Training Model for Extended Career Athletes: A Narrative Review

Abstract

Context:

Today’s elite and professional sports tend to feature older, more seasoned athletes, who have longer sporting careers. As advancing age can potentially limit peak performance, balancing training load is necessary to maintain an optimal state of performance and extend their sports career.

Objective:

To describe an appropriate training model for extended career athletes.

Data Sources:

Medline (PubMed), SPORTDiscus, ScienceDirect, Web of Science, and Google Scholar.

Study Selection:

A search of the literature between January 1, 2015 and November 22, 2023 was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Study Design:

Narrative review.

Level of Evidence:

Level 4.

Data Extraction:

Data were extracted from studies related to the management of training and performance of athletes with extended and long careers.

Results:

A total of 21 articles related to extended careers were found. Key themes from these papers included: expertise, biological maturation, and specificity; epidemiology and health; athlete monitoring; strength training; load management and detraining; success management.

Conclusion:

A training model for extended career athletes should balance the deleterious effects of age with the athletes’ knowledge of, and expertise within, the sport. Designing specific training that accommodates previous injuries, training load intolerances, and caters for quality of life after retirement should be key considerations. Load management strategies for athletes with extended careers should include strength training adaptations to minimize pain, load-response monitoring, a broad range of movement, recovery and intensity activities, and the avoidance of large training load peaks and periods of inactivity.

Contemporary elite sport involves older athletes than several decades ago, as can be seen in the higher average age of the participants in the Olympic Games of Tokyo 2020 compared with those of Barcelona 1992, up from 25 to 27 years. The median age also increased by the same proportion, from 23 to 25 years. ⁸ Simultaneously, there exists a tendency for athletes to extend their careers in professional leagues to uncommon playing ages. To take some successful media figures as an example, American football player Tom Brady competed until he was 45 years old, while basketball player Pau Gasol and tennis player Roger Federer both continued playing until age 41 years. Soccer player Megan Rapinoe played until she was 38 years old. Diana Taurasi and Marcelinho Huertas still play competitive basketball in the Women’s National Basketball Association and Asociación de Clubs de Baloncesto, respectively, as does Mahendra Singh Dioni in Indian Premier League cricket: all 3 are 41 years old. At 38, Lebron James still plays in the National Basketball Association, the same age as Jonathan Sexton who played in the Rugby World Cup 2023 with the Irish national team. These ages might be deemed inconsistent with the demands generally related to athletic performance and professional sport, particularly as these sports also require well-developed physical qualities such as strength and speed. Many of these sports also entail a heavy joint load, or involve contact and collision loads. In this specific context, athlete performance peaks may be conditioned by age and injury risk,^1,21 which may then limit their availability and career development.^7,15

The professionalization of sport involves 2 facts that may explain the opportunity to extend sport careers. From a commercial viewpoint, ⁴¹ large financial rewards can further motivate athletes to extend their careers with a view to increasing these earnings, especially if they are part of a successful sporting term, which naturally leads to greater economic benefits. This professionalization also permits these athletes to employ specialists with expert knowledge to develop a well-rounded training, recovery, and nutrition program. This is where sport sciences can contribute to improving performance, ¹⁶ by optimizing training and recovery.^16,27 Today’s elite and professional sport tends to feature older, more experienced athletes, with longer sports careers despite the potential for age to limit their ability to sustain peak condition. ⁴⁰ In these cases, it is necessary to determine the specific needs of an athlete so as to enhance their performance,^3,10,24 irrespective of their age and the workload they have accumulated across their career. ²⁴ Extending an athletes’ sporting career requires careful workload management to ensure they can compete at a high level and contribute effectively to the team. Thus, the aim of this literature review is to define an appropriate training model for extended career athletes.

