Reprinted with permission from Peak Performance.
Jo spent the whole of 1997 performing to a very high standard and improved her game. I first observed her when she reached the County Closed U-16 final, where she lost to a girl she previously beat twice.
Jo approached me and asked if we could have an informal talk about her recent performances. She revealed her complete distress at the previous tournament where she broke down in tears during the final, threw her racket around and argued incessantly with the umpire, causing her to receive warnings and points against her.
Jo assured me that this was unusual behaviour for her and an outside observer also confirmed this. Jo was concerned she was finding it increasingly difficult to concentrate during matches, especially on the 'big' points. The loss of concentration and emotional outbursts were proving costly and she wanted to know what she could do about the problem.
Three weeks later I received a phone call from Jo. It transpired that since the County Closed she had not won a match. The previous weekend, Jo finished 12th in the Masters tournament where she was seeded number 1. She told me she was frightened of not wanting to continue with her tennis.
Important issues emerged when she explained she and her father had a row caused by her decline in performance, and in general they were not getting on too well. This affected her home environment as well as her tennis. When I spoke to Jo's father, he told me she had no energy, didn't move and was a totally different player.
It was apparent that it wasn't lack of match preparation, technical ability or skill that were causing Jo's deteriorating performance. Instead, the cause seemed to be a physiological as well as a psychological health problem.
The extent of Jo's difficulties became very clear when I agreed to watch her at her next tournament. In the post-match discussion she confessed that she had absolutely no energy, no desire to play and found it more difficult than ever to concentrate. These symptoms seemed to indicate what I had earlier suspected - that Jo was suffering from overtraining syndrome. To test for this, I administered the Profile of Mood States - Children (POMS-C) psychological inventory (Terry, Keohane & Lane, 1996). This is a 27-item shortened version of the original profile of Moods States test (McNair, Lorr, Droppleman, 1971).
The POMS-C Assesses Six Mood States:
Research using POMS has shown with some consistency that success in sport is associated with an 'iceberg' mood profile (Morgan, 1980). This means that the athlete reports below-average scores for the five negative emotional states, and an above-average score for vigour. However, when an athlete reports below-average vigour and high negative-emotion states, an inverted iceberg profile, then this indicates that the athlete is chronically fatigued, or overtraining.
In fact, the British Olympic Association uses the POMS test as an indicator for overtraining. Athletes scoring high on fatigue and depression are more likely to suffer symptoms of burnout and need changes in their training schedule.
The POMS has been used to indicate those athletes predisposed to staleness long before the symptoms of poor performance and prolonged fatigue are observed. A study on swimmers (n=19) showed that the total mood disturbance (TMD), as evaluated by the POMS, may be used to indicate those athletes predisposed to the condition (Hooper, Mackinnon & Hanrahan, 1997).
Jo scored extremely high in fatigue and above average in depression, suggesting she was probably suffering from overtraining syndrome. This would account for her lack of energy, low enthusiasm, loss of concentration and, most importantly, her uncharacteristic emotional outbursts. Terry (1995) hypothesised that high levels of confusion and depression should result in difficulty in maintaining correct attentional control.
To confirm the diagnosis, Jo was advised by a sports physiologist, Raphael Brandon (whose name may be familiar to PP readers) to undertake a serum ferritin test. This is a test for anaemia, which is a blood-iron deficiency that can also lead to symptoms of fatigue and listlessness. Therefore it was important to check that her problems were not dietary. The anaemia test proved negative, and so the overtraining diagnosis was confirmed.
The first step was to change Jo's training and match schedule to allow her to rest and recover her physical and mental strength. I discussed this first with her, and then with her coach/father. This discussion proved valuable, because it emerged that Jo had not had a single day off for four-and-a-half months. She played in tournaments back-to-back, without rest days, and continued her training immediately after the final tournament of the summer run.
I explained the symptoms of overtraining to them both, and advocated indefinite rest for Jo. During this rest period, Jo was not allowed to play any tennis, but could engage in fun activities such as swimming and school games if she felt up to it. Jo further admitted that she was experiencing problems at school because of GCSE pressures - she was falling asleep in lessons and had been sent home on numerous occasions because of exhaustion.
In addition, she experienced cognitive stress from worries about her exams; the homework was clashing with her tennis. After further discussions it was agreed that she would reduce her number of GCSEs from ten to eight.
At this point, Raphael Brandon recommended that Jo should record her waking heart rate every day. This is a way of testing for fatigue. At the start of the intervention program, Jo's resting heart rate was very high at 83, well above her normal 58. This indicated very high levels of fatigue. By monitoring her waking heart rate Jo would know when she was physically ready to start training again.
In addition, a sudden jump in waking heart rate would show that training should be avoided and that more rest was needed. Brandon also reviewed Jo's diet, and stressed the important of wholesome carbohydrates and vitamin supplements (especially vitamin C) to boost the immune system.
During the first month of the program, I saw Jo for two sessions a week. These were devoted to enhancing her confidence and incorporated visualization techniques to desensitize her recent bad performances. The plan was to recall her 'great' tennis performances, and promote only positive, happy thoughts.
During this time, I also retested her POMS scores to see whether her 'mood profile' was improving. She was also shown how to use 'the quiet place' technique and 'centering'. These are interventions to enhance relaxation and improve focussing ability, to the relevant attentional clues. Jo performed these mental skills tasks at home, helping her go through a period of revision for her GCSE mocks.
After six weeks, Jo felt less fatigue and became motivated to play again. At this point her POMS test scores started to show the positive iceberg profile, and so it was agreed that she could play tennis twice a week. The training sessions were just for fun and she wasn't allowed to play any tournaments until she felt ready to compete again. I continued to see her twice a week for a further four weeks, and then reduced it to once per week because her 'mood profile' scores were so much better.
Jo's training increased to three times a week, making sure she was given two complete days a week for rest. Her training and tournament programs were completely restructured, to allow for tapering (peaking) to occur for her first tournament at the end of December. During this time, I stressed quality training sessions rather than quantity, and encouraged Jo's father to listen to her needs and not be so autocratic in his coaching style.
I also encouraged him to attend a few of the psychological skills training sessions, to ensure he understood the interventions being used, and to demonstrate how his mood was affecting Jo's performance at training and tournaments.
Another problem that emerged was their lack of communication. Both of them were not listening to each other, but had their own pre-conceived ideas of the way things should be done. This obviously affected their progress as a team. After airing their feelings, they both realised the amount of anger that was being generated, and how much distress it was causing to Jo.
She was expected to practise the various intervention techniques, and monitor how she felt after every training session by completing a short self-report measure. My role was to ensure that these techniques were followed and that there was a substantial improvement in Jo's 'mood profile'. I also acted as a training advisor to make sure Jo did not overtrain and that the symptoms did not recur.
Jo's performance has considerably improved. She trains four times per week and is boosting her fitness level. She is happier in all aspects of her life and her 'mood profile' has returned to positive.
She and her father are getting on considerably better, and have improved as a team. Their training sessions are more productive, and they listen to each other. Jo is now able to visualize herself playing well and incorporates this into her pre-match preparation. She also uses 'centering' during matches to help her relax and maintain concentration.
At a National Postal Final, she played her best tennis in more than six months, beating players of a higher rating. She won the final.