A recent recommendations report from TrueSport  detailed the ways different stakeholders can best serve young athletes in terms of mental wellness, and included recommendations for those systems and communities. Here, one of the authors of the report—widely recognized sports sociologist Jay Coakley, PhD,—and Jennifer Royer, PhD, Senior Director of TrueSport and Awareness at USADA, share the tangible ways communities* and systems can best support mental wellness for student-athletes.

1. Understand the impact an organization can have

“We have to have a healthy system in order to have healthy athletes,” explains Royer. “We need the tools to teach athletes resiliency, self-confidence, and self-advocacy. If we don’t have that in place at the systemic level, it’s really difficult to successfully support athletes.”

“I think it’s important to focus on restructuring youth sports, rather than dealing with individual issues here and there,” adds Coakley. While a coach may have a direct impact on their athletes, we will see more lasting and durable change from the community and larger systems.

2. Understand your responsibility as an organization

As the report lays out, individuals like coaches, families, and athletic trainers can actively support young athletes, but organizations are tasked with making broader changes at the policy level and then executing and enforcing those policies. Mental wellness as a complement to physical wellbeing for athletes must be the highest prioritization for any organization working with or supporting young athletes. Seeing each individual athlete as a human being who needs to be addressed in the broader context of their humanity rather than solely for their prowess on the playing field must be the starting point for any stakeholder in youth sports.

3. Understand the pressures that student-athletes face

“We have to recognize that this group of young people is not experiencing life, culture, sport, school, or work the same way as past generations,” says Royer. “Everything is different, including the fact that they live in an entirely global society that is more transparent because of social media. We have to advocate for athletes differently because they are living in a different world now. And sport has to be different going forward, or it stands to lose the participation of all these young people.”

4. Understand the importance of youth sport accessibility

Given that sport is a potentially crucial protective factor in many young people’s lives, ensuring access becomes a key step in addressing mental wellbeing for our children. As youth sports have gotten progressively more privatized and expensive, communities and larger systems can play an important role in improving access to sport for all young people, regardless of income status. The report notes that creating partnerships between public and private sport organizations as well as sport governing bodies may be key in helping bridge the gaps in sports participation.

This is best done at a systemic level: On a small scale, a private club coach may connect with a high school coach to help student-athletes coordinate training and competing for two teams. But that doesn’t address the issues of pressure and access that are facing many more athletes within that same system.

5. Understand the individualism of each athlete

It’s easy to see youth sports as a singular mass. A baseball team, for example, may seem like a singular entity. But in reality, it’s a group of individual teens with entirely different life experiences and stressors. As a community stakeholder, understanding that each athlete has a different cultural context, a different family or financial situation, and a different set of thoughts and feelings is key. And regardless of the economics in the community, statistics indicate that young athletes are likely to be struggling with their mental wellness.

Sport can’t help these individual athletes build resilience and healthy tools for managing emotion if they continue to drop out at alarming rates. “The report supported the assertion that in an advantaged situation where families could afford the pay-to-play model, athletes are facing burnout and anxiety and leaving sport,” says Royer. “Conversely, athletes in challenging economic situations aren’t getting the opportunities to play because they can’t keep up with the financial demands of individual coaching, year-round instruction, or travel for competitions.”

6. Understand what’s needed in your community

The report points out that looking for unconventional solutions to difficult problems—like the ability to use a local community center or gym after hours for practice time or providing public funding for sport—can help begin to solve the overarching problem of accessibility to sport. If your area is economically diverse, this can be even tougher to reconcile, as some athletes will have access to private clubs and travel teams, while other athletes may be struggling to find a place to simply train or practice. Look for ways to bring communities together and pool resources. The more athletes we can keep engaged in sport, the greater our chances to support healthy development and growth.

7. Understand that support should come from multiple sources

Even if you believe that the area you’re in has a thriving, healthy youth sport community, there are always more ways that you can support athletes. Remember, each athlete has unique needs. And beyond the current young athletes already participating in sport, there is a huge percentage of the youth population who aren’t playing a sport because of various external and internal factors. “Athletes get their support from multiple sources,” says Coakley. “Support doesn’t only come from one place. It’s best if it comes from multiple places.”

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Takeaway

The overall health of a youth sport program is dependent upon organizations and communities taking responsibility and creating change. Most importantly, systems need to prioritize athlete wellness alongside performance, find ways to support access to sport, and recognize the individual needs of athletes.

* Note: We’re using ‘organization’ and ‘community’ interchangeably here and are simply referring to any larger-scale group that has a stake in youth sport and the general health and wellbeing of children.

With this in mind, how can you best support their mental wellness while helping them grow as people and athletes? Here, one of the authors of a recent recommendations report on mental wellness in youth sport—longtime sports sociologist Jay Coakley, PhD—is helping break down the tangible ways that caregivers and coaches can support athletes.

1. Humanity over athleticism

The title of the report is “Humanizing Sport,” speaking to the fact that taking care of young people needs to be the top goal for coaches and caregivers. Adults often struggle to remember that young athletes are under immense amounts of pressure while still developing the life skills and resilience necessary to cope with that pressure. It’s important to understand that the situations a young person is dealing with are valid and important, even if as an adult, you can look back and see how minor those problems are in retrospect. For example, an athlete fighting with a teammate may seem minor, but for that athlete, it can take a huge mental toll.

As a coach, it’s also easy to see a team of athletes as one singular mass—’the team’—but Coakley urges coaches to remember that each team member is their own individual with a different set of skills and struggles. For family members too, it’s easy to focus on a young athlete’s talent on the field rather than prioritizing their happiness on that field.