Methods

Information Sources

A search of the literature between January 1, 2015 and November 22, 2023 was performed using the following online databases: Medline (PubMed), SPORTDiscus, ScienceDirect, Web of Science, and Google Scholar. The following keywords were used: extended careers, long-term careers, athletes, peak performance, injury, epidemiology, strength, neuromuscular training, range of motion, training load, and load management together with Boolean operators such as “AND” and “OR.” The literature review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. ³⁰ Due to the methodological heterogeneity of the studies included, a descriptive approach has been adopted in the research synthesis. ³³

Inclusion Criteria for the Study

The titles and abstracts of all the articles were analyzed to determine the relevance of the publications for inclusion. Selection criteria for the articles were followed. The complete text of the publication was obtained to determine whether it met the criteria for inclusion. In addition, the bibliographies of the selected articles were analyzed to find other relevant articles. Finally, for this review, only those studies focused on the management of training and performance of athletes with extended and long careers were included. Therefore, those articles relating to training load such as peak performance, epidemiology, strength, neuromuscular training, and range of motion were included.

Exclusion Criteria

Studies involving young or master (defined as highly active [nonprofessional] athletes from 40 years old) athletes ⁴⁴ were excluded. Also excluded were those articles related to dual career (athletic career developed simultaneously in the elite sports sphere and in another academic or workplace sphere) ⁴⁵ or those not addressing training or performance. Finally, studies that did not provide a longitudinal view of the injury epidemiology were also excluded. Duplicate articles, conference abstracts, nonpeer-reviewed works and book chapters were also excluded. As a first step, the titles, abstracts, and keywords screening of the literature was carried out by the author. In the second step, full-text articles of the relevant studies were screened, and in the third step the reference lists of the suitable articles and the review articles on the management of training and performance of athletes with extended careers were searched for additional articles.

Results

The initial search of the literature detected 328 articles about long extended career athletes. Of these, 283 were excluded for being duplicated or failing to fulfill the inclusion criteria, or both. In a second step, 17 were excluded for being unrelated to the training model, and 10 for involving other exclusion criteria (Figure 1). A total of 21 studies were included, of which 4 were identified by citation searching (Table 1).

Figure 1.

Identification of studies via databases and registers.

Table 1.

