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Mind-Body Training

Athletes often experience pressure as they compete in qualifiers and sanctioned events leading up to, and at the Olympic Trials and Games. One interpretation of pressure is a change in the per­ceived importance of the outcome of an event. The key in that phrase is the change in the per­ception. This change may lead athletes to modify or introduce new thoughts and emotions (and experience different physiological reactions) into their precompetitive routine. The downstream effects may be noticed first, for example in a pounding heartbeat, and the upstream effects may follow, with the athlete making sense of what the change in the heartbeat might mean - nervous, excited, ready? More thoughts flow from this interpretation, and part of psycho-physiology training includes better understanding the effects of thoughts and emotions on the body, and to practice the redirection and/or regulation of both. Upstream changes, namely those that originate from the brain and the mind, can flow downstream and the athlete can experience changes in physiology from thoughts or emotions. With biofeedback and neurofeedback technology, we can measure this interaction between the mind and body, with the goal of creating awareness and teaching athletes to more effectively regulate the two.

The purpose of training is to first help create awareness of internal processes that one does not typically exert conscious control over, and then to provide feedback in a manner that an individual can learn to self-regulate or gain more refined control over these internal processes. (Zaichkowsky & Fuchs, 1988). The activity of the body (sympathetic/parasympathetic activation in the autonomic nervous system) and brain (neuroelectric processing/cognition/emotions) is measured by sensors applied to the surface of the skin or scalp, and shown on a computer screen. The information is presented to the athlete in real time, and the athlete can see how her efforts to self-regulate are influencing her psychophysiological state. Data is presented in numbers and with bars that grow or shrink with successful efforts. Over time, with training, the athlete learns what the desired state feels like, and with the goal of entering this state on command, under simulated pressure.

The goal of biofeedback training begins with identifying suboptimal psychophysiological function­ing and learned situational responses, then feedback is used for developing strategies to self-regulate to a more optimal response. The ultimate goal of biofeedback is for the strategy learned during training to be successfully implemented in the relevant performance situation without the assistance of the technologically generated feedback (Blumentstein, Bar Eli & Tenenbaum, 1997). Athletes have the opportunity to train their self-regulation skills in years leading to Games, where­by the refinement in mental skills parallels the refinement in physical skills.

One of the strengths of using objective data is that for those athletes who are aware of the con­nection between the mind and body, the equipment provides real-time quantification of their state. For those athletes who may not have experienced upstream activity spilling downstream (or vice versa) affecting their performance, the technology helps illustrate that self-regulation skills can be assessed and developed. With equipment, athletes also learn that their self-regulation skills have boundaries. For example, athletes occasionally try too hard to focus and the counterproductive effects of their over-effort appear immediately on the screen with the success rate going down, or when athletes are tired at the end of a training session or at the end of a week of training, they can see that their skills are attenuated, much like at the end of a strength session they might ex­pect a reduction in their maximum capacity. The goal is to be able to effectively work with one­self in one's current state. Ideally, athletes will feel that they are in their optimal mind-body state for big performances. However if they are not, then they will have had experience working with themselves and know that they can still approximate the ideal state from their practice.

Skills emphasized in training are selected based on an objective assessment in combination with the athlete's stated goals, and generally fall into focusing, quieting, brief, and deep relaxation categories.

Assessment and Training Plans

Athletes generally begin training with a standardized assessment (Wilson & Somers, 2011). Mea­surements of brainwaves, heart rate, heart rate variability (the distance between heartbeats in milliseconds), respiration, muscle tension, finger temperature, and sweat response are taken. A baseline state is recorded first, then various tasks are introduced. Some tasks involve competi­tion, performing against the clock and reaction time, others for example aim to produce a stress response by asking the athlete to quickly count backwards out loud. Between each task there is a recovery period. Each physiological measurement is examined to see what type of change there is from baseline to competitive/stress task, then to see if there is a return to the baseline state when the task has been completed and the recovery period has begun. An imagery task is used, and repeated with the NBC Olympic theme song audio or the National Anthem, in order to elicit an emotional response. Athletes tend to have at least one system that changes under the competitive/stress tasks. This is the "most responsive" system and often an efficient place to begin training so long as it is relevant to the athlete's performance. As an example, an athlete might hold his breath during effort or clench her jaw while concentrating, the heart rate average might jump up more than ten beats per minute when a task starts and not settle down in spite of the athlete perform­ing well and the task being fairly simple, or finger temperature might not return to the baseline values in the recovery period. These responses give insight into what systems could be wired to respond to challenge/stress states in athletes and would benefit from increased awareness and self-regulation skills: lack of awareness of breath holding in certain sports can have negative performance effects; excessive jaw tension can be a sign of misplaced effort; sustained elevated heart rate can have en­ergy consequences over the course of a long or physically intense competition; poor blood flow (as expressed in low peripheral temperature) can be relevant to under-recovery.

