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juergfeldmann

Development Team Member
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Posts: 1,501
 #1 
Is there a difference between  top  world class  endurance athletes  and  patients in my clinic. ? 

An interesting  question triggered  by a  forum responds  I gave in Jiri's ongoing discussion on which leg is the injured leg ?

 I got  two intriguing  emails  after that   section of  showing one of   the current  problem  clients  I  have the privilege  to  treat,

fracture.JPG

I  as well get many  emails  telling me, that we are too  complex  and nobody  can do it that  way  and that  working  with top athletes is very different than working  with  patients.

Are you sure ?

Okay  let's  make a  hated  cookbook  to  make  a  counter  discussion point.
  There   2  categories  of   people out there.

a) the  people where the muscular system  is the limitation (  so the ability  to actually   use O2   as much  as  you get delivered. So  people  with a  capillary  and mitochondria density limitation.

This is the big big    %  of  people. This is the bets group  as no matter what you do  as long you can get them motivated  to work   more or less regular out they will make progress as the vital  system  are well   train  and healthy to delivery  what   is needed or  what  the muscle  may   demand  for  on O2.
  This is the group  where   we can increase VO2  max ( peak )  this is the group  where you can use any   system you believe in  as you not  have to proof   it works  as the progress will be simply  due to the fact, that they  start doing  regular  load  and recovery ideas. This group is great  as it  helps  any  Guru  from any  ideas or  system  to " proof " that your  or my  system using lactate, VO2 , MOXY,  FTP  or what ever we  talk   will be  successful as we see progress. You  can create any  " zoning" idea  and suck  and   LT  option out  of  thin air  and it will work.
 Even 220 - age is  successful

Group 2 .

This  are   the people with a  delivery limiter ( cardiac  or  respiratory  ) or in cook book terms   where the   vital  systems  limit the performance.

Interesting  in this group is, that VO2  max  or Peak are  very hard  to improve or increase.
 Why ? 
This is  why in  world class athletes  VO2 max testing  does not show a change  and in fact in  some cases they may  drop in VO2 max  values  as they improve.

 What  people are  this.
 Either world  class  or veyr  great trained endurance athletes  or  very  sick  people.

Example in a cardiac limitation.

Person   with a  cardiac problem   like after a heart attack  simply looses   suddenly the  ability  to    create a big CO. So   despite the fatc that eh was  just prior  to te  heart attack in great shape  and had a lot  of  capillarisation and mitochondria  density. Now  after the attack  this   proofs  to be a  risk  or danfereous. The   highly  trianed and O2  sucking leg  muscels create a real  steeling O2  risks  to his vital organs  and  we just  can hope  the CG  will  stop  the  O2 sucking before   he has a  real  problem.
 So  VO2  is  limited now  to his  cardiac  new  situation

High performance athletes.
 Most  of the top athletes  today    train so great and effective  and so many hours , that their muscular system  starts to create a real risks  to  steel O2  from Vital  systems  as well.
 It is easy to show  when we add O2  to their  workout  and therefor  help artificially  to  delivery  O2  as they can use it in their legs.
 EPO  ,  and any  current  allowed and not w  allowed enhancer of  O2  delivery  shows the need  for O2  but the inability  to deliver. If  it can be delivered  we see the incredible  additional performance boost  they really have.
 Something like the spleen dumping in   horses.

 So  when of for who  was EPO  produced  and used  originally ?

Critical question.
How many top coaches  actually   designe a  CO   or  specific  SV  workout based on physiological  information of their athletes on what  their   multimillion $  athlete  has as a  SV  or as a  EF%  or as a  LVET ?
I may be  wrong so  any  coach  sent  without names  some of the data's in here ?

Now  where is the difference in the above example between top athlete   and  cardiac  patient  who ahs to improve the cardiac situation  to improve  performance  besides  actual end performance. ?

 True  there is a fundamental difference,  but it is  not physiological related  but as a business free advice.
 With a  cardiac   patient  always collect the fee  you  charge  before you assess  and before you start  the  workouts  a she may  not  survive it  , if you make a mistake.

With the high performance athlete  you better make a picture  with him and you  so in case it  did not work  he will change the  coach   will not pay  but at least you can say  you  worked  with him. ( And hope  that after the fact he may not  get caught  with some  not  optimal  drinks  and   substances in his blood.

