Beyond the Diamond Resources

 Sudden Cardiac Death in Young Athletes

Sudden Cardiac Death in Young Athletes

Kevin Gorey, MS
Senior Director, US Council for Athletes’ Health (USCAH)

**Sensitive Content: This article depicts instances of sudden death of children and may be sensitive to some readers.**

What Causes Sudden Cardiac Death (SCD) in Young Athletes?

Most cases of SCD in young athletes are due to hidden heart defects or overlooked heart abnormalities. These deaths usually occur during practice or games. Another condition that can cause SCD is commotio cordis. Unrelated to any pre-existing heart conditions and caused by blunt cardiac injury, it accounts for approximately 20% of sudden cardiac deaths.

What is commotio cordis?

Commotio cordis occurs when a person is hit in the chest and that impact triggers a dramatic change in the rhythm of their heart. A projectile, such as a batted or thrown baseball, can cause a blow to the chest that results in commotio cordis. Researchers have found in animal studies that the optimum speed for a baseball to cause commotio cordis is only about 40 miles per hour. Many baseball pitchers can easily throw at that speed.

Keep in mind that optimum speed does not mean the minimum speed. There is a documented case where a father underhand-tossed a softball to his 6-year-old son at a picnic. The ball skimmed off the child’s glove, hit him in the chest, and caused a fatal cardiac arrest.

This may explain why that in most reported cases of commotio cordis, sudden death follows a seemingly benign blow to the chest. In these situations, witnesses have generally believed that the blow to the chest wasn’t hard enough to cause a serious injury.

What is the incidence of commotio cordis?

The U.S. Commotio Cordis Registry in Minneapolis, MN tracks cases of commotio cordis and has documented over 250 occurrences since its formation. Approximately 10-20 events are added to the registry every year. The actual incidence is believed to be greater, though, due to lack of recognition and underreporting.

Commotio cordis occurs most frequently in young people under the age of 18 during sports activities. The most recent data indicates that 53% of the victims were engaged in organized competitive athletics, while the rest were involved in normal daily activities (23%) or recreational sports (24%).

Healthy young athletes are especially at risk because of the pliability of their chest walls. One study of 55 cases of sudden cardiac arrest (SCA) found that 90% were 16 years old or younger. All were playing sports either organized or informally. None of these children showed evidence of any heart defect or disease.

Typically, when a young athlete collapses on the field, people are confused and unsure of what to do. This confusion delays necessary treatment and lowers the chance of survival.

Can These Sudden Cardiac Deaths Be Prevented?

The only true prevention of commotio cordis is to eliminate blows to the chest, so realistically there is no way to prevent it in sports like baseball.

The only proven prevention strategy for SCD is through emergency preparedness. Use of an Automated External Defibrillator (AED) dramatically increases survival rates if used within minutes of a collapse.

With defibrillation (use of AED) at one minute, the survival rate can be as high as 90%. Within 5 minutes, the survival rate can be as high as 50%. The survival rate of SCA decreases 7-10% for every additional minute that passes without defibrillation. By the time the Emergency Medical Services (EMS) typically arrive (9-12 minutes), the survival rate drops to 5%.

Importance of Emergency Action Plans

Emergency action plans are a critical component of the emergency response program for any sports team or organization. Not only should they be updated as often as necessary, but they also need to be readily accessible at all practice and game facilities.

The one action that can prevent deaths from sudden cardiac arrest is responding quickly and appropriately. Part of that response includes knowing CPR and having access to a functional AED.
Training parents, umpires, coaches and other staff to recognize commotio cordis, provide basic life support, and respond quickly is essential to a successful outcome. All coaches and staff should be trained in CPR and AED administration annually.

The sudden, unexpected death of a young athlete is a tragedy. It not only affects family and friends, but it also affects the coaches, players, league and entire community. It is natural for everyone to wonder what could have been done to prevent this sudden cardiac death. Now we know.

 **For more information about keeping your athlete safe during baseball season, check out USA Baseball’s Health and Safety Resources.**


Kevin Gorey is a Senior Director at the U.S. Council for Athletes’ Health (USCAH). Kevin brings extensive experience from both commercial health care and sports medicine to the USCAH team. His three-decades long professional experience has produced high-level results for the organizations he has had the privilege to work with.

