The team behind the team: Sports medicine in Brazil's Olympic quest

Olympics.com spoke to Brazilian physicians Leonardo Hirao and Felipe Hardt about the fundamental role of advanced sports medicine -- and an integrated approach to performance -- in the hunt for Olympic gold ahead of these Beijing 2022 Winter Olympic Games.

By Virgílio Franceschi Neto

It's impossible to separate performance in sport from the body of an athlete.

While the body is important for all of us, to be sure, top-tier athletes depend on a kind of total fitness to achieve the best results. It's the same across all sports -- on the athletics tracks, lawns and courts, and, yes, on the ice and snow of the Winter Games too.

Sports medicine has advanced much in recent years to become an integral part of the technical operation of teams.

The Beijing 2022 Winter Olympic Games are just months away and it is precisely on the eve of such major events when the wonders of sports medicine are most in demand and consequential. How to avoid pain and injuries? That's one common question on the cusp of any event. Another is: If injuries or pain do occur, how best to treat them?

In another chapter of our 'Team behind the Team' series, Olympics.com spoke to Leonardo Hirao and Felipe Hardt, doctors of the Brazilian Olympic team, who will be on hand at the Beijing Winter Games which run from 4 to 20 February.

Athlete of the Brazilian Olympic team during medical care. Photo: Brazilian Olympic Committee

Leonardo Hirao: 'Every hundredth counts'

A former swimmer at a major sports clubs in his birth city of São Paulo, Hirao opted for a future in medicine over his pursuits in the pool. He began his advanced studies in the early days of a residency program focused exclusively in sports medicine at the University of São Paulo during the first decade of the 21st century.

"I like everything about sports medicine, and the high performance [environment], I don't need to say how much I like that. From the first day to the last, the whole cycle...being able to be part of this world is very good [for me]," reflected Hirao.

The ideal goal for a physician in the world of sport is the prevention of injury, but, of course, with sport being sport, that's not always possible.

"It is possible [the avoidance of certain injuries] when we identify factors that lead to the injury. This starts with the training of the athlete," Hirao said. "Prevention starts with coaches and physical trainers. Physicians go after the consequence, yes, but they are much more focused on searching for and identifying the causes of injuries."

"Someone can be the strongest athlete -- the fastest, most prepared, most stable -- but he's subject to everything," added Hirao.

Leonardo has worked with many athletes in extreme circumstances. He recalled, during a national trials for an Olympic Games, one athlete with tendon problems. Hirao suggested a medication that would ease the athlete's pain during competition.

"Every hundredth [of a second] counts," Hirao told that athlete. And didn't it prove to be true in the end? At the finish line, the Olympic-earning time was reached by just that one hundredth of a second the doctor predicted. "A matter of details," he reflected.

That's the essence of high performance. It's those little details that can see you win -- or lose -- a medal. The all-important edge is chased on a daily basis. That's why there's so much work done to adapt to climate and time zone during big competitions.

Medical follow-up can become more important than the intervention itself.

Physicians are constantly analysing bio-mechanics and biochemical markers to find out if the athlete is responding properly to training sessions. This way the team, as a whole, can know if it's necessary to slow down or if there's an opportunity to ramp up the intensity toward improved results.

Medical staff are seen attending to Leonardo Vial Tercariol of Team Brazil during the Men's Preliminary Round Group A handball match between Germany and Brazil on day nine of the Tokyo 2020 Olympic Games at Yoyogi National Stadium
Picture by GETTY IMAGES

Sports medicine, these days, works under an umbrella. It's not a matter of the routine identifying of an injury, making a diagnosis, performing an examination and establishing a course of action for recovery. That's an antiquated approach. It's more than just intervention and follow-ups and support are crucial. It's a horizontally integrated approach in which all arms of a committee work together in concert.

Felipe Hardt: 'The most important is the day-to-day'

"We do this work side-by-side [horizontally] with our professional colleagues from other areas. It's necessary to do a type of universal work, the combination of the physical and mental part of the athlete," said Felipe Hardt, also a sports physician.

For Hardt, also from the College of Sport and Physical Education at the University of São Paulo, it is necessary to work together using scientific research and high performance methodology each day to apply solutions in practice and contribute to the monitoring, preparation and performance of an athlete. "The ideal is to go beyond injuries and orthopedic issues, and to focus more on sports science as well."

Hardt, born in Joinville, in Santa Catarina, has been a physician with the Brazilian Olympic Committee since 2013 and is so passionate about what he does that he can't enjoy sport without paying close attention to the minute details of his profession. "It's difficult, yes," he admitted. "I always have a critical eye. I always analyse everything. Naturally I do."

The evolution of Brazil's recent results in Olympic Games, both summer and winter, is, for Hardt, also a responsibility and a focus for the medical team. "Today we are able to monitor everything very early, on a daily basis," he said. "Today we do very few interventions that we did not know, in advance, about the athlete's situation."

Athlete of the Brazilian Olympic team during medical care. Photo: Brazilian Olympic Committee

One of his best-remembered interventions was with Thiago Braz, the Olympic pole vaulting champion from Rio 2016.

"It's nice to know that I was able to educate athletes, and have relationships with them. These athletes, who not only perform well but who have knowledge about their own health," said Hardt who worked with Braz for over ten years. "They [athletes] have the tools, autonomy and insight to know what is and what is not adequate for their training and preparation. That's the most relevant thing. It's not just operating on an injury, getting well and being a champion. What is built daily is the most impactful."

A relationship of trust

The high performance approach creates an edge for athletes and it requires much attention from the individual members of the technical staff. The contribution of technological advances and scientific research to the overall competitive approach is undeniable. Even so, it's clear, by listening to both Hirao and Hardt, that the closest care and the personal relationship between physician and athlete will always be paramount.

The relationship between athlete and doctor requires total trust and openness.

"I often receive phone calls from professional Brazilian athletes who live abroad and still have questions for us," said Hardt. "You can have an idea of how much they trust us."

The Road to Beijing 2022

The two Brazilian physicians will be on hand at Beijing 2022 in February. They are fully aware of the challenges that the Winter Games pose to the functioning of Brazilian sports medicine -- and the athletes themselves. They seek, always, to know more about winter sports and the background of the athletes who are looking to compete at these Games.

"We still need to learn a lot about winter sports. A lot," admitted Hardt about his country, where the Summer Games have historically, and for obvious reasons of climate and culture, taken precedence. "We are in a scenario that we have already experienced with summer sports for ten years, before London 2012. Let's wait for the athletes' demands so that we can do [our best], at this moment on the eve of Beijing, and during the Games."

"Sports medicine is fundamental because it facilitates decision-making of the head coaches," concluded Hirao. "Is it possible to do high-performance sports without medicine? Yes, but don't expect the same efficiency or results."

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