2. Relieve pressure

Even without meaning to, caregivers and coaches can add huge amounts of pressure for athletes. “For example, sports are often expensive these days, which is a source of pressure for a child who knows that parents are using discretionary money for their sport participation, and because of that, they feel trapped,” says Coakley. Mentioning things like the price of sport or the need for an athletic scholarship can put an unhealthy burden on your young athlete.

Coaches often create similar pressures for the team or for certain players by setting outcome-specific goals like winning certain games and placing more emphasis on wins than progress. Coaches and caregivers who limit unnecessary triggers for stress and pressure, while seeking opportunities to develop athlete resilience, create an optimal environment to support student-athlete mental wellbeing.

3. Take mental health as seriously as physical health

Often in youth sport, mental health is an afterthought, if it comes up at all. But Coakley says that mental health is potentially more important than physical health for young athletes. “Unfortunately, within sport culture, it used to be defined as a weakness if you had a mental health problem,” he says. “It’s hard to change that culture, but that’s our goal.”

To start, have open conversations with athletes about mental health, let them know that they can come to you if they’re experiencing any distress, and focus on mental wellness alongside physical wellness on the team. You can do goal-setting exercises throughout the season, make sure athletes and their families understand your open-door policy, and host weekly check-ins with the team to tackle any issues that have come up.

4. Have regular one-on-ones with athletes

Whether you’re a caregiver or a coach, having individual conversations with your athlete on a regular basis is an important part of monitoring their mental wellness. “Good coaches have weekly one-on-one conversations with their athletes,” says Coakley. “They might be short conversations, but these quick talks let the athletes know that the coach cares about them and helps coaches catch any potential issues early.” In alignment with athlete safety best practices, be sure these conversations are always observable and interruptible.

The same is true for parents and guardians: Make sure you’re having at least one check-in with your athlete each week, even if it’s just for 10 minutes. Intentionally creating time to connect with your athlete leaves room for them to share anything they may be struggling to process or move through on their own.

5. Don’t be afraid to refer out

Many of the recommendations in the report center around seeking appropriate help and guidance from other professionals. While coaches may feel as though they need to be the therapist, nutritionist, physical therapist, and sleep specialist, it’s important to remember that wearing all of those hats isn’t actually in the best interest of you nor your athletes. It’s simply overburdening you and keeping your athletes from getting the professional care that they need. Instead, build relationships with experts who are qualified in these different areas and try to make them readily available for your athletes. If financial means are a concern, Coakley suggests reaching out to local universities and seeking out students looking for internships in the fields of physiotherapy, sports dietetics, or psychology. Consider the sport administrators in your particular system as a great ally in this effort. Seek their guidance and support to identify appropriate resources to supplement the important work you’re doing as a caregiver or coach.

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Takeaway

Serving young athletes means taking care of their mental wellbeing as well as their physical health. This begins with seeing athletes as whole humans, rather than viewing them as one team, or as individuals who are only defined by their athletic achievements. For coaches and caregivers who interact closely with athletes, this should include regular check-ins and open conversations about mental health. It should also include seeking expert help when needed, rather than trying to do everything yourself.

Here, TrueSport Expert Nadia Kyba, MSW, President of Now What Facilitation, explains how coaches and caregivers can work together to prevent a workaholic culture from infecting youth sports.

Understand the pressure athletes face on all fronts

As parents, coaches, and caregivers, it’s easy to look at young athletes and feel as though they live an unburdened existence. But between school, sports, work, relationships, friendships, and the growing pressures presented by social media, young people are subject to huge amounts of pressure, says Kyba. To you, as an adult with bills to pay and many demands on your time, it may not seem like your athlete should be struggling to do it all. However, your athlete doesn’t have the same experiences as you, and for them, this point in time is the busiest and most pressured they’ve ever been.

Stop promoting a ’no pain, no gain’ mentality

Hard work is good—but it’s easy for hard work to turn into overwork. Unfortunately, as adults, we tend to either ignore athletes who are overworking, or worse, we praise their efforts, says Kyba. Rather than praising an athlete for showing up to practice despite pulling an all-nighter to study for a final exam after a late shift at the restaurant where they work, consider giving that athlete a pass to catch up on sleep. We live in a culture that touts the idea of “going above and beyond,” but an athlete who’s already at risk of injury or illness due to fatigue shouldn’t be pushing harder, they should be taking care of their physical health.

Understand how workaholism applies to youth sports

While you can’t control the amount of homework or after-school work an athlete has, you can control the environment you’re creating for them in terms of sport. Kyba has noticed two big issues on this front. One issue is the number of tournaments now taking place over holidays, on weekends, and throughout the summer. There’s also a growing pressure for young athletes to be in a single sport all the time. That leaves no time for multi-sport play, other school activities, and of course, even unstructured time with friends.

More Guidance for Coaches

Set boundaries at the beginning of the season

“At the beginning of the season, it’s important for coaches to talk to the kids and parents before they start registering them into tournaments,” says Kyba. “Find out what’s important to them: Maybe a tournament over Labor Day weekend works well for everyone, but Thanksgiving is off limits for many families. You’ll have to negotiate and compromise, since not everyone will have the exact same preferences, but try to take all the athletes’ needs into account.”

Kyba notes that it’s particularly important for coaches to not just consider Christian holidays, but to respect the range of religious and cultural traditions that athletes on the team may observe.

Don’t reward athletes for workaholic tendencies

We often praise those who “go the extra mile.” But in youth sport, pay close attention to an athlete who’s consistently going above and beyond—doing an extra weight room session, literally running the extra mile, and pushing beyond their capabilities to the point where they’re at risk of injury or exhaustion. It’s your job as the coach to pull them back, not urge them on. Even if they’re getting results in the short term, that kind of attitude and effort isn’t sustainable in the long term.

