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Jahan Heidari, Johanna Belz, Monika Hasenbring, Jens Kleinert, Claudia Levenig and Michael Kellmann

Context: Explanatory approaches for back pain (BP) in athletes focus on biomechanical factors while neglecting psychological perspectives. Psychological factors have gained importance in the prediction of injuries in athletes and BP in the general population, with stress and recovery emerging as central risk factors. However, scarce evidence exists regarding the role of these aspects for the prevalent burden of BP. Objective: To investigate the association between stress and recovery parameters and the presence of BP. Design: Cross-sectional design. Setting: The questionnaires were distributed after the training sessions. Participants: A total of 345 competitive athletes (mean age = 18.31 y [SD = 5.40]) were investigated. The classification of the athletes’ competitive status was based on performance level. Interventions: Data were collected using questionnaires for the assessment of stress, recovery, and BP. Main Outcome Measures: The authors performed a multiple logistic regression to obtain odds ratios for stress and recovery parameters with regard to the outcome variable BP status. Results: For stress, the dimension “overall stress” (odds ratio = 1.83; 95% confidence interval, 1.30–2.59; P = .001) and the scale “physical complaints” (odds ratio = 1.68; 95% confidence interval, 1.25–2.25; P = .001) of the general version of the Recovery-Stress Questionnaire resulted to be significantly associated with BP. None of the recovery-related scales displayed a statistically significant relationship with BP. Conclusion: The outcomes of this study imply a modest association between stress and the presence of BP in competitive athletes. Practitioners may take these findings into account regarding the conception of training and for monitoring purposes.

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Jahan Heidari, Jürgen Beckmann, Maurizio Bertollo, Michel Brink, K. Wolfgang Kallus, Claudio Robazza and Michael Kellmann

Monitoring recovery in the context of athletic performance has gained significant importance during recent years. As a systematic process of data collection and evaluation, the monitoring of recovery can be implemented for various purposes. It may help prevent negative outcomes of training or competition, such as underrecovery, overtraining, or injuries. Furthermore, it aims to establish routines and strategies necessary to guarantee athletes’ readiness for performance by restoring their depleted resources. Comprehensive monitoring of recovery ideally encompasses a multidimensional approach, thereby considering biological, psychological, and social monitoring methods. From a biological perspective, physiological (eg, cardiac parameters), biochemical (eg, creatine kinase), hormonal (eg, salivary cortisol), and immunological (eg, immunoglobulin A) markers can be taken into account to operationalize training loads and recovery needs. Psychological approaches suggest the application of validated and reliable psychometric questionnaires (eg, Recovery–Stress Questionnaire for Athletes) to measure a subjective perception of recovery, as well as the subjective degree of training- or competition-induced fatigue. Social aspects also play a role in performance monitoring and may hence provide essential performance-related information. The implementation of a monitoring routine in athletic environments represents a continuous process that functions as an effective addition to training and depends on a range of conditions (eg, organizational regulations, commitment of athletes). Current research in the field of monitoring aims to establish individualized monitoring regimens that refer to intraindividual reference values with the help of innovative technological devices.

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Michael Kellmann, Maurizio Bertollo, Laurent Bosquet, Michel Brink, Aaron J. Coutts, Rob Duffield, Daniel Erlacher, Shona L. Halson, Anne Hecksteden, Jahan Heidari, K. Wolfgang Kallus, Romain Meeusen, Iñigo Mujika, Claudio Robazza, Sabrina Skorski, Ranel Venter and Jürgen Beckmann

The relationship between recovery and fatigue and its impact on performance has attracted the interest of sport science for many years. An adequate balance between stress (training and competition load, other life demands) and recovery is essential for athletes to achieve continuous high-level performance. Research has focused on the examination of physiological and psychological recovery strategies to compensate external and internal training and competition loads. A systematic monitoring of recovery and the subsequent implementation of recovery routines aims at maximizing performance and preventing negative developments such as underrecovery, nonfunctional overreaching, the overtraining syndrome, injuries, or illnesses. Due to the inter- and intraindividual variability of responses to training, competition, and recovery strategies, a diverse set of expertise is required to address the multifaceted phenomena of recovery, performance, and their interactions to transfer knowledge from sport science to sport practice. For this purpose, a symposium on Recovery and Performance was organized at the Technical University Munich Science and Study Center Raitenhaslach (Germany) in September 2016. Various international experts from many disciplines and research areas gathered to discuss and share their knowledge of recovery for performance enhancement in a variety of settings. The results of this meeting are outlined in this consensus statement that provides central definitions, theoretical frameworks, and practical implications as a synopsis of the current knowledge of recovery and performance. While our understanding of the complex relationship between recovery and performance has significantly increased through research, some important issues for future investigations are also elaborated.