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Excellence for elite athletes demands painstaking attention to detail to all aspects of health, well-being and performance. Researcher and Olympic Taekwondo Gold Medalist Lauren Burns and coauthors1 use the power of the athlete story to argue strongly and convincingly that central to achieving excellence is durable interpersonal support.
‘If we look at an athlete as a whole person, there is a fundamental duty of care to ensure they are supported to become their best, most resilient self, both on and off the field. Athletes therefore need to be encouraged to seek interpersonal support that evolves as they move along their development pathway’.
These sentences, both important, appear sequentially; but I will make one distinction—the onus to create a supportive environment should not rest primarily on athletes.
Where then does the duty of care lie?
According to Fisher et al’s heuristic model,2 the power differential in sport particularly positions coaches to hurt or help their athletes, and as such coaches are responsible for athlete’s welfare.
Those, therefore, with the power to act—coaches and other leaders within sport—must create the climate; a healthy environment is a fair and enticing exchange for athletes’ time and energy. Even at the highest levels of sport, the positive link is clear between healthy coach–athlete relationships, athlete autonomy and performance.
Can high performance and autonomy coexist?
According to self-determination theory, the autonomy-supportive coach emphasises the needs of athletes, encouraging autonomy and involving them in the decision process.3 The higher the stakes, the more coaches tend to adopt a controlling motivation style,4 even though this is when athletes need support the most. Korean athletes with coaches who remained autonomy-supportive during the high-stakes London 2012 Paralympic Games experienced greater relatedness satisfaction and interestingly, performed better, winning more medals than those who did not.4
As an athlete, a coaching change made at a critical point during my own career illustrates this well. Rowing Canada Aviron’s hiring of two coaches from Denmark brought a refreshing philosophy to our National squad, where a culture was formed of athletes becoming better together instead of at the expense of one another, encouraging humour and involving us in training and racing decisions. It was our most successful season in years. Much later I read about the ‘Danish Way’ of coaching5 and understood that in Denmark, this is a cultural phenomenon as well.
As I had witnessed, the Danish model environment rests on a belief in athlete’s capabilities, building athletes up rather than grinding them down.
Protecting our most vulnerable—youth athletes
Coaches exert a major influence on how their athletes’ experience sport. The ways a coach brings out an athlete’s best—through negative or positive means—can have particularly significant ramifications in vulnerable population settings, such as youth sport, where the power differential between coach and athlete is at its greatest.
Competency, relatedness and autonomy are important concepts to adolescent athletes as well and contribute to their retention in sport.3 Significantly, youth coaches are more likely to identify with and emulate elite coaches within their sport,6 emphasising the need for role models at all levels.
To facilitate ‘the long and stressful journey to the podium’, Burns and colleagues underscore the importance of encouraging self-regulatory strategies, personal wellness plans and dedicated mental fortitude training for athletes, coaches and parents. Placing the onus on athletes to create their own supportive environments, however, can range from problematic to impossible in neglectful or abusive environments.
As a sport and exercise medicine physician, I can’t help but see parallels in the medical profession, including what many experience as a ‘long and stressful journey’ to fully fledged specialist. Burnout and mental health concerns in medicine are rampant.7 Wellness and resilience programmes achieve little in the face of controlling, stressful and even abusive teaching environments where ‘massive systems change’ is instead required.
Autonomy and relatedness are crucial for the physician–patient relationship as well. The ageless concept of good ‘bedside manner’ has expanded to include autonomy-supportive concepts such as shared decision-making, patient co-design and peer-to-peer healthcare which can improve patient outcomes and satisfaction.
Conclusion
Excellence at any stage requires a supportive interpersonal environment, key to long-term retention, performance, motivation, satisfaction and overall performance.3 Autonomy and relatedness are critical, and Burns and colleagues illuminate several additional important themes—social scaffolds, laughter and evolving support networks.
While coaches are expert change facilitators for their athletes, a major performance influencer may be a capacity to change themselves. Coaches’ ability to successfully incorporate ‘need supportive coaching’ suggests that coaches can change and thereby improve athlete’s performance.6
For those of us in positions of leadership in sport and sports medicine who care for athletes, patients and learners, let’s take the onus on ourselves to support autonomy and create healthy interpersonal environments. We are coachable and those we care for are worth it.
Footnotes
Contributors JST is the sole author of this work.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Commissioned; internally peer reviewed.