It is a pity that most venues do not have stadium seating where you don't have to look up at the contestants. The trick is to get a spot that is at waist height on the competitors. That way there will be little distortion and especially if you use a 200mm telephoto lens. The modern digital cameras like the 16.8 Mp Canon 1DsII is in incredible camera and will produce amazingly sharp photos even under spot lights. The ISO can be up to 1600 and you can use impressive lenses to capture everything and even check how you are going as you shoot.
What images to take requires some experience. Hitting the shots at the right time is tricky, too. Those good DSLRs allow you to take burst mode images of several images per second. You really can't compete with a pro using a tripod who has one of those great Canon cameras. Other digital cameras can produce excellent images, too. A tripod for physique contests is just about required because of the low level of lighting.
While photography is simple being a great photographer is not at all easy.