Introduction

High-performance sports medicine (HPSM) is an area of medicine that deals with individuals who can be unique and complex. They can represent the extreme of the spectrum of normality in relation to their physiological, psychological and behavioural characteristics, and can be exposed to extreme stresses in a range of environments.

When sport and exercise medicine (SEM) started as a discipline in Greco-Roman times, so too did interest develop in the effects of exercise on the human body.1 However, it was not until the 20th century that the field of exercise physiology really evolved. In the 21st century, ‘exercise sciences’ have expanded far into the reaches of metabolic and molecular sciences. Sport- and exercise-related research has become a vast field, ranging from biomechanics, all areas of clinical medicine and applied sciences, through to genetics, psychology, behavioural and neurosciences and technology. Nevertheless, our understanding of high-performance athletes (HPAs) remains limited. The field is rich in opportunities in research. There is the potential to enhance our understanding of adaptations and responses to extreme stimuli. Research can enhance the delivery of medical care to our athletes, and assist with the safe optimisation of human performance. Research in this field can also provide valuable insights into models of health and disease.

This article provides an overview of the framework of research models and methods. We outline some of the challenges of research in HPSM and discuss opportunities in developing the field. Some of the issues raised can relate to SEM as a whole.