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Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Ruud  gave me  some great critical pointers on    try to improve on  my messy brain  and how I   bring information's on here.
 So I will try to use a   specific case from a soccer  coach  to start with an absolute baseline feedback  we make with MOXY  and than we strip it down  to show you limitation for basic ideas  but  how easy they are  to more complex in depth observation which make it  very interesting but open  a  can of  worms  for many including me.
Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Start of a series  of  ideas  and explanation for teams sports  and a-cyclic  sports  .
 How  do you use MOXY  and  how  do you  set up a assessment with the team as well how  do you use the collected data  in the assessment  and during a training  as well as a game.

We use  data  from a soccer  coach /team  who starts  to  integrate MOXY into their  training ideas.
Thanks so much for the   data  and the ability to use them here to help   as well other team coaches  in the  interpretation  of MOXY
In many sports  we lack  the ability to make sport specific assessments.
 So we create a very unique situation:
Ask any endurance athletes like a cyclist or runner  to have a VO2  test or any assessment done   on a  skating treadmill or a rowing ergo-meter.
 What is the answer.
 Nevertheless  many team sports  pay good money to have their athletes assessed  on a bike   despite the fact , that they  may be  tennis players  or in our case soccer player.
 Summary . As soccer player  has to be assessed    on the soccer field  during a  game to understand  what he is doing a and what the energy  demand s  are  and what limits him to perform . Is it a  delivery limitation or is it a utilization limitation.
 So  to asses in a game sport  you do :
 1. TIP  ( training intensity profile  to find out  for training's on what intensity you can work on coordination  or on  the technical skill training.
 what is the intensity to get ready for a game , how long or when does he starts  to loose  systemic   performance  despite optically still great running. What are the recovery time in interval workouts  and how many repetition of a certain drill make  sense to perform  with  each athlete  and many more  questions  any  team coach can easy answer here.
 The following  assessments  will show you how we  can individually asses this and  integrate it into a tam  training plan without  really changing  that much..

2. After a TIP , which never gives us  high intensity feed backs  for interval workouts  we  than make a  sport specific  RIP ( Recovery intensity profile.
 . 3. Last but not least we   collect a  full game MOXY data  to see how  this player in this  position really  uses  his  energy   and how in  the " recovery " phases  he really is able to recover.

 So here the main question:

what is enurance.jpg 

The answer  could be both , but the key is not to create a marathon runner  but a soccer player  with the ability to go all out  and than recover  very fast. So what we need  is the game moxy information of this athlete or  a  simple analyzing of what is  actually going on   during a game  in soccer.
 Here  an example.

statstic  of  movement.jpg 

This depends  as well on position, but you can see in contrast  to ice hockey where  recovery is  actually  on the bench the soccer player  will still move.
 So movement in the situation of " recovery " have to be  what  we like to be , a recovery  respectively  an ability in this  situations to  reload energy  to be ready for the all out   performance which will randomly come  again.
 So we need  the ability to have the player in an " endurance " level  or shape , where  he or  she is really not performing  in the way of using energy  for  motions  which are  not relevant  for rte h  eh game  or     simply  have to be done    due to the system  you play.
 For   this " controlled  load s  we use  the TIP  as well to see, what  may limit the athlete  from performing  even better. Summary :
 The TIP  will give you individual intensities  for the different  workouts  you plan as well  will give you a feedback   to see in game data  where the athlete  actually is  during all his movement. Example : Is  he  always at least in the STEI  intensity so never really   able to recover  properly. So his  base line endurance  to   fight fatigue  may have to be improved, depending on the limiter , who creates this problem  in the first place.

