Traveling Management

  • Steven R. JosephEmail author


Significant (often international) travel is a common event in the life of elite athletes and teams; increasingly recreational athletes are participating in overseas competitions. This provides unique challenges for both the athlete and the supporting medical staff regarding training and performance. Knowledge of international climates, insect-borne diseases, local food customs, jet lag, and travel-related illness are essential for medical practitioners to ensure athletes and teams can achieve maximal performance and optimal health while traveling. Detailed preparation and planning are critical components of any practitioner’s toolkit who support the traveling athlete.


Travel Jet lag Elite athlete Climate Vaccinations Gastrointestinal illness Performance Sleep Nutrition 


  1. 1.
    Kary JM, Lavallee M. Travel medicine and the international athlete. Clin Sports Med. 2007;26:489–503.CrossRefGoogle Scholar
  2. 2.
    Pipe AL. International travel and the elite athlete. Clin J Sport Med. 2011;21:62–6.CrossRefGoogle Scholar
  3. 3.
    Reilly T, Waterhouse J, Burke LM, Alonso JM, et al. Nutrition for travel. J Sports Sci. 2007;25(Suppl 1):S125–34.CrossRefGoogle Scholar
  4. 4.
    British Journal of Sports Medicine (UK). How to keep athletes healthy when travelling [podcast on the internet]. Br J Sports Med. 2017 [cited 2018 Jun 18].
  5. 5.
    National Institute of Diabetes and Digestive and Kidney Diseases (US). Foodborne illnesses [Internet]. US Department of Health and Human Services; 2018 [cited 2018 May 25].
  6. 6.
    Seto CK, Way D, O’Connor N. Environmental illness in athletes. Clin Sports Med. 2005;24:695–718.CrossRefGoogle Scholar
  7. 7.
    Biem J, Koehncke N, Classen D, Dosman J. Out of the cold: management of hypothermia and frostbite. CMAJ. 2003;168:305–11.PubMedPubMedCentralGoogle Scholar
  8. 8.
    Racinais S, Alonso JM, Coutts AJ, et al. Consensus recommendations on training and competing in the heat. Br J Sports Med. 2015;49:1164–73.CrossRefGoogle Scholar
  9. 9.
    Noakes TD. Exercise and the cold. Ergonomics. 2000;43:1461–79.CrossRefGoogle Scholar
  10. 10.
    Cook J, Harcourt P, Milne C, Al-Tunaiji H. Traveling with a team. In: Bruckner P, Khan K, editors. Clinical sports medicine. 4th ed. Sydney: McGraw-Hill; 2012. p. 1208–20.Google Scholar
  11. 11.
    World Anti-Doping Agency (CA). WADA confirms attack by Russian Cyber Espionage Group [Internet]. World Anti-Doping Agency; 2016 [cited 2018 Jul 3].
  12. 12.
    Wingfield K, Matheson GO, Meeuwisse WH. Preparticipation evaluation: an evidence-based review. Clin J Sport Med. 2004;14:109–22.CrossRefGoogle Scholar
  13. 13.
    World Anti-Doping Agency (CA). The prohibited list [Internet]. World Anti-Doping Agency; 2018 [cited 2018 Jul 8].
  14. 14.
    World Anti-Doping Agency (CA). Guidelines – Therapeutic Use Exemptions (TUE) [Internet]. World Anti-Doping Agency; 2016 [cited 2018 Jul 8].
  15. 15.
    Buettner CM. The team physician’s bag. Clin Sports Med. 1998;17:365–73.CrossRefGoogle Scholar
  16. 16.
    Petersen E, Wilson ME, Touch S, et al. Rapid spread of zika virus in The Americas--implications for public health preparedness for mass gatherings at the 2016 Brazil Olympic Games. Int J Infect Dis. 2016;44:11–5.CrossRefGoogle Scholar
  17. 17.
    Hamilton B, Exeter D, Beable S, Coleman L, Milne C. Zika Virus and the Rio Olympic Games. Clin J Sport Med. 2017;
  18. 18.
    World Health Organization (CE). Vector-borne disease [Internet]. World Health Organization; 2017 [cited 2018 Jun 9].