Don’t penalize athletes for cultural or religious observances

It should go without saying, but an athlete who’s observing a religious or cultural holiday or tradition should never be penalized for it. “For example, for some athletes, observing the Sabbath or fasting during Ramadan is a very important part of their religion,” says Kyba. “In your eyes, this may interfere with practice or competition, but you should never make an athlete feel guilty for their religious or cultural choices.”

More Guidance for Caregivers

Listen to your athlete

As Kyba noted earlier, it’s easy as a parent to roll your eyes when an athlete says that they’re feeling stressed out or exhausted. But take your athlete’s feelings seriously, and respect and validate those feelings. If an athlete seems as though they’re struggling to do everything, try to help them prioritize and potentially even trim out some of the activities and extracurriculars that are causing stress. This may even involve a discussion with a coach about cutting down the number of practices your athlete attends, even if it’s just for a couple of weeks.

Help create boundaries for your athlete

As a caregiver, you do have the ability to affect change on the team. If the coach is considering adding a tournament over Thanksgiving weekend or Christmas week, the parents of the athletes can create boundaries that protect their athletes from overwork and allow them to have vacations and time away from competition. While you do want your athlete to be able to advocate for themselves, sometimes you do still need to step in.

Watch your language around work and sport

Athletes face such high pressure in school and sport, and parents can unknowingly add to it with casual observations about athletic or academic scholarships. More often than not, Kyba says, your child is already aware that they may need a scholarship in order to afford a university education—constantly bringing it up, even in a seemingly positive way, can contribute to an athlete developing workaholic tendencies.

Help your athlete understand your family values

“Often, workaholic culture clashes with an individual’s values,” Kyba says. “If you and your athlete value spending time with family and friends, you need to help your athlete respect those values. Often, workaholic cultures lead to putting all your energy into just one aspect of your life, which jeopardizes other core values. You need to help your athlete find balance.”

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Takeaway

Workaholic culture has seeped into youth sport and young athletes who are subjected to a  workaholic environment in school or sport are at higher risk for burnout, injury, illness, and mental health issues. Coaches and caregivers need to work together to ensure that athletes are training and competing in a team culture that values hard work, but not workaholism.

That’s why the U.S. Anti-Doping Agency and TrueSport began hosting an annual mental wellness conference in 2021. The first iteration focused broadly on youth athletes and the 2022 conference addressed the specific challenges facing student-athletes. In 2023, however, TrueSport has expanded the focus of the symposium to further address the larger sport landscape that athletes are operating in and the need for collaborative solutions.

Dr. Jennifer Royer, Senior Director of TrueSport and Awareness at USADA and TrueSport, explains, “We’ve focused narrowly on athlete mental wellness in the past. But we’re leaning into the idea that there must be an intentional system in place in order to best support athletes. If we don’t have healthy systems, we don’t have healthy participants. We need coaches, trainers, schools, and communities to be proactive and evolving around this topic. In order for athletes to learn resiliency, self-confidence and self-advocacy, we need the people around them to be able to teach those from experience. If we don’t make change at the systemic level, there’s no hope of supporting athletes correctly at the grass roots. Coaches, who have such an impact on young athletes’ experiences, deserve the support and training necessary to help them in these efforts.”

The focus on sport systems is the product of research TrueSport and mental health thought leaders, including lead researcher Jessica Kirby, PhD, began at the conference in 2022. The resulting recommendations report, “Humanizing Sport,” doesn’t focus on one specific mental wellness issue, but instead, looks at the challenge wholistically and proposes system-wide improvements.

Essentially the recommendation report argues that sport can act as a key protective factor in support of mental health. Additionally, it showed that student-athletes face two distinct problems that impede that benefit: For athletes in lower socio-economic situations, they were lacking in resources needed to engage in youth sport, thanks to the growth of ‘pay to play’ clubs and other expensive additions to youth sport. Then, for athletes in the middle and upper class who can afford those luxuries, burnout and overtraining became much more prevalent. It seems an obvious conclusion, but if athletes are not staying in sport, it can’t meet those young athletes’ needs and our opportunity to help stem the growing tide of youth mental health challenges is lost.

“But what I found encouraging is that the solution to both challenges is the same,” says Royer. “That gives us hope that there is a systemic approach that will work, one that allows us to address healthy, trusted adult relationships that make a difference for young people. We need an organizational culture that supports a process-oriented youth sport experience, communities that encourage participation, and student-athletes who learn to trust their intuition about what feels right for them.”

To be clear, this doesn’t mean getting rid of competitive sports or canceling club leagues and playoffs. “We’re not an organization making the case that healthy competition is a bad thing,” says Royer. “Competitiveness is a value we espouse and think is healthy, when done the right way. What shines through in this research is that a win-at-all-cost mentality is bad for everyone involved. That kind of performance-oriented culture doesn’t help anyone, and we’ve learned that it doesn’t even necessarily contribute to sustainable wins in a desirable sport culture.”

The research makes it clear that focusing on long-term whole athlete development actually leads to better performance, while a focus on winning at all costs may generate some early wins but will eventually lead to a team in crisis. “If we look at the long-term participation levels, having a process focus pays off,” says Royer. “That means making sure that we’re growth-oriented, that we’re creating a motivational culture, that we’re fostering healthy relationships, and that we’re watching out for the overall wellbeing of every athlete.”

Unfortunately, youth sport in the U.S. is arguably at a collective crisis point due to the focus on winning at all costs. The way to correct this, Royer and the researchers behind the paper believe, is to start by looking at athletes as humans first. “Recognizing that a young person is so much more than a singular identity as an athlete is critically important,” says Royer. “This concept helps the athlete—and those around them—establish some parameters around what feels productive and what doesn’t.”

This means athletes, coaches, families, schools, and communities need to focus on the athlete’s health first, and prioritize their safety, whether it’s safety from physical or emotional or mental injury. “It has to be OK for an athlete to ask for help, whether they’re struggling with an emotional situation or a sprained ankle,” says Royer. “It is just as vital to their growth and success long-term to address those social-emotional wellbeing issues as it is to recover from a physical injury.”