The objective data collected from the athlete is used in combination with his subjective report of what types of self-regulation skills would be most relevant to performance and that he would like to work on, and a training plan is created. Training sessions last from 30 to 90 minutes depend­ing on how many training objectives the athlete has and whether the athlete is acquiring or refining skills. When athletes are at the Colorado Springs or Chula Vista training centers, they typically have training from one to three times per week. They often travel for weeks at a time, and when they return, they resume training. Self-regulation skills involving heart rate, respiration, muscle tension, peripheral temperature, and sweat response can be reinforced when athletes are on the road. They typically learn to self-regulate quickly with the aid of biofeedback, and can replicate the state without the assistance of technology with practice (or with apps on their phones, or heart rate monitors they already use for training). We work to identify aspects of their routines already being used in their sport that could serve as a reminder to use their self-regulation skills. When they approach the start line, they do a quick muscle scan to release excess tension, typically starting with the forehead-jaw-shoulders and moving down the body. When the whistle blows or there is a stoppage in play, they count through one breath cycle and extend their exhale to emphasize heart rate deceleration. When athletes return to one of the training centers they can confirm that they have maintained their self-regulation ability during their next biofeedback session. Visual and audio feedback is gradually withdrawn during training to the point where the athlete herself will confirm when she has achieved the target state by relying on internal cues rather than external feedback, in order to reinforce the maintenance/refinement of the self-regulation skills.

Replicating neurofeedback training without equipment has proven to be more difficult. There are a few first-generation consumer grade neurofeedback products on the market. With the evolution of technology, neurofeedback training may be something that athletes can do on the road. Athletes can also engage in other types of attentional or quieting practices, often with the support of their sport psychologist. They can use audio guides or guide themselves through sessions. Keeping notes of observations of progress can support training goals, and can be reviewed at the next session with the sport psychologist. In my experience at the USOC, athletes who have a daily practice tend to acquire and maintain their neurofeedback goals rather quickly as evidenced by their self-regulation skills staying stable in spite of periods away from neurofeedback training. Athletes who deliberately use their self-regulation skills in their sport training (including strength and cardio sessions) have multiple daily opportunities to "practice" working with the mind and the brain.

Focusing

Neurofeeback training typically begins with focus training. During focus training, slow speed brain waves are recorded and shown on the screen in real time. The athlete's goal is to first become aware of what having slow waves in the attentional networks feels like, and then to reduce the amount of slow wave activity to create a more focused state. With practice, athletes can begin to estimate the amount of slow wave activity present before they begin training, and after each dis­creet training block in the session. Their awareness of and regulation over the conceptual "focus­ing" dial in their brain becomes more and more refined. My colleague Peter Haberl is careful to distinguish between thinking about focusing and actually creating a focused state in the brain. This delineation is brought to life with neurofeedback training. When an athlete first begins training, she generally has a good idea of what a focused state feels like and can enter a focused state with ef­fort. As training progresses, the goal is for the athlete to be able to enter a certain level of focused state with an efficient amount of effort, and to be able to maintain that state for an amount of time that is relevant to her sport. Just as strength training is modified for sport demands and individual athlete needs, the intensity and duration of focus training are always matched to simulate sport demands. Much of the success of the biofeedback or neurofeedback training is thought to be due to its integration into sport demands (Wilson, Thompson, Thompson & Pepper, 2011). Focusing demands for cycling are different from focusing demands in shooting disciplines, for example, and athletes from these sports have different neurofeedback training programs to support their needs.