Characteristics of selected studies

Year	Authors	Main Findings	Extended Career Training Model Concept	Method of Identification
2023	Zentgraf and Raab 46	Motivation and interests are linked indirectly to expertise—that is, both seem to operate on expertise via deliberate practice and neural mechanisms. Sport expertise are advised to acknowledge the holistic pattern of expertise, and this should ensure that scientists team up to address interactions on multidisciplinary basis. Sport-specific requirements of tasks have an impact on the selection of and training effects in athletes.	Expertise, biological maturation, and specificity Success management	Database
2023	Rey et al 34	Athletes’ physical competition performance reduces with increasing age. Such findings may have a great deal of practical implications to assist in decisions regarding player management. It is recommended that fitness coaches consider the players’ age and specific role when analyzing related physical performance to observe possible weak and strong points. Considering that the observed age-related physical performance impairments probably cannot be avoided, coaches and athletes can also benefit from monitoring because it can help them develop age-tailored training programs that focus specific capabilities	Expertise, biological maturation, and specificity Athlete monitoring	Database
2023	Hristovski et al 20	Aging is manifested by: the longer the fitness evolves (ie, ages) under a certain sequence of specific exercise stimuli; and the longer the fitness variables evolve, the longer the achieved fitness effects last after their cessation. By increasing specificity, the previously aged acquired adaptations stay stable. Detraining effects of aging are measured starting from the highest fitness value achieved from specificity	Expertise, biological maturation, and specificity Load management and detraining	Database
2022	Caparrós et al 7	Strength parameters, injury rate, and performance outcomes can be independent of strength training programs. Performance data and should be integrated in the workload monitoring process, with the aim to optimize training and individual availability. This process is longitudinal, and it is the responsibility of staff to involve players and front office in it	Epidemiology and health athlete monitoring Strength training	Citation searching
2022	Vretaros 43	The career length of male players is longer than of female players on 3 continents. At retirement age, in North America, female players have shown to have higher values compared with male players. Psychological and physical aspects directly influence career longevity in basketball. Thus, it would be necessary to maintain a balance in the players’ global health status to obtain positive benefits that impact their career longevity	Expertise, biological maturation, and specificity Epidemiology and health	Database
2022	Vieira et al 42	The losses of strength, agility, balance, and functionality caused by aging are harmful to the elderly population. Resistance training may be an efficient tool to mitigate such neuromuscular decline, but different methods as high-speed training can be used	Strength training	Database
2022	Rey et al 35	Elite soccer players with long-term careers were unable to maintain their match-related physical performance as they got older. However, players can annually improve their technical-tactical skills with increasing age as a possible compensation mechanism against physical performance declines related to aging	Expertise, biological maturation, and specificity	Database
2021	Gouttebarge and Kerkhoffs 18	While longitudinal evidence about any causal relationship is lacking, the relationship between sports career-related health symptoms in former elite athletes, warrants the development of support measures for elite athletes, transitioning out of sport with the aim to improve their quality of life	Epidemiology and health	Database
2020	Balogh and Trzaskoma-Bicsérdy 2	Although individual characteristics and skills should ought not to be ignored when judging a coach’s abilities, being cognizant of potential strengths and attitudes of the different age groups of coaches can help to improve sports’ environments for athletes and coaches alike	Expertise, biological maturation, and specificity Load management and detraining	Database
2020	Khalil et al 22	NBA players returned to play after severe tendon injuries, had shorter careers compared with uninjured ones. Players returning from tendon repairs had decreased game utilization and performance at all time points relative to their individual preindex baseline. However, for the injured players when compared with controls, game utilization but not performance was found to be decreased at 3-year follow-up	Expertise, biological maturation, and specificity Epidemiology and health	Database
2020	Bargoria et al 4	Elite runners’ main strategy to stay well and sustain their superiority in performance was characterized by constantly paying attention to symptoms of ill health, listening to medical advice, and not letting environmental strain interfere with adjustment of sports load	Expertise, biological maturation, and specificity Epidemiology and health Athlete monitoring Load management and detraining Success management	Database
2020	Esopenko et al 11	Participation in sport is associated with numerous physical and psychological health benefits, but also can have negative consequences, such as career ending injuries, which may have long-term effects on mental health. Recent research suggests that involuntary retirement, due to injury, illness, or being cut from a sport, can be particularly detrimental, as such the impact athletic retirement has on the psychological well-being of athletes	Success management	Database
2019	Huebner and Perperoglou 21	Performance increases and age at peak performances. The performance development varied by discipline and can be attributed to physical growth and learning highly technical skills. Athletes may discontinue training at competitive levels due to various reasons. Socioeconomic factors and availability of public support differ between countries. This impacts athlete development and athlete career termination	Expertise, biological maturation, and specificity Strength training	Database
2019	Lindanger et al 25	The study illustrates the importance of long-term evaluations in the risk assessment after anterior cruciate ligament reconstruction, as a significant number of subsequent injuries occur later than the routine follow-up. Knowledge of the rate of return to sports, length of sports participation, and the consequences to either knee from a long-term perspective is important and should be included when clinicians assist athletes in forming realistic expectations performance and injury risk expectations	Epidemiology and health Load management and detraining	Database
2019	Sousa et al 37	It seems evident that aerobic training with different intensities positively influences the performance of young adults. Furthermore, short-term training cessation (2-4 weeks) compromises the training-induced gains. The few studies revealed greater strength and neuromuscular performance gains when the aerobic training program combined high-intensity resistance training with low intensity aerobic training, and an interference effect seemed to exist for higher aerobic exercise intensities. Higher aerobic exercise intensities should be used to improve cardiorespiratory fitness, but improvements in strength could be compromised. The polarized model may be better at reducing interference in neuromuscular performance	Load management and detraining Strength training	Database
2019	Palmer et al 31	Almost two-thirds of the 3357 Olympians who completed a specific survey, reported ≥1 Olympic-career significant injury. The knee, lumbar spine, and shoulder/clavicle were the most commonly injured anatomical locations. One-third of this sample of Olympians attributed current pain and functional limitations to Olympic-career injury	Epidemiology and health	Database
2019	Richardson and McKenna 36	To meet the psychological, physical, and social demands of a professional sporting career can provide a platform to enhance long-term career sustainability. Moreover, the resources available to professional athletes that support careers in professional sport can also be leveraged for longer term career sustainability in other domains like discipline, education, public recognition, and expectations. These resources have transferability to other career domains in the next career stage. High earning capacity during the short-term sporting career can be used as a platform for future career sustainability	Success management	Database
2016	Longo et al 26	The ages of peak performance cover a wide range at the Olympic level. On average, male athletes reach the highest levels of performance at a more advanced age than female athletes. As a general trend for both sexes, the disciplines involving very specific technical skills include the youngest athletes. On the other hand, the oldest athletes are found mostly in sports requiring higher levels of tactical skills	Expertise, biological maturation, and specificity	Database
2016	Nikolaidis et al 29	Different patterns of age trends and sexes should be considered by coaches and trainers in the evaluation of neuromuscular fitness, for the development of specific training programs	Strength training	Citation searching
2007	Bradley and Portas 6	Soccer players with lower preseason range of motion in the hip flexors and knee flexors had a statistically higher risk for a muscle strain injury to these muscle groups during a competitive season. Age, body size, limb dominance, and playing position were not significant intrinsic risk factors for the development of muscle strain injuries. Screening of flexibility for soccer players should be conducted during preseason, and flexibility training should be prescribed to players with reduced range of motion to lower the risk of developing a muscle strain injury	Epidemiology and health Athlete monitoring strength training Load management and detraining	Citation searching
2003	Kujala et al 23	Despite the high absolute number of sports injuries, most are not usually severe and consequent permanent disabilities are uncommon. Former athletes have more degenerative changes in their joints and spine compared with control populations. There are former athletes who report disabilities due to different types of musculoskeletal injuries from sports careers	Epidemiology and health	Citation searching