Second  example.
 COPD  and high performance athlete.  What  is the SpO22  values in a  COPD ?
 What do  we discuss more and more in top athletes  as EIAH. What is the SpO2 in this  people.  Both have really the same problem in respiratory  function  and  a very similar  out come.
 SmO2 in a COPD assessment  and SmO2 in a highly trained  endurance athlete  with the  respiratory limitation look very similar  and if you do not have additional information  you  will have a 50 / 50 chance  to  decide  who is  who.

So  what about the training approach . Exactly the same . You look for physiological zoning  and you stress  what the goal or the limiter is. Do I need a  performance feedback  for this training. No not  at all. Can I benefit  form a performance  feedback . Absolutely as it is a  great motivator  for both to show that these strange    workouts  actually yield  progress in performance.

So  would I  do  with this groups  if we have a cardiac limiter a BFR training? 
If  yes  why  .?
 If  no  why not.?  So next time you read a  research  paper  ask yourself  what  kind of  people they had  group  1  muscular limitation
or
group  2  Vital systems limiter.

In Jiri's  case  we have 2 legs,  in what  groups  are this 2  legs?
Group  1  or  2








Jiri Dostal

Development Team Member
Registered:
Posts: 51
 #2 
My guy used to be group 2. I have not seen him before, but he used to be a WCH in his sport, and he just turned 42 with 25 years of training originally on bike ( one of the first MTB Czech), later on in his sport. 

However look what happened with the detraining... I did not do the IPAHD, but insdead I tried to simulare the race ( still not optimal on bike, but I would not have otherwise the power outpus feedback, and he does not do his discipline anymore anyway). Still there is a clear difference in the deoxygenation and tHb patterns... once again look at Biased 1 and Biased 2 and make your own opinion ...

Jiri
juergfeldmann

Development Team Member
Registered:
Posts: 1,501
 #3 
Jiri  thanks  for this great case.
 I will  as soon I get permission  form other  athletes  with injuries  some more case stdueis  to show you what detraining may do. but even  more interesting  what is missing in many rehab programs  because we  focus only on  short term strength readings like  with often do is the physiological rehab overall.

 This is  an on snow assessment  done by Andri  Feldmann and Brian Kozak and myself  on the glacier in Zermatt.
 It is a  work class downhill skier  a with a severe ACL injury coming back  for top level racing.

There where several runs  down  and here the left right  comparison  of  all  runs. including breaks in between

left  r  quad smo2 all.jpg

Dark green or  2  is  right leg 

Below a  closer look at the loads in between gates Super G  training run.


r closer look 2    push off thb.jpg 


Above dark  brown is  right leg  and it is  an insight ski  turn
 Below  an outside  r  leg  ski turn

r closer look 3    push off thb.jpg


Below  biased  view  of  both legs  right leg below

bias  r  all.jpg 



Left leg below

bias  l  all.jpg

CraigMahony

Development Team Member
Registered:
Posts: 178
 #4 
How many top coaches actually design a CO or specific SV based on physiological information of their athletes on what their athlete has as a SV or a EF% or a LVET?

I would say very few. As a coach i have no idea what these measurements are for my athletes and am not in a position to find out. Even if I did know their measurements, I have little idea on how to make a program specific to CO or SV despite have studied physiology for my Physical Education teaching degree and having done coaching courses and attending coaching conferences. It has all been about performance not physiology.

Over the last few years I have been under the belief that doing repetitions at MaxVO2 pace was a good way to improve SV and presumably CO. If someone could give me an example of a specific CO training session I would appreciate it. Thanks.
juergfeldmann

Development Team Member
Registered:
Posts: 1,501
 #5 
woww  Craig  what an honest  and great  feedback  from a  top coach.  I  admire your  feedback  here.

 I lie as well this  section here.

 I have been under the belief that doing repetitions at MaxVO2 pace was a good way to improve SV and presumably CO.

I think that is one of  all our  weakness, We  take  " education"  and  simply believe. I  dd not  have any study  found ( but that does not mean it does not exist )  where the  " zoning" ideas we all use  and see  has  some  research feedback , that  VO2 max  pace actually influences  SV  and as  such possibly  CO.