The U.S. Council for Athletes' Health (USCAH) was founded upon the need for trusted, independent athletic health care partners with the experience and expertise to advise and consult with organizations regarding their healthcare delivery system. This is why USCAH is committed to providing independent and unbiased medical expertise to organizations and individuals dedicated to the optimal health and safety for the athletes they serve. You can find out more about USCAH at or by reaching out to [email protected]

 The Mental Health of Youth Baseball Players

The Mental Health of Youth Baseball Players

Supporting psychological well-being in young athletes

Chad Asplund, MD, MPH
Executive Director, US Council for Athletes’ Health

Youth baseball is often the first organized sport that children start to play. Many of the lessons learned from youth baseball will help shape the thought processes regarding organized sports or sports in general for many young people. Organized sports, such as youth baseball, can be such a positive tool to learn things like how to be coached, how to compete, sportsmanship, and how to win or lose. However, there can also be a negative side to organized sports. Too much focus on winning, over-scheduling, and poor parent/fan behavior can create a toxic environment.

Youth sports are no longer the neighborhood pickup games of American lore. In recent years children as young as 6 and 7 are increasingly enrolling in high-level sports programs with professional coaches and year-round competition schedules. By age 13, up to 70% of children have dropped out of organized sports.

Evidence suggests that as young people compete more intensely in sports, gains in mental wellness may be replaced by mental health challenges particular to competitive athletics. Pre-pandemic, up to 20% of college athletes experienced major depression. For young athletes competing at national and international levels, anxiety and depression were 20% to 45% — higher in some cases than those in the age-matched control groups.

Parents are supposed to be the ones teaching good sportsmanship and how to behave, but more often than ever, umpires, coaches, and kids are dealing with tantrums from parents. This bad behavior by parents has led to a shortage of umpires and referees across many organized sports. Experts also say the amount parents invest, not just emotionally from the stands but also financially, adds to the pressure kids are feeling. Further, their actions often lead to a toxic environment in youth sports, when instead, they should be supportive and encouraging.

It is very important that coaches and parents are able to recognize the signs of decreasing mental health in young athletes. These signs include reduced interest in sport or other activities, sleep irregularities, irritability, change in appetite, and poor performance in sports or school. The recent position statement on mental health issues in athletes by the American Medical Society for Sports Medicine notes that the use of cognitive-behavioral therapy was stressed as an effective treatment for anxiety, depression, sleep disorders, and other mental health conditions in the youth athlete population.

Supporting psychological well-being in our young athletes feels especially urgent as we emerge from a pandemic that has probably affected everyone’s mental health in some way. Sports medicine experts are just beginning to seriously study the mental health problems that arise in youth sports, but it’s increasingly evident that constant competition, year-round training, and parental bad behavior can all contribute to worsening mental health in young athletes.

Dr. Chad Asplund is the executive director of USCAH, as well as a sports medicine physician and Professor of Family Medicine and Orthopedics at the Medical College of Georgia. Chad currently serves as the medical director for USA Basketball, and a team physician for USA Hockey, USA Triathlon, and Georgia Southern University. If you have any questions for Dr. Asplund, you can reach him at [email protected]

As a trusted partner with USA Baseball, we are pleased to offer a free online course, "Mental Health in Sport”. To access the free course, please visit and select “Create New Account with Program Code”. Enter your account information and the Program Code: PARENT. Follow the on-screen instructions after you create your account.

The U.S. Council for Athletes' Health (USCAH) was founded upon the need for trusted, independent athletic health care partners with the experience and expertise to advise and consult with organizations regarding their healthcare delivery system. This is why USCAH is committed to providing independent and unbiased medical expertise to organizations and individuals dedicated to the optimal health and safety for the athletes they serve. You can find out more about USCAH at or by reaching out to [email protected]

 High-Performance Coaching

High-Performance Coaching

Beyond the Diamond
By Dr. Anne Shadle

In this article, we will examine high-performance coaching. From here, we will look at specific coaching behaviors and how they affect performance. Today, we see the word “coaching” being used in many different fields. Whether you are a coach in sport, business or even in a leadership role, the word “coach” describes a way of interacting with people. Coaching is a specific type of behavior. Many leaders use coaching-type behaviors. We see these behaviors in leadership models such as transformational leadership theory (Wagstaff, Arthur, Hardy, 2017). The purpose of this article is to look deeper into specific high-performance coaching behaviors and how these coaching behaviors affect performance.