To be able to have these conversations means having a high level of trust with the adult in charge, though. And that’s where coaches play a vital role in improving youth sport. “Trusted adults are in positions of authority, and they are decision makers in this sport space,” says Royer. “They have to prioritize those healthy relationships, and develop their own toolkit of wellness practices, to help their athletes grow.” That’s why the 2023 mental health conference will focus on coaches and mental health.

Without these strong relationships and a commitment to the idea that the mental wellbeing of an athlete is as important as their physical wellbeing, youth sport will fail to live up to its full potential. Every individual has the ability to affect change on their team and in their community. But it starts with releasing the stigmas around mental health and prioritizing mental wellbeing as a pathway to a great sport experience that strives for success that far exceeds the narrow lens of competitive wins.

It can be daunting to think about overhauling youth sport from the ground up, but Royer believes it’s the only way to save it, to grow participation while also nurturing healthy athletes who stay in sport long after their time in developmental sport.

Here, TrueSport Expert Nadia Kyba, MSW, President of Now What Facilitation, explains what exactly communal care is, why we need it, and how to bring this idea to your team.

The Problem with Self-Care

In modern society, whether you’re reading magazines or scrolling TikTok, there’s a lot of discussion of self-care, ranging from seeking help from a licensed professional therapist to taking bubble baths to ease stress. But the issue with self-care, Kyba explains, is that it puts the burden of care on the people who are already struggling. To practice self-care pressures people to make themselves well—and it doesn’t always work. This is where the idea of communal care comes in.

What Is Communal Care?

Communal care is the shift from self-care to a community focus. Unlike self-care, where you’re expected to help yourself, and it’s your problem and responsibility to take care of yourself, communal care is based around asking for help and giving help when you can. “Communal care is a shift where people in your community—which can be your team—are committed to being there for one another, recognizing that sometimes people aren’t able to take care of themselves,” says Kyba. “It’s really about paying attention to how everyone on your team is doing, and figuring out what it is that they need to feel better.”

Communal Care Recognizes Privilege

To be in the position to practice self-care usually requires some level of privilege: It’s hard to make time for a bubble bath or to pay for a session with a therapist if your family is struggling financially and you’re working an after-school job in addition to playing a sport. Communal care is about each person recognizing their privilege, and acting accordingly. Communal care means asking how you can best serve your teammates. This may mean a more affluent teammate offering a ride to the teammate who’s usually left waiting for the bus after practice, or even accepting and acknowledging that teammates who are working after-school jobs may not be able to make every practice but shouldn’t be benched due to their circumstances.

Communal Care Starts with One Student

If your team seems disjointed and you don’t feel as though you’re practicing communal care right now, it only takes one teammate to start the process. There are two ways to begin creating a culture of communal care for your team: Offer help or ask for it.

Be Proactive and Be Curious

“Pay attention to what’s going on with your teammates,” says Kyba. “If there’s an issue going on in their family or in their community, pay attention to that. You don’t need to pry—just be open and listen. And if you think an athlete is going through a hard time, it’s okay to ask them, ‘What can I do to support you?’ The goal here is to offer help before they need to ask for it: The onus shouldn’t be on the person who’s struggling to ask for help. Ideally, their community is already offering it.”

Stand Up for Each Other

You may also consider how to use your privilege to help a teammate. For example, if you hear another team use a racial slur, rather than waiting for the target of the slur to complain, you can address it yourself knowing the negative impact it could have.

Ask For Help First

Often, a team isn’t practicing communal care because no one feels comfortable asking for help—even if everyone on the team would be happy to provide that help! And it is hard to ask for help, especially for someone who’s truly struggling. To make it easier for other teammates to ask for help, one of the best things that you can do is to find ways to ask for help yourself. “Once one person is okay asking for help, it becomes normal for the team,” says Kyba. “Even asking for help with little things can create a safe space where your teammates can now ask for what they need.”

Don’t Overcommit—Be Realistic

You shouldn’t be the only person on the team who’s helping everyone else. Reading this article, it’s easy to see how some athletes would fall into the trap of focusing so much on communal care that they end up overextended and drained. But how do you practice communal care while still preserving your own mental wellness? It’s important to remember that taking on the emotional burdens of others doesn’t help them, or you. The key is trying to find practical ways to offer help and support—without losing yourself in the process.

If you offer to drive someone home every day of the week for the whole season versus having everyone with a car on the team picking a day to drive your teammate home, you’re not only potentially overcommitting yourself, you’re denying the team the opportunity to join in the communal care.

Offer Options Rather Than Asking

It’s tempting to ask a teammate who’s struggling, ‘Do you need help?’ The problem with that well-intentioned question is that it’s too easy for your teammate to simply say no out of fear. Instead, ask, ‘How can I help?’ Whenever possible, Kyba recommends offering specific ways that you can help, whether it’s bringing extra food for a teammate for race day breakfast, offering a ride home from practice, or suggesting doing some extra practice together to work on their jump shot. Offering specifics takes the onus off the person who’s struggling and makes it easier for them to accept the help, says Kyba.

Helping Others Helps You

Communal care is actually a great form of self-care! Research has shown that when you help others, your mental state improves as a result. “If you’re thinking, ‘I don’t have time to help this person, it’s going to cut into my self-care time,’ that’s just not true,” says Kyba. Of course you need to make time for yourself and do what makes you feel good. But often, helping others is going to make you feel better than any traditional method of self-care.

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Takeaway

Communal care ensures that people who are struggling have the support they need without having to ask for help or feel like a burden. Research also shows that helping others is actually great for your own mental wellness!