As competitions approach, training is modified to simulate competitive demands as much as possi­ble. Athletes often become aware that they become competitive with themselves in a training ses­sion, and pay attention to the statistics recorded in every training block through the session. This becomes an opportunity to be aware of an outcome orientation, the potential distraction of focusing on score prior to/during the focusing training block, and the athlete's reaction to meeting or falling short of his expectations. Focus training includes the basic self-regulation of neuroelectric activity in the selected area of the cortex, as well as the awareness of and regulation of the mind. Simulat­ing competition in psychophysiology training allows athletes to explore responses of the brain and mind that might occur before, during or after competing, and to demonstrate to themselves that they have the self-regulation skills to effectively work with these responses. They can also begin to learn their habits and know what will likely occur, as well as begin to rehearse handling a range of unexpected-but-possible events.

Quieting

Using excessive self-talk or self-instruction during well learned skills (those skills that athletes are showcasing on the biggest stage at the Games) can interfere with technical performance. This has been demonstrated in studies with shooting athletes, and is commonly reported in athletes when they describe "over thinking" or the "paralysis-by-analysis" phenomena. Simply telling an athlete to "not think" might be effective for some, but it can leave the athlete vulnerable to a wide range of thoughts that are irrelevant to performance - namely, how to create the absence of thought. Basic education in motor skill learning and the development of automaticity is reviewed with athletes.

Given the thousands of repetitions they have done at this point in their career, they are very likely at the final stage of motor skill learning, and skills are largely executed automatically, requiring little conscious processing (Fitts & Posner, 1967). When athletes prepare to perform, they can get in their own way by priming their conscious brain, for example, with thoughts about the outcome of their performance, and what that will mean. Anxiety or arousal can increase to the point that skills that are typically executed under automatic processing become performed through conscious and deliberate processing. These thoughts and/or change in arousal state can continue through to the skill execution state, and have varying effects on performance (Baumeister, 1984).

With neurofeedback training, athletes can come to understand that there is often a certain emotional tone to the type of thinking that does not enhance performance - it might be doubt or nervousness that leads to the brain doing extra checks, or exerting more mental effort than is needed in order to meet the desire to feel that one is working hard. This can be measured with a sensor on the head that captures the EEG output from a selected area of the cortex. When an athlete realizes that thought can still occur, but certain types of thoughts are unlikely to support success, he can practice identifying the occurrence of this state then quiet and redirect his mind toward more useful states and/or concrete cues. Similar to focusing, quieting can be practiced with increasing pressure simu­lation to mimic what might be experienced at competitions.

Brief and Deep Recovery/Relaxation

Athletes are taught techniques that can be used for brief or deep recovery and relaxation. Brief recovery/relaxation is often compared to pressing the reset button on purpose in training or competi­tion. Deep relaxation is used for creating a longer lasting recovery state outside of real time sport demands. Athletes often have some idea of how to create the physical sensations of relaxation: they can reduce resting tension in their muscles, slow down the breathing rate, lower their heart rate and anchor their mind in these physical sensations. Specific times where an athlete feels she can have a brief recovery during performance are identified, and routines are practiced to create this state. By regulating breathing, athletes learn to control their heart rate and with inter-beat interval data from the biofeedback equipment, we can confirm that the parasympathetic system becomes more active.

With muscle sensors, athletes can differentiate somewhat low (less than ten microvolts of tension) to very low (under three microvolts of tension) resting tension in selected muscles, and replicate this state. Research (from non-sport domains) indicates that giving muscles microbreaks by reducing resting tension is an effective way to decrease the risk of repetitive strain injuries.

Athletes practice engaging in deep (longer) recovery sessions during psychophysiology training, ranging from five to twenty minutes at a time. They are encouraged to replicate this training at home and during travel. Deeper relaxation sessions are often scheduled as training demands inten­sify to promote recovery throughout the day.

