Systematic training is an indispensable requirement for the development of a successful performance. However, similar training modalities, such as achieved training hours, lead to individual responses, and finally, decide on athletes’ success or failure. To foresee individual performance development, potential predictors should be known.
To increase individual performance over time, sufficient training loads are necessary. Competitive sport is associated with frequent, prolonged and intensive training sessions, even at a young age. 13-year-old or younger athletes in several sports train 15–20 h per week. Due to the earlier professionalization, the danger of a premature training accumulation is obvious. These physical strains can be linked with an increased risk for illness and injury. Consistently, physical stress activates the immune system more or less, resulting in weakness or stabilization. However, it is unclear, from which load (e.g., duration, intensity, frequency) the immune system is negatively influenced, from when clinical complaints occur, and therefore, the performance development will be diminished.
Diverse parameters define and characterize an elite athlete: e.g., sport-specific skills, physical performance, anthropometric and physiological characteristics, maturation, genetic predisposition, length of training, experience, health, and psychosocial factors (Armstrong, 2011) . In the medical context, health plays an important role. Especially in adolescence, there are known parameters, which can negatively affect the risk of physical and psychological illness and injury: high training loads (Fleisig G. S., 2011) (Hjelm N., 2012), an early specialization (Jayanthi N., 2013), previous illnesses, environmental factors, and negative stressors such as school problems, parental conflicts, pressure to perform, and competition failure (Cohn, 1990) (Scanlan T. K., 1991)
The aim of prolonged and intensive training, respectively of a pre-season period, is to improve individual performance. In particular, in endurance athletes, performance is directly associated with a high maximum oxygen consumption (VO2max) (Bassett D. R., 2000). Beside oxygen utilization, one key factor of a high VO2max is an enhanced oxygen transport capacity accomplished by haemoglobin (Wagner, 1996). Previous studies proved the predictive value of a high hemoglobin mass in endurance sports regarding performance (Zelenkova I. E., 2019). In contrast, most athletes demonstrate normal hemoglobin concentrations because of plasma volume changes, so called hemodilution (Schumacher Y. O., 2002). Regular monitoring of hematological parameters is still recommended, not for the prediction of performance, but to detect abnormalities such as anemia. At once, further parameters should be considered, especially the evaluation of iron metabolism (e.g., ferritin), because a non-anemic iron depletion may impair performance (DellaValle D. M., 2011).
In the last decade, vitamin D has been given special attention. Low values are discussed as a potentially performance limiting factor, in contrast, high vitamin D supplies are associated with an enhanced performance (Dahlquist, 2015). Furthermore, a vitamin D deficiency can negatively affect athletes’ health.
In contrast to hemoglobin and vitamin D, Epstein Barr Virus (EBV) is often associated with a diminished performance and fatigue in competitive athletes.
Elite athletes are exposed to high strains, not only physically. The known stress factors include e.g., psychological pressure (e.g., annual selection, performing in competition), unstable financial support, training and competition environment factors (e.g., weather, inadequate training facilities), travel, nutrition, mismatch between internal and external expectations, protracted injuries, and repeated illnesses. In young age, also puberty, a changed physical development, school stress, surrounding conflicts (with e.g., parents, friends, coach, and teachers) and an upcoming prioritization (less leisure time) should not be underestimated. In addition, the trend of recent years shows an increased duration, intensity, and difficulty of training, a high-frequency participation in sports events, and an earlier specialization and professionalization (Armstrong, 2011). All these potential risk factors can negatively affect the risk of illness and injury (Armstrong, 2011). While exercise has various positive effects on athletes health and well-being (cardiovascular fitness, muscular strength, bone health, weight control, self-confidence stabilization, reduced morbidity), prolonged and intensive training, in competitive sports unavoidable, can diminish the immune competence with following higher rates of infections.
However, the phenotypes of athletes differ significantly among each other: only a small percentage of junior athletes achieve senior level, participate internationally, or even win medals at Olympics. Others are permanent sick or injured, moreover, despite apparently similar conditions, are not able to access their real performance in competition. In this regard, recent studies have shown fewer episodes of infections in successful top-ranking athletes, potentially based on selection mechanisms of “talented” ones (Hellard P., 2015). Unfortunately, a comprehensive definition of “talented” athletes is lacking, therefore, an identification in young age represents still a huge challenge.
The German scientists Katharina Blume and Bernd Wolfarth evaluate some subjective performance-related parameters with the purpose to identify performance-related parameters in young competitive athletes (Blume K, 2019). Individual performance developments of 146 young athletes (m: n = 96, f: n = 50, age V1: 14.7 ± 1.7 years) of four different sports (soccer: n = 45, cycling: n = 48, swimming: n = 18, cross-country skiing: n = 35) were evaluated by analysis of 356 visits in total (exercise intervention periods, 289 ± 112 d).
Results of this lately published study shows that in contrast, compared to athletes with an impaired performance progress, no differences in hemoglobin values, vitamin D levels and Epstein Barr Virus serostatus were found. Performance progress was dependent on extents of health senses and stress levels. Furthermore, the combination of declined health senses and rised stress levels was associated with an impaired performance development) and higher prevalences of clinical complaints above all, in contrast to hs-CRP (inflammatory parameter, may indicate an inflammatory process) (Blume K, 2019).
An improvement of performance can be assessed at different levels: long term until reaching top-level status, short term during training periods for season or competition preparation. Beside sport-specific skills, the development of an adequate endurance capacity is necessary to ensure resilience and to affect health, training and ability for a fast regeneration progress (Borresen J., 2009) (Dhabhar, 2014). For example, road cyclists establish their base for the season in the winter months. This requires a systematic training and the knowledge of strengths, weaknesses and limitations. Inadequate strains, such as to intensive training loads, can lead to a diminished immune competence affecting recurrent infections. Ignoring medical issues can cause frequent interruptions, lack or stagnation of performance, up to retirement from competitive sports (Maffulli N., 2010).
As part of annual systematic medical examinations, mostly organized only in adulthood, physiological conditions can be evaluated and disorders excluded. In addition, performance tests are used to determine parameters for regulating training (e.g., heart rate, lactate thresholds). Nevertheless, despite apparent similar conditions and regular participation in training, performance developments differ between athletes. In the absence of performance or appearing complaints, diagnostic evaluations are initiated, not infrequently too late or with unremarkable results. During the season frequent medical follow-up examinations are not feasible. Therefore, simple diagnostic tools are necessary to characterize athletes’ status and well-being for ensuring an optimal performance development.
Systematic training is an essential demand for the individual success of an athlete. However, similar training modalities cause individual responses, and finally, decide on athletes’ success or failure. To predict performance development, potential influencing parameters should be known. Therefore, the purpose of this study was to identify performance-related parameters in young competitive athletes.