A survey of elite and pre-elite athletes’ perceptions of key support, lifestyle and performance factors

Abstract

Background

Success at the elite level in sport is often attributed to physical prowess, technical skill, and mental attitude. However, underpinning these factors are various lifestyle, support and social factors that may contribute to successful performance, but which may be absent from athlete development programs.

Methods

An online survey was used to investigate athlete perceptions of lifestyle practices and support services amongst 135 Australian Olympic, Paralympic, National, and state-level athletes across 25 Olympic sports.

Results

International athletes perceived psychological skills and attributes, along with strong interpersonal relationships as vital to their success, and they also rated ‘Recovery practices’ as very important and made extensive use of available support services. These athletes also indicated that they would have liked access to these services earlier in their careers, a wish that was reiterated by the sub-elite athletes. Furthermore, athletes wanted greater knowledge, mentoring, and autonomy earlier in their careers, and the importance of ‘athlete wellbeing’ as well as ‘athletic performance’ was evident in a number of contexts.

Conclusions

An athlete development system into which these are included may assist in generating an environment that facilitates athlete success, repeated podium performances, retain athletes in high-performance sport for longer, encourage human-flourishing, wellbeing and smooth transitions for retiring athletes.

Background

The pursuit of excellence requires elite athletes to have an intense, myopic focus on their sport, yet they must also contend with the demands of daily life [1]. These psycho-social and ‘well-being’ aspects can impact upon their performance, as well as the athlete’s pursuit of sporting excellence having the potential to affect their well-being in both positive and negative ways. Athlete wellbeing and performance may be influenced by family, friends, professional and personal-development programs, spirituality and social-connections [1, 2]. In conjunction with this, the strengthening of life-skills is essential for developing resilience [1], which is needed in both the athlete’s sporting and non-sporting environments. It is therefore a responsibility of those overseeing athlete development to maintain a duty-of-care that ensures the wellbeing of athletes throughout their sporting life and beyond. In accordance with this, international sporting bodies advocate an holistic approach to the athletic profile, and one that incorporates lifestyle and system level factors that are required for world-class sporting performance [2]. Yet despite this, key lifestyle, relational, psycho-social, performance and recovery practices are commonly overlooked in athlete development and support systems.

Our previous research into this topic, involved interviewing World and Olympic Champions, from which we identified four key ‘Psycho-social and Lifestyle’ themes: (1) psychological skills and attributes; (2) interpersonal relationships; (3) performance factors/strategies; and (4) lifestyle practices [3]. These findings suggested that achieving world-class podium-level performance is multi-dimensional, involving not just ‘talent’ and training, but key psycho-social factors that athletes believe to be of paramount importance [3, 4]. From this we deemed that success both within sport and transition out of sport requires an holistic approach to athlete development that includes a complimentary mix of wellbeing, lifestyle practices, performance strategies, psychological attributes, education, and supportive interpersonal relationships [5]. Pre-elite athletes have been identified as the most vulnerable population coming through athlete development pathways and are subject to drop-out and burn-out [6]. Therefore, it is essential to quantify and understand gaps in the system and provide support, screening, and education platforms that can assess a developing athlete’s competence, facilitate sport-specific education, and implement interventions to maximise an athlete’s longevity, performance-success, and transition to retirement. In pursuit of this we wished to further understand the perceived significance of these key factors for athletes within the athlete development pathway, as this would help to inform the evolution of an holistic approach to athlete support and development. Additionally, the findings could be used to inform the development of a valid and reliable screening tool for the assessment of a ‘developing’ athlete’s support, access and awareness of key psycho-social and lifestyle factors.

The aims of this study were therefore to gain a deeper understanding of the prevalence, utilisation and perceived impact of key lifestyle, relational, and support practices of athletes across a variety of sports at different stages of their development pathway. A secondary aim was to identify any differences in these between athletes of different levels of achievement; able-bodied (AB) athletes and athletes with disabilities (AwD); male and female athletes; and sports in which winning was determined by centimetres, grams and seconds (cgs) and non-cgs sports [7, 8].

