Article in the St. Galler Tagblatt newspaper on sports medicine and Olympic plans

"No, soccer players are not whiny": Two sports doctors on clichés, Olympic plans, and Switzerland's need to catch up

Article in the St. Galler Tagblatt, November 12, 2025

Medical preparations for the Olympic winter season are in full swing. At the heart of it all are two sports doctors from eastern Switzerland. Hanspeter Betschart, who heads the medical team, and his predecessor Patrik Noack talk about sports medicine clichés, embarrassments, and Switzerland's need to catch up with other nations in terms of sports policy.

First, the nasty question: Which athletes are the most whiny?

Noack: (laughs)

To put it another way: which sports generate the most work for you?

Noack: Probably in high-impact sports such as ice hockey or high-speed sports such as alpine skiing/ski cross. Depending on the conditions, however, there is also a lot to do with cross-country skiers, as in Pyeongchang in 2018, where it was so cold that respiratory problems arose.

Betschart: For spectators, a freestyler with a knee injury sounds far more dramatic than a cross-country skier who wakes up in the morning with a sore throat. But in terms of medal chances, both can be equally bad. It is important to have an Olympic doctor who can take both seriously and assess them. If you can only help with broken bones, you are in the wrong place. Sometimes there are more complex issues.

Noack: Just one small example: air conditioning was a big issue in Tokyo in the summer. On the one hand, it promotes infections, but at the same time, the quality of sleep is significantly better when the temperature is lowered. Almost everyone needed special advice. Or someone would come in who couldn't hear anything after showering because of earwax that had to be flushed out. Or the hotel detergent would cause a rash.

Hanspeter Betschart is chief physician at the Berit Sportclinic, a specialist in general internal medicine and a sports physician. At the 2026 Winter Olympics in Milan, he will be the chief medical officer of Swiss Olympic for the second time, with primary responsibility for the Olympic team's medical care. The 40-year-old is also chief medical officer at Swiss Sliding and the association physician responsible for Nordic skiing and Swiss Cycling. Patrik Noack is a sports physician at the Medbase Sports Medical Center in Abtwil. He has served as Chief Medical Officer at eight Olympic Games and handed over to Betschart for the Summer Games in Paris. The 51-year-old is Chief Medical Officer of Swiss Athletics and Swiss Cycling. He is also the association doctor for swimmers and triathletes. Both sports doctors look after many athletes and sports teams in eastern Switzerland, sometimes in close cooperation. (rst)

Mr. Betschart, you were once the team doctor for FC St. Gallen and now look after SC Brühl, among others. Let's get to the cliché: Are soccer players more whiny than other athletes, such as professional cyclists?

Betschart: No. I have great respect for soccer players. Three games in seven days is a huge strain. And it's not really comparable to Tour de France cyclists, who get on their bikes every day but don't engage in physical combat. But of course there are big differences from person to person. Just like in society in general. Mountain farmers are less likely to visit the doctor than city dwellers.

Noack: Fundamentally, it is not whiny athletes who are the problem, but rather those who do not report injuries or report them too late.

For example?

Betschart: A cross-country skier who tells himself "it'll be fine" even though he's feeling a little unwell may end up missing half the season. We tend to encourage athletes to report any problems as soon as they arise. I have also seen athletes who were afraid to come to me because they would have missed training and their coaches might have interpreted this as them being whiny. This is counterproductive and puts the athletes' health at risk.

Have you ever had to say: Why didn't you tell me sooner?

Noack: Often. Here's an example from the days when athletes still recorded their resting heart rates on graph paper: a cross-country skier documented significant overtraining over several weeks, but didn't come to see me. He ignored all the warning signs.

Because he didn't want to believe it.

Noack: Even his sports psychology questionnaire was a disaster. But he was in the autumn of his career and wanted to give it his all one last time.

Who was that?

Noack: (laughs)

Women are tougher than men, right?

Noack: I wouldn't say that.

The Olympic winter season is beginning. What tasks are you currently working on?

Betschart: There is still a lot to be clarified with regard to the Winter Games. Italy is running late in terms of organization. To make matters worse, everything is very decentralized, with the sports venues located far apart, from Milan to Cortina, Bormio, and Livigno.

Where does the difficulty lie?

Betschart: For example, more hospitals are involved than usual. Where can we find MRI facilities? Where can we find the necessary infrastructure? Which staff should we send where? All of this is more complicated than it was in Beijing or Pyeongchang, where the distances were shorter. One advantage, however, is the proximity to Switzerland.

Are Olympic athletes already flooding your office with nervous questions?

Betschart: Not that, but there is already work to be done. The main thing now is to avoid infections. We make recommendations for COVID and flu vaccinations and work with coaches to determine the right time frame for them. Then it's a matter of refreshing infection prevention measures. During the "COVID Games" in Beijing and Tokyo, we learned how valuable it is to stay in a well-protected bubble. We want to maintain a lot of things, even if it was easier to raise awareness for them during Covid. If service staff think they can still go to the pub in Predazzo in the evening, that's not going to work. (laughs)

Patrik Noack, you stepped down as chief medical officer of the Olympic team two years ago, but you are still involved. You will be experiencing Milan 2026 at home. Don't you miss the excitement?

