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Juerg Feldmann

Fortiori Design LLC
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Posts: 1,530
 #1 
Over the next month we have some internship from the University  of the Okanagan in combination with UBC. As well we have some students coming over from Europe  as well as Andri ,who will help to mentor some of them. 
We will do  many  case studies where we have some open questions, as well Brian Kozak from Next Level is integrating many ideas in the Ice hockey summer centers.
 He starts integration sport specific assessments on Skate mill and on other ice hockey related assessments, as the ide of testing an Ice hockey player on a bike or a treadmill is comfortable but  tells you very little on how to create a sport specific workout  for the summer.
The majority will simply work  very very hard but how specific for their needs.
 How many plyometric double leg jumps do you do during a game? True after you scored . Here some pics from skate mill IPAHD assessments  and an inside view in a ice hockey specific recovery phase of  players, as they simulate  recovery  and core strength combined. Goal : Balance H +  and maintain lactate levels for the next load. Workout intensity is controlled by MOXY and  load  duration as well as  rest period in between is collected from IPAHR. # different goals.
a) Deoxygenating  with a limited  oxygen independent phase
b) deoxygenating with a follow up o f  a hypoxia ( O2 independent phase )
c)  deoxygenating with a follow up hypoxia  and a stimulation of blood transfer to active muscles from inactive muscles. ( Vasoconstriction in the  load inactive muscle group.

 This type of testing  will be more and more available now  in different countries. As well in Northamerica  ( Canada and USA )
 What you look for is for an assessment. where Respiration ( over VO2 ) NIRS over Portamon  or MOXY and possibly for a few more month lactate , till the transition is comfortable , as well as in  some cases with Physioflow.
 Look around , as for the moment we have many  calls and mails from test center  anywhere, who lie to upgrade to some of the new equipment and combine it with the  current  systems they use. This is a smart and great transition. We are preparing this month with the internship a seminar  content  and hope ti make it flexible enough so it can be upgraded any time we find new information and ideas. It is an ongoing  learning in progress and as more coaches and centers we have sending us infos as better we can make progress. I will show many of the infos . Just got some interesting test from  a university from an NHL team sent to me and will show you some of the problematic , if tested VO2  for this sport.

Summary : Come with ideas you like we try to test like Marcel did with his drift and we will show  some of the results on here

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Juerg Feldmann

Fortiori Design LLC
Registered:
Posts: 1,530
 #2 
Here a first question. Not in the direction I was thinking but thanks for this one.

Question : What would you suggest I shall buy to start  a minimal but optimal small test lab for our small running community. ?

1. A HR monitor you can download and a MOXY .
You can  than make a  simple field test on a flat stretch or a 400 m  oval if you have one and you  have already a great info. You can use the MOXY excel sheet move your Hr ion it and you have the graph and main info you look for.
 Active recovery intensity.. A structural and functional  development intensity and a high above  homeostasis intensity.
 You can have form the graph the information , whether you have a delivery problem or an actual oxygen bio availability  problem.
. We will   develop this coming month the small  handout you will get with a MOXY monitor   when you buy one and you have all the info to run a simple test in there and you are ready to go.
 The speed on the  test stretch can be done over GPS or over a pacer like in the olden days with Conconi ideas. or  time versus distance. or simply HR and MOXY.

2. If you are already existing test center  you can easy add  to get to the next step a MOXY and the more in depth software we will create so you can add all your existing information to the same  sheet and you have now a very nice additional info on the possible Limiter and compensator, when using all respiratory info and the delayed  blood gas information.

3 last step is the  nice combination of the tools like VO2  Physio Flow , Portamon and MOXY and you are ready to change the view on assessments.  This will come sooner or later  anywhere but it is now available in Europe more and more and some specific places here, with Brina leading the way in the game sports. and Clint in any sport down in the USA. We are offering soon workshops and clinics and seminars so stay tuned or  email me or MOXY if you like to be on a list to be informed as soon we are starting up.
EternalFury

Development Team Member
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Posts: 25
 #3 
My main question these days is simple and extremely complex:

How can I best measure recovery rate? What biomarkers can I use?

Context:

I do a hard run on Monday. On Tuesday, I need to decide if I have recovered enough to train again. How do I quantify my recovery rate?

Obviously, everyone can go on gut feeling, but for driven, type-A personalities, this never works.

Any ideas? Concrete and practical, please.
Juerg Feldmann

Fortiori Design LLC
Registered:
Posts: 1,530
 #4 
This is in deed a very simple but very complicated question. I like to make 2  short sets of an explanation as an example.
 1. Serious athlete making money from it. 2. Athletes who like to compete but as well like sot have it practical.
 The second version always has some limitation but it is what we look for. I like to start with the first version and than show the compromises we have to make , when make it easier but  more practical.