First, let’s look at the definition of COACHING and then HIGH-PERFORMANCE COACHING:

COACHING -> Leaders attempts to improve performance by facilitating the acquisition of new knowledge, skills, and competencies.

I have highlighted the words that I think are most important for us to examine for the purpose of this article. Please read through the entire definition and then take a second to reflect on the words highlighted. If we take the first definition of coaching, the keywords highlighted are knowledge, skills, and competencies. If you remember from the ABC’s of Self-Determination Theory, this theory says that the key elements needed in a person’s life to nurture intrinsic motivation are autonomy, belonging and competence. These elements lay the foundation for intrinsic motivation leading to a self-determined individual. The C within the ABC’s of Self-Determination Theory is competence when developing knowledge and skill.

• HIGH-PERFORMANCE COACHING -> A systematic application of collaborative, individualized, solution-focused psychological practices by leaders to enhance individual, group, or organizational performance. It is intended to support individuals in better regulating and directing their intrapersonal and interpersonal resources to attain goals and help individuals to maximize strengths through self-directed learning. (Wagstaff, Arthur, Hardy, 2017)

The words of importance highlighted here are: systematic application, enhance performance, support individuals, attain goals, help individuals, maximize strengths, self-directed learning. Out of these words, support, goals, help and self-directed learning are keywords/skills for our attention. These words speak to the A and B of the ABC’s within Self-Determination Theory which is the need for (A) - autonomy (goals, self-directed learning) and a sense of (B) - belonging (support individuals, help individuals).

In the field of psychology, we are interested in creating theories and frameworks from knowledge acquired that help us better understand and predict behavior. Keeping the Self-Determination Theory’s framework in mind, let’s next look into specific coaching behaviors.

Regardless of the employment area, the literature on all high-performance coaches has similar behaviors. Those behaviors are: observing and performance analysis, ask effective questions, facilitate goal setting, provide developmental feedback and motivational feedback (Wagstaff, Arthur, Hardy, 2017). These specific behaviors have been proven in research to offer psychometrically sound, brief, and easy ways to measure high-performance coaching behavior. This framework was developed through the workplace, leadership, and sport coaching literature (Wagstaff, Arthur, Hardy, 2017). What are these specific behaviors?

1. Observing and Performance Analysis
1. Plays close attention to what the athlete does
2. Carefully observes athlete’s skills
3. Carefully watches athlete doing the skills and drills
4. Analyzes athlete’s performance

Observation as a coaching behavior key. Try stepping back and taking a researcher’s eye to practice. Training as a researcher, one of my assignments in graduate school was to go into an environment that we were familiar with and sit back and observe. This allowed us to see the familiar environment through a different lens and from a different perspective. I challenge you to do the same. Step back, slow down and intentionally watch interactions and skills being practiced. What do you observe? Be specific on what you observe. Write down what you observe and think. Later allow yourself time to process what you have observed as it relates to performance analysis.

2. Effective Questioning
1. Encourages athlete to think about how they can improve performance
2. Encourages athlete to question the way they do things
3. Encourages athlete to make suggestions on how they think they can improve performance
4. Asks the athlete’s opinion on how they can improve performance

My graduate school professor would often remind us that, “It is twice as hard to LISTEN as it is to talk. This is why we have two ears and only one mouth.” Take the time to ask the right questions and then being PATIENT enough for the reply. PATIENCE can be very challenging yet extremely important and effective in helping our athletes perform. Coaches need to create space for their athletes to answer questions. Great teams I have been part of, have done this at team events, dinners and on bus rides when practice times did not allow for the time and attention needed. Effective questioning allows the athlete to understand and digest what they are learning. Effective questioning allows the development of a key piece of autonomy (ownership). Two challenges: 1. Think about a specific athlete and create a list of questions that get at helping them perform better. 2. Create a question list that addresses the four items listed above.

3. Goal Setting
1. Monitors athlete’s progress toward goals
2. Helps athlete set short-term goals
3. Helps athlete identify targets for attaining goals
4. Helps athlete set long-term goals
5. Provides support to an athlete to help attain goals

Coaches, hopefully, are usually pretty good at goal setting. They have meetings with their athletes at the beginning of the season, meetings (individual/team) throughout the season and reflection/summary/team input at the end of the season as well as setting goals for the off-season. I would encourage you to continue to improve on the five areas listed above. Continue to talk to your athletes about the process of success. Continue to build the vision for them on where we are going and how each individual in practice and training is responsible for helping us get closer to the end goal.