Noack: No, I looked after the Swiss team during eight Olympic Games, starting with Beijing in 2008. The two "Covid Games" in Tokyo in 2021 and Beijing in 2022 have been somewhat "lackluster." And with Hanspeter, we already had a colleague in place for Paris 2024 who has been involved for a long time.

But you're still helping out?

Noack: I remain part of the medical team, and as a "health performance officer" I lead the task force on topics such as sports nutrition, sports psychology, and training science, but also independently of the Olympic Games. We maintain regular exchanges with other nations such as Sweden, Norway, the Netherlands, Belgium, and Brazil.

What can we learn from this?

Noack: That everyone else is just as ordinary. Which naturally raises the question of whether, for example, the Norwegians have something up their sleeves that they don't want to reveal. (laughs).

Betschart: It's true that we would like to know more about the approaches the Norwegians are currently taking in Nordic skiing. But the exchange at these meetings is becoming increasingly open, international medical cooperation has gained momentum, there is no parochial thinking, and the focus is on the athletes. But as a Swiss, you also sense that other nations have more resources.

Noack: The Netherlands and Norway are extreme examples. Norway runs the state-funded center "Olympiatoppen", while the Netherlands has a similar center in Pappendal, both of which employ several full-time sports physicians, whereas we often prepare for our assignments on the side.

Is it a question of mentality that this is how things work in Norway or the Netherlands?

Noack: It's a question of mentality, supported by the state. Our federalist system doesn't make it any easier. At Olympiatoppen, elite athletes receive uniform medical care early on in their careers – nutrition, psychology, physiology. Here, everyone works in their own little village or valley. That may be justified. But we have to ask ourselves whether we still want to be in contention for medals in the future.

Betschart: If I want to launch a project at Swiss Ski to prevent infections, I'm fighting against the project that aims to make skis faster. But Swiss Olympic's hands are tied if no more government money is coming in. You can't increase funding for medicine and cut jobs in other areas.

Noack: The federalist nature of the system is also evident in the fact that sports associations have a lot of budgetary freedom. For a while, Swiss Olympic's payments to sports associations were tied to specific obligations: a thousand for sports psychology, a thousand for nutrition, and so on. But this led to a lot of paperwork, with receipts to check, so it was scrapped again. As a result, medical care took a back seat again, because the associations now tend to spend money on another assistant coach or on training camps rather than on medical issues. Other sporting nations are more stringently organized in this respect.

But in athletics, for example, Switzerland has caught up considerably with other nations.

Betschart: That's right. There was a boom there. In addition, elite athletes also benefit from the fact that equipment suppliers also provide medical resources; companies such as Puma, Nike, and On also want to win their medals. This fundamentally reduces the gap between Switzerland and other nations. But even there, there is still a lot of medical potential.

Noack: An analysis after the Summer Games in Paris showed that we are lagging behind in terms of sports nutrition across all disciplines. We repeatedly pointed out that we need good nutritional coaching and that this should be important to us. That's where we stand. Other nations are further ahead in this regard.

Aren't all elite athletes well-versed in nutrition anyway?

Noack: It's not that simple. Take carbohydrate intake, for example. It's normally around 60 grams per hour, but professional cyclist Stefan Küng has increased this to 150. But you have to train consistently and under supervision. Even for top athletes, it's not enough to just hand out a leaflet.

What are the differences in the treatment of amateur and professional athletes?

Noack: I see the main difference in rehabilitation training, where a professional can simply invest much more time. Amateurs or semi-professional athletes often underestimate this.

Betschart: Basically, however, amateur athletes benefit from elite athletes in terms of medical knowledge.

Are you both fans too? And at the forefront when there are medals to celebrate?

Betschart: Always at the forefront (laughs). No, but of course we have a huge affinity for sport, otherwise we wouldn't have become sports physicians. We share in the excitement, but we stay in the background. It's more about the great joy for the athlete when everything comes together.

Noack: When Ditaji Kambundji won gold at the World Athletics Championships, the entire staff waited until she arrived at the hotel at half past one to celebrate. Of course I'll be there too. It can't be right that a world champion comes home and everyone is asleep.

Betschart: When people saw me in photos of celebrations in Paris, they asked me: Did you have a nice vacation? But I see these moments as a reward. It's a privilege to be there. I find the quiet moments during doping tests impressive, when the hustle and bustle is far away and you can talk to the athlete for a few sentences in peace – whether they've been successful or not. When you're sitting next to bobsledder Rico Peter in Pyeongchang, who has just narrowly missed out on a medal, it's also about finding the right words.

What have been your greatest Olympic moments so far?

Betschart: For me, it was the triple victory of the female mountain bikers in Tokyo.

Noack: There were quite a few. Nicola Spirig's Olympic victory in London in 2012, because I had been involved in her training since 2005, knew how difficult the journey had been, and then saw her sprint to victory. And in winter, it was probably Dario Cologna's medals in 2014 after his injury – but above all the gold medal in 2018, when no one expected it anymore.

Are there any sports that require little medical attention?

Betschart: No, we deal with all Olympic athletes. And of course we are also prepared for all sports. We also need to know that in judo, for example, you can't continue fighting with bleeding wounds. Of course we have a greater affinity for certain sports – but we are interested in all of them.

Noack: And if I don't know something, a quick Google search helps. Otherwise, it can get embarrassing. I've seen a physical therapist ask an athlete, "So, what sport do you play?" Standing in front of him was Mujinga Kambundji.