 Before this a  very simple explanation so you see where I am coming from and what I do since 40 years.
 1. It is super easy to write a training program , that's why we all do that . It looks great smart  and we have no clue whether it works , but it brings money in.
 Why do we not know the outcome. Because we have no clue  how the body will respond to the load.
 Problem.
 I charge you 500 - 1000 dollar a month, because I was once lucky to coach a world class athlete. Now I can charge money for a training program.
 I can't charge you for a recovery program , because  you would have on your paper or in the morning a call. Please  rest today. Than  how about one more day just active recovery and a walk with the dog , and by the way that will cost you 500 $ to tell you to do nothing.
Could I run a business.
Really  you can do anything if you are ready to take the consequences after that workout, that you may  be not allowed to work out  decent for 3 - 4 day.
 Now here is the interesting part.
 When you work out you stimulate Catabolic reactions, meaning you " destroy "  something. Now in the recovery time you create an anabolic reaction and you rebuild . This in simple terms.

 What are top athletes taking in . Catabolic  drugs or anabolic drugs. So when and where would you get the most out of your workout. At rest or in another crazy load the next day ?
 Result. I only can get a decent recovery plan, when I know , what system I overloaded and how much I overloaded it.
 Example. I workout with the goal to load/ overload  the respiratory system but not the other systems  ( Cardiac and  muscles.
 So I can now find out how long it takes to recover  my respiratory system.
 If I train hard  so I overload the respiratory system but use the cardiac system or the  extremity muscles to compensate , than I have  another open question. How long for the respiratory system to recovery but as well how long for the compensator to recover. With VO2 max tests and  lactate test I never can find that out. Therefore I need a physiological assessment to find this out. So I have this now I can plan recovery including a perfect nutrition as that is what is needed in recovery besides some other information. The following summary is a 3 week seminar we give for  pro athletes .


1. serious athlete . How do I assess recovery mode.
a)Cardiac info. Resting cardiac hemodynamic looking at HRV, SV . EF %  LVET and LcWi as well as MVO2 . Time 5 min.
b)Respiratory system:  RRA ( resting respiratory assessment for VE , RF and therefor TV, VO2 and EtCO2 ( last 2 lead into the recovery of the metabolic system Time 10 min and it is done at the same time as the cardiac assessment.
c) Metabolic assessment : Lactate / ammonia at rest and after  breakfast as well as BIA ( 30 second duration ) to see phase angle as well as hydration ( water balance ).
 SmO2 in resting and upright position in combination with the resting of  cardiac hemodynamic and respiratory reaction.

 Duration  15 min test 5 min preparation. This is a standard assessment I do here in  my clinic with cardiac and respiratory clients  to get a feeling for their resting  situation and than after a workout the same the next day and so on. We have a protocol sheet , where you give in all this info for a week and we see than a trend in reactions.( Will show if there is interest some results.

 Now the person on the street .
We look for some biomarker.
 a) I can try to get this at rest or  at a low intensity . If we take  it during a low intensity assessment we take the ARI ( active recovery intensity  and than have a baseline from that initial IPAHD. let's start at rest.
 Possible biomarker.
 a) HRV ( heart rate variability . Indication cardiac or respiratory  system still not recovered.) equipment  any HR watch with HRV.

 2. Respiratory resting test  RF and respiratory pattern   If this is off the HRV may be off because of respiration and not due to cardiac overload. ( Many  respiratory  factors will directly influence HRV ( If interested another long  read but super interesting. Tool Bio harness and if you have this you have as well HRV at the same time.
Now you covered 2 vital organs.
 Simple muscular reaction Orthostatic check . Take values above and than stand up and check reaction. now you see Respiratory respond and heart HRV respond and how the "over shoot and  how long it takes them to balance back to resting test level. Key make all this test after a good rest phase 3 - 5 x in one week no activity but enjoy live. That gives you a baseline and thjhna you can compare  with this information. Than keep track on reactions after certain favorite  workouts  and how long it takes to get back to base line or better. Readjust base line as you go along.
 If you make it active, make a 5/1 5 IPAHD ARI set and compare the following info , HR, RF, SmO2  including recovery situation  after the second 5 min.  You can than n make some conclusion on what is going on and for sure, if you now the  " zoning " for the cardiac system  the zoning for your respiratory system and the zoning for you metabolic load. This will tell you whether you loaded one 2 or more system with your workout. Summary. Get  the BIO watch , where you have HR ( HRV ) RF and SmO2 all on one watch and you have done a big step forward.
 I am sure it was confusing but again great question and  a shy tryout to see, whether we can get more answers on the above initial explanations.