4. Developmental Feedback
1. Makes sure athlete understands what they need to do to improve
2. Gives athlete advice on how to improve their skills
3. Offers advice on what the athlete needs to do to improve
4. Shows the athlete how to improve their skills

Feedback is critical information that helps individuals understand how they are performing and what changes, if any, need to be made. Coaches have a lot of different ways in which they give feedback. Coaches employ different tools to give that feedback. Key factors for feedback are the development of skills and strategies that align with your athlete’s and team’s goals. Developmental feedback provides athletes with direction, builds self-awareness, allows for self- reflection, and performance improvement. In the organizational psychology literature, it has been found that developmental feedback is aligned with intrinsic motivation which enhances learning and improvement. What this is saying is that developmental feedback helps build intrinsic motivation in your athletes which helps them be more engaged in the learning and focused on improvement.

5. Motivational Feedback

1. Tells athlete when they do a particularly good job
2. Sees that the athlete is rewarded for good performance
3. Expresses appreciation when an athlete performs well
4. Gives athlete credit where credit is due
(The five topics listed above were adapted from Wagstaff, Arthur, Hardy, 2017).

There is a lot of research that highlights the importance of positive feedback and/or behavior that is reinforced or rewarded by the coach. Motivational feedback recognizes when the athlete performs well or does something well in training or competition. Providing genuine positive feedback about an athlete’s development and progress help coaches recognize improvement, build autonomy, and competence within their athletes. Coaching research shows that these autonomy-supported environments have been related to self-determination, persistence, and motivation. Autonomy-supportive coaching behaviors are important in helping our athletes perform and succeed (Wagstaff, Arthur, Hardy, 2017).

In closing, the purpose of this article was to look deeper into specific high-performance coaching behaviors and how those coaching behaviors affect performance. These behaviors are: Observing and Performance Analysis, Ask Effective Questions, Facilitate Goal Setting, Provide Developmental Feedback and Motivational Feedback (Wagstaff, Arthur, Hardy, 2017).


Wagstaff, C., Arthur, C., Hardy, L. (2017). The development and initial validation of a measure of
coaching behaviors in a sample of army recruits. Journal of Applied Sport Psychology, 30: 341-357, 2018.

Deci, E.L. (1975). Intrinsic motivation. New York: Plenum.

Deci, E.L. & Ryan, R.M. (2008). Self-determination theory: A macrotheory of human motivation, development, and health. Canadian Psychology, 49 (3), 182-185. Doi:10.1037/a0012801

Dr. Anne Shadle, Ph.D., is a contributor to the USA Baseball Sport Development Blog, a certified consultant in Sport Psychology CC-AASP, a member of the United States Olympic Committee’s Sport Psychology registry, and is currently the Senior Research Psychologist for the United States Air Force Research Laboratory.  She also serves on the Athlete Advisory Committee for USA Track and Field (USATF) and currently is the President-appointed committee chair for Psychological Services for USATF. She is heavily involved with coaching education and certification for the International Association of Athletics Federation (IAAF) and USATF. Shadle received her Bachelor of Science in Education and Human Sciences from the University of Nebraska, where she also ran track and field. She was a two-time National Champion in the mile and 1500 meter distances before going on to run professionally for Reebok and compete in the 2008 Olympic Trials.

 The Individuality of Coaching

The Individuality of Coaching

Beyond the Diamond
By Dr. Anne Shadle

As someone who loves psychology and finds the intricacies of human interaction fascinating, it is easy to see why I would be drawn to the topic of the individuality of coaching. Most of us would agree that the psychology of each person is quite fascinating. We might also agree that understanding the unique psychology and communication needed in coaching someone would prove to be important in helping our athletes achieve their fullest potential.

Each of our personalities, along with life experiences and the environment in which we live and learn plays a huge part in how we socialize, communicate and interact with others. The ability to relate to others is a key topic in effective communication and coaching.

- How do effective coaches build relationships and trust with their athletes?

- What are some keys to effective communication?

- How does effective communication help us to teach sport skills and evaluate progress in performance?

