Why China is the Ultimate Destination for high performance sport

The year prior to the Tokyo Olympics, weightlifter Chen LiJun suffered a devastating elbow injury and underwent surgery in October 2020. Amid the pandemic, his team had written him off as an Olympic hopeful. His strength and conditioning coach (or “performance coach,” as they’re called here) contacted me for assistance with his return to training. Over the next four months, we used remote coaching and rehabilitation to prepare Chen LiJun for the last-chance Olympic qualification event, he not only won, but went on to win the 67kg Olympic medal in Tokyo.

I share this story to highlight opportunities at the absolute top tier of sport in China. Unlike other programs, China boasts a deep pool of exceptional athletes ready to become champions. In China, sport is not something done out of passion, it is pursued out of necessity. Athletes like world record weightlifter JiangHuiHua, who grew up in an impoverished mountain village, saw her natural abilities as a way to lift her family out of poverty, beginning full-time weightlifting at just 10-years old. I once told her about some of the Canadian weightlifters and described that most have no funding. She looked at me with confusion and asked:

“Why would they ever be a weightlifter if you don’t have support”

The athletes here dedicate everything for one goal, to be champion in their sport. The Chinese system is built to ensure the athlete can dedicate all their attention to achieving their best performances. JiangHuiHua’s mother was having some medical issues that couldn’t be properly managed due to the limited resources in the mountain village. The leader of weightlifting took it upon themselves to personally travelled to the family home, and within a day got all the medical care sorted for HuiHua’s mother. Team China actively searches to improve their support of the athletes. One such method is to hire experts from around the world. I will share my experiences from the past six years working with provincial and national teams, offering insight into China’s high-performance sports world.

Most of you won’t know me. I’m a strength coach and chiropractor who has worked in China for six years. I was fortunate to have been taught weightlifting by Trevor Cottrell at the University of Waterloo, sparking my passion for effective training. Before moving to China, I worked primarily in athletics – coaching Canadian sprinters under Desai Williams, and supported Team Jamaica at the Penn relays alongside Dr. Thien DangTan. Simply put, I was early in my career when I applied to work with a Chinese national team. A recruiter mentioned an opportunity in Guangxi (a province near Vietnam) leading rehabilitation for a provincial program. I learned that Guangxi is economically underdeveloped, with lower education levels, shorter average stature, and famously spicy rice noodles. This blend of unique genetics and low education gives Guangxi an incredibly competitive sport program, being home of many of the best gymnastics, wrestling, and weightlifting athletes in the world. Unmentioned was that each province houses nearly a thousand high-level athletes in dedicated training bases. I’ve worked with 300 international-level athletes across 55 sports. This led to consulting roles with China’s national weightlifting, gymnastics, trampoline, wrestling, and athletics teams, as many of my athletes progressed to these squads.

Before describing how foreign experts support the athletes, it is important for you to understand how important high performances are to the athletes. Being an athlete in China is a full-time job, the kids leave their families before puberty to dedicate the rest of their athletic lives to being the best. The athletes live on a base, in rooms of 4-8 athletes, and having leaders and coaches act as parents. Each base will have a school attached to it for education, however as you go up the ranking file, education quickly takes a back seat. Take the journey our Olympic silver medalist wrestler CaoLiGuo had to go through. He was first recruited into sport due to his lack of attendance at school as a kid, and he luckily found wrestling as a safe way to spend his time. He won a city level competition and was asked to do a 3-month trial at our provincial team at the age of 16. He left his family and fought for his place on the team, outperforming dozens of other hopefuls. His friends that he had that didn’t make the team, are sent back to normal schools. High training volumes leave little time for academics, and those who fail in sport often struggle to find success elsewhere, making the stakes of competition life-defining. Take our weightlifting program in Guangxi, the local city schools will have a total of 1000+ weightlifting athletes training. The provincial program takes on about 100 athletes. The national team will only take about 20 athletes in weightlifting. Consider that Guangxi is but 1 of 34 provinces that have a sport program, you are looking at thousands of athletes that don’t make the cut. I wanted to highlight this aspect of the program so that you understand that sport is not taken lightly. This is why as a foreign expert, you are basically taking the livelihood of your athlete in your hands. I do believe that this pressure is seen across many of the professional sports, as sports is a way out for many young athletes, and it is why China puts a lot of money behind us foreign experts to bolster their chances of making more champions.

