Evert Verhagen | Director of Amsterdam Olympic Research Centre

It’s in our core DNA to be motivated and energized to provide healthy activity for all.  That’s what we’ve been doing for many years now and, out of that, we keep coming up with new ideas and new questions and new solutions that no one ever thought of before.  And we are lucky to have such a facility here within our University, to have that freedom to go any direction we want, that keeps us on the forefront of things, keeps us asking  new questions that no one dared to ask before, or could not ask before. And, maybe that’s what got us a seat at that select table.

DMacA: You’ve done some super research. Tell us about your own research trajectory

EV: I started trying to figure out how we could use balance exercises to prevent ankle sprains in volleyball athletes.  There were a lot of ankle sprains in volleyball- there’s a lot of jumping in close proximity with a lot of players so landing awkwardly was common. It still is common.  So, we thought, let’s see if we can reduce that a little.  It was my master’s thesis when I was doing my Masters in Sports Sciences here in Amsterdam.  Out of that came an excellent result, much to my surprise, because we didn’t do much but it seemed to work. And, out of that we got a second grant to follow that up with a more specific research question.  Out of that came another interesting result and that was followed up as well.  So, out of that curiosity we managed to do a lot of work on injuries and injury prevention, kept pushing the boundaries of what we thought we knew, surprised ourselves with our own outcomes, and asked new questions. I don’t know if you would call that super research- I think basically we were just having fun and trying to find practical answers instead of staying  with in the lab and trying to figure out how things work in a laboratory environment.  We try to go outside and see how things really work in practice, to benefit athletes.

DMacA: As your own research career developed you collaborated with many other researchers around the world and, indeed, in Amsterdam, you have collaborations across many different units. Tell us how those collaborations developed.

EV: …kind of organically, like the rest of the story. You go to conferences, you talk to people, you see other people’s work, you’re interested in how they did it, why they did it, and how they interpreted their results and what their challenges were, because you want to improve yourself and you want to improve your own work.  And, out of that you create friendships, you create a network, and you create long-standing collaborations with like-minded colleagues.  They don’t necessarily have to be researchers. There are clinicians, there are students who can take you in any direction, and that’s a lively network of people that you drag along in your pathway.  ‘Drag along’ sounds negative but I mean it in a positive way.  And they keep inspiring you.  So, I try to connect them with each other – past collaborations, current collaborations – so that once you’re part of our network you cannot escape!  I will keep nagging you but it’s a lively conversation and new things keep popping up, new ideas keep popping up, and I think the philosophy is to think out of the box, think out of your own box. Because, there’s so much out there that you haven’t thought of yourself, that other people can think of, can help you with.

DMacA: I’m very interested in this idea of thinking out of the box and bringing in different ideas because now, as a medical journal editor yourself, you’re faced with lots of different areas outside your own field of research.  There are huge challenges in sport and exercise medicine at the moment.  We have the problems of drug taking, of gender alignment, of concussion.  What are your thoughts on these particular areas?

EV: It’s difficult to keep track.  Our field is growing exponentially.  When I started in 2000 it really small.  There was a handful of people doing research in our area and now there are so many scientific journals, and meetings, and colleagues, and peers, it’s so hard to keep track of it.  Its amazing because that means our area of interest is broad and fast moving and deserves attention. And that’s awesome. But keeping track of that requires a lot of specific expertise, skills, and knowledge and that’s difficult for one person. So, I tend to be a generalist. I try to understand what research is. I try to understand what these topics entail, to be able to connect the dots. And I surround myself, within my own little network but also in my professional network for the medical journal, with people who have the expertise and who can tell me if some specific small part of a topic is of Interest or novel or correct or valid.  You need that broad range of specific expertise and skill sets around you. And you also need people who can connect these skill sets and experts to each other. It is so easy to be the one-eyed King in the land of the blind with new topics and I see that happening every now and then. It’s something we have to be aware of. Always be critical and don’t accept all new topics at face value if (just) one or two people are doing a lot of work and trying to grow a particular field.  Always be critical and ask questions. Keep asking questions.

DMacA: You talked about skill sets and one of the things that intrigues me is that, while  you’re an epidemiologist by training, you’ve taken a turn in the road and you’re now interested in qualitative research.  Tell me about that interest and how that combines with epidemiology.

EV: I don’t think they’re mutually exclusive.  Epidemiology is all about numbers… there are there’s fewer injuries or, there’s a higher risk of this or, the odds of that is doubled.  But what do these numbers actually mean for the people involved?  You need to have that understanding as well.  If you look at epidemiology we don’t just report relative risks anymore, we also report the absolute values.  So, we already place some of our epidemiological outcomes into perspective.  These measurements don’t, however, say anything how these values are experienced in the field, and what they mean. We saw tremendous effects in our injury prevention trials, with a 50% reduction in injury when the exercises were done the exercises as recommended, but we also found that no one was doing the exercises. We started with surveys (asking)  “why don’t you do the exercises, what do you need”  and then categorized and put frequency tables on the answers and thought we now have the answer and this is where we need to focus.  Yet, it didn’t work as well as we thought it would and then we figured, let’s talk to them.  Let’s just have an open talk and see what the barriers are, what are the facilitators, why don’t they do it.  And out of that came such rich data and the insight that we needed to turn things around.  Instead of us trying to develop what’s based on the best evidence, we need to try and develop things that fit with their reality.  I usually use the analogy of a race car because, we have all the elements, the nuts and bolts, and the knowledge to build the perfect race car. We do that, and then we open the garage door, and realize that we drive on a dirt road full of rocks and uneven surfaces. So, what’s best? You are better build a car that suits the context rather than build the perfect car out of context.  And we’ve been doing the latter for a long time.  We need qualitative research to add that last jigsaw piece.

DMacA: Putting all this together, and as one of the leaders of the discipline, what is your message to someone who’s starting off and would like to follow a career in sport and exercise research?

EV: Follow your own motivation, be curious, and don’t let anyone tell you what you need to do.  Try to push your own boundaries.  I think I say this out of my own reflection of how I got here.  I keep saying the word ‘organic’. I never had a big plan. I never had a big mission or research vision of where I wanted to go.  One came from the other just out of curiosity and an internal motivation to drive research and to support athletes. That how we built what’s we’ve built up here in Amsterdam.  I think that’s the reason I still go to work every day with a big smile and the same energy I had when I was that young PhD student.

DMacA: I just love that idea of going to work with a big smile.  Thank you very much for all your thoughts and reflections of sport and exercise medicine, and your huge contribution to the discipline. It’s been a pleasure talking to you.