3 Keys to Effective Communication
• Cues
• Feedback
• Personal Coaching style

In the world of athletics, one of the most important sport skills is the mental ability to focus one’s attention. Previous research in the field of sport psychology has shown that successful athletes have honed their ability to use visual, verbal and kinesthetic cues to intentionally focus their attention. When distracted or not focused on the task at hand, these athletes also use visual, verbal and kinesthetic cues to refocus their attention. Research conducted with Olympic Medals winners indicates that cue systems were most successful when the cues had been established and used by the coach and the athlete in the weeks and months leading up to the Olympic finals (McGuire, Shadle, Zuleger, & Low, 2014). Both coaches and athletes reported that this type of communication was one of the factors that significantly helped the coach-athlete duo to win an Olympic Medal.

As expected, the actual cues a coach uses with athletes depends on both the coach and athlete and their preferences. It is important to understand the individual’s learning style and tailor your cues to that style. Listed below are some of the benefits, of using cues systems, for athletes as well as for coaches.

Cues from the coach help the athletes to:
1. Focus their attention on specifically what the coach considers to be most important in that exact moment – i.e., cues connect the coach with the athlete and are able to provide immediate guidance and attention to the athlete. Cues tell the athlete what they need to do, how to do it, and when to do it.

2. Immediate feedback, learning, and direction - these cues are especially important during practice because they tell the athlete about their progress. Loaded with information, these cues enable the athlete to make decisions about where to focus their time and effort; e.g., on perfecting technique, or developing strength or how to improve footwork/stance.

3. Feel supported psychologically - cues can give the athlete energy, reassurances, inspiration and have a calming effect.

Cues help the coaches to:
1. Direct the athlete’s focus and attention. By using a cue system coaches can provide specific feedback to athletes during practice as well as during competition in a very efficient and precise manner (Keep cue language short and to the point. Can you say it in 3 words vs. 10?) When a coach needs to communicate with an athlete and time is limited, such as in the heat of competition, a cues system can be especially valuable.

2. Immediate feedback, learning, and direction- these cues are especially important during practice because they enable coaches to teach athletes exactly what to do “next” or when they find themselves in a specific situation. Thus, cues help coaches process the information through their eyes, digest it and then teach athletes what to do next.

3. Provide psychological support to athletes and to maintain own emotional balance and mental fortitude - cues help the coach manage their own energy and composure while also helping to support the energy and composure of their athlete(s).

Effective ways to establish and use cues:
Use results from the individual communication style and preferences inventory to create a mutually acceptable plan for improving the efficacy of communication between the coach and the athletes.

How to give cues:
Cue from the ground up: verb body part direction
(Example: Lift your elbow up).

We know for an athlete to learn a skill, the skill must first be performed and programmed into their body’s motor learning. Skill is defined as, “the capability to bring about some desired end result with maximum certainty and minimum time and energy,” (Schmidt and Lee, 2014). A few of the different components involved in the process of learning and performing a skill are the perceptual or sensory processes, along with decision making, and finally the movement. Taking the time to explain why you are doing something and connecting it to the end goal for the athlete helps to strengthen not only trust with the athlete but also understanding the learning that is occurring.

When giving feedback, it might feel like you are saying the same thing over and over. This is part of the learning process. When you teach, you often repeat the same thing, but it helps to vary how you say the same thing until the athlete gets it. This is when you know a cue works. A cue that works for one athlete might not make sense to another and vice versa. The great John Wooden has a book entitled, You Haven’t Taught Until They Have Learned: John Wooden’s Teaching Principles and Practices. This is a great book to further dive in and learn more about the individuality of coaching individuals as well as a team.

How much feedback is too much?
It has been found with a group of elite Olympic athletes that one correction was enough for the athlete when learning a new skill. Coaches must prioritize, from their own coaching style, what is most important. This will help guide which corrections are most important and need to be made first. Some athletes can handle two corrections but for most one correction was enough when learning a new skill. Once the athlete has mastered and made the first correction, you can move on to another.

The issue we often see is that coaches give too much information with their feedback which can often overwhelm the athlete (it is also too much information for the brain to process-thus why the athlete feels overwhelmed). It is best to take it slow when coaching/teaching new skills or correcting/breaking bad habits. Some athletes will adapt and learn quicker, others are less flexible and thus take more time to learn new skills. This is where the psychology of the individual comes into play and understanding how your athlete learns and the style in which they best absorb the information being communicated.