  19. 19.
    Terrell AG, Forde ME, Firth R, Ross DA. Malaria chemoprophylaxis and self-reported impact on ability to work: mefloquine versus doxycycline. J Travel Med. 2015;22:383–8.CrossRefGoogle Scholar
  20. 20.
    Sport Med BC (CA). Emergency action plan [Internet]. Sport Med BC; 2017 [cited 2018 Jun 28].
  21. 21.
    Parsons CJ, Bobechko WP. Aeromedical transport: its hidden problems. CMAJ. 1982;126:237–43.Google Scholar
  22. 22.
    Teichman PG, Donchin Y, Kot RJ. International aeromedical evacuation. N Engl J Med. 2007;356:262–70.CrossRefGoogle Scholar
  23. 23.
    Reilly T, Edwards B. Altered sleep-wake cycles and physical performance in athletes. Physiol Behav. 2007;90:274–84.CrossRefGoogle Scholar
  24. 24.
    Reilly T, Waterhouse J, Edwards B. Jet lag and air travel: implications for performance. Clin Sports Med. 2005;24:367–80.CrossRefGoogle Scholar
  25. 25.
    Fowler PM, Knez W, Crowcroft S, et al. Greater effect of east versus west travel on jet lag, sleep, and team sport performance. Med Sci Sports Exerc. 2017;49:2548–61.CrossRefGoogle Scholar
  26. 26.
    Simpson NS, Gibbs EL, Matheson GO. Optimizing sleep to maximize performance: implications and recommendations for elite athletes. Scand J Med Sci Sports. 2017;27:266–74.CrossRefGoogle Scholar
  27. 27.
    Watson AM. Sleep and athletic performance. Curr Sports Med Rep. 2017;16:413–8.CrossRefGoogle Scholar
  28. 28.
    Maughan R, Shirreffs S. Exercise in the heat: challenges and opportunities. J Sports Sci. 2004;22:917–27.CrossRefGoogle Scholar
  29. 29.
    Wendt D, van Loon LJC, van Marken Lichtenbelt WD. Thermoregulation during exercise in the heat. Strategies for maintaining health and performance. Sports Med. 2007;37:669–82.CrossRefGoogle Scholar
  30. 30.
    Arendt J. Managing jet lag: some of the problems and possible new solutions. Sleep Med Rev. 2009;13:249–56.CrossRefGoogle Scholar
  31. 31.
    Eastman CI, Burgess HJ. How to travel the world without jet lag. Sleep Med Clin. 2009;4:241–55.CrossRefGoogle Scholar
  32. 32.
    Waterhouse J, Reilly T, Atkinson G, Edwards B. Jet lag: trends and coping strategies. Lancet. 2007;369:1117–29.CrossRefGoogle Scholar
  33. 33.
    Rendi-Wagner P, Kollaritsch H. Drug prophylaxis for traveler’s diarrhea. Clin Infect Dis. 2002;34:628–33.CrossRefGoogle Scholar
  34. 34.
    Riddle MS, et al. Guidelines for the prevention and treatment of travelers’ diarrhea. J Travel Med. 2017;24:S57–74.CrossRefGoogle Scholar
  35. 35.
    Riddle M, Arnold S, Tribble D. Effect of adjunctive loperamide in combination with antibiotics on treatment outcomes in traveler’s diarrhea: a systematic review and meta-analysis. Clin Infect Dis. 2008;47:1007–14.CrossRefGoogle Scholar
  36. 36.
    Spence L, Brown WJ, Pyne DB, et al. Incidence, etiology, and symptomatology of upper respiratory illness in elite athletes. Med Sci Sports Exerc. 2007;39:577–86.CrossRefGoogle Scholar
  37. 37.
    Leder K, Newman D. Respiratory infections during air travel. Intern Med J. 2005;35:50–5.CrossRefGoogle Scholar
  38. 38.
    Lee A, Galvez JC. Jet lag in athletes. Sports Health. 2012;4:211–6.CrossRefGoogle Scholar
  39. 39.
    Igreja RP. Olympics in the tropics and infectious diseases. Clin Infect Dis. 2010;50:616–7.CrossRefGoogle Scholar

Copyright information

© ISAKOS 2019

Authors and Affiliations

  1. 1.Department of Family MedicineWestern UniversityLondonCanada
  2. 2.Fowler Kennedy Sports Medicine ClinicLondonCanada
  3. 3.Roth McFarlane Hand and Upper Limb Centre (HULC)LondonCanada

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