Athlete

An athlete is someone who regularly engages in an activity and usually competes at a high level, particularly in sports. Athletes dedicate more time and perform at a higher level than casual or hobbyist participants. They specialize in their respective sports, and that specialization affects how their bodies are impacted.

The demands of an athlete’s body include:

• Musculoskeletal movements that involve repetition, force, and endurance (these movements can include running, walking, jumping, standing, sitting, lifting, pulling, pushing)
• Use of the senses: eyesight, hearing, balance, body awareness
• Good general health: physical fitness, cardiovascular and respiratory health, strong immune system
• Cognitive: mental effort, attention, decision making, memory, problem solving
• Tolerating and recovering from physical and mental loads, such as physical contact and high stress

Health and safety issues for athletes can vary, but may include:

• Concussions, traumatic brain injuries (TBI), chronic traumatic encephalopathy (CTE)
• Injuries depend on the type of sport, body movements, and body parts used, and can include:
  • Tendon Disorders
  • Tennis Elbow
  • Bursitis
  • Carpal Tunnel Syndrome
  • Spinal cord injuries
  • Broken bones or fractures
  • Dislocations
  • Soft tissue tears
  • Sprains and strains
  • Lower back pain
  • Knee pain
• Staphylococcal (staph) infection
• Lacerations (cuts and scrapes)
• Infectious diseases from physical touch, close contact, or frequent travelling (including respiratory infectious diseases)
• Pain or injury from physical overexertion, repetitive manual tasks, heavy lifting, rapid or forceful movements, or physical contact with other players or objects
• Allergic reactions or contact dermatitis from cleaning products used on equipment
• Mental health issues, including stress, fatigue, and burnout 
• Slips, trips, and falls
• Workplace harassment or violence
• Dehydration or heat-related illnesses
• Ultraviolet (UV) radiation from sunlight if sessions are held outdoors

Performance-enhancing drugs are generally prohibited in organized professional sports, but not always. 

Some known performance-enhancing drugs are:

• Anabolic steroids
  • Testosterone
  • Nandrolone (synthetic testosterone, commonly called “Deca”)
  • Oxandrolone (Anavar)
  • Turinabol
• Peptide hormones
  • Testosterone-stimulating peptides
  • Growth hormone-releasing factors
  • Erythropoietin (EPO)
• Diuretics (for weight cutting)
• Stimulants
  • Amphetamine (Adderall)
  • Cocaine
• Blood doping (for endurance)
• Beta blockers

It is not common for an athlete to test positive for any of the above drugs without deliberately taking them, but some over-the-counter supplements could lead to failed drug tests. It is important to read the labels (ingredients) of all medications and supplements, and verify that the product has been approved by Health Canada as well as the sport association. Licensed natural health products can be identified by looking for the eight-digit natural product number (NPN) or homeopathic medicine number (DIN-HM) on the label. Make sure to always consult with your doctor before taking any supplements. 

The negative impacts of performance-enhancing drugs depend on the drugs taken by the individual. They can include:

• Anabolic steroids: infertility, hair loss, breast development (in men), acne, increased aggression and risk of medical conditions such as stroke and heart attack 
• Peptide hormones: hypertension, headaches, stroke
• Diuretics: headache, fatigue, gout, dizziness
• Stimulants: anxiety, insomnia, increased heart rate and blood pressure, stroke, heart attack
• Blood doping: increased stress on the heart, heart attack, blood clots, stroke
• Beta blockers: dizziness, fatigue

When the brain is shaken in the skull, it can lead to a traumatic brain injury called a concussion. It may not appear in diagnostic imaging (such as a computed tomography (CT) scan), but it can still impact the health of the athlete.

Understanding the nature of an activity or sport is the first step in preventing concussions. It does not always take a direct blow to the head to cause brain trauma. Consider the following actions, which are common elements of many sports, that can cause a concussion:

• Body-to-head strikes (common in combat sports such as boxing, but can also occur in non-combat sports such as hockey)
• Object-to-head strikes (baseball player hit by a pitch, heading the ball in soccer, etc.)
• Full body collisions (tackling in football or rugby, body checking in hockey, etc.)
• Falls from height (gymnastics, cheerleading, horseback riding, rock climbing, etc.)
• Slams, takedowns, and falls from the same level (wrestling, judo, etc.)
• Whiplash or rapid movements of the head (blow to the body, motor vehicle collision, bicycle crash, etc.) 

Factors that could affect getting a concussion:

• Having a previous concussion (having had an initial concussion increases the risk of sustaining another)
• Intensity of play (a competitive match is more likely to result in a concussion than practice)
• Sex (females may have a higher risk of suffering traumatic brain injuries than males)

Not everyone who suffers a concussion will experience symptoms, but the following may indicate that a concussion has occurred:

• Headache
• Dizziness
• Nausea
• Memory issues
• Problems focusing or thinking clearly
• Behavioural changes
• Blurry vision
• Neck pain

Get emergency medical attention immediately if experiencing more serious symptoms, such as double vision, severe headache, neck pain, repeated vomiting, seizures, or loss of consciousness.

An athlete who could have a concussion should speak with a healthcare professional. It is important to get a medical assessment and diagnosis so that appropriate guidance can be provided. The following tools* are used when dealing with concussions:

• Sports Concussion Assessment Tool 
• Concussion Recognition Tool (as part of Parachute's Canadian Guideline on Concussion in Sport)

*We have mentioned these organizations as a means of providing a potentially useful referral. You should contact the organization(s) directly for more information about their services. Please note that mention of these organizations does not represent a recommendation or endorsement by CCOHS of these organizations over others of which you may be aware.