One final note: I would caution learning a new skill or changing the way an athlete does something too close to championship competitions. We want the athlete to feel confident going into major competitions. If this is a new skill you are working on and it is early in the season, I would say go ahead and work at that new skill. Be sure to communicate that information and the learning process to your athlete. For example, “I know we are working on this new batting stance. I want you to stick with this during the next game.”

Dr. Anne Shadle, Ph.D., is a certified consultant in Sport Psychology CC-AASP, a member of the United States Olympic Committee’s Sport Psychology registry and is currently the Senior Research Psychologist for the United States Air Force Research Laboratory.  She also serves on the Athlete Advisory Committee for USA Track and Field (USATF) and currently is the President-appointed committee chair for Psychological Services for USATF. She is heavily involved with coaching education and certification for the International Association of Athletics Federation (IAAF) and USATF. Shadle received her Bachelor of Science in Education and Human Sciences from the University of Nebraska, where she also ran track and field. She was a two-time National Champion in the mile and 1500 meter distances before going on to run professionally for Reebok and compete in the 2008 Olympic Trials.

 Fueling Gains in Lean Mass During the Off-Season

Fueling Gains in Lean Mass During the Off-Season

By Dave Ellis, RD

Sprint, Lift, Fuel, Sleep! These are four keys for any baseball athlete who seeks to build lean mass during the off-season. The great news is that the way you would train to be a more explosive baseball athlete is also the way you need to train to add lean mass.

While the focus of this article is fueling gains in lean mass during the offseason, one of the most fundamental elements for gaining lean mass is to simply find a good training partner! A good training partner with similar goals can help you attempt extra reps that alone, you would potentially be too fatigued to attempt alone. A good training partner challenges you to up the weight on the bar when you are completing your reps on a set too easily. Most importantly, a good training partner creates some meaningful accountability to show up and work out when you really felt like taking the day off. However, even if you have the most dialed-in workout to stimulate gains in lean mass and a good training partner, your drive to work out will be greatly compromised if you are coming up short on your sleep as will your ability to resolve muscle soreness from one workout to the next (deep sleep, or slow-wave sleep & hGH) (1).

When it comes to the fueling side of the story for adding lean mass, realize that your first decision cannot be a trip to the local supplement retailer or some questionable website. If you walk into any dietary supplement retailer, a good portion of the store will be dedicated to products purported to improve your chances of doing more work in the weight room or improve recovery efficiency from bouts of resistance training (2, 3). Unfortunately, the cast of characters behind many of the energy and muscle focused dietary supplement brands seem to feel they can’t compete in the marketplace unless they intentionally adulterate dietary supplements with active pharmaceutical ingredients (APIs) that can cause positive doping outcomes for drug tested athlete and risk drug to drug interactions for anyone using medications! This is such a big problem that the US Department of Defense has dedicated extensive resources to the identification of API adulterated dietary supplement trends that put our military warfighters at risk (Operation Supplement Safety), as has US Anti-Doping with educational resources for drug tested athletes (Supplement 411) (4, 5). Many who desire a leaner, more muscular body are vulnerable to seek out and abuse “appearance and performance enhancing drugs” that could cause serious physical and mental health dilemmas. Organizations like the USA Baseball, the Taylor Hooton Foundation (THF) and the American Academy of Pediatrics are dedicated to raising awareness with young athletes who often seek to accelerate biochemical maturation by any means possible (6, 7).

Making gains in lean mass each off-season and hanging onto the gains in-season allows young baseball athletes to gradually fill out their frames from one year to the next. This is a process that continues into the collegiate year for the majority of male power athletes. It’s a long process that requires patience and dedication. Here are some key dietary elements for adding lean mass:

• Athletes who are trying to gain weight are most likely going to be pushing their calorie intakes up above the 18-21 kcals per pound of goal body weight.
• Protein-calorie distribution over the course of the day is very important when training three to four days per week with hypertrophic loads in the weight room designed to add lean mass. Binge eating patterns are not going to get the job done when it comes to lean mass gains or visceral fat avoidance (8, 9).
• Essential amino acid (EAA) rich protein sources are key to ramping up the tissue remodeling process to recover from hard resistance training sessions. Exactly how the EAA-leucine acts is still under investigation, but it’s a well-established fact that has elevated the value of high leucine protein sources in the marketplace, targeted at muscle sparing and recovery (whey isolate, egg white, casein, soy isolate) (10, 11). This is why you will see the same proteins in the formulation of recovery shakes and bars that often utilize a blend of fast digesting whey, slow digesting casein and moderate pace digesting egg white or soy protein isolate.
• The priority right after a workout is hydration and getting some well-timed carbohydrate into your bloodstream. By the time a baseball athlete gets out of the shower, it will be time to either eat an EAA-leucine rich meal or gap up till meal time with an EAA-leucine rich recovery snack or shake of some type. For drug-tested athletes, we only use NSF Certified for Sport dietary supplements or highly fortified conventional food snacks (functional foods) because of the aforementioned adulteration trends from some unethical fraudsters in this space… supplements are riddled with stimulants, many of which can’t be accounted for on the label. Stimulant based pre-workout products are some of the most highly API adulterated dietary supplements that routinely cause positive drug tests for athletes. A safer and smarter pre-workout alternative is hot tea with beet powder to stimulate nitric oxide driven blood flow and work capacity, all while helping manage blood pressure (12, 13, 14).
• Creatine can also be put in the pre-workout mix for college athletes who are still struggling to gain a functional amount of lean mass, but it’s not ideal for high school athletes trying to gain lean mass. There are big gains coming for high school athletes initiating offseason workouts designed for adding lean mass. There is also a significant vulnerability for adulteration of creatine products with API’s. If you do go this route, PLEASE find an NSF Certified for Sport source of creatine and use it pre-workout on the days you lift. No loading, no use on days you don’t lift. You will find that you can do more reps at the same weight and ultimately increase the amount of weight used (15, 16, 17).
• While supplements like creatine do help athletes gain lean mass as a result of increased rep capacity during workouts, I can tell you, athletes quickly fatigue of dietary supplements. Athletes never get tired of eating and they have always sought out protein snacks before bed, so it was no surprise to see some research surface in 2015 that looked at the benefits of a protein snack before bed for athletes who seek to gain lean mass (18). Greek yogurt works great as a slow digesting protein source that supports recovery while we sleep and leaves athletes hungry for breakfast!

I could continue, but let’s stop here for now. If you would like to digest all that goes into High-Performance Fueling you can watch this American College of Sports Medicine (ACSM) webinar from 2016 “Nutritional Myths & Practices of the Elite Athlete” that will answer many of your questions.

2. Muscle Energetics During Explosive Activities and Potential Effects of Nutrition and Training
3. New strategies in sport nutrition to increase exercise performance
4. DOD - Operation Supplement Safety (OPSS)
5. USADA - Supplement 411
6. Taylor Hooton Foundation
7. Promotion of Healthy Weight-Control Practices in Young Athletes
8. Timing and distribution of protein ingestion during prolonged recovery from resistance exercise alters myofibrillar protein synthesis
9. Quality protein intake is inversely related with abdominal fat
10. Sestrin2 is a leucine sensor for the mTORC1 pathway
11. Whey protein ingestion enhances muscle protein synthesis in aging males
12. Nitrate Intake Promotes Shift in Muscle Fiber Type Composition during Sprint Interval Training in Hypoxia
13. Effects of Chronic Dietary Nitrate Supplementation on the Hemodynamic Response to Dynamic Exercise
14. Dietary nitrate provides sustained blood pressure lowering in hypertensive patients: a randomized, phase 2, double-blind, placebo-controlled study
15. Creatine supplementation combined with resistance training in older men.
16. Creatine supplementation improves muscular performance in older men.
17. Effects of creatine supplementation and exercise training on fitness in men 55–75 yr old
18. Protein Ingestion before Sleep Increases Muscle Mass and Strength Gains during Prolonged Resistance-Type Exercise Training in Healthy Young Men

Dave Ellis, RD, CSCS is a veteran Sports RD with over three decades of experiencing working at the highest level of sports. Dave was the first president of the Collegiate and Professional Sports RDs Association (CPSDA) and is currently CPSDA’s Ambassador over all matter Food and Supplement Security related, as well as the President of Sports Alliance Inc. and creator of the Fueling Tactics System. Dave is also the Consulting Registered Dietitian for MLB/MLBPA and USA Baseball.