Methods

Online survey

An online survey was designed to: (1) collect data on the type, frequency and quality of lifestyle aspects and practices used by athletes (psychological skills/attributes, interpersonal relationships, support, recovery, sleep, extra-curricular activities, and relaxation); (2) determine athlete knowledge and awareness of the potential impact of these psychological skills/attributes, support services and lifestyle practices; and (3) compare these responses between athletes with different demographics and sporting achievement. The survey was informed by the major themes identified in our previous research and entailed 35 questions with four written response questions [3]. The survey was administered on-line using QualtricsXM software. To ensure reliability, a pilot survey was completed by five retired elite athletes who had competed at senior international level. These athletes completed the draft survey twice and their responses were assessed for reliability (individually and collectively), as well as for the refinement of the questions.

Recruitment, participants and procedures

Australian athletes in Olympic and Paralympic sports, who had competed at state level or above in the past 10 years, were invited to participate. Participants were recruited via an email sent from one of the following: National Sporting Organisations (NSO’s); State Institute and Academies of Sport; State Sporting Organisations; and the Australian Olympic and Paralympic Committee. This email contained an invitation to participate in the study, a participant information form, and a link to the online survey. Athletes aged over 18 years were emailed this information from their relevant sporting body (listed above), whilst for athletes aged less than 18 years, the email was sent to their parents/guardians with a request to forward the information and survey link to the athlete. Within this email it was stated that parental consent would be inferred, if they forwarded the survey to their child, and that child assent to completing the survey would be inferred from their submission of the completed survey. The survey was completed ‘anonymously’, however, whilst minimal personal and identifying information was asked for in the survey, the researchers acknowledged that in a few cases there was a risk that the sporting achievements reported by the athlete, such as individual medals in international competitions in a specific sport, could enable the researchers to identify the respondent. Participants were informed of the study’s purpose and informed that no identifying information about them would be used when reporting the results of the study. Participation was voluntary, and only the researchers had access to the data.

Analysis

Data were exported from Qualtrics (Qualtrics Labs Inc.) into SPSS (v 25) and cleaned. Cleaning involved: removing all participants who did not meet the inclusion criteria (see below) and the removal of data from partially completed surveys.

In the analysis, the FTEM (Foundation, Talent, Elite, Mastery) developmental framework was used to classify the achievement levels of the athletes [7, 8]. These classifications are as follows: M = Attained Multiple Podiums (medals) in Senior International Events; E2 = Attained a Single Podium (medal) in a Senior International Event; E1 = Competed at Senior International level (but no medals at Senior International level); T4 = Competed at Junior International or Senior State or Senior National level; T3 = Practicing/Achieving at state level. ‘Foundation’ level athletes, as defined in the model, as not having competed at state level or above, were not intentionally recruited or their data included in the survey, since the focus of the research was on the issues facing athletes at a higher level in the development pathway. Athletes meeting the criteria were then categorised into two groups for comparison: (1) M and E2 athletes who had achieved at least one International Podium (IP) and (2) E1, T4 and T3 athletes who had not achieved an International Podium (n-IP). Additional classifications were: Able-Bodied (AB), and Athletes with a Disability (AwD).

A total of 331 participants commenced the survey. One-hundred and ninety-six were excluded due to not meeting the inclusion criteria, such as their event not being an Olympic sport, or having competed more than 10 years ago. Incomplete responses and duplicates were also removed. The responses of 135 athletes were therefore included in the analysis. Quantitative data were checked for statistical violations and SPSS (v25) statistical software were used to analyse the data. Descriptive (mean and SD) and comparative (ANOVA and t-tests) statistics were used for parametric data, whilst frequencies, percentages and chi-square analyses were used for categorical data.

The responses to the qualitative questions (written response questions) were categorised, using Strauss and Corbin’s method of grounded theory into headings consistent with the higher order themes identified from previous research [9, 10], these being: Psychological Skills and Attributes; Interpersonal Relationships; Performance Factors/Strategies; and Lifestyle Practices [3].

