Return to Play after symptoms of inability to takeoff in pole vaulters: A case series study

Abstract

Purpose: This study aimed to clarify the occurrence situations and recovery strategies for the "inability-to-takeoff syndrome" in pole vaulting. Through a case analysis of athletes who successfully returned to ompetition, we aimed to provide foundational data for understanding and addressing this specific psychomotor disorder. Methods: A qualitative study was performed using semi-structured interviews with four Japanese pole vaulters (three male, one female; mean age 24.3 years) who had experienced and recovered from inability-to-takeoff syndrome within the past year. Participants were recruited via online platforms, and data on their symptoms, situational triggers, and recovery processes were collected through one-hour videoconference interviews. Thematic analysis was applied to the interview data, while descriptive statistics summarized participant characteristics. Results: The findings revealed two primary onset patterns for the syndrome: sudden, unexplained occurrences and onsets triggered by catastrophic incidents, such as falls or dangerous vaults. The timing of anxiety and the specific number of approach steps (from 6 steps to a full approach) at which symptoms appeared varied among individuals. Key recovery strategies identified included a gradual increase in the number of approach steps from a shortened approach, practicing approach runs outside the vaulting area to reduce pressure, practicing under favorable conditions (e.g., tailwind), and changing coaching environments. All participants reported receiving psychological support from coaches, teammates, or mental health professionals, which they found beneficial for recovery. Conclusion: The inability-to-takeoff syndrome in pole vaulting appears to be a complex psychological issue, potentially linked to traumatic experiences and performance anxiety. The recovery strategies employed by the athletes shared characteristics with principles of exposure therapy, particularly a gradual, systematic re-introduction to the feared activity (i.e., full-approach vaulting). This suggests that a gradual exposure approach may be an effective method for facilitating recovery. Furthermore, minimizing high-risk vaulting situations during practice is considered crucial for preventing the onset of this syndrome. Future research should aim to further explore the psychological mechanisms underpinning this syndrome and develop structured prevention and intervention protocols.