“If an athlete is optimal physically, that is going to enable them to optimize their mental health as well,” says Michele LaBotz, TrueSport Expert and sports medicine physician. “If they’re sick, injured, or otherwise not well physically, then mental health often suffers too.”

Here, LaBotz shares five ways physical health issues can give rise to struggles with mental health for athletes.

1. Injury

“When you’re injured, the risk for depression or anxiety is higher,” says LaBotz. “Being physically well isn’t just the absence of illness, it’s being able to pursue those things that enhance your overall well-being. Activities that enhance physical health, like exercise and good nutrition, generally benefit mental health as well.”  Athletes with injuries that prevent them from participating in sport and/or conditioning activities place them at risk for mental or emotional difficulty.   LaBotz states, “Most athletes will have some degree of sadness after injury, but for some athletes an injury can precipitate more severe mental or emotional effects, including depression, anxiety and a loss of self-confidence.” LaBotz has even seen athletes experience post-traumatic stress disorder (PTSD) after injuries like ACL tears or severe concussions that can make it hard for them to return to sport.

Mitigate it: Keep an open line of communication with athletes and their families, and “check in” with how athletes are coping with their injury. Encourage athletes to stick with their rehabilitation plan. Many athletes benefit from staying engaged with team activity and should be encouraged to check with their health care provider for any exercise or conditioning they can do during the recovery period. If you suspect an athlete is dealing with a more serious issue like PTSD or depression, encourage them to seek professional help.

2. Illness

“We know that depression and anxiety are eased by spending time in nature and with exercise,” LaBotz says. “Illness often takes away those capabilities temporarily.” Whether your athlete is dealing with a long-term illness like mononucleosis or long COVID, or a short-term illness like a severe stomach bug or flu, it can have an impact on their mental well-being. Short-term illnesses are less likely to be an issue, but if an athlete is out for weeks or months with something more chronic, they’re at higher risk for depression or anxiety.

Mitigate it: Even if an athlete is ill and can’t take part in practice, they can still likely enjoy nature to some extent—and even images of nature have been found to be beneficial for mental well-being. Urge athletes, especially those with more long-term illness, to find ways to get outside and develop a conditioning plan that is doctor-approved and feels good for them.

3. Underfueling

It’s a cliche, but we do know that hunger can lead to stress and anger. Anyone who’s been on the team bus with hungry teen athletes can attest to this. Research has found that chronic underfueling in and around workouts can lead to ‘increased emotional distress due to hunger, fatigue, and stress related to following an energy-restricted diet.’ And when done for intentional weight loss and body image-based reasons, underfueling may be an indicator of disordered eating patterns or even a more severe eating disorder.

Mitigate it: If you suspect an athlete’s mental well-being is suffering due to underfueling, whether intentionally or unintentionally, ensure that they have access to the help and information that they need. A registered dietitian and/or a counselor or mental health expert can help an athlete work through potential food-related issues and make a plan that optimizes physical health and energy.

4. Overtraining

As LaBotz points out, overtraining can lead to an increase in the stress hormone cortisol, which can have adverse effects on mental health as well as physical health. “When athletes “overtrain” for brief periods, they will often feel fatigued but can recover quite quickly after backing off,” LaBotz says, but warns that “when overtraining persists for longer periods athletes can develop a true ‘overtraining syndrome’ which can lead to all sorts of emotional and psychological symptoms.”  Research has found that overtraining syndrome can lead to various mental health side effects, including fatigue, depression, low motivation, insomnia, irritability, and agitation.

Mitigate it: Recovery from overtraining syndrome can take many months, so prevention is the best strategy.  As a coach, you may not be able to dictate exactly how much an athlete trains on their own, but you can make sure that your athletes have a rough understanding of what an ideal week of training should look like for them. Particularly during periods of high intensity training, focus on the importance of high-quality recovery.  For athletes in multiple sports and activities, or those who are balancing school, sport, and work, help them optimize their training in a way that prioritizes a balanced lifestyle to prevent burnout.

5. Concussions

When an athlete sustains a head injury that causes a concussion, they are at a much higher risk of developing a mental disorder. In fact, a recent study found that one in five people who sustained even a mild head injury would develop a disorder like depression, anxiety, or PTSD.

LaBotz states, “There is a tight link between long-term concussion symptoms and anxiety and depression, and it’s important for coaches and families to be aware of that.”

Mitigate it: First, start by ensuring that if an athlete sustains any head injury during competition or practice, concussion protocols are observed, even if the athlete has no immediate symptoms. If an athlete does have a concussion, follow the most up-to-date concussion protocols around return to play, and ensure that your athlete has access to help if they do notice signs and symptoms of a more serious mental or physical issue stemming from the injury.

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Takeaway

Mental and physical health are interrelated and each one affects the other. If an athlete is dealing with a physical health problem stemming from illness, injury, concussion, overtraining or under-fueling, coaches and caregivers should be on the lookout for signs of mental health issues like depression, anxiety, disordered eating, and even PTSD, and should have a low threshold for seeking professional assistance when symptoms are persistent or creating significant issues for the athlete. And, while physical health impacts mental health, the reverse is also true: concerns related to an athlete’s mental health may be the underpinning behind physical symptoms or difficulty with performance during training or competition.

TrueSport Expert Charron Sumler, LPCC, is the Athletic Counselor for Ohio State University, where she helps athletes better understand the connection between sleep and mental wellbeing. Here, she shares a few tips and tools to help coaches better understand the challenges faced by athletes and pave the way to better sleep, better mental health, and better performance on the field.

WHY ATHLETES SHOULD PRIORITIZE SLEEP

Understand the Role Sleep Plays for Performance

“You simply cannot talk about mental health without talking about sleep,” says Sumler. “When you look at all of the strategies that are marketed towards athletes to boost preparation and recovery, none of them are as effective or as important as simply getting enough sleep.”