Results

The responses of 135 athletes (58 male and 77 female) were included in the analysis (see Table 1 for athlete demographics). Twenty-five different Olympic and Paralympic sports were represented. All quantitative data are presented as mean ± SD, unless otherwise stated. Forty-five percent of athletes described their Daily Training Environment (DTE) as centralised, with services such massage, physiotherapy provided through sports institutes or similar, 48% were de-centralised, and 7% selected ‘other’. Forty-four percent of athletes had a scholarship with a state sporting institute, 3% with a regional academy, 15% with a professional club, and 37% indicated ‘other’.

Table 1 Athlete FTEM classification and AB/AwD athletes

Three independent-sample t-tests were conducted to compare the training hours per week of IP and n-IP athletes at time periods: (i) throughout the year, (ii) lead-up to a competition, and (iii) during competition. The mean training hours of IP-athletes throughout the year was higher than for IP-athletes (19.7 v 14.1 h; p < 0.005). Training hours in the lead up to competition and during competition were not different between these groups. However, female athletes reported training more hours than male athletes in the weeks leading up to competition (18.5 v 15.4 h) and during competition (11.7 v 8.6 h) (p < 0.05). Further analysis using ANOVA did not reveal this difference to be associated with any other factor, and it cannot therefore be explained based on the type of sport or level of sporting achievement.

Time spent away at international events in the previous year was significantly higher for IP-athletes (10.9 v 5.2 weeks; p < 0.001) while time spent away from home at domestic events were similar (IP 6.2 v n-IP 8.1 weeks). Factors such as male vs female and AB vs AwD were not associated with any differences in training or travel time.

The results and findings are presented under the established themes of: Psychological Skills and Attributes; Interpersonal Relationships; Performance Factors/Strategies; and Lifestyle Practices. With illustrative responses from the athletes presented in Table 2.

Table 2 Representative quotes in response to questions:

Psychological skills and attributes

Athletes were unanimous in perceiving psychological attributes as vital to their success, and all the psychological attributes previously reported by elite athletes were rated as highly important by more than 80% of both AB and AwD respondents across the achievement spectrum (Table 3) [3]. Notably, all IP-athletes stated that their Ability to Change and Resilience were vital to their success. Similarly, ‘Self Discipline’ and ‘Mental Toughness’ were deemed as important by virtually all athletes. There were no statistically significant differences between males and females, or cgs and non-cgs athletes, for any of the responses concerning ‘Psychological Skills and Attributes’, but AB-athletes were more likely than AwD to perceive ‘Ability to Manage Performance Nerves’ and ‘Rituals’ as being vital to their success.

Table 3 Psychological Attributes: percentage of IP/n-IP and AB/AwD athletes who agree that these psychological attributes are vital to their success

These quantitative data were supported by the athletes’ written responses (qualitative data), whereby for example, when asked, “If they achieved a medal at a benchmark event, why, in their opinion, did they succeed compared to their less successful counterparts?” the athletes identified the themes of: superior self-regulation; strong mindset; and effective coping strategies as being fundamental.

Additionally, when in relation to psychological skills and attributes, they were asked for their thoughts and suggestions concerning “What KEY advice/strategies would you advocate for younger athletes?” the responses were in the themes of: Superior self-regulation; Intrinsic Motivation; and Effective Coping Strategies and Positive Mindset. Furthermore, when asked: Is there anything in your sporting journey so far, that you would have done differently? A key recommendation was: “invested in mental training earlier”, so as to develop ‘Superior Self-Regulation’ (IP).

Interpersonal relationships (Table 4)

Table 4 Support network: importance, achievement classification (IP/n-IP), Able-Bodied/Athletes with a Disability classification, nature of the relationship and times of support

Virtually all athletes (> 98%) perceived that having people to support them during their career was important for their success. These included: Family members/partners; Friends; Coaches and Professional Medical/Allied Heath staff, with all being highly prevalent in the athlete’s responses (72–94%). Furthermore, most (> 88% of athletes) said their coach’s ability to relate on a personal level was as important as their technical ability. Additionally, the majority of athletes (> 93%) agreed that having someone in their life who made them laugh was important to their success. The importance of family members was valued by more AwD (100%) than AB-athletes (87%) (p < 0.05), but there were no statistically significant differences between males and females, or cgs and non-cgs athletes in the responses to these questions.

