• SPRINT project

What every coach needs to know about ADHD & athletes




Attention deficit hyperactivity disorder or ADHD affects 3-5% of children and 2% of adults, but these rates may be even higher in athletes. Some of the World’s most successful athletes are known to have ADHD, including for example:

  • Michael Phelps (swimmer)

  • Louis Smith (gymnast)

  • Bubba Watson (golfer)

  • Simone Biles (gymnast)

  • Ashley Mckenzie (judo)

  • and Adam Creek (rower).

Given how common ADHD is in athletes, it is important for every coach to better understand neurodiversity, or the different ways human brains may function, and the effects of ADHD. This knowledge is not only important for coaches, but anyone in the sporting support network of athletes (e.g., managers, teammates, captains and nutritionists).


This post is the first in a new series on the SPRINT project website. It will focus on what ADHD is, how to recognise its symptoms and outlines key benefits of participating in sport for people with ADHD. This understanding will help coaches to better support their athletes with ADHD to reach their full potential and experience positive mental health.


First, let’s take a closer look at what neurodiversity means. Neurodiversity is a way of describing the human brain and its differences compared to the ‘typical’ human brain. Known as neurotypical, humans have invented this concept to identify what is ‘normal’ in human society. Those that do not fit into this ‘norm’ are referred to as neurodiverse. It explains differences in the wiring of the brain and therefore its functioning which can be displayed as behaviours. Examples of neurodiverse conditions include: autism, ADHD, ADD, dyslexia and dyspraxia.


But what exactly is attention deficit hyperactivity disorder (ADHD)? The main symptoms of ADHD are listed in the below table (adapted from: NHS). It is important to remember that not everyone who has these symptoms will have ADHD and a diagnosis must be made by a qualified medical professional.

Symptoms of inattentiveness

Symptoms of hyperactivity and impulsiveness

Short attention span

Fidgeting

Difficulty with organization and time management

Interrupting people

Easily distracted

Answering questions before they have been asked

Difficulty completing time consuming tasks

Talking lots

Difficulty following instructions

Difficulty waiting

Often changes tasks

Not thinking before acting

​Difficulty blocking out thoughts and environmental stimuli including noises, conversations or visual stimuli

​Act as if ‘driven by a motor’

But ADHD is a misunderstood and complex condition, not helped by its name. The name suggests that all individuals experience the same symptoms, have a deficit in attention, and are hyperactive. Calling it a disorder implies that all the symptoms of ADHD are negative.


However, not everyone with ADHD will experience all symptoms or show them in the same way. Also, there are far more symptoms than the name suggests. For example, there are said to be 3 main ‘types of ADHD’:

  • Predominantly inattentive: also referred to as attention deficit disorder (ADD)

  • Predominantly hyperactive and impulsive

  • Combined – inattentive, hyperactive and impulsive

These different types of ADHD help to explain the most significant symptoms that an individual experiences.


Finally, ADHD is not a disorder, no matter what type we are talking about. In fact, there are positive and negative aspects to it, as there are to all personality traits. For example:

  • ADHD symptom: Act as if 'driven by a motor'

  • Positives: Can achieve many tasks in a day, and comes across as enthusiasm

  • Negatives: Can be exhausting for the individual

  • ADHD symptom: Often changes tasks

  • Positives: Can work on many things and tasks at the same time

  • Negatives: Can become overwhelming for the individual, and can result in tasks taking a long time to complete

But wait, isn’t it only children who experience ADHD?

ADHD is often thought of as a childhood condition. There is a myth that people will ‘grow out of it.’ This is not true. The condition does continue into adulthood, but the symptoms may appear differently to those of a child.


For example, this table (adapted from: I Have ADHD) shows additional symptoms and behaviours that are not always discussed or seen. These may be more common in adults than in children.

