Nutrition, Recovery, Technology and Injury

This topic covers the last five content groups of Training for improved performance.

• Sleep, nutrition and supplementation: dietary requirements of athletes in different sports; eating before, during and after performance; fluid intake; how sleep, nutrition and hydration reduce fatigue and influence movement and injury prevention (guidelines, planning, routines and monitoring); supplements, carbohydrate loading, protein, caffeine and creatine.
• Sustained movement and performance: developing efficient movement; justifying recovery strategies (physiological: cool-down and hydrotherapy; psychological: relaxation).
• Technology: training innovations, equipment advances, and recording and monitoring training and performance.
• Sporting injuries: classification; assessment with TOTAPS; management; rehabilitation; return-to-play policies and responsibility.
• Drug use: its impact on injury management and performance, including health implications, ethical considerations and drug testing.

Dietary requirements by sport

All athletes need enough total energy, a balanced diet, and micronutrients such as iron (for haemoglobin; endurance athletes and menstruating females are at higher risk of deficiency) and calcium (bone health).

Before, during and after

• Before (1–4 hours): a high-carbohydrate, moderate-protein, low-fat, low-fibre meal that the athlete is used to. Avoid trying new foods on competition day.
• During: for events longer than about 60–90 minutes, carbohydrate from sports drinks, gels or bananas, plus fluid.
• After: carbohydrate to restore glycogen, about 20–40 g of high-quality protein (roughly 0.3 g/kg) for repair, and fluid and electrolytes.

Hydration

Losing more than about 2% of body mass through sweat impairs endurance, decision-making and skill.

• Monitor by weighing before and after training and checking urine colour.
• Replace about 125–150% of the fluid lost (1 kg of body mass lost ≈ 1 L of fluid).
• In hot conditions or long events, add sodium to help retain fluid.

Worked example. A cyclist weighs 82.0 kg before a ride and 80.7 kg after, and drank nothing.

To rehydrate, he should drink about $1.3\times 1.5\approx 2.0$ L over the next few hours.

Sleep

• Guidelines: Australia's 24-Hour Movement Guidelines recommend 8–10 hours of uninterrupted sleep a night for 14–17-year-olds, and 7–9 hours for adults.
• Why it matters: growth hormone release and tissue repair, glycogen restoration, faster reaction times, better decision-making and mood, and consolidation of newly learned skills. Adolescent athletes who regularly sleep less than about 8 hours have a higher injury risk.
• Planning and routines: a consistent bedtime, no screens before bed, a dark and cool room, naps on heavy days, planning sleep around travel and night games, monitoring with diaries or wearables.

The AIS Sports Supplement Framework groups supplements by evidence: Group A (good evidence for specific uses, such as sports foods, caffeine and creatine), Groups B and C (weaker evidence) and Group D (prohibited or at high risk of contamination). A food-first approach comes first, and supplements are generally not recommended for adolescents except sports foods and medical supplements prescribed by a professional.

Strict liability: athletes are responsible for any prohibited substance found in their sample, so contaminated supplements can lead to a ban. Use batch-tested products.

Efficient movement

Training technique, through coaching, video feedback and drills, reduces wasted movement. For example, a swimmer who reduces drag or a runner who stops overstriding uses less energy at the same speed (better economy), so fatigue is delayed. Efficient technique also reduces stress on joints, lowering overuse injury risk.

Recovery strategies

• Physiological: cool-down. Light activity and stretching gradually lower the heart rate, help clear metabolic by-products and prevent blood pooling.
• Physiological: hydrotherapy. Cold water immersion (about 10–15 °C) causes vasoconstriction, reducing inflammation, swelling and perceived soreness. Contrast therapy alternates hot and cold. Regular cold immersion straight after strength sessions may blunt strength gains, so it is often saved for competition periods.
• Psychological: relaxation. Progressive muscle relaxation, breathing techniques, meditation and imagery lower arousal after competition, improve sleep and reduce mental fatigue.

To justify a strategy, explain how it works, link it to the demands of the sport, and say why it fits the time available (for example a six-day turnaround in rugby league or a multi-day tournament).