 Combine this with a sport specific RIP  and you have as well the  interval training  with  length of  load  and length of recovery  and amount of reps  covered  and again you see in the game moxy data , whether he  actually is able to maintain the performance   or whether  his training information shows, that he simply can't sustain all out    as long as the game  would require him to do.
what we need.jpg

So here is a TIP  from the soccer coach.
 He  used a great  idea of  having one MOXY on a leg muscle  ( Vastus  lateralis ) and one on a non involved muscle  and they did in this case  a treadmill test.
 ( we will show later how you test a full team in 2 hours  in a  track  and field   400 m track or on the soccer field ..
He  did a  step test  and he  did  already a big step forward.
 The regular reader    knows, that 3 min step test miss a lot of information so any  longer step  will give more feedback and at least they should be 5 min long.
 It does not has to be a 5/1/5. In this case the coach g did a 5 min step test  and  the great part was, that he added the  1min rest in between which will help to find limiter  much easier  as well as compensator.
 A  simple 5 min step test  can give a similar zoning but we  miss the main  information for a assessment , the   findings on strength and weakness of the athlete.  so why not add this  easy  feature to it.
 So here the  SmO2 data  from both muscles.

tip  inv and non nv.jpg 
 Dark green is  leg  , light green is   less involved muscle.
 Great  assessment with 1 min calibration followed  by 5 min  load  1 min rest

 Now  first to keep it simple. This is all what  we  need  and if the client   simply is doing  blind  what  we tell him  we  give him the next   picture  as his individual  " zoning " idea.

Now  you can plan your workouts  accordingly  and   data  form the game will show you , where the player mainly is  and why he  is so good or why he  can not recover  at all.
 The training plan  than  can be done either over HR  or  performance   but really the best is  over live  feedback with MOXY. We discussed this already  so many times, but    any surrogate is not  really optimal as it changes  daily so  live feedback is   what we can do now.
 The panning than  will contain  a  simple  summary in numbers of the TIP
Yes it is a cook book  so be careful and really asses individually how they react. The result is  easy  as  you  may  do a re-assessment after  a few weeks  as a TIP  or even better you can get the feedback during games, as you can see, when  and how often  and how many minutes he moves in what " endurance  intensity .The coach  can on the  side  during a game see, what happens  with SmO2  and tHb reactions on his lap top or tablet  and can make  some  decisions.
 The RIP than will tell you  what the limitation is in all out situation.
 So back to the  TIP.  Based on SmO2  alone ( not  great but often used ) he has a systemic limitation  and  most likely the respiratory system is the reason why he  quits  the  assessment , but  this is  most likely just the limiter in the  assessment  and it is triggered  due to another limitation. The real limiter  for  his sport soccer  can be found  by using MOXY during a game.
 . . Summary .
 Basic  MOXY use.
 Make a  step test  with 1 min rest look at SmO2  and make  an individual zoning . You than can use  performance  or HR  as guide  for simple workouts. ( not  optimal but better than what we had till now.)
 This really is  all what you would get  from any current testing. VO2  max and use a calculator  and give zoning.   . Here at least we have   an individual  information which is not calculated  at all but a feedback  from the body on how he  uses  energy.
. Now next up we like to get a step further  for coaches  and show  why we believe there is a systemic  limitation  who stops  the assessment  and why it may  or may not be  the respiration. For this  as so often mentioned   you use  both information tHb  and SmO2  and you need the one min breaks.
His  strength and therefor   compensation is the utilization.

Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Part 2  soccer  assessment.
 1. For a team sport you like to have three  information's.
 a) TIP  to design programs and intensities  accordingly to the  needs of this player  and work on the limiter , which may create  a problem  for this sport activity
b) RIP  to design  sport specific interval ideas  and work on the limiter in the high intensity loads.
c) ongoing assessments  during games to see, what the actual limitation during a game is  and  adjust  training programs accordingly.
So  for the moment we have the info  from a TIP
 Here again the base picture when using just  SmO2.