Symptom

Examples of behaviours

Impulsivity: there is no “stop and think”

  • Starting tasks without thinking about the steps involved, resulting in unfinished tasks

  • Quick decision making

  • Interrupting

Distractibility: paying attention to too many things at once

  • Hyper-focusing on one thing until it is finished – unless something more exciting is found

Seeking gratification: Seeking instant gratification rather than long-term rewards

  • Tedious tasks are extremely difficult

  • Intolerance for boring or un-interesting tasks e.g., sorting bills

Restlessness: hyperactivity as a child, but it may look different in adulthood

  • Thoughts running through the brain at 1000 mph

  • Doing everything quickly e.g., thinking, reacting & speaking

  • Difficulty relaxing

  • Fidgeting, tapping feet, and difficulty sitting still

Time blindness: lack of awareness of time

  • ​Difficulty estimating time tasks will take

  • Often running late

  • Procrastination of tasks until they are due

Emotional dysregulation: difficulty managing emotions

  • Feel things more intensely and may get more upset than what is seen as 'normal'

Poor working memory: Difficulty keeping things in the mind long enough to accomplish a task

  • Forgetting to do things

  • Forgetting and losing things

Difficulty with organization: lack of method or system in life

  • Difficulty prioritising as everything seems important

  • Difficulty making plans

Task initiation & completion:difficulty starting overwhelming, hard or boring tasks, but difficulty finishing them once they’ve been started

  • The need for deadlines to get things done

  • Difficulty finishing un-interesting tasks

Limited ability to self-reflect: difficulty assessing progress, learning from the past, or planning for the future

  • Making the same mistakes repeatability

  • Difficulty setting or remembering goals


Masking means that these symptoms may not be seen to the outside world.


Masking is the actions individuals take to hide ADHD symptoms to feel that they are a better fit in society.


ADHD is a hidden disability and can be further concealed by individuals masking their symptoms. It can be exhausting and can contribute to mental health issues.


So now that we have looked more closely at what AHDH is and how it might affect a person’s behaviour, what does all of this mean for the world of sport and exercise?


Sport & Exercise and ADHD


The importance and benefits of sport & exercise for those with ADHD


Sport and exercise can provide benefits for all humans but can be particularly beneficial for those with ADHD. Being physically active increases two chemicals (known as neurotransmitters) in the brain called dopamine and norepinephrine. It has been suggested that individuals with ADHD have a shortage of both.


Dopamine helps with emotional regulation and feeling pleasure whilst norepinephrine helps with concentration and paying attention. Therefore, sport and exercise can help with various ADHD symptoms including focus and emotional regulation, and the behaviours associated with these. Sport and exercise can also help athletes with ADHD to manage restlessness and excess energy.


Besides from chemicals, sport is an important way to build confidence in those with ADHD. Many have low self-esteem due to struggles in the education system or at work, negative consequences of their behaviours, and exhaustion from masking. This is because most of society is not accommodating for ADHD because of a lack of knowledge and understanding of the condition. Sport serves as a much-needed confidence boost for those struggling in this ‘neurotypical’ world.


As you can see, there are many benefits of sport and exercise - not only for athletes, but importantly for non-athletes with ADHD, too. Conclusion and further resources


This post has highlighted some of the biggest misconceptions surrounding ADHD, and how the name contributes to this misunderstanding. It has explained the main symptoms of ADHD, and how these may be different in adulthood. This will help coaches to better to understand athletes with ADHD, and why they may behave in the way that they do. This is important because of the significant role coaches play in the lives of their athletes, the wide reach of sport, and the number of individuals with ADHD.


We have also seen how sport and exercise produce many benefits for managing the symptoms of ADHD. What is needed now is action to make sport a more inclusive environment for those with ADHD.


This post should spark further discussion and motivate those in the sporting environment to better understand neurodiversity, including ADHD. This will move us a step closer to making society more accommodating for those with ADHD and other neurodiverse conditions, to improve their quality of life.


In the next post we will discuss:

  • the benefits of ADHD symptoms in a sporting context

  • difficulties that an athlete with ADHD might face

  • and practical recommendations for those in the sporting network to support athletes with ADHD to perform optimally and experience positive mental health.



Bio: This post was written by Kirsty Brown, an MSc by Research student in the School of Sport, Exercise and Rehabilitation Sciences at the University of Birmingham. Her research interests include mental health stigma, student athlete mental health, and mental health help-seeking in athletes.