Foreigners work at all levels—provincial, national, or with individual athletes. The common thread? The reality defies expectations. Let’s start with national teams, a coveted role offering Olympic podium moments. Roles vary by team and profession. A strength coach hired for an Olympic cycle might be assigned to athletes, a head coach, and a support team (doctors, massage therapists). You’ll run warm-ups, training sessions, and do “whatever needs to be done” for success. However, you’ll quickly realize you must align with the team’s unspoken expectations—the first major obstacle. This is less a language barrier than a matter of interpreting unspoken demands and navigating high-performance politics. Provincial rivalries and coaching hierarchies influence athlete support. While everyone competes for China, understanding dynamics between provinces, athletes, and coaches is essential. Few foreign coaches master this; my province cycled through five before finding the right fit. Once you decipher expectations, resources become abundant: cutting-edge equipment, massive facilities, and testing tools. Schedules follow a “hurry up and wait” rhythm. Little downtime exists, but actual training occupies limited hours (typically 2–4 sessions weekly). Most time is spent observing technical training, programming, or analyzing data.

For manual therapists (physios, chiros, athletic/massage therapists), your role diverges sharply from Western norms. Despite global trends toward active rehabilitation, pain science, and structured return-to-play protocols, these approaches often don’t translate here. Unless your Chinese is flawless, discussing pain science is unlikely—sometimes you won’t even speak to patients during treatment. Athletes expect manual therapy, which I acknowledge as necessary given their extreme training volumes. Compounding this, they primarily seek treatment from 7 PM to 12 AM. This relentless approach is emblematic of China’s broader high-performance culture, one of sacrificing comfort and convention in pursuit of sustained training capacity. Olympian wrestler Cao LiGuo treatment schedule is typical across the elite. He trains 16 times weekly, most days are 3 workouts a day, and he will receive pre-training, post-training, and thrice-weekly full-body manual therapy. The philosophy? Never stop. Training is aggressively modified to avoid worsening symptoms.

“I have so many injuries that if I stop, I’ll never start again” Says CaoLiGuo- a philosophy shared by many elite athletes here.

Therapists thus focus on keeping athletes competing. It’s astounding to watch him dominate despite injuries. For workload-tracking enthusiasts, observe the genius in avoiding training stoppage: chronic loads stay high, while acute spikes occur during random training camps or when athletes play soccer for three hours on rest days.

As director of Guangxi’s provincial rehabilitation program, my work differs from national teams. In the provincial level, I am taking the hundreds of potential Olympians and helping them reach the national teams. I lead a team responsible for getting this work done. This requires not only clinical expertise, but also coordination of care across multiple departments. At this level, active care is more feasible, especially for injuries that impede training (e.g., surgical/traumatic cases), whereas on the national teams your rehabilitation time will be limited. Our 12,000 sq ft clinic has 20 treatment beds, 30 therapists, a sauna, pool, contrast therapy, all modalities, an entire training space, and a whole lot of pressure to get athletes back into action. Foreign experts often lead teams of local staff, and the strength coaches juggle programming for 6–10 teams daily, rotating groups every 90 minutes while completing programming and data tasks. They work hard and are treated well. This role tests your ability to program for diverse populations amid pressure—every coach believes they know “best,” and you will navigate teams who already strength-train with their coach, play extra sports for fun, and are perpetually exhausted.

Working as a foreign expert in China is the “ultimate” place, not just because of the challenges, but because those challenges forge unique skills and opportunities for coaches and therapists. I have benefited tremendously from my time in China as I have learned to work under extreme pressure and confusion, to communicate assessments nonverbally (using broken Chinese/gestures) and resolve most injuries in weeks. After six years, I have learned this: China’s system isn’t for everyone. But for those seeking to understand elite sport’s razor edge—where athletes view training as survival and manual therapists become guardians of resilience—it offers unparalleled lessons in human performance.