NBA, National Basketball Association.

The main characteristics of the 21 included studies are set out in Table 1. Studies appear in decreasing chronological order, the first being the most current. All the selected studies focused on elite and professional sports, and how age and workload undertaken during sporting life may affect the state of performance and health on more seasoned athletes.

The studies presented have a high heterogeneity, ³⁰ according to methodology, sports involved, periods of data collection, number of participants, sex, or nationality. The studies methodologies include literature reviews (n = 3),^18,37,46 opinion articles (n = 2)^9,23 and a special communication (n = 1). ¹¹ There are qualitative (n = 2) ^4,36 and quantitative (n = 2)^2,43 research studies, all them conducted from surveys. Ten studies are observational, being cross-sectional (n = 6) studies^{21,26,29,31,34,35} or cohort studies (n = 4).^6,7,22,25 Finally, a clinical trial (n = 1) ⁴² is presented.

The data of the observational, research, and clinical trial studies involve athletes from sports like basketball (n = 4), Olympic disciplines (n = 2), soccer (n = 2), taekwondo (n = 1), weightlifting (n = 1), long-distance runners (n = 1), pivoting sports—basketball, handball, and soccer—(n = 1), and high-speed contact or collision sports (n = 1) like rugby or Australian football. There is a study focused on basketball coaches (n = 1).