The great webinar, which triggered  at least in my brain many  interesting thoughts  and I  spelled them out on here,  did  not  activated a  discussion as of  yet.  Why.  Is an open  though  looed as something negative  so a  negative critic ? hopefully not.

 For me the  fascinating  section in there was, that they used  125 %  of VO2 max  as you may recall ,  so  clear a  pace  above  VO2 max, but  when they at the same time  measured actually VO2  levels they reached  only  80 +- % of their  VO2  max  actual performance ?

 Why?

  So  the   direct question is, if  we load  125 %  of  VO2  max pace, but we do not even trigger a  VO2  max value   what  do we stimulate here  and  why did  we not even got a  full cardiac  respond  on it. ?

 Now this  question was  one of the first  questions we look upon,  once we had Frank Bour  showing us his  Physio flow  and the  reality we found ( true never published ) was, that in many cases  where we load  VO2 max  pace  and above we never  actually saw a decent respond on CO  or on SV as  such. We than  where looking on what  actually  triggers a  SV  respond  and than we combined it  with Portamon and later with Portamon  and MOXY  to see,whether the tHb  in combination  with Physio flow  could be  an indicator  of a  SV   stimulation.
  And it was.
 So  as so often  mentioned  we look  or better I look  forward to have some confirmation  from accepted  great  places, where  for the moment  a lot is based on theories,  but I will have fun to see sixths places actually going  and measure  live  feedback's as we do ,  as this is what we  try to achieve.
 MOXY is one tool  to combine and that is what we do on here since many   month and years and some additional loud  thinking on  how the SmO2  and tHb  can be interpret.
 I was running   far before this forum a  forum on another website  where we showed   many many assessment  and live feedback on  SV  workouts  over many years  far back.
Result :
 Zero   just some smiles  and some   short feedback's.
 So no point   making the same  work  and mistake  again  just  helping here a great tool  to  get  some recognition and  we show  very open how we  hoe we  can do some interpretation.
I will dig  in may  small case studies  I  did over the last  15 years  with this combination  and will show  you  some live feedback's .

 Some of the  assessments  are  from Europe,  from Italy , Norway and Switzerland.  Groups  we  work together  and  we  get some incredible fair  and critical feedback.
  will NOT   sell any cook book  or  any  %  calculation for  CO improve  as it simply  does not work  as a statistic . BUT I am sure  there will be somebody  calculating and  coming up  with a formula.  Hope fully    we than  can use this  and look at individual reactions  as   for me that  what coaching is  all about.
. So  step one is  to look at  through the calculated  Zoning critically  and   perhaps give some individual physiological zoning  some   thoughts.
Summary.
It is all about   finding the limiter and finding the compensator.
 So  if you have a  cardiac limitation  you have assessed than look whether  you an go and overload  for a stimulation or whether you take a  risk. If you have a muscular delivery limitation than you will compensate  with a delivery system  and the cardiac system is one of them. Now  you have to look carefully , whether  we interfere  with pre load   and one  next   and the second  part is we have to look whether we create a resistance  for the   left or eh right ventricle.
  Just as a  small feedback. I was running over   now about  10 years back  with Mary Ann Kelly  workshops   where we  showed  with  all the tools    like Physio flow  and more  to    what can be done. Small interest no  serious feedback not any thoughts. We  even  pushed in a  work shop in Boulder in the  " capital ' of biking a  workshop and Stuart  was there,  where we  even had Frank Bour there. The only feedback  from there where we  had top cycling coaches    and a  real smart  Swim coach  as  or is  from the  swim coach ( Thanks Dominique ) , the rest is  deep  silence,   
 Sorry  very  much  a lot of  interest  from the Chinese  group  who was there .

Why.?
Is it   because many " established  " ideas  can  no be confirmed  and  change is  hard to come by. Why in cycling and in some other endurance  sport  the  drive to increase  delivery with   allowed  ( beet juice)  and less allowed  drugs  is  so prelevant is it  because we see  and  know that the delivery is a limitation in many to athletes but   we have no clue  how we  can improve that physiologically ?
? Just loud thinking.  And yes I wait  as wlel  for a  post  whit a suggestion how to improve  SV  and as  such CO. Thanks  for this great  feedback
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