smo2  all leg only.jpg 
Above is the SmO2  information from this soccer player legs  only ( vastus lateralis )
 a) he starts  with a " resting calibration SmO2  value  of 55-60 %. ( good is if you get this " calibration value in the sport specific assessment. ( example you run on a treadmill stand on the treadmill for 1 min. You  row , you  sit on the rower  for one minute in the same position as you will be in the one minute rest.
 You are on a  cross country erg  stand in the position you will rest for 1 min.
 You are on the skate mill,  rest in the position you will rest in the one minute.  Important is  that you have the same  position always  so we  can understand certain reactions.
 Now let's start very simple ( risk  that we get  many questions)
70 - 430 load.
 Initial load  without warming up.
-Rapid  drop of SmO2 is very common as an indication of an immediately use  ( Utilization ) of  O2  as we start out.
True  this throws into question the  common current believe, that this start suppose to be " anaerobic" and a part of an  O2  deficit?? But let's stay  simple  and focus  what we see.
 But if there are questions  we  can try to  show you research justifying  some of the  out of the BOX  interpretations.
- after a an initial drop we   see  most often ,  if the load is  low enough, a " recovery" of SmO2 trends  and it will increase during the rest of the load.
frist load smo2.jpg 
Above a closer look at the first load  SmO2. You can see an interesting  drop  over a time  of  about 30 seconds..
There  are some different reasons why 30 +- seconds  and it is  one part   where we  see changes  due to certain training interventions. A  Rip test will give even more  information's.
Now  if we have as well a second  bio marker  like HR  we  have some better ideas  what is going on.
 If we  add a third bio marker like RF ( respiratory frequency [wink] we have even more information.
 So lets' start with what   more or less every assessment has  HR.
In this case we have no HR  so I take Ruud's  5/1/5  first  step.
ruud  frist step 5 1 5.jpg  So above  red is HR  and green as usual  SmO2.
 The critical reader will very   fast  understand   by now why we like a 5/1/5  meaning repeat the same load  twice  with a 1 min rest in between.
 Here  an additional example below. With HR  brown /red  and  smo2 in a 5/1/5

Col Hr  and smo2  start.jpg 

You can see in both case  where we have HR  a " lag time" of the HR respond  of  about  +- 30 seconds.  It i getting much better  but lets' stay simple.
 The  HR ' Lag :" time means  that we have  not  an optimal needed  CO ( cardiac output  immediately  at the start.
 CO = HR  x  SV.
 So lower  HR  and slowly increase of HR means slowly increase in CO  and slowly increase of a better  and needed  " delivery " of O2.
 The time between the optimal needed  delivery  and the  start   needs to be  " survived"  and this is  why we see the drop in SmO2.
  It is not a deficit as we still have  O2  . It is in simple terms a  " bank account" and we  have some " savings" and are happy about that , so we  can afford  to  spent  something from the saving  till we  " earn ( get a delivery  paycheck  again). The  physiological system simply  never allows you in sport  to drop into an O2  deficit  , we always will sustain a minimal needed pO2  all the time  as we always  will need a minimal ATP level  as well.. If  we  get to this critical needed  levels the CG ( central governor  will simply  try to reduce  O2  use    and ATP use in non vital areas  first  by reducing  motor unit recruitment  and therefor loos  and reduction of performance.( More for sure later )

Now  if the load is low enough we will see after +- 30 seconds the mentioned   rebuild of SmO2 levels. simply meaning , that we  spent O2  as we had an insufficient delivery of O2  but as soon the delivery  can catch up   and we  do not need   all the O2  now  delivered  we rebuild the  bank account    as much as possible   to have a savings  for the next time. In a  single step , as in the soccer case, we  do not have an optimal rebound  of SmO2 , as it is  NOT  just HR    resp CO which has to be activated , it  is also respiration  as a part of delivery    help  as well as  vasuclarisation as a part of delivery help..
 Now  if we repeat  we  give the other physiological  system , which help to compensate   the time  to  pick up their tasks.
 In Ruud's  example look at the  green markers at the start and end of  each load .
 The same " time lag " to get going  is  as well   a similar time lag to stop the task.
 So a sudden stop  ( 1 Min rest) will immediately reduce the   demand of O2    but it  will not immediately stop the delivery system  form delivering what we asked for.

