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. 2019 Apr 29;7(5):101. doi: 10.3390/sports7050101

Table 1.

General guidelines for illness prevention in athletes; adapted from Schwellnus et al. [14].

Behavioral, Lifestyle, and Medical Strategies
Athletes are Advised to:
  • Minimize contact with infected people, young children, and animals;

  • Avoid crowds and minimize contact with people outside the team/support staff;

  • Keep at a distance to people who are coughing, sneezing, or have a “runny nose”;

  • Wash hands regularly and effectively with soap and water, especially before meals;

  • Carry insect repellent, antimicrobial foam/cream, or alcohol-based hand washing gel;

  • Not share drinking bottles, cups, cutlery, towels, etc., with other people;

  • Choose beverages from sealed bottles, and avoid raw vegetables and undercooked meat;

  • Wear open footwear when using public showers and swimming pools;

  • Adopt strategies to facilitate good quality sleep at night and nap during the day.

Support Staff are Advised to:
  • Develop, implement, and monitor illness prevention guidelines for athletes and support staff; screening for airway inflammation disturbances (e.g., asthma, allergy);

  • Identify high-risk athletes to take precautions during training/competition;

  • Arrange for single-room accommodation during competition;

  • Update athletes’ vaccines needed at home and for international travel.

Training and Competition Load Management
Poor load management with ensuing maladaptation can be a risk factor for acute illness and overtraining. Changes in training load should be individualized in small increments <10%. General recommendations are:
  • Detailed training/competition plan, including post-event recovery strategies;

  • Training load monitoring, using measurements of external and internal load;

  • Adequate nutrition, hydration, sleep, relaxation strategies, and emotional support.

Psychological Load Management
Psychological load (stressors) such as negative life event stress and daily hassles can increase the risk of illness in athletes. Clinical practical recommendations center on reducing state-level stressors and educating athletes, coaches, and support staff in proactive stress management:
  • Develop resilience strategies that help athletes manage negative life events, thoughts, emotions, and physiological states;

  • Education for stress management techniques, confidence building, and goal setting;

  • Reduce training/competition loads after negative life events to mitigate risk of illness;

  • Implement periodical stress assessments.

Measuring and Monitoring for Early Signs and Symptoms of Illness Over-Reaching and Overtraining
An athlete’s innate tendency is to continue to train and compete despite physical complaints or functional limitations. It is recommended that:
  • Ongoing illness (and injury) surveillance systems should be implemented;

  • Athletes be monitored for subclinical signs of illness, such as non-specific symptoms;

  • Athletes be monitored for early symptoms and signs of over-reaching or overtraining.