The data collected are from athletes since the year 1948 to 2019 and from 131 different countries. They analyzed both sexes (n = 9) or male athletes only (n = 4). None were focused on female athletes only. The number of participants in the studies ranged from 36 to 3782 athletes. The study related to coaches is from 157 Hungarian female and male coaches. The main authors are from the United States (n = 3), Spain (n = 3), Brazil (n = 2), Greece (n = 1), Australia (n = 1), Argentina (n = 1), Sweden (n = 1), Norway (n = 1), Finland (n = 1), Portugal (n = 1), United Kingdom (n = 1), Scotland (n = 1), the Netherlands (n = 1), Hungary (n = 1), Germany (n = 1), and North Macedonia (n = 1).

According to the results obtained, all studies address 6 key themes: expertise, biological maturation, and specificity; epidemiology and health (physical and mental); athlete monitoring; strength training; load management and detraining; and success management.

Discussion

The aim of this narrative review was to provide tools to enhance the management of expert athletes, ⁴⁶ balancing the needs of the team (or working group in the case of individual sports) with those of the sports schedule, and any possible age limitations,^29,34,35 together with the load accumulated during an extended career. ²³ According to the main findings of the results obtained and following the guidelines of other existing models, ¹³ an integral and holistic perspective training model is proposed for extended career athletes. It is developed from 6 key themes (Figure 2): expertise, biological maturation, and specificity; epidemiology and health; athlete monitoring; strength training; load management and detraining; and success management.

Figure 2.

Training model for extended careers athletes.

Expertise, Biological Maturation, and Specificity

Although different definitions of “expert” exist,^39,46 an expert athlete is typically capable of managing their resources based on their knowledge of competition and limitations of their own body. The best athlete is not always the fastest, ²⁸ but rather the one who is in the right place at the right time, in both offensive and defensive situations. Equally, when faced with an important competition, experts know how to attain the necessary state of arousal for optimum performance, ⁹ and when required, adapt their strategy for an opportunity to win. ³⁸ Coaches play an important facilitatory role in managing the talent, experience, and egos of expert athletes.^2,46 Based on this, it is key to identify how age, ie, biological maturation, can affect the performance of an athlete in accordance with the type of sport they engage in. Coaches should know how to manage workload and motivation to achieve the necessary conditioning needs during practice, to take advantage of the athlete’s experience in the moments that are really required during competition.^9,38 Finding the balance for the needs of every athlete on a team (or work group) and the collective goals is a challenge and responsibility of coaches and staff. ⁷ From this point on, the specificity and characteristics of each type of sport will dictate how the necessary actions should be handled to obtain the best performance, availability and health for athletes with extended careers.^20,29

In different sports, the physical qualities of players, and the intensity of competition decreases with age.^4,21,26,35 In most cases, these performance decrements manifest through reductions in strength and speed. However, from a certain age onward, there may be no significant differences. ²⁹ Reaching these ages, close to 30 in men and later in women, the decline in performance starts to plateau in elite athletes.^21,26,29 It would then enable us to guide workload to sustain the necessary values for each type of sport, sex, position, or style of play, rather than trying to develop or reach a peak performance that, with regard to their condition, would no longer be acceptable as a result of their age. Two potential explanations for an earlier reduction in peak performance have been proposed. First, athletes may miss critical windows of athletic development if they specialize early and the development of athletic qualities has not been planned in a progressive and appropriate manner during the formative years. ⁴⁶ Second, socioeconomic (eg, economic) factors, ⁴⁶ which may result in rapid or inappropriate training progressions could increase injury risk, and impact the longevity of extended-career athletes.^29,43 In these cases, overload and any resulting injuries may be connected to a premature decrease in sporting performance, resulting in a curtailed sports career. ²² Sex may also influence this longevity, which is greater for women on continents with a more established and egalitarian sports culture, such as North America. ⁴³

What should the training approach be for athletes who have greater expertise and biology maturation, but are unable to develop their game in top physical condition? Appropriately applied specificity could be the key ingredient to enhance performance and reduce likelihood of injury. ²⁰ Training in a specific manner provides stimuli to tissues and systems that prepare athletes for the demands of competition. By reducing unnecessary variability^7,20 and proving a specific stimuli, joints are protected from overload,^4,23 allowing adequate time for recovery. ⁷

In any event, to maintain a high athletic level, training specificity requires knowledge of the athlete’s injury history and ensuring their health, both during sport and after retirement, is a priority. To this end, it is necessary to monitor athletes in accordance with their needs, schedule individualized strength training, and manage training load with respect to individual capacity.