It takes time to recover from a concussion – weeks or longer for proper recovery. Athletes should be medically cleared by a healthcare professional before they return to the sport after a suspected concussion. 

All efforts should be made to prevent additional concussions. Repeated brain trauma could lead to long-term issues such as chronic traumatic encephalopathy (CTE). 

It is better to prevent concussions than to treat them. Consider the following preventive tips:

• Avoid activities that could cause a concussion, especially if you have a greater vulnerability (such as having had one or multiple concussions before)
• Play smart and avoid blows to the head or activities that shake the brain
• Prioritize your brain health (for example, if you think you might have a concussion, report it and take recovery measures)
• Wear a suitable, properly fitted helmet that complies with a recognized standard, such as CSA Z262.1-15 (R2024) for ice hockey helmets. A helmet does not prevent a concussion, but may reduce the severity of injury

You can find more information on concussions from the Public Health Agency of Canada’s concussion resources and Parachute Canada.

While sports may appear entirely physical, an athlete’s mental health can also be affected. Some challenges athletes may face include:

• Anxiety and depression
• Job burnout
• Stress from having to stay in peak physical condition, feelings of extreme pressure to perform, weight cutting, dealing with media, etc.
• Meeting the expectations of coaches, parents, fans, and supporters
• Work-life imbalance due to irregular hours, including early mornings, evenings, and weekends, which can contribute to burnout
• Job insecurity (being cut, unsigned, traded, etc.)
• Substance use
• Mental health concerns after sustaining a physical injury or following retirement
• Stigma related to certain types of injuries, such as concussions and mental health
• Dealing with cumulative and recurring injuries

While retirement is not always the first thought of an athlete, they should have a plan for life after sports. Most professional athletes have a relatively short career and need to prepare for a change in lifestyle after retirement. Early planning, including financial and career transition planning, can help prevent mental health difficulties after the end of an athlete’s career.

To reduce the effects associated with injuries, athletes should take preventive measures based on their risk:

• Avoid overtraining
• Avoid using performance-enhancing drugs
• Perform routine medical health screenings and examinations (such as a physical exam, echocardiogram, blood tests, etc., as recommended by a qualified physician)
• Minimize activities that could cause brain trauma (for example, a boxer who spars should not take hard punches to the head)
• Use proper lifting techniques
• Wear proper footwear for the activity and terrain to prevent slips and falls, as appropriate
• Stay hydrated
• Take appropriate breaks throughout the day
• Inspect equipment before use to make sure it is not damaged or defective
• Ensure all equipment is clean and well-maintained
• Do not share training masks (or disinfect before and after use if shared)
• Treat other athletes, coaches, officials, and other individuals with respect and follow the rules and etiquette of the sport 
• Report all incidents and injuries, and follow the proper return to play protocols, including doctor clearances
• Report all incidents of harassment or violence to management for follow-up
• Participate in Workplace Hazardous Materials Information System (WHMIS) training and education (relevant when the athlete could be exposed to hazardous products)
• Review the safety data sheet (SDS) of any hazardous products used in the training facility
• Know the location of muster points and what to do in an emergency

Athletes should always train safely to prevent injury. This approach can mean managing training intensity and frequency, and taking time to rest and recover. Often, athletes push their bodies to the limit and suffer injuries. When this happens, consider the following tips:

• Avoid playing while injured
• See a healthcare specialist. Professional athletes may want to see a sports medicine physician
• Report the injury to a responsible person, such as a coach
• Get rest and follow recovery protocols, as directed by your healthcare specialist
• Access physiotherapy and rehabilitation services, as necessary
• Seek guidance from a sports psychologist if faced with psychological challenges (such as dealing with being unable to compete while injured)
• Avoid returning to training or competition too early. Discuss your concerns with your coach, sports psychologist, and others who can help
• Understand your collective bargaining agreement, the workers’ compensation process, and your medical insurance policy (if you have one) to ensure you know your rights, entitlements and the process to follow after an injury. Workers’ compensation, medical insurance coverage, and health benefits may be different for each sport, league, and team. Speak to a union or player representative, your agent, insurance company, or a lawyer for guidance 
• Return to training or competition only when cleared to do so

If proper care is not taken to safely deal with injuries, an athlete could face a longer layoff, or long-term health issues. 

Athletes should consider the following safe work practices: 

• Train with others who can help if you are ever suddenly injured
• Follow training protocols
• Report unsafe acts and unsafe conditions to the coach, trainer, or manager
• Know where the first aid equipment is located and follow first aid procedures
• Learn about chemical hazards, WHMIS, and SDSs, including consumer chemical products
• Prioritize self-care and seek peer support
• Know when and where to get professional support
• Establish work-life balance
• Practice good housekeeping and keep areas clear of clutter
• Familiarize yourself with the emergency response procedures, including what to do when there is a fire, structural collapse, active shooter, bomb threat, extreme weather, or other emergency
• Seek out mental health support when needed

Athletes suffer physically and mentally when injured. It is important to provide the right support to help them recover. Consider the following tips:

• Create an environment that makes the athlete feel comfortable reporting injuries
• Do not put pressure on an athlete to return too soon to training, sport, or activity after injury
• Provide resources so that the athlete can get medical care and mental health support when necessary
• Be supportive – listen to their concerns, keep them involved in events (such as social gatherings), and respect the rehab process
• Understand the early signs and symptoms of an injury or mental health distress, including concussions and anxiety, and take the appropriate steps to get the athlete the help they need
• Refer athletes to the appropriate healthcare professional when an injury or mental health issue is suspected (only doctors and qualified health professionals can diagnose and treat these concerns)