Performance factors/strategies

Mental preparation, recovery strategies, and using medical/allied health services were all rated as important, as was sleep (Tables 5 and 6).

Table 5 Recovery practices: percentage of IP and n-IP athletes, and AB and AwD athletes who practiced these techniques and procedure, statistical comparisons made using chi-square with contingency tables

Table 6 Athletes’ utilisation of service providers, their perceived effectiveness and referrals, comparisons made using chi-square with contingency tables

Recovery strategies

The most prevalent recovery strategies were: ‘Remedial Massage’, ‘Stretching’ and ‘Mindfulness’. ‘Visualisation’ was also highly prevalent, thereby further reiterating the perceived importance of psychological skills and attributes. Athletes’ perceived sleep, a lifestyle factor as well as being important for recovery, to be important and reported getting 7 ± 1 h a night. There were no differences between any of the athlete categories for the reported amount of sleep.

Eight recovery practices were identified with statistically significant differences (p < 0.05) in the prevalence of utilisation, with IP-athletes use being higher than n-IP-athletes for: Remedial Massage, Mindfulness, Hot/Cold Immersion, Ice-bath, Meditation, Plunge-pool, Infrared sauna, and Neuro Linguistic Programming (NLP). Finnish saunas and Spas were used more by AB-athletes than AwD (p < 0.05), and NLP used significantly more by AwD-athletes than AB-athletes (p < 0.005). There were no statistically significant differences between males and females, nor cgs and non-cgs athletes.

Service providers (Table 6)

All athlete referrals to frequently used practitioners were via their State Institute, except the family GP. Overall, IP-athletes had higher utilisation than n-IP-athletes for all services except for osteopathy. Of these, there were statistically significant differences in the use of four service providers, with utilisation by IP-athletes being statistically greater (p < 0.05) for Massage Therapist; Dietician/Nutritionist; Sports Medicine Doctor; and Sports Psychologist. Chiropractors and Naturopaths were used significantly more by AB-athletes than AwD-athletes (p < 0.05) and Sports Psychologists were used significantly more by females than males (p < 0.05). There were no differences between cgs and non-cgs athlete.

Weight division practices

Around one quarter of participants (n = 35) were required to make a competition weight division (89% from combat sports). Nine athletes dropped 1–2 kg below what they considered their baseline training weight, 12 athletes dropped 5 kg below baseline, 6 athletes dropped 6-8 kg below baseline, and one athlete dropped 10 kg below baseline weight. Fifteen athletes reported using a sauna to lose weight before competing. Other weight-loss strategies included running, skipping, walking, and sports specific exercise. No differences in the prevalence of these practises were evident between; IP and non-IP; males and females, nor cgs and non-cgs athletes.

Qualitative responses

In response to the question: If they achieved a medal at a benchmark event, why, in their opinion, did they succeed compared to their less successful counterparts? Having the right support team was perceived to be crucial, particularly amongst IP athletes (IP 79%, n-IP 21%).

Responding to the question: What could be done better to educate and empower athletes regarding their knowledge and effective usage of athlete and lifestyle strategies etc.? Two new sub-themes emerged within Performance Strategies, these being: education (for athletes and coaches), which was mentioned by more than 98% of athletes, and get advice from experienced/retired athletes. Additionally, making effective use of sports science and sports medicine (SSSM), maximising training, and performance opportunities, were also emphasised.

Lifestyle practices

The vast majority of athletes (> 91%) agreed that activities that helped them relax when not training or competing was important to their success. Similarly, Lifestyle practices such as: nutrition/hydration, the importance of having time-out, and lifestyle ‘balance’, were also perceived as important. As a recovery practice (mentioned previously), the importance of sleep was a common theme in recommendations athletes would make to younger athletes.

