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Kim

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 #1 
Hello everyone!
 
This is my first post here. I am a new Moxy user. I know you would all prefer to look at the actual data but I'm embarrassed to say that once I export to excel, I have not had time to figure out how to then create a graph. It's on my list of things to learn! Anyway, this is a 5-1-5 assessment on a runner. A sensor was on each rectus femoris. I understand most of this data except for the asymmetry in ThB trends. On the left leg, why does ThB dip during rest and then increase during the load? It's the opposite of the right leg and not what I typically see in a runner. Okay, it actually shows this trend on his deltoid too and I cannot claim to understand. 
 
He failed during the first of the fifth load but I kept the monitors running. He is more likely to injure the left side and currently has high hamstring tightness/pain that is only somewhat limiting is running.  Inked5.30.19_LI.jpg 

ryinc

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 #2 
Hi Kim,

Welcome to the forum - its a bit quieter these days.

Overall my interpretatuon is that this athlete has a cardiac limiter. This is primarily based on the Thb overall trend across the right leg and deltoid, particularly deltoid as this would not be as involved as a muscle.

That then leaves the left leg to explain. One explanatuon is that there is possibly a partial venous occlusion happening locally here, this causes blood to 'pool' during the interval as blood flows into the muscle at a faster rate then flowing out. The blood then rushes out on release causing the drop in Thb again on rest. The left leg injury and poor cardiac output may both be contributers, since a partial occlusion would be more likely both due to a weak muscle (injury?) and/or because weak bloodflow (poor cardiac output).

No concrete answers in the world of Moxy just ideas.

ryinc

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 #3 
One other point, if this was done on a treadmill, it is worth reflecting on what happened at start and stops of those intervals. Sometimes jumping off to one side or holding the rail etc, can change the dynamics of the Smo2 and Thb traces.
ryinc

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 #4 
Now perhaps a question to get you thinking? Why om the right leg do you see a rise in Thb at rest but deltoid you see a drop in Thb?
Kim

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 #5 
That's a good thought that perhaps it's the right leg that is showing abnormal trends compared with the deltoid and left leg. I hadn't thought of that. 

During the rest period, I pause the treadmill and have my runners sit on the edge until it is time to go again. I am careful to have them sit symmetrically. They are starting from a treadmill at rest. 

And now I have to disagree with you about the cardiac limitation. I agree that there are signs of cardiac limitation but the primary limitation is pulmonary. 


AED

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 #6 
Try 5-1 instead of 5-1-5, I find it more accurate.
Also for runners I'd prefer putting one moxy on gastrocnemius as runners switch muscles/technique while speed changes.
ryinc

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 #7 
No, sorry i wasnt clear. i dont think its the right leg showing abnormal trends. i think there is a vasoconstriction occurring on deltoid at rest to protect blood pressure, again because i think cardoac output appears weak.

i cant see the respiratory limitation unless the argument being put forward is that respiratory muscles are "stealing" the bloodflow and thats the reason for downward thb trends.

What are you basing a pulmonory limitation interpretation on?
Kim

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 #8 
Thank you for that clarification. That is helpful. 

Regarding my reasoning for reading this as pulmonary -- take a look at a close up of the right leg. Like I said, I am new and still learning but I see increasing THb max at rest and it is hard to tell because of the trends, but max THb at rest on the deltoid is 12.5 on all loads at high intensity but yes, there is a downward trend within the high intensity loads. 

You can see that starting after the just first step of the second load (which was a very easy pace), he has a long delay in SmO2 recovery (30 seconds) compared with his ThB recovery. Doesn't this point to pulmonary? A delay in clearing CO2? Actually it's interesting because as I look closer, I can see that he has this delay up until his last two intervals. Hmmm. Every time I think I am understanding Moxy data, I suddenly feel like I still have so much to learn.  

Even that left has slightly increasing max SmO2 at rest (45%, 48% and lastly 52%) and relatively stable trends of SmO2 within the high intensity intervals. It also has increasing trends of THb. Am I reading this all wrong? 

Inkedjf right leg_LI.jpg 

Kim

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 #9 
To AED: I like using the rectus femoris. I work with many mountain runners and I think the gastroc is a bad choice for that reason. If I use rectus femoris, I can stay consistent when I'm working with a runner who is running at a 1% grade vs a 12% grade (this is where I test my mountain runners). Also, it's what Nike uses! 😉 
ryinc

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 #10 
We're all learning :) still. Also i'm by no means trying to force my interpretation, just sharing thoughts/ideas.

