogens.  The experimental group had significant improvements in enzyme activity for lymphocytes and erythrocytes after exercise, indicating improved immune response.  Phytoestrogens are not female-specific but can be obtained naturally through legumes, whole grain cereals, flax, various seeds, and even bourbon, among several other sources.


Although not swim specific, Walsh (2011) notes that nutritional supplements including flavonoids such as quercetin and Lactobacillus probiotics can augment some aspects of immune function and reduce illness rates in exercise-stressed athletes Quercerin-rich foods include: Black and green teas, apples, onions, red grapes, leafy green vegetables, and several berry types.  Lactobacilus probiotic food sources include yogurt, dark chocolate, pickles, miso soup, and tempeh.  Walsh (2011) also notes that “Limited data are non-supportive or mixed for use of N-3 polyunsaturated fatty acids, beta-glucans, bovine colostrums, ginseng, echinacea or megadoses of vitamin C by athletes.” 

Vitamin C is commonly recommended for immunity, but as noted, the evidence on vitamin C and the immune system is mixed.  In swimming, Constantini (2011) studied the effect of vitamin C on upper respiratory tract infections in male and female adolescent swimmers but found that only males improved immunity.  However, authors specificalluy called for additional study to confirm or deny these conclusions. 

Interestingly, vitamin C may indirectly affect immunity as it is often linked to iron absorption.  Healthy iron levels can help swimmers absorb their training loads, making them less vulnerable to overtraining.  Although vitamin C has received mixed reviews in the literature, supplements combining vitamin C with other vitamins such as vitamin E have been shown to improve immunity in athlete populations (Tauler 2002, Sureda 2008)

Minerals also play a key role in immunity: Dragan (1990) studied thirty three top level male and female swimmers and found that selenium supplementation improved blood markers for immunity.  Brazil nuts, oysters, fish, and sunflower seeds are among the top sources for selenium.

Conclusion
Ensure your swimmers are training appropriately and meeting basic nutrition needs before worrying about supplementation.  Nevertheless, know that robust evidence supports adding flavonoids, phytoestrogens, and selenium to the diet specifically to improve immunity among athletes.

References

  1. Constantini NWDubnov-Raz GEyal BBBerry EMCohen AHHemilä H.  The effect of vitamin C on upper respiratory infections in adolescent swimmers: a randomized trial.  Eur J Pediatr. 2011 Jan;170(1):59-63. Epub 2010 Aug 6.
  2. Walsh NPGleeson MPyne DBNieman DCDhabhar FSShephard RJOliver SJBermon SKajeniene A.  Position statement. Part two: Maintaining immune health.  Exerc Immunol Rev. 2011;17:64-103.
  3. Drăgan IDinu VMohora MCristea EPloeşteanu EStroescu V.  Studies regarding the antioxidant effects of selenium on top swimmers.  Rev Roum Physiol. 1990 Jan-Mar;27(1):15-20.
  4. Tauler PAguiló AFuentespina ETur JAPons A. Diet supplementation with vitamin E, vitamin C and beta-carotene cocktail enhances basal neutrophil antioxidant enzymes in athletes.  Pflugers Arch. 2002 Mar;443(5-6):791-7.
  5. Sureda ATauler PAguiló ACases NLlompart ITur JAPons A.  Influence of an antioxidant vitamin-enriched drink on pre- and post-exercise lymphocyte antioxidantsystem.  Ann Nutr Metab. 2008;52(3):233-40. Epub 2008 Jun 19.
  6. Mestre-Alfaro AFerrer MDSureda ATauler PMartínez EBibiloni MMMicol VTur JAPons A.  Phytoestrogens enhance antioxidant enzymes after swimming exercise and modulate sex hormoneplasma levels in female swimmers.  Eur J Appl Physiol. 2011 Sep;111(9):2281-94. Epub 2011 Feb 18.
By Allan Phillips. Allan and his wife Katherine are heavily involved in the strength and conditioning community, for more information refer to Pike Athletics.

Immune System and Elite Swimmers

Certain periods seem to bring a higher than normal incidence of illness: holidays and training camps are common sick periods, but early fall is another sick time.  Stress levels escalate as school resumes, schedules get more frantic, and kids gather into a petri dish of germs, all of which challenge the immune system for swimmers.  School incubated illness can afflict adults as well, especially in our highly mobile society. 

For swimmers of all ages, the immune system is a vital yet often underappreciated key to improvement.  Whereas a bad shoulder still allows cross training and kicking, full blown illness often requires time away from the pool.  Take a couple days off for while sick, a few days easy in the pool to avoid a relapse, and then a few more days to get back to where you were…that’s a week or two (or more) interruption right there!  Swimmers are notorious for pushing the envelope, particularly during training camps.  Understand that even if symptoms are not present, underlying physiology still may be impaired, making illness very likely. 