 Short sideline. The recovery protocol for Pro's would take  15 mn  after the race and 15 min n the morning doing nothing. When you think how much minutes and hours Pro athletes sometimes have take for blood transfusion and other interesting recovery ideas ( Anabolic drugs are preferred as we know recovery is the key ) than I am surprised, when I get mails from top athletes, who not even know their resting Stroke volume nor do they ever had taken a RRA and have no clue what their TV and RF is after a race day nor how it may or may not recover  for the next day.. You wonder what they do in the bus or in the morning when getting ready for another day ? Hard to believe, when we here use this as a basic  start exam before we move any client ( Patient ) n a workout program. Nevertheless I like to see how bad or how good my ideas may work and this not after 1 year but as we go along.( meaning steady small  Bio marker steps  even during a workout once in a while.



EternalFury

Development Team Member
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Posts: 25
 #5 
Thank you, Juerg. I really appreciate the time you spent to post this. There is a lot of info to process in your reply.

I am not a pro or a really competitive athlete, so I cannot really justify checking in with a lab every morning, even if only for 15 minutes.

In my previous training cycle, I tracked HRV first thing in the morning, every day for a period of 18 weeks! Put the HR monitor strap on, run the test that takes 1 minute, rinse, get ready for the morning run, etc. Sounds simple, but even this was a bit over-the-top for someone at my low level.

Alas, I am not sure I believe in HRV at this point. It's too sensitive to pretty much everything. Pee before taking the measurement and you get one value. Pee after and you get a different value. Breathe slow or fast and you get different values. Picture a field of blue flowers and you get a different value. Think ahead at your work day and you get a different value. Sneeze when you get out of bed and you get yet a different value. If you had beans the night before, you get different values. I exagerate a little, but overall, it is true. Over those 18 weeks, I got all sorts of inconsistent readings. Low values the day after easy runs. High values the day after a hard run. Etc.
I look at the trend over those 18 weeks, and I see my HRV index peaking at around 85/100 8 weeks into the training cycle and then it just declines progressively all the way to marathon day. In a sense, that may be normal, since marathon training is supposed to tire you out...but I couldn't use it to make day by day training decisions and that was disappointing.

My conclusion is that for HRV, I missed a proper protocol. Maybe I should formalize it this way:
1) Get dressed and get out.
2) Run 1 mile at 9:00/mi pace. Stop and take a HRV reading.
3) Change into my regular running watch and HR monitor and do my run based on that HRV reading.

But, even if I do this, I bet there will be noise in the data. I should make sure to eat and drink the same thing every morning, but I cannot control other factors, like the weather.
I guess it may be worth a shot.

Other things I plan to try in my new cycle are: 1) Tracking supine resting HR upon waking up, 2) Tracking HRR at the end of a fixed submaximal interval, 3) Training Effect (as defined by Firstbeat Technologies).

Ideally, I would love something that would give me a recovery percentage.

In the morning, it would tell me: "Hello, today you are 80% recovered! Have a fine day!" or "Hello, today you are 40% recovered! Please take it easy!"

I think it's a dream, at this time.
HallvardN

Study Participant
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Posts: 16
 #6 
Nice topic and so much interesting information. So interesting to see the recovery assessments by Juerg live in Zürich, and so much potential for the athlete in day-to-day guidance of training. 

Before we started digging into limiter-compensator ideas we had so much strange results using HRV with manual analysis and different commercial systems like Omegawave etc. At the moment I actually have one athlete involved in a HRV research project with Daniella Schäfer at the University of Bern. Interesting project, but proves that using HRV isolated have some serious problems. The main problem seems to be that HRV in stressed athletes could be either very high with high HF dominance or low with LF dominance. What would be interesting in this case is a complete analysis of the systems as Juerg do and more knowledge about the limiting system in the tested athlete. 

Would be a dream to have some simple tests that does not require too much equipment for recovery testing for athletes and combine this with complete IPAHD testing from time to time. What about combining Moxy and SmO2 with HRV? With this relatively cheap combination you could perhaps see if high HRV means well functioning central systems with nice blood flow and Smo2 or if high HRV means that the central systems are fried and works at low gear and is paired with low SmO2. Speculation

Have started Moxy testing at arms and legs in cross country skiing at snow and rollerskiing so stayed tuned for some interesting results the next couple of days!