In fact, one study found that basketball players who were getting six hours of sleep or less per night had 30 percent lower levels of concentration than those who got the recommended amount. Research has also shown that physical performance from players who weren’t sleeping enough dropped by roughly a third, including time to exhaustion. Additionally, the risk of injury increased: Over a single season, athletes in that study were 80 percent more likely to be injured. Finally, insufficient sleep has been linked to decreased focus and concentration while playing.

Understand the Role Sleep Plays for Mental Health

It can be easy to explain the performance benefits of sleep to your athletes, but the mental health piece is just as important, especially for young athletes who deal with high stress levels on and off the playing field.

“I don’t think there’s a single mental health disorder that doesn’t affect sleep or is not affected by sleep,” says Sumler. “But even beyond mental health disorders, your ability to manage your emotions is decreased when you aren’t sleeping enough. So is your perception of how difficult things are. A workout that was fine yesterday can suddenly seem impossible to finish after a night of poor or inadequate sleep. And those kinds of mental blocks start to increase more with more sleep deprivation.”

Understand What “Enough Sleep” Means for Adolescents

It may come as a surprise, but teens and young adults often require more than the 7-9 hours that are recommended for adults. Young athletes in particular need more sleep to allow their bodies time to fully recover.

“Often, I hear from college athletes who think six hours of sleep is adequate, because they’ve heard that 6-8 hours of sleep is ‘normal,’” says Sumler. “Athletes think they’re in the safe zone with that amount of sleep, but that’s actually sleep deprivation.”

Ideally, athletes should be getting 9-9.5 hours of sleep every night, according to Johns Hopkins Medicine.

HOW TO PRIORITIZE SLEEP

Start with Improving Total Time in Bed

Most athletes and students assume that time in bed is the same as time spent sleeping.

“Unfortunately, if an athlete was in bed for eight hours, that doesn’t mean they were sleeping for eight hours,” Sumler says. “To sleep for eight hours, most people need to be in bed for around 10 hours.”

Simply understanding that reality can change when an athlete starts to wind down for the evening. If they’re planning to sleep from 10 p.m. to 7 a.m. to get the full nine hours of sleep, they may actually need to get into bed around 9 p.m.

Ask Athletes to Track Their Sleep

What gets measured gets managed. But most athletes do not think much about their sleeping habits. They are aware that sleep is good but rarely record when they went to bed, when they woke up, how refreshed they feel, or any specific sleep notes. Encourage your athletes to start keeping track. There are free apps available to track sleep; Sumler recommends Sleep Cycle, a free app that monitors movement through your phone, but a fitness tracker or smart watch will often include a sleep function as well.

“These apps and devices help give athletes a sense of how well they’re really sleeping,” Sumler says. “At minimum, recommend that athletes use a notebook to write down when they went to sleep, when they woke up, and how they felt in the morning.” Athletes can also use TrueSport’s Road Map to Clean & Healthy Performance to track nutrition, hydration, and sleep habits.

Recommend Napping

Napping is often considered to be something that only very young and very old people need, but the truth is, we can all benefit from naps sometimes! Sumler is a fan of using naps to augment sleep, though not replacing time spent in bed at night.

“Napping won’t make up for only getting six hours of sleep at night, but it can be extremely helpful,” she adds. “I like to suggest athletes get eight hours of sleep and take a 90-minute nap in the afternoon if possible.”

If there isn’t time for a nap, a short meditation can help boost a person’s mood to counter the irritability of sleep deprivation. Meditation can help lower blood pressure and stress levels, providing a sense of calm that improves focus, which can be difficult when sleepy.

Recommend Creating a Nighttime Routine

Rituals and routines are great for helping athletes prepare for a restful night of sleep and can lead to higher quality sleep with an optimized environment. Decreasing caffeine intake starting in the early afternoon, shutting the schoolbooks and laptops well before lights out, and decreasing stressful moments in the evening can all help make getting to sleep easier.

“I love a mindfulness practice before bed for athletes,” says Sumler. “Something like a progressive muscle relaxation activity can be really helpful, and I’ve found athletes tend to respond really well to it.”

Having these routines in place at home is ideal, but make sure they can be used on the road as well, since athletes are often traveling for matches and meets.

Recommend Making the Environment Sleep-Friendly

Cool, dark, and quiet are the top three recommendations sleep experts make when it comes to setting up for a great night of rest. The ideal room temperature is 66-69 degrees Fahrenheit, and the less light and sound, the better. In a shared room or while traveling, this could look like using ear plugs and an eye mask, while an athlete with their own room may have blackout blinds on the windows and a white noise machine to block out sound.

How Little Sleep is Too Little?

Athletes should feel comfortable coming to you for help with sleep if they are concerned.

“As soon as there’s a sleep concern, an athlete should be talking about it with their coach, caregiver, or another trusted adult,” says Sumler. “We can work to identify the issues and modify their environment to prevent a more severe case of insomnia from occurring. We don’t want to wait for it to become a severe problem, so I encourage athletes to talk to ask for help if they struggle to sleep more than three nights in a row.”

Coaches Need to Take Care of Themselves Too!

“I’ve noticed that coaches’ sleep also tends to be extremely deprived,” Sumler concludes. “There is so much focus placed on coaches being better and more compassionate. But if they aren’t sleeping well, it’s going to be really hard for them to have the emotional agility needed to respond compassionately or check in with athletes. So, this advice applies to coaches as well as athletes!”

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Takeaway
Sleep is one of the most useful and underutilized tools in an athlete’s toolbox, but athletes are rarely encouraged to focus on sleep hygiene. Athletes should be sleeping 9-9.5 hours per night, and doing so will help young athletes perform better, and more importantly, significantly improve their mental well-being.

