Performance in Sports & Academics: Training an 800m Sprinter in Med School

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The path to achieving sporting excellence requires more than talent alone. For many athletes, progress through the years of this journey is often nonlinear and subject to a number of unexpected opportunities, bumps in the road, and setbacks. It takes incredible passion, determination, confidence, and resilience to travel this “rocky road to success.”

In my last article for SimpliFaster, I described the realities of training a young female short track speed skater who was also a full-time med school student, and the programming strategies we used while she was completing various internships. Here, I would like to share the story of another full-time med school student—Maïté Bouchard—whose training I have been supporting for almost three years now. Not only does Maïté have to maintain academic excellence with classwork, exams, and internships, she also competes in one of the fiercest track & field events in Canadian Athletics: the 800m.

Maïté’s coach is responsible for putting together her annual training plan and programming the different running-specific sessions. She works with him three times a week on the track and completes the remaining weekly running sessions on her own. My responsibility, as a member of Maïté’s Integrated Support Team (or IST), is to oversee her physical preparation. On a weekly basis, we usually meet for 1-2 training sessions in the weight room, depending on the time of the year. Communication with Maïté’s coach at the start of each training cycle is important so that I can adjust our training objectives to ensure that both training and running objectives remain in sync.

I will provide a detailed look at some of the programming strategies that we have used until recently during her physical preparation while she concurrently trains with her coach on the track, completes different internships, and travels the world to participate in meets. This way, it is possible to share some aspects of a coach’s decision-making process and how it aligns with current practices.

Needs Analysis of the Event and Targeting an Approach

The process of performance training starts with a thorough understanding of the sport and athlete that you’ll be working with. In 2018, at the beginning of this new collaboration, I was still mainly involved with Canadian football players and knew little about track and field and the 800m. It was therefore crucial for me to get as much information as I could about Maïté’s event, her training and competition background, and her current physical competence.

Middle-distance running events such as the 800m are complex and require a varying blend of (1) aerobic, (2) anaerobic, and (3) neuromuscular performance to perform at a high level.1 Speed is without a doubt an important performance factor, but relative contribution of the aerobic system is estimated to be around 55-65% aerobic2. From an athletic development perspective, our focus was to prepare the different structures (muscles, tendons, bones) for the demands imposed on the body while letting her coach take care of the sport-specific sessions. By examining the research on sprinting—and in line with the suggestion that neuromuscular and mechanical qualities related to maximal sprinting speed and anaerobic speed reserve can enhance performance in middle-distance events1—I identified three main elements to our approach:

    1. Force application and orientation into the ground
    2. Posture
    3. Skill acquisition and refinement

There are obviously many more pieces to the performance puzzle, but I like to keep things simple and identify key principles around which I can design a flexible framework. When combined with a physical competency assessment (flexibility, single-leg squat, forward lunge and return, double-single leg landing), this brief task analysis served as our foundation for choosing the different exercises and methods that would constitute the training program.

Consideration of prior training experience and injuries was also important. We eliminated exercises that would cause unnecessary delayed onset muscle soreness (e.g., barbell reverse lunges supersetted with lying leg curls), as those would prevent her from completing high-quality sessions on the track. We also eliminated exercises that put high loads on the lumbar spine (straight-bar deadlift, for example). After all, the most specific training sessions were to be done on the track, and athletic development would act as support for her performance.

These choices were necessary to facilitate the transition from one training philosophy to another. At first, exercises using mostly her body weight and dumbbells such as squats, lunges, step-ups, and various pushing and pulling exercises were included 1-2 sessions per week to focus on developing general strength. Simple plyometrics such as box jumps were progressed over time and adjusted according to her running volumes and periodization of training. Olympic weightlifting variations such as jump shrugs and high pulls were performed using dumbbells. The why behind including Olympic weightlifting movements was:

    1. To apply force into the ground by developing lower body muscular power by overloading the triple extension movement.
    2. To work on the optimal, sequential recruitment (coordination) and timing of the ankle, knee, hip, and shoulder.

In addition, these movements are time-efficient and provide variety. The other parameters, such as load, number of reps, rest intervals, and order of the exercises (single exercise, superset, circuit, etc.) were manipulated to fit the objectives of the session. Nothing fancy—a simple progression over time that allowed us to establish a solid training foundation and for Maïté to perform her sessions on the track without any muscle soreness. Our goal was also to help her improve on her 2017 result of 2:03.91 at the Abidjan Francophone Games and reach the standard to qualify for the Olympic Games.

This simplicity was necessary, especially with the different internships that were part of her predoctoral training. At the Université de Sherbrooke, where Maïté is enrolled, medical school students have to complete 2.5 years of predoctoral training divided into three phases. It was important for us to account for the demands and schedules of these internships, and how they can impact training. For example, in April 2018, during the second phase of predoctoral training, she had to complete two full weeks of medical training in Victoriaville, which is a 75- to 90-minute drive from Sherbrooke. That distance prevented her from driving back to Sherbrooke on a daily basis, except for two weekly sessions with her coach on the track.

From a resistance training standpoint, during such times, we often came back to identifying the exercises that provided us with the most bang for our buck, and that Maïté felt comfortable doing without any supervision. In this case, we would choose some sort of plyometric exercise, an Olympic weightlifting derivative, one or two lower body exercises (either double-leg or single-leg), an upper-body superset, and a core stability exercise.

After this month (April 2018) came a number of competitions in both America and Europe. At that time, most training sessions were performed on the track with her coach and were specific to her event. In the gym, the first weekly session again mostly focused on enhancing strength and power qualities by progressing the demands of plyometrics exercise and by transitioning from double-leg lower body exercise, such as hexagonal bar deadlift, to single-leg movements like split squat and step-ups. The second session mostly consisted of circuit training focusing on coordination and postural strength.

