The Unwritten Medical File of Vietnamese Athletics

On the track at a national athletics meet, at the 60-metre mark of the 400m hurdles, the leading woman suddenly straightened up, slowed, and walked toward the finish. No one in the stands knew exactly what had just happened. The press conference afterwards called it “fatigue”.

Two weeks later, at another meet, she left the track with the same posture.

I stayed in the back row for a long time that day. My notebook had three lines: the moment she slowed, the distance remaining, and one word that named everything — “fatigue”. Those three lines were not enough to conclude anything about her body. But they were enough for me to understand one thing: most of Vietnamese athletics’ injury data does not live in medical files. It lives in shrugs.

“Every press conference has two stories: one that is read aloud, one you have to find yourself.”

At the 31st SEA Games, held in Hanoi in May 2026, Vietnamese athletics topped the medal table for the sport, according to organisers’ published figures. Nguyen Thi Oanh won several gold medals across middle- and long-distance events. Those facts were reprinted, repeated, and became the yardstick of an entire cycle.

They could not measure something else: how many of those athletes entered the Games with an unhealed injury, how many left with a new point of pain, and how many would no longer be at their peak two seasons later.

Athletics is a sport of load cycles. A 1500m runner does not “race” once; they repeat a load pattern hundreds of times in a season. The body does not respond to a single session — it responds to the accumulated total of the whole sequence. A team doctor does not treat one afternoon; they treat the seasons ahead.

To treat the seasons ahead, you need to know what those seasons look like. And that is where our system is empty.

In many countries there is a national injury surveillance system: every withdrawal, every examination, every diagnosis, every rest day is recorded in a shared database. From that, people build charts — which events produce the most hamstring injuries, which phase of the season carries the highest risk, how long before a returning athlete re-injures.

Vietnam does not yet have that system at national level for athletics. Information is scattered across coaches’ notebooks, team doctors’ memories, and a few hurried photos in a clinic. When an athlete re-injures, no one can cross-check against the previous episode, because the previous episode was never written down.

At 25, I learned to read injuries through data rather than through inspiration. “The 2026 World Cup sofa taught me to read injuries like open-source code.” I sat in front of a screen, tracing every acceleration and every minute of play, and realised the athlete’s body is readable — provided someone is willing to write it down.

There is a principle I have kept for years: without data there is no conclusion, and one honest refusal to conclude is worth more than ten plausible-sounding guesses.

That principle sounds simple, but it runs against every instinct of the trade. When a famous athlete leaves the track, the pressure to produce a story is enormous. Fans want to know what happened. Editors want a headline. And into that gap, speculation fills the space where data is missing.

Four questions, if unanswered, reduce everything that follows to storytelling: which specific event and technique; the exact mark with its conditions, including wind and altitude; the competition context; and the reference benchmark for that season.

Take the sprints. A year-by-year personal-best table is the most valuable anti-doping document I have, and at the same time an injury-diagnostic tool. If an athlete improves almost linearly by 0.08 seconds a year for four years, then suddenly jumps 0.35 seconds in one season, two possibilities need checking: a genuine leap in ability, or a biological signal worth examining closely. Both require a series, not a single data point.

In Vietnamese athletics, series data exists but is not used properly. The federation holds championship results across many years. Training centres keep logs. But the two are rarely joined together, and almost never joined to injury history.

The result is that the right questions go unanswered. A 22-year-old hits a personal best exactly when she changes head coach — is that a sign of better training method, or a sign the load threshold was pushed past its limit? Without injury history attached, we cannot answer.

“7 June 2026 — when I stopped trusting intuition and started trusting data.”

When domestic athletics resumed after the 2026 lockdown, I published my first tracking sheet inside a training group. During four months without competition, I rebuilt the load profiles of a group of middle-distance runners: weekly volume, number of speed sessions, and estimated muscle-mass indices from indirect measurements taken before the pandemic.

