The Runner Who Wants to Withdraw
Two weeks before the district athletics meet, S, a Class X student and the school's best 400 m runner, tells you she wants to withdraw. Her best time has worsened from 62 s to 66 s in three weeks. She sleeps about four hours, wakes at 3 a.m., and before practice her heart rate is 108 beats/min. She says, 'I will fail and everyone will laugh.' She has no fever, injury or recent illness. The physical education teacher thinks she needs 'toughening up' and wants her to add an extra hard session each week. You have 15 minutes in a busy corridor and no private room. Her parents expect a medal, and the entry list must be submitted in ten days.
1. How would you handle the 15-minute conversation, and what would you avoid doing?
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First find a quieter space - an empty classroom or the library corner - because this is not a corridor conversation. I would listen before advising: ask what changed, how long sleep has been poor, what she thinks about before races, and whether she has any thoughts of harming herself. Her sleep loss, early waking, performance drop, pre-practice heart rate of 108 and catastrophic self-talk suggest significant anxiety and possibly overtraining; I would not diagnose, but I would screen for red flags such as persistent low mood, panic and self-harm risk, and refer to the school counsellor or a doctor if present.
I would normalise the stress, separate her worth from a medal, and teach one brief skill she can use that day: slow breathing with a longer exhale for 3–5 minutes, then a short body scan. I would set one controllable process goal for the next session, such as relaxed shoulders in the first 100 m.
Avoid: telling her to 'toughen up', promising a medal, sharing her disclosure with the whole staff, or adding hard training while she is sleeping four hours. Confidentiality and a follow-up appointment are part of the response.
2. Design a two-week support plan with the PE teacher. How would you measure whether it is working?
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Plan:
- Training: reduce volume by about 20–30% for one week, keep one quality session, and remove the extra hard session; review after 7 days.
- Daily 10 minutes of breath awareness and 5 minutes of visualisation of the first 200 m, plus progressive muscle relaxation before bed.
- Sleep hygiene: fixed wake time, no screen after 10 p.m., no caffeine after afternoon, and a wind-down routine.
- A pre-race routine: same warm-up, two cues, one breathing pattern.
- Parent meeting: explain that the goal is consistent sleep and calm execution, not a guaranteed medal; reduce pressure at home.
- Clear referral pathway if low mood or self-harm thoughts appear.
Measurement: sleep hours, resting and pre-session heart rate, RPE, mood rating, session attendance, and 400 m time in training - not only the competition result. Review at 7 and 14 days. If sleep and mood do not improve, or if red flags worsen, the priority is medical/counselling review, not the entry list.