“Athletic trainers have such a strong influence on the athletes they work with,” says Dr. Michele LaBotz, TrueSport Expert and sports medicine physician. “And teaching athletes the importance of recovery is one of the most valuable things an athletic trainer can do. Athletes already know the importance of training hard. But they also need to pay attention to their recovery.  If you’re going to train at high intensity, then you have to recover ‘like you mean it.’”

So, what exactly does that look like? ATs can support recovery by helping athletes understand the importance of sleep, how to dial in nutrition, and how to reduce stress and strain, both physically and mentally.

Sleep Duration Matters

When it comes to sleep, it’s hard to overdo it for young athletes.  In fact, athletes between 13-18 years old need 8-10 hours of sleep per night, and athletes 12 and under need 9-12 hours. Recent evidence shows that these recommendations are not only important for health, but for athletic performance and injury prevention as well. This means actual sleep (not just time in bed) and the amount required for young athletes is higher than the 7-9 hours of sleep recommended for adults. For busy student-athletes balancing full school, sport, and social schedules, getting that amount of sleep can be incredibly difficult.

Research has shown that nearly 70 percent of adolescents get under seven hours of sleep, and LaBotz thinks the number is likely even higher than that, especially for busy athletes. “Junior year is a real pressure cooker year for students, and it’s not uncommon for student-athletes to laugh and say, ‘How the heck do you expect me to be able to sleep 8-10 hours a night?’” says LaBotz. “Between schoolwork and practice, there aren’t enough hours in the day. But if performance is a priority, then sleep should be too.”

Acute loss of sleep from an all-nighter may leave students feeling drained, but chronic sleep deprivation is the bigger problem, says LaBotz. “You don’t feel tired when chronically sleep deprived, but that’s when injuries and illness are more likely to occur. Performance will also suffer. If an athlete is not getting enough sleep, extra time sleeping is going to be better than the equivalent amount of extra training.”

Dial in Sleep Hygiene

As an AT, you won’t be able to control how much an athlete sleeps, but you can counsel them and send recommendations home to help create an optimal sleep environment. Aim for cool, dark, and quiet in the bedroom, and keep that space as uncluttered as possible.

Recent research shows lower sleep time and quality when screens are in the bedroom. We know this is tough for teenagers, but if they take their sport seriously, it’s key! Encourage athletes to avoid too much screen time before bed and practice a nighttime routine that helps them wind down.

For athletes who are consistently “under-sleeping,” LaBotz often recommends that they set a sleep schedule by the clock rather than going by how they feel. “The first couple nights can be a little rough,” she says. “But if they can stick with it for a week or two, they often notice a big difference.”

Dial in Post-Practice Nutrition

While overall good nutrition is critically important to recovery, the biggest gains are made with the post-practice or post-game meal or snack. “The big gap in nutrition that I see most frequently is a lack of consistency and appropriate fuel intake, especially immediately following a training session,” LaBotz says.

After a hard or long effort, athletes require a combination of carbohydrates to replenish glycogen stores and protein to aid in the rebuilding of muscles. Often, LaBotz says that athletes are picking one or the other, rather than combining them. Endurance athletes tend to focus on carbohydrate intake, while those in strength-based sports often focus more on protein. In reality, the blend of the two is what makes for the best recovery fuel.

“Ideally, an athlete is getting some form of carbohydrate within 20 minutes of finishing a workout,” she explains. “This might even be a sports drink and some fruit while in the locker room or during the post-practice team meeting. It doesn’t have to be complicated. And then, ideally within an hour of practice, the athlete should have a full meal that contains a good balance of carbohydrates and protein.”

While a meal after practice sounds simple in theory, when games and practices run late in the evening, it can be hard to make time for a meal if an athlete isn’t getting home until 9 or 10 p.m. But even in that case, it’s important that your athlete is having a protein and carbohydrate-rich snack ahead of bedtime at minimum. Otherwise, they’re missing that valuable recovery window, and potentially negatively impacting their sleep by going to bed under-fueled. They’ll also head into practice the next day already low on fuel. If this is the case for your athlete, consider these simple snacks and easy meals for late night practices.

Find a Mindfulness Routine

While physical recovery is important, mental recovery is critical as well. TrueSport Expert Kevin Chapman, PhD, clinical psychologist and founder of The Kentucky Center for Anxiety and Related Disorders, is a fan of helping athletes find a mindfulness practice that works for them. “Doing some form of meditation is very important,” he says. He also recommends having a mental health professional or sports psychologist as part of your network if possible. While an athlete may not need to work with a mental health professional right now, as an AT, it’s helpful to have recommendations available if an athlete does begin to struggle with something in life or sport.

Recover on Recovery Days

Training leaves the body a bit broken down, and the biggest gains happen during recovery periods. “Beyond sleep, it’s important for ATs to emphasize that rest days are meant to be actual rest days,” says LaBotz. “Often, athletes have this idea that more is better, and think that recovery days should be used to work with a personal trainer or sneak in extra cardio, but athletes should spend 1-2 days per week away from structured sport training or competition.”

This can be especially tricky if you work with an athlete who is on multiple teams, either for the same sport (on a school and travel team) or in multiple sports. Often, those athletes won’t have recovery days because the overlapping schedules don’t leave any day empty. In that case, as an AT, your authority and advocacy may encourage coaches to find the best options for rest and recovery days for these athletes.

“It’s ideal if ATs are able to help an athlete avoid double practice sessions or weeks without rest days,” says LaBotz. For example, if an athlete is on a school soccer team and in a travel soccer program, they can likely skip one of the team’s strength training sessions each week. Most coaches actually prefer that athletes aren’t doubling up on practice, conditioning, and competition.

“It can be hard, but ATs have the relationships with the athletes, and the authority and expertise within their programs, that make them ideally suited to advocate for good recovery practices,” LaBotz adds. Sometimes, you’re the only person in an athlete’s life who has this overarching point of view, and you can make a big difference.