Now in research they use  occlusion  to calculate  O2  and blood flow (  later if needed ) as a  metric options, but I use  a  stop to the demand area ( muscles).As you can see, a sudden stop " normally " will show  a  rapid  increase in tHb   and  a relative rapid  increase as well of SmO2. No need  for O2  and blood flow, but still delivered , so we  have this nice peaks  at the 1 min rest. Later we  will come back  why we use this rest period  to actually find  Limiter and compensator  much easier   than during load. ) or  at least   we need both to confirm each other)  Now look the soccer   SmO2 trend  and the relative slow increase in SmO2  and not even back to baseline( indicating  a  recovery of the initial  load  and use  of SmO2  but not  enough recovery to rebuild  at least to baseline.
 2 main reasons.
 1. Too high   start load
2. Not enough time given  for all the system to get ready to deliver  what  may be the demand.
 Look in Ruud's  5/1/5  .
 After the first load a  rapid  fats  increase in SmO2    and reaching plateau but not that much of  an overshoot  yet  after the first 5 min. Increasing the  stimulation time with the same  load  shows the  second time  1 min rest a much better   feedback on the  power of the delivery  and the   reduce  need of O2  compared to what  we deliver   there. As well you can see  again an initial drop  but again a very fast increase in SmO2  to a plateau  and actually higher than  baseline SmO2.

This  very specif  point I mention here  are all used in individual training's  as well   give us feedback in retesting on the changes  we  achieve  with the individual  training program.
1. recover  SmO2  faster.
How long and  what do I have to  use  as a warm  up strategy  to achieve  the highest  SmO2  and tHb  values.
How long  do I  rest in between specific  intervals . Do I wait till SmO2  is on baseline  ,or  above baseline. D  I wait  till tHB is   higher than before  and so on.

Summary  for now.
 The soccer assessment shows  a  " normal " SmO2  reaction with unloading  and than  loading again.
 It shows  an insufficient  " recovery   from the beginning  compared  to baseline  and an insufficient  peak reaction in the   rest  minute.
 This opens a set of  speculations.
The speculations could be ruled  out with actually information  when we  add tHb  to it  and we  add a  repeat of the same load if  we like that.

So stay on speculation.
 The  inability  to " reload"  SmO2  back to at least baseline  can :
 1.  Too high start  load ?
2. Not enough time  to  react on O2  demand  with the delivery options( 5/1/5)
3. No  relaxation at rest  period of the leg muscles?
4. Inability to reload due to  O2  Disscurve shift to the right. (  which could be  due to  1  and 2)

 So next up  we go a step further to try to remove  some speculations  by adding  tHb as  an additional help  to it as well the options  of a feedback  by using a non,  or minimal involved muscle.

Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Part three.
smo2  all leg only.jpg  Here  to  get the picture  back. Our  5 min  load  1 min step test from our  soccer player.
 Now what is interesting ( not cookbook but  is often seen in game players. ) is the fact, that the  biggest  de-saturation ( drop of SmO2) is  at the first  step start  and at the last step when they  quit.
 In endurance  athletes  it is very different.
In fact in many cases we see the biggest drop in SmO2  at the start (  if you do not warm up.)
 It is in fact the biggest  need  for O2  from the  "local "  storage, as  all the delivery systems  are  not working yet..Players  with a great utilization ability will show a very if not the biggest drop  at that stage and it is an initial indication of a  good utilization, but depending how  fast the SmO2  response is a less optimal delivery system or  recovery ability.
The trend in SmO2  and as such the recovery  is  closely linked  to the recovery  and refueling of the creatine  phosphate  reaction.
 Dangerous  to use this after one assessment like here. The drop yes, the recovery no. But as you repeat  the same  start load  in many workouts  as a part of  warm up  and get ready you will see a  pattern  and as well, if your idea is to improve  delivery ability in this athlete you see a much faster increase in tHb after a while when using same performance /load   every time you start. So in the  first step  we know we have a   bad delivery situation. In the  last step  we may have created a bad delivery situation as  the delivery may be a limitation.