Correct, a delayed Sm02 recovery relative to Thb increase can point to C02 buildup associated with a respiratory limter. However in such an instance the CO2 also increases vasodilation, and we would expect THb peak increases and general Thb upward trends across multiple muscles since it is systemic. Here we only see it slightly on right leg, and even then peak Thb at later peaks is still lower than the value right at the start of the assessment. Also the "delay" in Smo2 recovery would tend to show up in the last more intense intervals when respiratorybsystem in real trouble, rather than at early easy pace.

i agree that on right leg there is a strange smo2 profile at the start of recovery, particulalry early intervals - i don't have an interpretation on what that could be.

Overall to me whatvspeaks loudest to me, and that which gives clearest insight, is how the non-involved deltoid behaves. Thb is clearly got downward trend both for intervals and at rest. This is despite limited involvement/contraction of this muscle. So it seems supply(bloodflow) is being directed elsewhere - why? I,m arguing taht its because there isnt enough to go around.

Again not trying to force you to adopt this interpretation, just explaining how i see it.
Kim

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 #11 
I meant to come back and thank you for taking the time to look at this data.... a few days late! I'm sure I'll be back with more questions. [wink] 

Kim
andrifeldmann

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 #12 

Dear Kim

 

Thank you for sharing your data, and nice to see the discussion. I will add a few points that can be discussed, but I am not sure if my input will be very satisfying.

 

Firstly, I would say that the tHb results of the left leg, which you are having trouble with is very much the irregular response. When I say irregular, I mean in that I see it far less often and it us much more difficult to explain physiologically. I have had this discussion often. First, I will discuss why the physiological explanation is more difficult and then I will provide you with some possible approaches to get the best out of the results.

 

In your left leg example you have increasing tHb values during activity and decreasing SmO2 and then as soon as your activity stops tHb drops instantly and SmO2 increases. This looks like an occlusion picture you can simply create through isometric contraction, and that is why often people discuss occlusion. For sure there is still blood flow to the muscle so it is not complete occlusion, therefor it would at most be partial causing blood pooling and this pooling is released upon muscle relaxation. My problem with this explanation is that you essentially have this trend already happening at every activity level, not just the high speed/high contraction levels. Something to consider is running economy and biomechanics, how much braking phase for example in each leg, as this does cause large muscle forces. Another point is, how the individuals stands during rest, but I think this is much less effect at high intensity efforts with high cardiac output and blood flow. Correct me if I am wrong, but SmO2 values look pretty similar in right and left, which would also be strange if one leg had major blood flow impediment (occlusion), however if this was a chronic condition perhaps there is local muscular adjustment (change in muscular structures).

 

I don’t want to drag this on to long, but please ask if something is unclear.

 

My recommendations, is to always expect human error, or abnormal day. Re-test and see if you get the same results. If you get the same results, now go with the basics:

 

  1. SmO2 up, down, or flat: what does that mean?
  2. How low does SmO2 get?
  3. tHb, up, down or flat; what does that mean?

 

Answering these questions will at the very least give you an understanding of what is happening, even if the cause may be unlcear. From this you can work on case by case.

 

With Moxy we have a wonderful tool for muscle bioenergetic insight, but the exact causes are far from understood and biology is very dirty and very confounded.

MetaTrainingSST

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 #13 
Hii Kimm

Would it be possible for you to send or upload the CSV files here so I can analyze it better?

metatrainningsst@hotmail.com

Only some comments

- How did you hit the devices to the leg? Did you use some kind of bandage? What material did you use?

- Nobody has said it but there is one very remarkable thing that I want to be able to analyze when I have the data of the CSVs first, it seems that there is a delay in SmO2Rest. This may indicate two things, a pulmonary limitation (although it is unlikely) or a venous occlusion

- I know it's difficult, but you need at least 8 moxys to analyze well. Right now you only have one piece of the puzzle and to solve the big question, what has happened in the body of your athlete? What problem or limitation has caused it? You need to have the complete picture of all the muscles, you have lose valuable information or you have get wrong conclusions, because maybe the problem is not in those two muscles. Maybe the problem is in some other muscle that you have not been able to monitor. (Only it's my opinion)


Cordially, Martí Verdejo
Kim

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 #14 
Thank you for your comments! I did notice the delay and drop in SmO2 during rest, which is why my original conclusion was that the athlete had a pulmonary limitation. He does not have that delay, however, after his highest intensity intervals. I did note that his breathing was in no smooth starting early in the assessment.

I attached the sensors with the white adhesive stickers that I purchased through Moxy.

I am on the road today but will upload the file when I have a chance this evening. Thanks for taking a look!

Kim
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