By Gina Pongetti Angeletti, MPT, MA, CSCS

One. More. Year. 25% more time. Around 300 more days of practice. And, in that time, only 50 or so days off. 100 more PT sessions. It’s like running a marathon and having someone ask you to do six more. Try having four kids, and randomly having someone tell you that you need a fifth without your approval. Senior in high school? Nope, no graduation. One. More. Year. 

This year has been a trying one for sports, from the athletes to the coaches, parents, and everyone from media to medical. Navigating training at the Elite level for the Olympics, in and of itself is a challenge that takes meticulous planning. Add on top of that distancing, time off for quarantine and the constant in and out. Many athletes had to take multiple breaks from the gym due to potential exposure and gyms shutting down. MyKayla Skinner was out for weeks on end with COVID and then post-COVID issues including pneumonia.

The physical health of the athlete has always been front and center. We see braces and tape. We hear about diagnosis and physical therapy, progress of their return to full throttle, and struggles through the process. 

We do not, however, often hear about the psychological challenges and mental and emotional challenges. It has been a societal norm to be ashamed, or have a stigma attached to admitting, needing and getting help. Why is this different from rehabbing a sprained ankle or a hamstring tear?

The concept of perfectionism is one that many struggle with including the elite athlete and the CEO. Because of the intense training and orchestrated preparation, athletes think that they should be well-oiled machines.

Gymnasts have often been looked down upon for mental weakness, performance anxiety, or competition falters. As such, they are also lauded for consistency beyond imagination. With all of the possibilities and potential room for error (think of how small a beam is, how tiny the bar is or how flipping a bit too fast alters landings), not being “perfect” is assumed, if you go by mere odds. The intense amount of repetitions of skills and routines day after day, year after year, does train the mind to have greater odds of success. Muscle memory kicks in as well as the knowledge, with experience, of how to “fix “things mid-air, or make corrections and adjustments. 

Sometimes, however, mistakes just happen. Bad days happen. Life throws a curveball, and mentally, focus is altered. 

Even with the best sport psychology, keeping mentally tough and fit is a constant challenge. 

Consistency over time gets gymnasts experience, to be chosen for the National Team, and prepared for the path of representing the country in international competition. However, on the day of the meet, there is still just one chance. 

To be the best in baseball, there are over 160 games to determine the champion. Anything around 40% in consistency is considered nearly un-achievable. If you are anything less than 90% in gymnastics, you may as well think about a new sport. 

Recently, tennis player Naomi Osaka made headlines by declining to participate in the French Open media, stating that she has been struggling with her mental health, and media opportunities at times trigger emotions and alter her frame of mind. She was fined, per the rules as they were (and still currently) though there are calls for change from both inside and outside the sport. 

Osaka’s purposeful absence was not done to be spiteful, and she swallowed the pill of the $15k fine. Her absence did, however, create a talking point and begin an awareness process that has been lacking. 

The conundrum that presents itself is a difficult one: people want to know about what is happening in a sport, what the athletes are thinking, how they are preparing. Yet, the athletes should be respected for putting their health and wellness above a good story. 

Sam Mikulak, two-time Olympian and six-time national All-Around Champion, recently opened up less than two weeks ago about his mental health and focus. USA Gymnastics created a panel, in honor of Mental Health Awareness Month where Mikulak explained his challenge of being too hard on himself, and not enjoying the process of what he did, simply striving for the perfect outcome noting he often would ask himself, “Why are you doing this? Is it for the right reasons, or for the wrong reasons?”

Mikulak wishes that he had gone down the road with support as he looks back. USA Gymnastics has always had sports psychologists to work with, dating back years when the athlete wellness group had a glossary of sorts of medical professionals from around the country. Reaching out to them, or knowing when to use their services, however, was still up to the athlete, their coach and family. 

With the subjectivity of choice within gymnastics – from who makes the team, to who gets invited to camp – showing any sign of weakness was, and still is potentially, used against the athlete. They keep things to themselves about physical pains as well as a lack of mental perfection, in order to appear to be stronger, ready, and unshakable. 

