Run faster, jump higher, shoot harder. Pushing your body, and sometimes your mind, always further, in search of the ultimate performance. The daily life of a high-level athlete, punctuated by training and restricted by dietary requirements, creates a very unique relationship with the body.
“The athlete’s body is his work tool”, recalls Mathieu Sissler, sports psychologist. However, winning at all costs has its share of consequences, and athletes run the risk of jeopardizing their physical and mental health. “It’s been proven: intense daily practice induces premature aging of the joints. We no longer count, for example, the operations of top athletes for defective cruciate ligaments”, adds the mental trainer.
Physical and psychological risk taking
To prevent these long-term lesions, doctors and psychologists play a key role in supporting athletes. But when they are launched in a race for records, how to convince them to take it easy or even slow down, so as not to cause irreversible physical injuries? ” It’s not always obvious, admits Mathieu Sissler. Among young athletes, we sometimes hear speeches like “If I have a medal, I can die in peace.” By stopping them in their tracks, we go against their dreams. »
“When you are 15, 16 or 17, the future seems far away. We don’t think about what comes next, adds Martin Ducret, sports doctor at the National Institute of Sport, Expertise and Performance (Insep). It’s our role to warn, even if it gives us a party pooper label. » Thinking of being slowed down in their progress, “Some athletes practice what is called medical nomadism: they go to see another doctor who will perhaps go more in their direction. »
For Élise Anckaert, head of the sports psychology unit at Insep, “A quest for performance also translates into a psychological risk, in particular of depression: limiting the athlete too much, telling him not to cross this or that level so as not to injure himself, we can demotivate him”. To accompany them well, she adds, it is necessary “Above all, present them with the factors that can alert and protect them. It is then up to them to evolve knowingly. It is the principle of the acrobat on his wire: our role is to help the sportsman and to help his body, to remain in balance, in a situation of imbalance”.
The weight of the surroundings
Certain figures in high-level sport reflect the consequences of this search for performance at all costs. “When you look at Rafael Nadal, you see a very great champion. But the reality is that he is already suffering a lot physically, with repeated injuries and a risk of suffering for the rest of his life, says Mathieu Sissler. It wouldn’t be surprising if he lived on corticosteroids for many years. This is the hidden side of the job. »
Recently, during the FIFA World Cup in Qatar, the Brazilian Neymar, victim of a sprain in the first match, returned to the field in the round of 16, less than a fortnight after his injury, when this guy injury usually requires three to four weeks of rest. “The Brazilian medical staff took a big risk by accelerating the recovery process”believes Martin Ducret.
Does the pressure come from the athlete’s entourage? “In reality, it’s quite rare for athletes to do more than what is asked of them. The problem often comes from coaches who are less aware of the risks and who see, in front of them, young people ready to do anything to surpass themselves,” believes Mathieu Sissler. Doctors, physiotherapists or osteopaths can set limits. “When an athlete has a sprain, the idea is to know until when he will be unavailable. But the bigger and richer the club, the more pressure there will be on the doctor’s shoulders. »
Prevention and follow-up
Often constrained by economic realities and in search of champions and performances, sports federations have not yet taken the full measure of the necessary physical and mental support., believes Mathieu Sissler. “Awareness of physical risks is growing, but there is a lack of real reflection, which is very current, to help the athlete manage his body over time”he argues.
“Prevention is not lacking now within the federations. Some, like the swimming, golf or tennis federation, are undoubtedly more advanced than others but, overall, everyone is progressing”, observes Élise Anckaert. According to the specialist, mental support and psychological prevention have become more democratic over the past ten years.
This development is accompanied by technological innovation, in particular by progress made in medical imaging. Developed as a diagnostic tool, this technique is used to better understand how the body works. The Bachaumont imaging center in Paris is a reference in the pathology of athletes. And, yet, « lasports medicine is not yet a specialty as such, it is a superspecialization, recalls Martin Ducret. But I think it will be! »
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Insep, the factory of graduate champions
The National Institute for Sport, Expertise and Performance (Insep) offers diploma courses, initial and continuous, adapted to the needs and constraints of high-level sport.
The results of Insep’s “double project” led to exceptional results in 2022: 100% success in the baccalaureate and 78% of mentions; 88% success rate in the BTS Operational Commercial Management (MCO); 100% success rate for professional training related to sports professions; and 86% success rate for post-baccalaureate training.