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How to Coach Athletes with ADHD from Personal Experience

BY Tom Epton

Being aware of the condition and how it can impact an athlete's training and performance is vital to having an empathetic relationship with your athletes.

Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder leading to overactivity, erratic behavior, and inability to concentrate for long periods. I know this condition well, as I’ve spent my whole life managing it. As a coach becomes more and more experienced, they’ll coach athletes who either have been diagnosed and possibly medicated or someone who exhibits the behaviors of ADHD. Extraneous factors can also affect symptoms, which can be induced by sport-related factors, often exacerbating ADHD symptoms, especially hyperactivity.

Many of the symptoms experienced by athletes can affect training and an athlete’s approach to it. While ADHD is not a limiting factor to performance, it requires the coach’s awareness, empathy, and sensitivity to recognize when an athlete is undergoing symptoms. To do this, coaches must be aware of the symptoms of ADHD and also know-how these may influence training. Some research points to physical health and activity reducing the negative effects of ADHD, at least in adolescents.

Symptoms of ADHD and Training Effect

  • Impulsiveness: This can lead to an athlete exhibiting behaviors such as going off-plan and doing “unexpected efforts” during easy endurance sessions, entering races at the last minute and doing different training than the coach prescribed. Impulsiveness should be met with flexibility from coaches. Training will need to be adjusted based on any training load increase if an impulsive session has been conducted.
  • Disorganization: Lack of time management skills can lead to missed workout sessions. One way of combating this is scheduling definitive plans and workouts into TrainingPeaks and encouraging your athletes to consciously schedule more aspects of their lives. Helping guide time management will increase the proportion of training completed as planned and lead to a happier, better-adjusted athlete.
  • Problems Focusing: Long training sessions can lead to focus problems for an ADHD athlete. Giving athlete-specific goals to work on during these sessions can help them maintain focus. This approach also prevents other impulsive “random efforts” from happening and the desired training effect of the session to be achieved.
  • Trouble Multitasking: This is a common symptom of ADHD but typically doesn’t impact endurance sports training. With a focus on a specific workout activity, the activity typically doesn’t lead to multitasking concerns. Keep this in mind when prescribing strength sessions or training with several aspects.
  • Excessive Activity/Restlessness: Fighting an athlete’s desire to “do more training” and restlessness from recovery periods is common among many endurance athletes, as most coaches know. An athlete with these tendencies does not automatically mean they have ADHD. Recovery from hard training is an achievement and should be stressed in the TrainingPeaks comments or notes section — the goal of an easy day is to recover.
  • Poor Planning: Many athletes with ADHD will seek a coach for this exact reason. Sometimes, seeing the “bigger picture” can be tricky. If an athlete recognizes this as a weakness, they will seek help, which is where a coach can be extremely beneficial.
  • Low Frustration Tolerance: All experienced coaches will know that endurance sports performance gains are rarely linear, which must be stressed to any athlete. Individuals with ADHD will struggle with “trusting the process” if their progress is not plainly evident. Explaining the long-term vision and revisiting goals with your athlete with clear direction is likely to mediate this low frustration tolerance; however, this can be tricky.
  • Frequent Mood Swings: People with ADHD tend to experience high highs and low lows. Frequent mood changes are something coaches will not interact with too often; however, tough training sessions can provoke mood swings if a workout has not been completed or misses any measured goals. This is something that can’t always be avoided by coaches, however.
  • Stress Sensitivity: Low-stress tolerance is a common symptom of ADHD. These athletes often feel as if they’re overwhelmed faster or easier than others. Often this stems from disorganization as they have no clear path to resolve what is causing the stress. During periods of high stress, coaches should be wary of piling on heavy training loads to avoid backsliding in training or managing symptoms.

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How ADHD Medication can Impact an Athlete

Often, individuals with ADHD require medication to help them adapt to everyday life. Common medicines to medicate ADHD are methylphenidate, lisdexamfetamine, dexamphetamine, atomoxetine and guanfacine. These drugs all have side effects, including loss of appetite, trouble sleeping, headaches and more. Some medications have a performance-enhancing effect and as a result, some are banned or restricted. If you’re working with high-level athletes, it may be worth looking into these rules to ensure no anti-doping violations occur inadvertently. If an athlete has been prescribed medication, a coach would ideally be aware of the drug use and how the side effects may impact training. Depending on the local laws, a coach may not be able to ask for this information legally.

If an athlete is suffering from a loss of appetite from their medication, a common side-effect, pay close attention to their diet and cumulative training load. In multiple studies, dietary deficiency has been linked with athletes’ bone stress issues.

Thoughtfully Managed, Success with ADHD is Attainable

ADHD may be overrepresented in adults competing in athletic events relative to the population. A 2011 study shows that sports therapy reduced anxiety in children with ADHD. It’s possible that adults, through greater life experience, have discovered this also works for them. Most psychological research regarding ADHD and sport seems to have been done on children, with studies on adults thin on the ground.

The disorder can impact athletes through some or all of the symptoms discussed above and performance issues from medications. There are a few more pitfalls to monitor with these athletes, whether it’s boredom leading to silly efforts on rides and runs or medicine leading to an athlete feeling unwell or not wanting to eat. ADHD is a common condition that coaches are likely to encounter during their careers. The personality traits associated with the disorder can help and hinder triathlon training. Many athletes with the condition have found ways to manage their health well enough that others would not even know.

Athletes with ADHD can discover what works for them with the help of an empathetic coach. While some of the behaviors exhibited can be frustrating to a coach, they must be met with clear and kind communication — making an athlete aware of destructive behavior will lead to them becoming better in the long run. This article was written from the perspective of an athlete with ADHD and not intended as medical advice. Please direct your athlete to a qualified doctor or mental health practitioner for medical advice.

To read more about the symptoms of ADHD and learn more about how the condition is managed or how it can affect various aspects of an individual’s life, you can find more information on the Johns Hopkins website.

Resources

Pagani, L. et al. 2020, April 7. Childhood exercise as medicine: Extracurricular sport diminishes subsequent ADHD symptoms. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0091743520302802

Nazeer, A., et al. 2014, June 17. ADHD and Adolescent Athletes. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4060024/

Lufi, D., Parish-Plass, J. 2009, December. Sport-Based Group Therapy Program for Boys with ADHD or with Other Behavioral Disorders. Retrieved from https://www.tandfonline.com/doi/full/10.1080/07317107.2011.596000

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About Tom Epton

Tom Epton is a writer and data scientist based in the South East of England. He is a founding member and principal data scientist at PyTri Ltd, a consultancy specializing in applying data science techniques to performance sports and healthcare. Tom has a first-class BSc in Physics and has worked at several well-known brands on big data and machine learning projects. Away from work, he is an elite triathlete racing a mixture of draft-legal short courses on the British Super Series to middle-distance non-drafting triathlons. Tom also offers coaching, physiological testing and endurance sport consultancy services. Email him for more information.

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