Epidemiology and Health

Maintaining the health of an athlete during their sports career results in greater availability, which in turn leads to greater chances of successful performances. Better health across the course of the career should contribute to better postcareer quality of life. ³¹ Injuries are a part of sport, especially those that occur due to joint overload or exposure to a higher risk of injury, such as in contact and collision sports. ¹⁸ Healthy training should begin at an early age for athletes who plan to have long-term careers. ⁴⁶ As biological maturation and age increase, athletes may need to cope with pain or adapt movements in specific drills. ⁴ In these cases, the management of training loads is vital in minimizing pain and preventing injuries. Appropriately prescribed strength training is a suitable modality for minimizing the risk of muscle and joint injuries. ⁷ Joint unloading of nonspecific work, the liberal use of blood-flow restriction, and management of body mass through nutritional strategies can be applied during injury rehabilitation. ²¹ Severe and chronic injuries, ²¹ which may be exacerbated with age, ³³ are associated with shorter careers.^4,22,23 The availability of specialized professional equipment enables these conditions to be addressed. ⁴ An awareness of the athletes’ physical qualities and biomechanics is necessary to inform training program modifications. Experts in mental health should also play a role in any professional team. ¹⁷ Mental health is important during every stage of an athlete’s career, and equally important when they approach retirement.^18,31,36

Athlete Monitoring

Technological advances have offered sporting teams numerous possibilities for the continuous monitoring of athletes, during their training, competition, and day-to-day life. However, excessive monitoring may be counterproductive if it leads to poor compliance. ⁵ Research identifying the most important variables to monitor for health and performance is needed on a sport-by-sport basis, although it is acknowledged that these variables may be different for individual athletes—even within the same sport or position. ³⁴ Monitoring athletes across the entirety of their sports career enables sport medicine and performance staff to assess their physical state and potential performance at each stage, ⁷ as comparisons can be made with other previously recorded stages and situations. This process also involves the need for professional specialists and sport scientists with the capability to holistically analyse and interpret monitoring data, ⁴ propose comprehensive and customized training recommendations, and do so with the short-term goal of maintaining performance, and longer-term objective of health and longevity after retirement.^23,31

Strength Training

Higher levels of strength and power (specific to each type of sport) are associated with lower injury rates and better sports performance in adult male athletes. ⁷ Strength training, when using a specific, customized program, is a key element that enables many of the needs of extended careers athletes to be addressed. It follows 3 premises, the first of which is that the individualization of strength training programs in the same team or working group does not necessarily mean that the desired peak-performance or conditioning levels cannot be achieved collectively at the desired time. It is important to clearly define objectives and progression, and to manage the working group by applying experience. ² In adult athletes and experts in strength training, more qualitative approaches do not vary from others employing lower intensities. ⁴² Second, load specificity can be managed via strength training as well, ⁷ offering both content that minimizes the impact on joints that may show signs of overload or chronic injury, ³¹ at progressive intensities that also ensure adequate recovery. ³⁷ Finally, a long-term athletic development plan that promotes appropriate strength training from an early age, and taking into account sex differences during maturation may have a beneficial effect in extending the careers of athletes. ²⁹

