Tokyo 2020

An Insight into Tokyo 2020 Paralympic Games by Team GB Prosthetist, Richard Nieveen

Preparation in sport is key; its huge, it’s everything.

Every athlete knows the value of “optimisation” so as a prosthetist preparing an elite level prosthesis, there are many small gains which can add up incrementally, to deliver a significant advantage

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It was a privilege to be given official accreditation by British Paralympic Association (BPA) and to be the first prosthetist to be part of Paralympics Team GB for the Tokyo 2020 Games. Paralympic accreditation is a very significant document; it dictates where you can go and what you can do at the Games. Unlike previous Games (London 2012 and Rio 2016) where I travelled independently as personal prosthetist with occasional access to a workshop, in Tokyo I was with the athletes 24/7 as they prepared and competed in their events.

The preparations for Tokyo 2020 began soon after the Rio 2016 closing ceremony. Anyone involved in competitive sport will know that preparation is key. Certainly, in the year that we have had, in what was to be a lockdown games, what you appreciate is that absolutely nothing is left to chance.

The attention to detail across all sports is incredible. For example, the Olympic astro pitches and features of the aquatics centre were replicated in training facilities in the UK so that the athletes are familiar with the environment or playing surface, at or on which, they would be competing in Tokyo. Where this is not feasible (for running tracks, for example) athletes rely on test events prior to the games to test out the facilities for their own sport.

However, as a result of the pandemic, there were no test events in Tokyo, therefore track and field athletes did not have the opportunity to even step onto the Tokyo stadium track prior to their Paralympic event. Every track is different; the bend radius and the track surfaces are typically are made firmer for each Olympic host stadium in an attempt to achieve world records over the sprint events. This makes preparation and selection of running blades a complex process. The difference between a hard and soft blade and a hard and soft track is very significant in terms of prosthetic preparation. The German long jumper Markus Rehm made reference to this after winning gold in the long jump; he explained that the run-up track was very fast, however he found it difficult to convert the speed into distance jumped with so little track time and was unable to improve on his previous world record jump of 8.62m set earlier this year.

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In elite level sprinting or long jump the forces transmitted through the prostheses are significantly higher than in normal activities therefore the fit of their prosthesis for both training and competitions become more critical and the time required in optimising socket fit and blade alignment significantly increases.  The running blades are manufactured in Iceland by Ossur and we have been able to work closely with them over many years during the blade design stage with access to gait and force analysis to analyse running mechanics and performance. They were one of the many important partners in this journey.

The specific preparation around travel in terms of Covid testing and paperwork was enormous for both athletes and staff; simply getting on the plane was a major achievement.

On arrival in Tokyo we were met by the most personal and warm welcome. Anyone who has travelled to Japan will know how welcoming they were as a nation, in contrast to what was being portrayed by media in the build up to the games. Every morning when leaving our holding camp hotel and arrival at our training facility in Yokohama we were greeted with such warmth and walked through a procession of games makers and local staff holding banners and waving flags. This was repeated on leaving each day and right up to the final day when the remaining few athletes left the holding camp for the Paralympic Games village.

Our first destination was the holding camp, in Yokohama. To arrive at the holding camp for me was a whole new experience. Having been very focussed on the track and field sprinters (Richard Whitehead, Jonnie Peacock and Sophie Kamlish) and a long jumper (Stef Reid) I had been working with, we were then surrounded by about 60 athletes from many different sports along with the coaches, guide runners and support staff.

The function of a holding camp is acclimatisation; to temperature (which was significant factor – 35⁰C most days with 70 – 80% humidity) and the time zones, allowing athletes to start fine tuning and tapering their training to the critical day.

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For me as a prosthetist I knew from my time in Rio to prepare for a very different experience in that you know what your job and responsibility is but to adapt your role into what is a very strange place in terms of being able to do that job in very different surroundings with athletes and coaches under intense psychological pressure was an interesting adjustment in itself.

During the week in holding camp I continued where we left off in the UK in fine tuning prostheses. This was obviously late in the proceedings to make change but the reality was having lost 18 months of preparation due to the pandemic, this concentrated time together with their coaches on competition surfaces allowed time to further optimise where we could.

The extreme heat played havoc with some of the materials and bonds therefore a number of visits were made to local prosthetic workshops to effect repairs or make adjustments, all under the watchful eye as our movements in and around Tokyo was tracked on the mandated mobile phone Apps.  However, and fortunately unlike at Rio 2016 there were no major issues with either socket builds or blades failing.

After 8 days at the holding camp in Yokohama, I moved to the Tokyo Games hotel which was central to the various arenas and the main Olympic Athletics stadium. This was a welcome change and as the games had started and the months and years of preparation was now being played out, on the track and field, in addition there was the opportunity to see the prostheses other athletes were using and to talk and share the experience with athletes from other counties.

The days were long. When in the village and games hotel the day started at about 6 am with daily COVID testing before transferring to the stadium and warm up track. The warmup track is adjacent to the stadium and is where athletes spend the final hours before their event. In the days leading to competition, we would meet and make final changes to alignment, check connections and components. With a +8 hour time difference with the UK late afternoon in Tokyo was the start of the working day in London and work often continued through the evening after the competition finished which was typically around 9:30 pm.

With respect to prosthetic support, all athletes have their final days of physical preparation pre-competition carefully planned out months in advance. The psychological preparation is also key; some athletes want people around them while other want there own time and space. Knowing when to be close by or at a distance (with individuals you know very well) was important.

The feedback from the athletes was that they appreciated my presence as it came with the reassurance that I had conducted the necessary checks and that I was on hand should there be a sudden catastrophic failure necessitating a socket repair or blade change.

Prior their events being at the warm-up track I was able to provide support to athletes who didn’t have their personal coach with them, while others were in their own zone and quietly got on with the job in hand and some just needed chat and banter to help them relax

No one can prepare you for the highs and lows in sport, it is amazing and also devastating with such fine margins; by example Team GB missed out on two medals in both the women’s and men’s long jump by a total combined distance of 5cm or by 0.003 of a percent.

You hear athletes talking about the importance of the team and the strength in team GB, to witness the established athletes at the 3rd or 4th Paralympics supporting those at their 1st games, along with the preparation and coaching support is something very special and has to reflect on the financial investment in sport, by lottery funding and professionalism with which it is run.

I am particularly very proud of the four athletes I had supported in their preparations for the games, with sprinters Jonnie Peacock and Richard Whitehead both winning medals at what was their third Paralympic Games and Sophie Kamlish who has reached the final in both Games she has attended. And of course Stef Reid, long jumper, who narrowly missed a medal at this, her fourth Paralympic Games, before swapping her jumping blade for a microphone to join the Channel 4 commentary team.

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Going home, moving forward, the memories, the experience appreciation of the opportunity that I had. The opportunity to be there, to experience the emotions with the athletes with the support staff is something that I will always remember. I had been part of that big jigsaw, a small part of a big team that came second in the medals table; a huge achievement after the 18 months of Covid we have been through.

In my own clinic we understand and see the power and role sport has in rehabilitation across all age groups and levels of disability, so to be a part of this at an elite level was truly memorable.

If you’re wondering what’s next; with only 3 years to go to Paris 2024, the preparations started before we left Tokyo!