Olympic and Paralympic Elite Sports in Times of the Corona-Pandemic - Current Challenges and Future Opportunities

In the past months, the Corona pandemic has caused major changes in the national and international world of sports, as in other areas of public life.

Since the occurrence of the first cases in Germany in late January 2020, there has been massive detriment to the structural circumstances for athletes in all types of sports, all performance classes and all age groups. This leads to a wide variety of challenges for sports medicine and all its sub-disciplines. Among other things, it affects physical activity among children and adolescents just as much as organized sports in clubs, rehabilitation sports and sports therapy of our patients.

Numerous limitations have also arisen in the area of high-performance sports, whereby various exceptions were made for high-performance team and professional sports based on sometimes very cleverly-devised and complicated hygiene concepts. At the moment, preparations are being made for the Paralympics and Olympic Games 2021. Some problems have already arisen due to the postponement of the games for a year, which have resulted in great challenges for all participants. Starting with the new scheduling, through limitations in training possibilities and on to the difficult structural circumstances for national and international qualification requirements, many aspects must be taken into account which have a direct or indirect influence on sports-medical care.

Continuous balancing of an infection risk which cannot be adequately estimated with the understandable desire of the athletes for optimal training conditions and participation in competitions at home and abroad have set – and continue to set – high demands on team physicians. Even though serious courses of a corona infection have fortunately been rare, an infection can still easily rob the athletes of their maximum performance capacity. Thus, the Damocles sword of an infection with sequelae is always hanging over those persons with the greatest physical performance capacity in our country. The Paralympic elite sports were characterized by even more caution and restraint in light of risk constellations which are more often present. The athletes more frequently reported worrying about their health and the National Council acted with the required care and responsibility for its athletes.

In orthopedic care at the start of the pandemic, an increase in overload complaints due to altered training methods and environments was in the foreground. The numbers of injuries increased with the sometimes very abrupt restoration of sports operations in the leagues of team sports under limited availability of players. In light of a further increase in measures, still further rise in the number of injuries can be expected. Trainers and managerial staffs should be made capable of recognizing overload situations early on to protect the athletes who are fatigued from injury. Close watch on the athletes using a so-called Injury and Illness Surveillance System appears to be absolutely recommended in this context. This topic will thus be discussed in several articles in this issue.

The influence which the restrictions have on the emotional health of the athletes has not been much examined yet. The first systematic data recordings, however, signalize a clearly elevated stress situation which must be taken into account in the care of the athletes.

Despite all restrictions, incalculabilities and uncertainties, the pandemic year also had very positive effects with respect to health. Among other things, the high efficacy of preventive measures was revealed – in this case the effectiveness of simple hygiene measures. Every care-giving sports doctor must have noticed the felicitous reduction in common respiratory tract infections in the winter months. The iterative repetition of effective hygiene measures showed great efficacy. Thanks to a positive augmentation among athletes and trainers, these effects may be maintained ideally beyond the end of the corona pandemic. Many elite athletes are important role models for the people in our country despite the reduced competitive events. The way the athletes cope with the difficult situation, with usually a high level of professionality - always striving to optimize their own performance capacity even under the most difficult conditions – can be justifiably considered exemplary.

It remains to hope that this role model function will be applied with respect to the restitution of organized sports in general in Germany. We sports doctors view the developments in our country with concern, not only because of the growing exercise deficit, but also with reference to the performance development in elite sports. Today’s next-generation athletes are the elite athletes of the coming games and access to training halls and sports arenas has been denied most of them for several months now. The games in Tokyo – regardless of the conditions under which they will finally be held – as well as the role models among the participants in the Paralympics and Olympics will hopefully be able to contribute by showing our children and next-generation athletes as well as the entire population the attractiveness of sports, put across the importance of exercise and create motivation for individuals to become physically active themselves.

The Paralympic and Olympic Games in Tokyo in 2021 will definitely present a special kind of challenge and also influence sports-medical care in a wide variety of ways, completely independent of whether the doctors’ focus is internistic or orthopedic-traumatological. In addition to care on site, this issue of the DZSM should also focus on prevention in Paralympic and Olympic sports, since the pandemic has thrown enormous light on its importance and emphasized it in all areas of medicine - and that regardless of the types of sports, performance class and age group.