Athletes predominantly sought dietary advice from either a qualified naturopath or herbalist (95% IP 94% n-IP) or qualified dietician or nutritionist (44% IP 36% n-IP). The prevalence of source of dietary advice was not statistically significantly different between athlete categories. Most athletes (> 94%) predominantly ate home-cooked meals. A range of dietary practises were reported, with a ‘high protein’ diet being most prevalent, and the proportion of n-IP-athletes on a ‘high protein’ diet was statistically significantly higher than for IP-athletes (n-IP 54%, IP 38%) (p = 0.047). There were no other statistically significant differences in diet between IP and n-IP athletes and no statistically significant differences between the other athlete categories.

Water was the most common beverage consumed (> 95% of athletes). Teas and herbal teas were drunk by 20–30% of athletes, whilst the consumption of commercial sports drinks was only reported by 20% of athletes. The percentage of IP-athletes who regularly consumed coffee was significantly higher than for n-IP-athletes (IP 68% and n-IP 47%). There were no other statistically significant differences between athlete categories.

Discussion

Psychological skills and attributes were perceived by athletes as vital to success across the range of attainment levels, with an ability to change and resilience being rated the highest. While the importance of resilience and adaptation is well documented [2], most athletes wished they had had access to these skills earlier in their career [2]. It may therefore be suggested that an holistic psychological support program, inclusive of training in mental fortitude [2], emotional intelligence [11], mental toughness [12], and mindfulness-acceptance-commitment (MAC) practices could be incorporated into athlete support programs to facilitate athlete wellbeing [13,14,15]. The suggested potential value of such an inclusion would be in assisting athletes to enhance performance and embrace the pressure and expectation to perform and succeed at important benchmark events, as well as contributing to the attainment of important psychological and mental aspects of wellness.

In support of this, athlete responses indicated that pre-elite athletes desired deeper knowledge, understanding, and autonomy. Given the focus on psychological skills being perceived to be critical to performance, this receptiveness presents an opportunity to hone and develop psychological skills earlier, so that they are well-practiced by the time the athlete reaches career maturity. However, interestingly, the second most common response concerning sports psychologists was: ‘I don’t discuss my sport with them’. Hence whilst the athletes’ perceived their sport psychologist to be important to them, their role may not always be what the referring Sports Governing Bodies and Institutes assume. Hence the potentially important role of ‘sport psychologists’ in contributing to the mental wellness of athletes should not be underestimated, and further clarification is required to better understand the multifaceted role of sport psychologists in providing support, education and skills training in both the athlete wellbeing/mental arena as well as for performance optimisation. Additionally, education about this service earlier in the developmental pathway may provide more targeted as well as holistic and effective use of this professional service, as indicated in the following quote:

I wish I had asked for help sooner from professionals regarding my coping strategies and stress levels. The pressure and stress of hitting my peak in sport at a young age has permanently affected my mental and physical health….I wish I had diversified my support network to outside of the sport itself. (n-IP-athlete).

All athletes perceived interpersonal relationships as vital, and valued people who made them laugh and supported them during their careers. Most also valued their coach’s ability to relate to them on a personal level as being as equally important as their technical ability. Perceived support is understood to affect emotional and informational esteem positively and have stress-buffering effects on self-confidence and resilience [2, 16, 17], including performance factors [18]. The coach-athlete relationship can directly influence an athlete’s motivation as the coach’s ability to facilitate autonomy-supportive behaviours, beneficially impact an athlete’s intrinsic and extrinsic motivation, drive performance and perseverance [17]. Conversely, in an environment where there is pressure to perform and high stress levels, some negative relationship aspects may develop, such as controlling behaviours, accidental violence [19], non-accidental violence, maltreatment, harassment, coercion, and abuse, which are not uncommon in elite sport [20, 21]. Hence an emphasis on a culture of personal support and respectful interpersonal relationships may not only serve to drive higher levels of performance and enhance athletes lives both within and external to the sporting arena but may also prevent potentially harmful interactions [4].