At the end of her summer 2018 outdoor competition season, she had achieved a personal best of 2:01.95 in Belgium. She concluded her season with confidence, and the team felt that we all were on the right track for the next season. But we know that life does not always go according to plan…

Learning to Adapt: School Demands and Performance Setbacks

Fast forward a few months—we found ourselves in winter 2019 preparing for the Pan Am Games. Training had gone well over the fall, which served as a general preparation phase with higher running volumes and more general work in the weight room. We certainly did not expect that January and February 2019 would be heralds of the months to come.

From an academic standpoint, Maïté was about to start her clerkship (or rotation) in different departments at the hospital. Her first rotation, at the emergency, included day and evening shifts and was pretty intense; her second rotation in radio-oncology, a month later, was a bit more relaxed. This stretch also followed the holidays, during which quality training is always a challenge.

Due to her rotations and two indoor competitions early in January, we only had two training sessions in the gym before her first competition (in Boston). Nonetheless, she was able to offer a solid race and a first-place finish at 2:04.64. The following week she flew to France to participate in another meet, but her time of 2:08.70 was a huge disappointment. Encouragingly, she bounced back with a solid race at the end of February with a 2:03.59, breaking the indoor 800m record for Quebec.

All in all, during those two months she completed a total of six resistance training sessions in addition to her track sessions with her coach, which were given priority. This would be a lesson for us in the future, as we came to realize that maintaining training frequency was very beneficial and allowed her to have a mental break from work and studying and continue with a very organized schedule. It was also during that period that we came to find a time-efficient structure to the training session in the gym. Within 60 minutes, we came up with the following exercise order for the first resistance training session of the week:

    1. Olympic weightlifting variation (jump shrugs, power clean from the hang)
    2. Single-leg lower body exercise (step-up variations)
    3. Foundational strength (e.g., Gambetta leg circuit)
    4. Upper body pushing-pulling superset (e.g., chin-ups and overhead pressing)
    5. Core stability

While the first session focused on force production, the second session focused on coordination and postural strength. At this time, we also started experimenting with different variations of the hip lock and other coordinative strength exercises from Frans Bosch3.

In March, Maïté was away in Quebec City for another rotation in gastroenterology—she described that period as very intense, with 7 a.m. to 6 p.m. shifts and a drive through traffic to get to Laval University to have access to the indoor track and weight room. Her training was initially divided into two resistance training sessions:

    1. Lower intensity, which she could complete the day after a high-quality session on the track.
    2. A second session of higher intensity in the gym after a lower intensity day.

Instead of going back to simpler exercises and methods, we decided to stick with our recent training routine. We had worked on perfecting her technique on the Olympic lifts for a few months by first using dumbbell high pulls and snatches and gradually introducing the barbell. This emphasis on teaching the why, perfecting technique, and progression allowed her to feel competent and confident in using the lifts by herself without supervision. Even though the initial plan seemed manageable, we came to a decision that it would be better for her to perform only one resistance training session considering her academic workload. Depending on how she felt, she had the option of completing one of the two sessions.

The next two months (April and May 2019), Maïté’s schedule included a number of competitions in California. Again, the emphasis at this time was on her specific running workout, with resistance training sessions supporting her preparation for those meets. Given the uncertainty of having access to the right equipment, resistance training sessions were designed to include some plyometrics, some dumbbell work, and postural strength exercises. During these congested competition schedules, DB complexes and variations of the Gambetta leg circuit4 were valuable tools. Then, at the end of these two months, we took advantage of 14 days without competition to lift some heavier loads using complex training, which alternated biomechanically similar high-load exercises with lighter-load exercises.

Roy Table
Figure 1. Examples of DB complexes and Gambetta leg circuit from Vern Gambetta (2007). A tempo of one repetition per second is a must for the leg circuit.

June and July mostly consisted of specific workouts on the track and extensive traveling in the U.S., Italy, and Canada to participate in different meets. After some disappointing performances, self-doubt started to creep in. Time was starting to run out to qualify for the World Championships, and the Pan Am Games were also fast approaching.

The 2019 Pan Am Games were held in Peru—with a reignited fire, Maïté ran her semifinal race according to the plan designed by her coach. With 150 meters left, she was in a good position to attack the runners ahead of her when she got tripped from behind and fell hard on the track. This 2019 outdoor season was obviously disappointing at many levels, but we were hopeful she would bounce back.

On the Rise

Interestingly, looking back at the design of the training sessions performed in preparation and during the 2020 indoor season, there were no major differences compared to 2019. The first session of the week still focused on improving the muscular qualities associated with sprinting, while the second session focused more on the coordinative and postural aspects of performance. At times we would alternate the performance of those sessions during the week based on how she felt on the track. Regular subjective feedback about her energy, soreness, and overall mood was essential to adjust training considering the absence of more objective feedback that you can find in the sport science literature.

She had resumed her monthly rotations at the end of August 2019 (planned rotations in internal medicine, cardiology, and pediatrics), but you could tell that there was something different at this moment in her preparation. Our most objective feedback were her times on the track, and we could see that we were heading in the right direction. Maïté and I started to have discussions prior to our weekly meetings about how she felt on the track during certain training sessions and what we could do in the weight room to enhance those sensations. Some of the content of the training sessions was decided at the start of each one, depending on whether she felt she needed strength work or more “pop” when sprinting on the track.

It was also at that time that we jointly decided to fully commit to using step-ups as her main lower-body strength building exercise. Essentially, the start of an 800-meter race is not as important for her as it might be if she were competing over shorter distances, and she felt that the vertical force application and posture associated with the step-up might provide a better potential for transfer later during the race. Maïté was thus more involved in the decision-making surrounding her training, and I believe this proved beneficial in adjusting to her reality as a med school student-athlete.

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