SSA Blog: Testing times

Preparations for England’s first test in Pakistan have been hit by an outbreak of illness amongst the touring party. Talks are being held over the possibility of delaying the start of the series by a day as 14 members of the England team and staff have been affected. 

Ben Stokes, England Test captain is reportely ill ahead of the first Test with Pakistan

Injury often gains the headlines in terms of athlete preparation and its impact on player selection. However, avoiding illness, particularly when teams and squads are in such close proximity remains a concern for performance and medical staff.

But how susceptible are athletes to illness?

For a number of years, researchers believed that intense exercise temporarily decreased immunity and provided an “open window” for infections. Examining the scientific markers associated with immune function following exercise also seemed to support the logic of this belief. However, Prof. Neil Walsh in his 2018 paper, Recommendations to Maintain Immune Health in Athletes, highlighted a number of studies demonstrating that elite athletes actually suffered fewer upper respiratory tract infections than their sub-elite counterparts.

Could the reason for these immunological differences be due to superior genetics? Are the ultra-elite just more resistant to illness due to innate physiological function? Although some evidence exists to support this idea, according to Walsh & Oliver (2016), a much simpler explanation resides in the lifestyle and performance behaviour of international athletes. They highlighted key factors such as better hygiene, infection avoidance, diet, sleep and stress management as areas where elite athletes have developed improved habits and systems to maintain their health compared to others.

The England Cricket team will have significant processes in place aimed at reducing the risk of infection and transmission within the squad. This is done, primarily to keep players and staff healthy, which is the first duty of team doctors. But from a performance viewpoint, unsurprisingly, research supports the idea of remaining injury and illness free as a defining factor in sporting success. In essence, if a team can get its best players to play more often than the opposition it enhances its relative chances of winning. 

So winning isn’t just about training but combining a series of performance behaviours that manifest themselves in the ability to train and perform. At the elite end of sport, such as the England Cricket team, the behaviour guidelines to try and contain any illness outbreak and support recovery are likely to be very similar to the below:

Recommendations athletes receive:

1.   Try to avoid sick people (social distancing)

2.   Ensure good hand hygiene (wash your hands)

3.   Avoid self-infection (don’t touch your face)

4.   Do not train with below the neck symptoms (feelings of fever or fatigue)

5.   Monitor and manage all forms of stress (physical and mental)

6.   Carefully manage increments in training

7.   Replace overly long training sessions with more frequent spike sessions

8.   Plan recovery

9.   Aim for at least 7 hours of sleep each night

10.   Eat a well-balanced diet

When looked at as a list, the guidance seems so simple. But for it to be effective, it has to become habitual. The fact that delaying a Test match because of illness is so rare shows that usually, players are adhering to guidelines and are able to take to the field. 

The message surrounding player hygiene obviously came to the fore during the pandemic. A host of hygiene partners entered the sponsorship market across Football, Rugby and Cricket in particular. Their role as part of the performance mix still hasn’t been well communicated. Research has shown, particularly during congested fixture periods, that the risk of infection and illness increases significantly as players’ immune systems are tested by intense exercise with limited time to recover (Morgans et al 2014). 

In football, this has been particularly true during this fixture-congested season. In cricket, the load some England players have been subjected to, via the World Cup, an ODI series against Australia and now a Test series in Pakistan could help explain why some are now suffering and need to rest. 

Across a tour, players exist in very close proximity to each other for weeks on end. They share a dressing room, they train together on the pitch and in the gym, they eat together, travel together and obviously play games together. This means that if a player or member of staff does become ill the risk of infecting others can be high.

Hygiene partners have the chance to tell both the hygiene and the elite performance behaviours story. They can credibly put their products and messaging at the heart of the content. As the research has shown, remaining injury and illness free is a defining factor in sporting success. What is the power of sports sponsorship if it isn’t to create a credible link to success?

The ECB is seeking to delay the start of its Test series in Pakistan by a day because of player and staff illness. A delay could give the ECB’s marketing team time to consider how to tell the tale of elite performance behaviours. Working with its hygiene partner it can then showcase how it can keep the players fit and healthy for the rest of the tour.

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