• Training innovations: video analysis, altitude tents, virtual reality decision-making training, wearable heart-rate monitors.
• Equipment advances: carbon-plated running shoes, aerodynamic bikes, helmets and suits, lighter and stronger racquets, safer protective equipment.
• Recording and monitoring: GPS units (distance, speed, accelerations), heart-rate variability, force plates, sleep trackers and apps that measure training load and readiness.
• Limitations: cost and unequal access, too much data, reliance on technology instead of feel, and rule limits (for example World Athletics' limits on shoe sole thickness).

Classification

• Direct: caused by an external force (a tackle, being hit by a ball). Indirect: caused by forces inside the body (a hamstring tear while sprinting). Overuse: repeated stress without enough recovery (stress fractures, tendinopathy).
• Soft tissue: muscles, tendons, ligaments, skin (strains, sprains, bruises). Hard tissue: bones and teeth (fractures, dislocations).

Assessment: TOTAPS

1. Talk: how did it happen, and where does it hurt?
2. Observe: swelling, bruising, deformity.
3. Touch: tenderness, heat, deformity.
4. Active movement: the player moves the joint themselves.
5. Passive movement: the trainer moves the joint.
6. Skill test: a sport-specific movement.

Stop at any stage if there is significant pain, deformity or loss of function, and remove the player from play.

Management and rehabilitation

• Immediate soft-tissue care (first 48–72 hours): RICER (Rest, Ice, Compression, Elevation, Referral) and No HARM (no Heat, Alcohol, Running or Massage). Some clinicians now use newer frameworks such as PEACE & LOVE, which place less emphasis on prolonged icing, but RICER and No HARM are the approaches named in most HSC resources.
• Rehabilitation: progressive mobilisation (restore pain-free range) → graduated exercise (strength, flexibility, endurance) → sport-specific training → return to play. Heat helps after the acute phase by increasing blood flow; cold continues to manage pain and swelling.

Return to play

Policies protect athletes from returning too early and being re-injured or suffering more serious harm. Typical criteria are full pain-free range of motion, regained strength, passing sport-specific tests and, for significant injuries, medical clearance.

Concussion: the _Australian Concussion Guidelines for Youth and Community Sport_ (2024) say "If in doubt, sit them out". After a concussion a player should not return to competitive contact or collision sport for at least 21 days, should be symptom-free at rest for at least 14 days before returning to contact training, and should follow a graded return with medical clearance.

Responsibility is shared: the athlete reports symptoms honestly; medical staff assess readiness; coaches and clubs follow policy even under pressure to win; sporting organisations set the policies; parents are involved for juniors.

In injury management

Painkillers and anti-inflammatories can be used legitimately to manage pain and swelling. The risk is that masking pain lets athletes play on and worsen an injury. Corticosteroid injections can relieve inflammation but may weaken tendons with repeated use, and their use in competition is restricted under the anti-doping rules. The ethical issues are pressure to play while injured and the duty of care of clubs and doctors.

To improve performance

Ethics: using drugs is cheating, goes against the spirit of sport, puts pressure on clean athletes and sets a poor example for young people. Drug testing: WADA publishes the Prohibited List; Sport Integrity Australia tests athletes in and out of competition (urine and blood, and the biological passport); strict liability applies.

• Recommending carbohydrate loading for short events.
• Saying caffeine or creatine is banned. Neither is on the Prohibited List.
• Applying heat or massage to an acute soft-tissue injury.
• Getting the TOTAPS order wrong (active comes before passive).
• Describing recovery strategies without justifying them for the athlete and the sport.
• Writing only about performance-enhancing drugs when the question asks about drugs in injury management.

• Use numbers from guidelines (grams per kilogram, 2% body mass, 8–10 hours of sleep, 21 days), and say which guideline they come from.
• Link nutrition and sleep to fatigue, movement quality and injury, not only to performance.
• For technology, cover all three areas the syllabus names: training innovations, equipment, and monitoring.
• In a 12-mark response, organise by syllabus area and finish each paragraph with a judgement.

• Exercise prescription and training design (HMS-T1): recovery and nutrition allow the adaptations that training principles aim for; poorly managed overload causes overuse injuries.
• The healthcare system, change and health promotion (HMS-H2): being a critical consumer of supplements and technology uses the same skills as judging health products.