Here are some resources used in this blog post if you want to read more:


ADHD Project Subgroup CAMHS Advisory Group. (2018). Delivering effective services for children and young people with ADHD: Good practice guidance for commissioners and service providers across Greater Manchester. https://www.england.nhs.uk/north-west/wp-content/uploads/sites/48/2019/03/GM-wide-ADHD-guidance.pdf


ADHD UK. (n.d.). About ADHD. Retrieved October 18, 2021, from https://adhduk.co.uk/about-adhd/


Barkham, P. (2012, August 1). What can athletes with ADHD teach us about the condition? https://www.theguardian.com/society/2012/aug/01/athletes-with-adhd


BBC News. (2016, September 14). Simone Biles “not ashamed” and “not afraid” as Russian hackers reveal ADHD treatment - BBC News. https://www.bbc.co.uk/news/newsbeat-37361676


Cassata, C. (2015, December 11). What is norepinephrine? https://www.everydayhealth.com/norepinephrine/guide/


Coach Brock Bourgase. (2014, July). Coaching student-athletes with attention deficit/hyperactivity disorder (ADHD). https://bourgase.com/teaching/special-education/adhd/


Duggal, N. (2021, September 1). Attention deficit hyperactivity disorder (ADHD): The role of dopamine. https://www.healthline.com/health/adhd/adhd-dopamine


Everill, B. (2021, June 18). Bubba Watson opens up about mental health struggles. https://www.pgatour.com/long-form/2021/02/16/bubba-watson-opens-up-mental-health-struggles-adhd-anxiety.html


Hattenstone, S. (2017, May 6). Nicola Adams: ‘I jumped in front of my mother and tried to protect her’ . https://www.theguardian.com/sport/2017/may/06/nicola-adams-i-jumped-in-front-of-my-mother-and-tried-to-protect-her


I Have ADHD. (n.d.). A breakdown of adult ADHD symptoms. Retrieved October 18, 2021, from https://ihaveadhd.com/adult-adhd-symptoms/


Moodcafe. (n.d.). A coach’s guide to attention deficit hyperactivity disorder (ADHD). Retrieved October 18, 2021, from https://www.moodcafe.co.uk/media/43280/A Coach’s Guide to ADHD.pdf


NHS. (2018). Symptoms of attention deficit hyperactivity disorder (ADHD). https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/symptoms/


PTS coaching. (2019, September 19). Helping kids with ADHD thrive in sports. https://ptscoaching.com/2019/09/helping-kids-with-adhd-thrive-in-sports/


Wake Forest University. (n.d.). What is neurodiversity? Definition and resources for teachers, counselors and schools. Retrieved October 18, 2021, from https://counseling.online.wfu.edu/blog/what-is-neurodiversity/



Journal articles:


Beyer, R., Flores, M. M., & Vargas-Tonsing, T. M. (2008). Coaches’ attitudes towards youth sport participants with attention deficit hyperactivity disorder: International Journal of Sports Science & Coaching, 3(4), 555–563. https://doi.org/10.1260/174795408787186422


Braun, R., & Braun, B. (2014). Managing the challenges of hidden disabilities in youth sport: A look at SLD, ADHD, and ASD through the sport psychology lens. Journal of Sport Psychology in Action, 6(1), 28–43. https://doi.org/10.1080/21520704.2014.991051


Ekman, E., Hiltunen, A., & Gustafsson, H. (2021). Do athletes have more of a cognitive profile with ADHD criteria than non-athletes? MDPI, 9(5), 61. https://doi.org/10.3390/SPORTS9050061


Franke, B., Michelini, G., Asherson, P., Banaschewski, T., Bilbow, A., Buitelaar, J. K., Cormand, B., Faraone, S. V., Ginsberg, Y., Haavik, J., Kuntsi, J., Larsson, H., Lesch, K. P., Ramos-Quiroga, J. A., Réthelyi, J. M., Ribases, M., & Reif, A. (2018). Live fast, die young? A review on the developmental trajectories of ADHD across the lifespan. European Neuropsychopharmacology, 28(10), 1059–1088. https://doi.org/10.1016/J.EURONEURO.2018.08.001


Ng, Q. X., Ho, C. Y. X., Chan, H. W., Yong, B. Z. J., & Yeo, W. S. (2017). Managing childhood and adolescent attention-deficit/hyperactivity disorder (ADHD) with exercise: A systematic review. Complementary Therapies in Medicine, 34, 123–128. https://doi.org/10.1016/J.CTIM.2017.08.018


Pagani, L. S., Harbec, M. J., Fortin, G., & Barnett, T. A. (2020). Childhood exercise as medicine: Extracurricular sport diminishes subsequent ADHD symptoms. Preventive Medicine, 141, 106256. https://doi.org/10.1016/J.YPMED.2020.106256



Photo credit: @kenna.eliza on Reshot


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