Mikulak explained while on the panel, “I never wanted to be seen as a gymnast that was weak, or had issues. And that’s what I always thought people that got therapy, that was the reason you went, because you had some major issues, something huge.”

It should be the norm that athletes have weekly check-ins, or however often they need. It should be a part of their training that they are taught how to self-manage, not just optional. Coaches should be educated on how to spot signs of a lack of self-regulation, focus, enjoyment and balance. 

“I now see that it is more so of a resource… to make yourself better even if you are in a strong mental health state. And that was a big shift that I’ve had over the past couple years,” Mikulak expressed. 

Of course, the adage of “only the strong survive” holds true to some point. The athletes have to hold it together, mentally and physically, enough to sustain the training that the sport demands – long days, back to back days, few days off, and little (if no) time for a physical vacation.

In NCAA gymnastics, this is more the norm – and their training schedule is much less demanding compared to the Olympic path. They have to balance the stress of being away from home and academics, and the coaches and programs are open to being proactive about managing this care. 

Within the last two years, stories abound of the mental and emotional abuse that athletes endure while training. In the U.S., coaches have been suspended and athletes have stood up against this by surfacing complaints, switching gyms, and in cases, filing lawsuits. Parallel stories surfaced from England, Romania, Canada with more in the hopper.

Much of this focuses on the strive for perfection, guilting athletes when mistakes are made, and judging their efforts and toughness through the injury process. Athletes are then distrusting of being honest with coaches about their state of mind for fear of punishment or judgement, and then, not only does the issue not get addressed, it festers. 

Mikulak went on to state, “What I have been honestly doing for my whole life was just holding in all of the things that I always worried about, pushing it deep down inside… and so I was continually just lying to myself… even though I would have this stream of thoughts that would come into my head. There’s these fears, there’s these worries. For so long, I was not tackling them. I would just ignore them… I would think (about the sport): ‘Why are you doing this? Is it for the right reasons, or for the wrong reasons?’”

Success – whether medals, consistency, difficulty level – comes when all parts of the athlete are in balance. From sleep habits to nutrition, confidence to controlled anxiety, the emotional side of our bodies is connected to the physical side. Without quality sleep, there is less quality recovery. With heightened stress hormones, such as cortisol, the body sits in a constant state of muscle breakdown. This is in direct opposition to the point of training, which is to build or at least maintain muscles through workouts. 

Overtraining can lead to fatigue and a subsequent lack in performance-quality and increased injury risk. When athletes are not honest about their exhaustion, depression, or lack of energy because of the fear of being told to “toughen up,” this can affect thyroid levels, metabolism, aerobic capacity and reaction time. All of these lead the athlete to continue to push through even more, often thinking that training harder is the answer due to a subpar performance. Rest, relaxation, time off and others may assist in physical health. Addressing the psychological aspect of being “okay” with needing a break, and allowing one’s body to heal without guilt, can help to control the physical side effects. 

Even when addressing injuries, physical therapists and physicians need to be mindful of the athlete’s entire state of being. Tissue healing times have been shown to decrease with proper metabolic balance. The level of pH, or acidity, in the body can be mitigated and therefore present a better environment for recovery. From swelling to ligament injury, joint stiffness to tight muscles, healing chances are always improved with a healthier system. 

Tonight, Mikulak will go for his seventh national title but is currently sitting in seventh place after feeling fatigued and making mistakes throughout on Day 1. It’s a place he never expected to be. But one we expect him to fight back from, as he puts all he’s learned and experienced on the line in what he says will be his final U.S. Championships. It will be one of the biggest tests of his career.

Gymnasts are not machines, although to the lay public, their amazing feats seem to only be accomplished because of being superhuman. Let’s remember that as many dreams will be achieved on Sunday night, when the men’s and women’s qualifiers to Olympic Trials are named, an equal amount of hearts will be left empty, wondering what could have been. They are still in the top 25 of American gymnasts right now, and seemingly, the top 3-500 in the World. That should be celebrated as well. 

Photos by Lloyd Smith  for Inside Gymnastics

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