Impact case study database

The EIS works with elite sport athletes, most notably the Olympic and Paralympic teams, to provide access to leading-edge technology, engineering, and new research in science and medicine that help athletes improve their performance. Known as the ‘team behind the team’, the EIS was awarded GBP67,400,000 by UK Sport for the Tokyo Olympic games cycle. The EIS Performance Innovation team aims to ensure that Britain’s top athletes are among the most prepared and best equipped on the world stage [ E1]. Since 2013, Northumbria research has supported EIS work to ensure optimum performance in three main ways: (1) providing protocols and guidelines for practitioners delivering cryotherapy for athletes, (2) providing advice to athletes, coaches, and practitioners directly, including at the Rio Olympics, and (3) by using research to develop and test an improved cryotherapy intervention that has been used by athletes at international competitions and in preparation for the Tokyo Olympics.

4.1 Protocols and guidelines for cryotherapy treatment

In collaboration with the EIS [ E2], Northumbria’s Optimising Human Performance research group developed evidence-based protocols for the practical application of CWI. Previously, CWI was frequently used by elite athletes without clear guidelines. Northumbria’s protocols drew on the body of research to clarify when and when not to use the intervention, and provided athletes with guidelines on the duration, timing, temperature, water depth, and number of exposures that would achieve the most optimal recovery [ E3, p5]. The EIS took forward these findings by sharing them directly with support staff in Olympic and Paralympic teams [ E1]. Additionally, Professor Howatson delivered training on the guidelines at CPD events for EIS specialist exercise science and medicine practitioners, and those from all national support institutes (Sport Scotland, Wales, and Ireland) [ E1]. The new protocols were disseminated among [text removed for publication] enabling them to ‘ practically apply the knowledge’ [ E1].

‘Absorb’ is an online information platform for EIS physiotherapists and doctors. Knowledge is categorised into key module areas covering a range of recommended interventions. Physiotherapy is a broad-ranging discipline and accounts for more than 70 employees at EIS, many of whom travel with sports for anything up to 120 days a year. Some practitioners are based in relatively remote locations and experience levels vary significantly. ‘Absorb’ enables them all to access the same standards of treatment protocols ( 'Absorb' website). In addition, ‘Absorb’ forms an important part of the induction programme for all new EIS starters [ E1]. Technical content based on Northumbria research focussing on best practice for recovery has been delivered via ‘Absorb’ since its launch in 2017. To date, the recovery content has been accessed by more than 60 EIS physiotherapists [ E1], upskilling the new cohort of specialists by providing clear protocols on how to use cryotherapy for recovery.

4.2 Advice on recovery for Team GB athletes

The EIS provides support directly to athletes via an app which enables them to record their daily training and wellness, as well as storing medical records. In 2015, the EIS condensed Northumbria’s cryotherapy research into bite-size chunks and developed a new ‘Recovery Tips’ section for the app. The app allowed athletes to easily access the state-of-the-art and best practice guidelines on recovery [see Figure 1 within E1]. The content of these ‘Recovery Tips’ was underpinned by research from Northumbria [ E1]. In the build-up to Rio 2016, ‘Recovery Tips’ was trialled by [text removed for publication]. During the trial, ‘Recovery Tips’ was used by more than 80 athletes, who actively engaged with the content more than 1,200 times [ E1]. As a result of this successful trial, ‘Recovery Tips’ was adopted by the British Olympic Association, which has responsibility for athletes during the Olympics. Thus, the information was used by athletes across the 23 sports for which Team GB submitted athletes, in order to achieve effective recovery and aid performance during Rio 2016. During BBC Sport coverage of Rio 2016, six-time Olympic gold medallist Sir Chris Hoy explained that in-depth knowledge of how and when to apply CWI is required to enhance recovery. Hoy added that this sector-leading expertise came from (Northumbria-led research collaborator) [ R1, R2] Jonathan Leeder [ E4].

4.3 Increasing access to, and benefits of, cryotherapy for elite athletes

Traditional cryotherapy has known benefits, but it also presents logistical challenges, particularly when athletes are travelling for competitions as it requires static periods of immersion at low temperatures. In 2017, Northumbria introduced a novel cryotherapy intervention (PCM) to the EIS, as a way of circumventing the logistical issues associated with CWI, and concurrently increasing the time for cooling [ E5]. PCM modules are compact and easily transportable, cool quickly, and can be simultaneously used with whole squads for periods of up to six hours, facilitating recovery even while athletes are on-the-go (e.g., when travelling between competition and training venues) [ R5].

The benefits for recovery derived from Northumbria’s research were clear to EIS and so they worked with Northumbria [text removed for publication]. Athletes provided positive feedback on the intervention [ E6]. Following these positive trials, athletes from six Olympic sports [text removed for publication] have adopted PCM for use in preparing for, and during, the Tokyo Olympics [ E6].

In addition, EIS has implemented the PCM intervention as standard practice: ‘each of the five main EIS hub sites across the country [have] been equipped with PCM [text removed for publication] to augment recovery’ [ E6]. Due to high tolerability by athletes, these are applied beyond original recovery interventions for injury management. This strategy has enabled the five Technical Lead Physiotherapists across each region to implement PCM for the management of injury in elite athlete populations [ E6]. [text removed for publication] stated that: ‘[Northumbria’s] investigations have instilled confidence to coaches, athletes and support staff that the PCM … had real potential to enhance recovery between repeated bouts of training and international competition leading up to and including the Tokyo Olympics. This work was essential in enabling the EIS to take the project forward from just an idea to implementation with athletes’ [ E6].

The exceptional degree of applied science used to take a team to compete at the highest level means it is difficult to unpick the role of any one tool in achieving success, however, some practitioners supporting elite athletes have seen clear beneficial outcomes of using PCM to accelerate athlete recovery. For example, [text removed for publication] explained how PCM contributed to [text removed for publication] success in [text removed for publication]: ‘[text removed for publication] didn’t tolerate traditional CWI particularly well … We were able to use the phase change material as part of our global recovery strategy and [text removed for publication] was able to tolerate this strategy really well. I believe this intervention was an important component, it allowed [text removed for publication] to recover between each qualification [text removed for publication] and between events’ [ E7].