A female 800m runner had a muscle index below her pre-pandemic baseline. I had no medical conclusion; I had a forecast. If training were pushed back to old intensity within three weeks, the risk of adductor and hamstring injury would rise markedly. Two weeks later, she left an internal test in the second minute.

That was not a miracle. It was the consequence of recording and cross-checking. What matters is not that the forecast was right, but that no one previously had the data to compare.

An athletics injury does not appear at the moment an athlete leaves the track. It appears at the moment load exceeds the adaptation threshold, usually weeks earlier, in a tracking sheet nobody opens.

Consider the load cycle, which results tables never show. A 5000m runner may race eight to twelve times in a season, plus internal time trials and speed work. Every race is a load peak. The spacing between peaks determines whether the body adapts in time.

At the SEA Games, this problem is pushed to its maximum. An athlete entered in three events may have to run heats, semi-finals and finals within days, across different disciplines. One pair of legs, three different load patterns, not enough recovery between peaks.

Without a surveillance system, we only see the final outcome: a medal, or a withdrawal. We do not see the price paid in between.

There is another layer readers of results tables usually skip: conditions. A 100m mark is only comparable when the wind is known. The maximum legal wind is +2.0 metres per second; beyond that, a mark is not recognised as a record. On particularly fast or indoor tracks, equipment and surface advantages can create meaningful gaps. Su Bingtian set the Asian record of 9.83 seconds at the Tokyo 2026 Olympics, and people debated for a long time how much the competition context contributed to it.

Without those facts, comparing two athletes means comparing two different contexts. But precisely for that reason, another signal matters more: consistency. An athlete who runs the same event with small variation between attempts has a stable physical foundation. An athlete with large swings is usually carrying a problem that has not been named.

In my tracking sheets, one pattern repeats more often than I would like. An athlete has a stable series of results, then a single abnormally slow run appears, then a return close to the old level, then another slow run. None is severe enough to call an injury. But the variance rises month by month.

Each time, if I had injury history in hand, I could cross-check. Without it, I have only a suspicious series and an intuition not permitted to speak.

Based on my experience tracking many domestic seasons, the recurrence pattern usually does not begin with a tear. It begins with three consecutive abnormal slow runs that nobody recorded, because each had a plausible explanation: weather, track, competition nerves. By the time the injury takes shape, no one can trace back to the starting point.

Vietnamese athletics does not lack talent. It lacks a medical file written consistently enough, and long enough, to show the cycle before that cycle becomes a career cut short.

There are two opposing reflexes in handling injury, and both are dangerous in their own way.

The first reflex is to force a return. The athlete wants to compete, the coach is under performance pressure, and an injury “not serious enough to rest” gets pushed through. In athletics this threshold is especially hard to see, because a person can still jog a few laps on a tightening hamstring. That very ability to “still run” conceals the risk.

The second reflex is to label every signal a tragedy. One withdrawal is not necessarily a torn tendon. One slower season is not necessarily a decline. Canonising a story of overcoming hardship is also a way of avoiding a conclusion — just a better-sounding one.

What I want to say is not about those two reflexes. It is about something else: an injury case is a test — not of the athlete’s character, but of whether a system trusts people or trusts data.

A system that trusts people relies on the coach’s feel, the athlete’s account, the team doctor’s experience. All of that is valuable. But it cannot be cross-checked, cannot be traced, and cannot be handed to a successor.

A system that trusts data is slower, drier, and sometimes says what nobody wants to hear. It will point out that one medal may be paid for with two seasons that follow. It will record even the abnormal slow runs nobody wants to mention.

That medical file has never been written. But it can begin with something small: a tracking sheet kept consistently enough, recording every withdrawal, every examination, every rest day, for at least three consecutive seasons.

When that sheet is long enough, people will begin to see what medals conceal. Not to blame anyone. Only so that the question “is she just tired?” has something to answer it, instead of an entire press conference shrugging together.