The results revealed that IP-athletes were more likely to utilise support services for recovery practices (hot/cold immersion, infrared sauna etc.), massage therapists, dietician/nutritionists, sports medicine doctors and sports psychologists. This finding concurs with our previous research, in which the use of ice-baths was reported as a common practice amongst world-class athletes and the finding that the use of hot/cold immersion [3], plunge-pools and ice-baths was more common amongst IP-athletes suggests perceived merit in introducing contrast bathing to athletes earlier in their career. Furthermore the current reported difference in the use of the aforementioned range of recovery practices is likely a reflection of access to facilities and professional services, since they are often recommended by NIN/NSO’s who also offer financial support. With the perceived benefit of these practises and services being indicated by numerous athletes who expressed that they would have liked access to these services earlier in sporting careers.

Further insight into athletes’ perceptions were gained from the responses to the qualitative questions, which resulted in the generation of two new sub-themes within the Performance Strategies theme, these being: education (for athletes and coaches), which was mentioned by more than 98% of athletes, and get advice from experienced/retired athletes. Within these was the advice to young athletes, which included being proactive in the context of being a knowledge-seeker, and ‘standing up for yourself’. Contextually this included, the advice to ‘change clubs earlier’. As some athletes commented that their choice to remain at their club was often due to loyalty or ‘aiming to please’ rather than making the right career choice. But with hindsight they reflected that it was important to know when to move to a more specialised club or DTE. Furthermore, the recommendations to young athletes included seeking professional assistance, such as sports psychologist, dietician and other specialists earlier, which reiterated the established athletes perceived benefits of these support services. Within these responses, the perceived importance of an understanding of nutritional strategies and the implementation of recovery strategies was strongly reflected, particularly concerning preventing burn-out, fatigue, and injuries.

Finally, a new lifestyle sub-theme of ‘balance’ emerged from the survey responses and was interlinked with social activity and connection/support, where athletes made recommendations to connect with other aspects of life such as study, family, and friends.

In virtually all aspects of the data there were almost no statistically significant differences between AB-athletes and AwD, and the few statistical differences that were identified may be due to their disability e.g., ‘walking’ was utilised more as a recovery practice amongst AB athletes (79%) compared to AwD (25%). Family support was greater for AwD, perhaps indicating support for managing various disabilities. The reasons why AB athletes reported practicing more rituals than AwD, requires further investigation as the reasons for this are not overtly evident. Again, there were very few statistically significant differences between males and females, but notably there were differences in the use of some recovery strategies and training hours leading up to and during competition.

Conclusions

The findings of this study indicate that athletes of state level and above perceive lifestyle factors, performance strategies, and social support as important factors in sporting success. Their responses also indicate that they would welcome the implementation of educational strategies, recovery practices, and access to service providers earlier in their athletic career. To facilitate this, athlete development programs may benefit from facilitating athletes’ social support networks and implementing specific programs to foster a culture of respectful interpersonal relationships amongst athletes and their friends, coaches, family and support staff.

The importance of Psychological Skills and Attributes, Interpersonal Relationships, Performance Factors/Strategies, and Lifestyle Practices were all identified as important by the athlete, and where possible should be considered within holistic models of athlete development and support. Furthermore in such models there needs to be an awareness that the impact of the ‘sport psychologist may extend from aspects of sport performance into the broader realm of athlete well-being.

In conclusion, whilst athletes’ perceptions of the perceived benefits of services and lifestyle factors does not prove their significance in contributing to improved athletic performance and success, the perceptions of successful and aspiring athletes are nevertheless important in providing insight into their expectations of which support services and attributes are needed to most effectively enable their success, Furthermore it is recognised that athletes are individuals and their needs and expectations will vary, as indeed will the relative importance of the attributes and services between the diversity of athletic events/sports with their disparate physical, mental, and technical demands. Nevertheless, sporting institutions, coaches, support providers and athletes should be aware and informed of these potential factors, to thereby facilitate the most effective support for and development of athletes at the elite and pre-elite level.