Cognitive/mental aspects of recovery and relaxation are emphasized along with physical aspects. Athletes identify with the concept that the body cannot be "on" for the whole competition day, or that if it is then energy is likely not being used efficiently. They often take time between warm up and competing, or throughout the competition day to have physical rest. Engagement in cognitive and mental recovery are sometimes more difficult, with the excitement that surrounds big events, the pressures of performance expectations, the availability of competitor performance data, the ease of access to social media, demands of family, friends, fans, sponsors, and so forth. Athletes learn to regulate their attention, typically using physical sensations of the breath or of muscle relaxation, or at times the monotony of counting to anchor the mind in a setting with minimal distractions, like our psychophysiology training space, and gradually practice these skills with performance relevant dis­tractions. Brief cognitive recovery typically takes the form of giving the brain a break from the atten­tional demands of sport, by doing something else that is less taxing on the attention networks in the brain. Mental recovery can be practiced with the idea of letting go of the performance that just took place. Neurofeedback training can reinforce this to teach the athlete what it feels like to decrease faster processing speeds, when it is previously confirmed that these speeds are associated with rumination or non-productive busyness. Routines can be created around this by creating a short window of time for analysis - if appropriate - and useful for ongoing performance, letting go of the last effort, resetting with a mental and physical routine and redirecting oneself to the next effort.

Optimal Health

In some cases, the goal of training is to optimize health to enhance sport performance. Athletes can be genetically predisposed to certain patterns or acquire them through injuries. As an example, after injuries, athletes can end up with excessive muscle tension at rest. This can result from immo­bilization or repeated bracing due to pain. Muscle tension can restrict blood flow and slow recovery. By identifying areas of excessive tension and learning relaxation techniques, athletes can reinforce a state conducive to healing. Similar to the general population, some athletes are prone to head­aches. Tension headaches and certain types of migraines occur in conjunction with stress. Antici­pation of a big competition, international travel, adapting to a new setting can often be enough to trigger a headache or migraine at inopportune times in the days before or of competition. In some cases tension headaches can be prevented with muscle relaxation training, and some migraines can be prevented by regular peripheral temperature training, whereby the athlete's goal is to raise finger temperature (finger temperature is raised by creating improved blood flow, transporting heat to the periphery) (Nestoriuc et al., 2008). In some cases, biofeedback and neurofeedback can be used to promote optimal health, minimizing or removing health-related barriers to performance in competition.

Biofeedback and neurofeedback are used to assess and reinforce self-regulation skills. After an assessment to better understand the athlete has been completed, his individual patterns, the re­quirement of his sport demands, and his stated goals for training are considered in tailoring a plan to utilize his strengths and bolster his weaknesses in the areas of self-regulation skills. Technology allows the athlete to see in real time how the brain and body work together with simple graphs and figures. The psychophysiological responses that are detrimental to performance are quantified, and clear feedback as to the direction and degree of change is provided. Athletes learn that they still have the ability to self-regulate when they are tired/nervous/excited/frustrated and can practice to use these skills under pressure simulations, such that they have the belief in their ability to employ them in the heat of competition.

References

Baumeister, R. F. (1984). Choking under pressure: Self-consciousness and paradoxical effects of incentives on skilled performance. Journal of Personality and Social Psychology, 6, 361-383.

Blumenstein, B., Bar-Eli, M., & Tennenbaum, G. (1997). A five-step approach to mental training incorporating biofeedback. The Sport Psychologist, 11 (4), 440-453.

Fitts, P.M., & Posner, M. I. (1967). Human performance. Belmont, CA: Brooks/Cole.

Green, E., Green, A., & Walters, E. (1970). Voluntary control of internal state: Psychological and physiological. Journal of Transpersonal Psychology, 2, 1-26.

Nestoriuc, Y., Martin, A., Rief, W., & Andrasik, F. (2008), Biofeedback Treatment for Headache Disorders: A Comprehensive Efficacy Review. Applied Psychophysiology and Biofeedback 33: 125 - 140.

Wilson, V.E. & Somers, K.M. (2011) Psychophysiological assessment and training with athletes: Knowing and managing your mind and body. In B. Strack, M. Linden &V. Wilson (Eds) Biofeedback and neurofeedback application in sport psychology. Wheat Ridge, CO: Association for Applied Psychophysiology & Biofeedback.

Wilson, V.E., Thompson, J.W.G., Thompson, M. & Peper, E.(2011). Using EEG for enhancing performance: Arousal, attention, self-talk and imagery. In B. Strack, M. Linden &V. Wilson (Eds) Biofeedback and neurofeedback application in sport psychology. Wheat Ridge, CO: Association for Applied Psychophysiology & Biofeedback.

Zaichkowsky, L. D., & Fuchs, C. Z. (1988). Biofeedback applications in exercise and athletic performance. Exercise and Sport Science Review, 16, 381-421.

Courtesy of the United States Olympic Committee