Several researchers have studied the link between training and immunity in swimmers.  Recently, Rama (2012) studied elite swimmers’ immunity during an entire season from September to April.  Authors broke the season into four blocks: pre/early season (September to November), seven week build (November to February), six week intense training (February to April), and post-championship (end of April).  The swimmers were compared to a control group of non-swimmers during these same blocks.

During the study, authors related incidence of upper respiratory symptoms with natural killer cell levels (note: natural killer cells are part of innate immunity and help fight infections).  Whereas the non-swimmers suffered no upper respiratory symptoms, 67% of upper respiratory symptoms clustered around higher training loads in the elite swimmers.   Additionally, as training load increased during the build and intense periods, natural killer cell levels decreased and never returned to pre-season levels. 

In a similar study with a similar research team Morgado (2012) also compared elite swimmers to non-swimmers during a season.  Their results showed that not only can intense training affect natural killer cell levels, cell function may also suffer impairment.   Specifically, evidence showed an increase in blood cortisol levels during the initial training buildup, which the authors identified as cause of suppressed responses by the natural killer cells.  Non-swimmers showed no impairment in immune system function.    

Intense training can also increase susceptibility to Epstein-Barr reactivation among elite swimmers. Epstein-Barr triggers mononucleosis and can lay dormant after symptoms resolve years prior.  Gleeson (2002) studied fourteen elite swimmers during a thirty day intensive training period.  Of these, eleven tested positive for prior Epstein-Barr infection.   Seven showed Epstein-Barr DNA during the study, while six of the seven had upper respiratory symptoms.  Three of the four who did not reveal Epstein-Barr DNA still suffered upper respiratory symptoms.   Before symptoms appeared, authors noted an increase Epstein-Barr DNA and reduced levels of salivary IgA. 

The robust correlation between increased training and suppressed immunity seems ominous, so what can we do about it?  Aside from optimizing training so that athletes can adapt to the demands imposed on them, understanding certain markers along with the time course of suppressed immunity can help.  Gleeson (1999) studied correlations of three classes of salivary IgA in both elite swimmers and a non-exercising adult sample.  Most notably, salivary IgA1 during early season was significantly correlated with upper respiratory infection. 

On a smaller time scale, Kakanis (2010) studied cyclists and found suppression of total lymphocyte counts, natural killer cell counts, and neutrophil phagocytic function between two and eight hours after intense exercise.  Each of these factors is linked to increased risk of upper respiratory infection.

Conclusion
There’s no doubt about it: intense training raises upper respiratory infection risk.  Does this mean we should just train everyone easier?  Maybe yes, maybe no.  The issue is not about training easier, but instead finding ways to ensure the training is delivered within the athletes’ adaptive reserves.  The immune system is equally important as the cardiovascular, respiratory, and musculoskeletal. 

Illness is multifactorial encompassing training, life stress, nutrition, and even hygiene.  However, know that intense training places nearly all swimmers at risk from the first training buildup, thus demanding greater attention to detail to ensure swimmers stay in the pool with minimal training interruption.

References
  1. Gleeson MHall STMcDonald WAFlanagan AJClancy RL. Salivary IgA subclasses and infection risk in elite swimmers.  Immunol Cell Biol. 1999 Aug;77(4):351-5.
  2. Gleeson MPyne DBAustin JPLynn Francis JClancy RLMcDonald WAFricker PA.  Epstein-Barr virus reactivation and upper-respiratory illness in elite swimmers.  Med Sci Sports Exerc. 2002 Mar;34(3):411-7.
  3. Morgado JMRama LSilva Ide Jesus Inácio MHenriques ALaranjeira PPedreiro SRosado FAlves FGleeson MPais MLPaiva ATeixeira AM.  Cytokine production by monocytes, neutrophils, and dendritic cells is hampered by long-term intensive training in elite swimmers. Eur J Appl Physiol. 2012 Feb;112(2):471-82. Epub 2011 May 17.
  4. Rama LTeixeira AMMatos ABorges GHenriques AGleeson MPedreiro SFilaire EAlves FPaiva A. Changes in natural killer cell subpopulations over a winter training season in elite swimmers.  Eur J Appl Physiol. 2012 Sep 19. [Epub ahead of print]
  5. Kakanis MWPeake JBrenu EWSimmonds MGray BHooper SLMarshall-Gradisnik SM.  The open window of susceptibility to infection after acute exercise in healthy young male elite athletes.  Exerc Immunol Rev. 2010;16:119-37.
By Allan Phillips. Allan and his wife Katherine are heavily involved in the strength and conditioning community, for more information refer to Pike Athletics.