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Takeaway

As an AT, you’re in the unique position of ensuring that your athlete is recovering physically and mentally. This means taking time off during the week, getting plenty of high-quality sleep, and prioritizing the right nutrients after a workout or competition. It also means supporting an athlete’s mental wellness, whether that’s through meditation or access to mental health professionals.

Here, TrueSport Experts Kevin Chapman, PhD, clinical psychologist and founder of The Kentucky Center for Anxiety and Related Disorders, and Nadia Kyba, MSW, the President of Now What Facilitation, share a few important ways that coaches, athletic directors, and school administrators can help athletes navigate traumatic times and become better prepared for moments like these.

Understand what athletes face

Hamlin’s traumatic cardiac event had the nation focused on what caused his heart to stop, and what his road to recovery looks like. But there are traumatic injuries in sport happening constantly, and at every level of sport. According to the CDC, high school athletes account for an estimated two million injuries, 500,000 doctor visits, and 30,000 hospitalizations annually. Student-athletes are also under a tremendous amount of stress, which can be hard to acknowledge as a coach or administrator. As adults, we tend to forget that students have high levels of stress because we often look back at our teen years as feeling worry-free relative to the challenges we face as adults. But acknowledging that students are feeling stress even without a specific tragedy or trauma can help you better understand and guide your team through good and bad times.

Communicate as a team

“It’s so important for coaches to not push away tragedy and instead, talk about it openly,” says Chapman. “I think that it’s really important for coaches to explicitly set time aside to have in-depth conversations with their team about the tragedy, the transient nature of life, the importance of relationships, that kind of thing.” This doesn’t mean waiting for a tragedy to befall your own team: Coaches can look at a situation like Hamlin’s and use that to start the conversation. It’s likely that many students, especially the serious athletes, are looking at Hamlin’s cardiac arrest and feeling stress or anxiety about how something similar could happen to them—or are fans of Hamlin’s and are concerned about his welfare. “Having these conversations as a team acknowledges that when life happens, we as a team are going to come together as opposed to pushing things away and ignoring them,” Chapman adds. “When we can talk about these things, we all heal in healthy ways.”

Create an open door policy

You may not know about a tragedy or trauma that happens to an athlete on your team, but as a coach, you can have an open-door policy that makes it more comfortable for athletes to come to you when they do have a tragic event. “Adopt a team culture where talking about hard things, and talking about emotional experiences on and off the field, is normalized,” says Chapman. “That’s incredibly important to a team’s culture. I believe in a preventative mentality as opposed to what most coaches do, which is an intervention mentality. When it comes to tragedy, trauma, and emotional hardship, it’s necessary to have a healthy team culture where those conversations are welcomed. We want to be prepared for adversity, on and off the field.”

Encourage athletes to stay IRL, not on social media

“Especially at a youth level, encourage athletes to stay away from social media as much as possible,” says Chapman. “Tragedy and trauma are retweeted and reposted at a stunning rate now, and our society is obsessed with seeing things happen in real time, often at the expense of other people. Spending time online searching and scrolling can retraumatize many people and keep athletes emotionally dysregulated.” Some students will turn to social media to seek support and healing, but as a coach, you can help provide resources like a mental health professional to better help athletes deal with trauma.

Remember not every injury is visible

It’s easy to overlook the more ‘invisible’ injuries that can lead to trauma and tragedy, says Chapman. While Hamlin’s traumatic incident was impossible to miss, we’re also seeing thousands of athletes suffering from post-concussion symptoms because they aren’t outwardly showing signs of injury, or they appear to be recovered and return to play too early. Unfortunately, the aftermath of an injury like a concussion can be impossible to see but can impact an athlete for years afterwards. And despite the evolution of coaching best practices, the typical response of ‘no pain, no gain’ or ‘suck it up’ is still far too prevalent.

Instead, encourage athletes to be on the lookout for signs and symptoms of concussion-based symptoms, overtraining or chronic fatigue issues, or even more basic injuries like muscle tears and strains that may not be obvious to the naked eye. Helping athletes who are struggling with any type of ‘invisible injury’ feel seen, validated, and taken seriously is important as a coach or administrator.

Engage in community care over self-care

Telling athletes to take more time for self-care may not be entirely helpful. “We hear a lot about teaching athletes to focus on self-care, but community care is equally important, if not more so,” says Kyba. “There’s so much emphasis on self-care in the media, but that’s not always helpful for an individual who’s having a tough time coping with a situation but feels powerless to change anything in their lives. Self-care can be useful, but it also puts the responsibility of care on the athlete. Instead, it should be about the community coming together to support those who are in need. Telling an athlete to take a hot bath isn’t as helpful as bringing a therapist in to speak to the team about a tragedy that has impacted them.”

Have a plan

Ultimately, if you’re reading this article and thinking, ‘I don’t have any tragedies to worry about with my team,’ now is the optimal time to plan for how you will handle those tough moments. “Be prepared for when those situations arise—don’t wait for when trauma or tragedy happens,” says Kyba. “When things are going smoothly is the best time to think about how to support a team in times of trouble.”

“Each school will have to identify and determine what makes the most sense practically in a given situation,” says Chapman. “A tragedy at your school might lead to holding an assembly for a larger discussion and/or having smaller conversations within teams. But any of these conversations should, in my estimation, be done with a grief counselor or a mental health professional present along with coaches and administrators. Coaches should be working with administrators, psychologists, therapists, and trainers to create an action plan that you can easily put into place if the need arises.”

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Takeaway

Tragedy and trauma are, unfortunately, often part of the athletic experience. As a coach, administrator, or other sport official, you can help athletes navigate these difficult moments by creating a culture of openness and communication, and having an action plan and resources ready for when there is a need.