Effective strength programs for extended career athletes focus on reducing pain and minimizing stress to chronically overloaded joints and tissues. Pain can result in compensatory movement strategies, which may in turn lead to injuries in other structures. ²⁵ In the progression of strength training, both short- and long-lever isometric exercises can be included. ⁷ With adequate volume and intensity, isometric training can maintain and improve muscular strength, without pain, and provide a neuromuscular stimulus,^29,37 which, for an expert athlete, ⁴⁶ may enable them to assess their condition and activate the tissues required for training or competing. ²⁰ This stimulus improve different capabilities such as position sensation and joint movement, muscle activation patterns, and physical qualities such as strength and balance. ¹² For no painful structures, neuromuscular dynamic exercises are specific in nature, ¹² and the aim would be oriented to maintain volume of the phasic muscles and range of motion for tonic muscles. ⁶ The goal is to improve both the structure and function of the joints involved in the sporting movements. ⁷

Load Management and Detraining

Specialization, biological maturation, health, strength training, and athlete monitoring converge under the umbrella of “load management.” The effective management of these factors ensures that athletes maintain their best physical condition, in as many games as possible.^4,7 As exposed before, the main aim is to sustain the necessary values performance. To this end, and taking into account their experience, ⁴⁶ and technical-tactical resources, ³⁶ the necessary preseason progression must be considered rigorously. ⁶ The relationship between spikes in training loads and susceptibility to injuries has been researched extensively (based on the proposals of authors such as Hulin, ¹⁹ Gabbett, ¹⁴ or Murray ²⁸ ), and it is at the beginning of the season when injury risk is greatest. If athletes are injured in preseason or early in the season, it can negatively impact performance goals for the rest of the competitive calendar. ³² Load management for an extended career athlete should prioritize reducing the risk of injury, maintaining “specific” physical activity, and minimizing unnecessary training variability. ²⁰ High intensity cardiovascular and strength training can help maintain and improve athletic qualities during the off-season in preparation for preseason training. However, training adaptations resulting from this type of training can decline as quickly as 2 weeks after the cessation of detraining. ³⁷ For older athletes, it can be difficult to recoup these lost adaptations after such periods of inactivity, so maintaining ongoing physical activity at appropriate intensities is required, especially when performance decrements are observed.^4,21,26,35 The off-season represents a period whereby athletes can develop physical qualities in preparation for preseason demands and in-season competition. ²⁰

Success Management

Thus far, this narrative review has framed arguments in terms of the type of training loads required for managing athletes. However, longevity and success must be also considered through the lens of the socio-affective needs of the athlete. Emotional stability and happiness will enable the athlete to focus on their career, thereby minimizing distractions that may detract from success. Athletes who can manage lifestyle external stressors effectively and objectively are better prepared to face their final years and competitions confidently and focused.^11,31

Limitations

Despite efforts to be comprehensive, only English-language articles were included, potentially excluding significant research conducted in other languages. Although this approach allows for the inclusion of a wide range of studies to provide a broad overview of the field, included studies are just related to high level or professional athletes. It also means the strength of the results, but the evidence presented cannot be definitively appraised. Another limitation of this study is the heterogeneity of the sports involved in the articles included. Consequently, readers should interpret these findings with an understanding of these inherent limitations of the proposal. Further approaches may adopt this model to each sport-specific requirements and epidemiology, and include potential differences in workload by sex, level of play, and specific type of play (eg, position) or competition (eg, distance).

Furthermore, this review did not assess the methodological quality of the included studies, and it is not common to include case studies/series on reviews, but the research process has allowed to observe the need of longitudinal studies and study cases specifically focused on long extended careers athletes. They could provide an applied perspective and detail related to the health, performance, quality of life, severity, and epidemiology in daily training and competition.

Conclusion

Extended career athletes are impacted by the effects of age and biological maturation, which leads to a decrease in their peak performance compared with younger athletes. The training model for extended career athletes is designed to take advantage of their expertise while catering for these potential decreases in performance. Under these premises, the model must consider training specificity, injury, and health history, individualization and, where appropriate, modification of strength training and monitoring of the load-response, with load management focused on avoiding large peak and troughs in training loads and periods of inactivity that can lead to detraining.