Juerg Feldmann

Fortiori Design LLC
Registered:
Posts: 1,530
 #7 
Thanks for both of you for the great feedback.
 It shows nicely , where we have to work on. A decent assessment with an affordable tool so we can track down  some of the major physiological systems.
 1. To the HRV and its variation. I absolutely agree, that there are many complex questions and many factors influencing HRV. So yes, when closing as so often the eyes and ears we can use anything and say it works. When looking somewhat more carefully we see that  a lot of limitations have to be in place. So the " dream" is for the moment a BIO - Watch meaning a system , where we have HR HRV as some indication of the cardiac system at rest and at controlled load Like a short jog in the morning.
 Than RF as the  same idea but for the respiratory system.
 CO ( cardiac output = HR x SV
 so in respiration VE as the total air = RF x TV. So very similar. Like we have a HRV we have what I call ( not official   name) Respiratory frequency variability. meaning , that you have a very specific  ratio in in and expiration at rest . So you breath in followed by  same ratio breathing out and a short break. The ratio is about like 3 for inspiration 3 for expiration and 2 for complete rest.
There is a great old `book on respiration and it was written by Prof Dr.sc.med. Herbert Edel  and Katharina Knauth Physiotherapist originally in 1969.
 So  with some  small learning moments, you will be able in the morning to assess this feeling together with HRV. But easier again is the early morning jog where you have HR+ HRV  and RF + step count ( for example 4 in 4 out plus as  Hallvard suggests SmO2 from MOxy.  for  oxygenation info. Now you make your jog anyway you have a fixed loop a time and RF HR and SmO2 as baseline. Now you see very fats what may change depending on what you try to keep as a stable situation : Time for example or Speed.
The big question we than have and where we need many more info is:
 What do the different changes we will see mean.
 Example  higher HR for the same speed, is this a cardiac sign of a limitation or is it a muscular sign. That`s where we hope by integrating SmO2 we may start to understand more , when looking at the overall picture.
 Our Norwegian friends will help us to get many more ideas, when looking at a sport lie cross-country , as this is one of the sport, where possible in a top athlete the  delivery systems lie heart and respiration will be limiters due to the `sleeping `giant   question.
 This will be super fun to see as they use 2 Moxy`s  one lower and one upper body. We will do here at the same time same ideas but with untrained athletes , where we most likely  have a muscular limitation rather than a `sleeping `giant. So stay tuned for more questions than answers, but all this feedbacks are great and show us how little we know , and how absolute  we often tell how something suppose to work. .
Really this testing does NOT take the guess work out of assessment as you can see, it is rather the opposite it puts a lot of great  guessing and therefor many questions back in.
 If you like a training testing system without guess work  just take 220 - age no guessing here. Take VO2 max or estimated VO2 max and % of that and no guessing here as well.
 The big question just is : How much value do we get out of this non physiological but mathematical  oriented  ideas. How many of the existing  studies based on estimated  max HR and VO2 max and groups are really of how much value for  the person in the field  and  questions we have here open as well. Do we have an answer  NO do we try to understand  yes we try , are we successful , sometimes. BUT lot`s to learn  and it is lot`s of  fun.
HallvardN

Study Participant
Registered:
Posts: 16
 #8 
A little add-on to Juerg's post. This is morning info from a "warm-up test" on two different days from a cyclist. This athlete has done this kind of testing before nearly every ride the last 4-5 months, before deciding the training load that day. . Not so much equipment every time, but he is always measuring at least HR and BR(often HRV as well with Bioharness)at standardized loads. 

This is before and the morning after a day with a 6 hour low intensity training ride.

Morning test 0100713
Watt Hr Sv CO Edv Lvet Ef CCT SmO2_Vas BR
150 122 78 9.6 111 293 70 35.7 60 16 
200 135 85 11.6 116 277 73 37.4 52 18
250 142 85 12.1 115 272 70 38.6 46 20
 
Morning test 020713
Watt Hr Sv CO Edv Lvet Ef CCT SmO2_Vastuslateralis BR
150 107 89 9.5 135 245 66 26.2 65 16
200 122 92 11.3 135 231 68 28.2 67 17 
250 133 95 12.7 134 237 70 31.5 60 18

Felt good both days, but a little more "heavy legged" feeling the last day. Last tested this athlete had a muscular limiter. 

Enjoy!
Juerg Feldmann

Fortiori Design LLC
Registered:
Posts: 1,530
 #9 
Thanks to  the Norway group great info and  super interesting. I will add  lot's more to that and will use one specific IPAHD test to show  how the NIRS info and the  other system  move perfectly together and support the information so at the end it makes all sense.
  Will take me some work here but I will use a current test done in Switzerland with  one of our Norwegian Friends and it is a running test. I will  give you may points of vie ( which not have to be the right once but I like to show you the thinking process and than we can correct and  discuss and see  forward to many fun discussions. To start out the NIRS info. Look at the trends and  tell  what you see. Make some thoughts and why and what may cause the trend we see.

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Juerg Feldmann

Fortiori Design LLC
Registered:
Posts: 1,530
 #10 
Sorry forgot the  att here it is . look at Hb diff and look at tHb.

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