Now   for easy start. What is  considered a part of the delivery:
 a)Cardiac system  so cardiac output.HR x SV
b)  respiratory system   as a part of O2 intake  from air to lungs  and  a part of O2 release  from blood to  cell   but as well as a part   of CO2  output.
( besides the respiration is closely linked  to heart beat as well )
c) a big part of delivery systems  is the capillary bed  or  in other words the  situation on blood vessels  who can deliver blood to the  active muscle areas.
Now  when we go back to the " zoning" ( which is stupid  to have a  zoning and use  surrogate)
than we had this picture
Now  watch carefully  and I will try to explain.
1. First step leg , biggest drop in SmO2 and indicating a  good utilization, when O2  demand is high and delivery is low as  delivery  just got  woken up.
 2.The non involved muscle show no reaction as they are  not involved.
 But they as well show no increase in SmO2 as well..
3. The first  1 min rest in legs  does  not allow a full re saturation to baseline , so he is already lower in his bancacount indicating  already a limitation in  refueling or  at least an initial trend.
 ( careful by interpretation of the drop in  non involved muscle just  before  the 1 min stop ????? )
 What we  can see is as well that despite an increase in CO  ( HR goes up and we  can  safely assume that  SV  at least stays the same or  may go up a little bit as well.) we do not have  in the  start step  and increase in SmO2 in the non involved muscles  as we often see.
Reason again : Start load  was  perhaps to  hard already  and   or not long enough  for the CO  to react  and be a part of  an optimal delivery.
 So  using on this athlete a MOXY and start  easier  will  give a clear answer, whether he can increase SmO2 in the non involved  muscles  and  as well , whether he would be able to  create in the recovery a higher than start  SmO2  level. So SmO2 in all  1  min rest periods has a trend  to drop more and  more  so less and less re  loading.
 If  this is a delivery problem  from the cardiac system  and or a   problem , that he is not relaxed in the  rest period or  whether it is a respiratory limitation  can be answered  when we  add later tHb  to it.
 Or better   the first two points  can be ruled  out.
. But first look at the non involved trend at the end.
 Here a potential explanation which can be discussed.

hirarchye of O2.jpg
 What does this means. Try to wrap your head around.
 The  physiological systems  are   on a great  situation in the way  that in a healthy body  the  O2    delivery is on a priority list depending on survival opportunities.
 So  lucky for most of us is that at  the end of a  400 m run we   will still breath but we  not will run  anymore. Otherwise  it would be not good.
 So make a simple story out of the picture  on where  and  what  will happened  if the O2  demand overreaches the O2  supply.
 So when we have the  picture  from the soccer player , we  get   O2  from   where?. If  we  do not use this  body part or very minimal, than  we  have the  drop of SmO2  not due to use of O2  but due to not  delivery of O2  towards this body part. So  in that case  we  again would go back to tHb  and look what happens there. What we  know is, that BP  as well as  O2    situation can be  nicely regulated and  people with an incredible capillary bed like cross country skiers or rowers  will show a  clear BP  reaction by having to close  blood vessels  for less flow  so tHb will drop to maintain  blood pressure.
 ( No wonder that  specific  physiologists  understand  that by giving plasma expander  we can improve performance in this sports  easy. Difference between training to reach that goal  or  injecting to reach that goal. ???) Why do they find responders  and nonresponders. Because it only works  if  you know the limiter  and if this is not the limitation it does not work , same as  with EPO. What has to be the limiter  to be successful in that   section ?
 In people with  little  capillary bed we  may see this less , of that as the heart may  easy be able to maintain BP  even if all blood vessels are open.
 The drop in SmO2  could ( not sure yet ) indicate a  systemic limitation  in this test , as  delivery of O2  either over cardiac  situation  or over respiratory influences  can't  be maintained  and now the non involved muscle  will have to reduce the O2  , but no problem ,as he  anyway does not ask  for  anything more than  needed  minimal pO2, which is always  maintained  in sport (  exception  but   later perhaps )
We have SmO2  values  form involved  and non involved  muscles, indicating a good utilization ( start trend )  but as well a systemic  limitation ( end  trend in non involved muscle. So delivery problem.
 Which of the suggested three options?.
 Cardiac, respiratory   situation or  capillary beds.
 Or  as usual  more. Interlink between one or the other.
 tHb will reveal more  as well whether we may have a compensator  as well. so stay tuned  and come back with ideas and questions.


Development Team Member
Posts: 1
Juerg - Thanks for the detailed analysis.  I'd like to clarify a couple of things about this assessment.

1. The lack of HR data is due to the use of a bluetooth monitor that wasn't compatible with the computer I was using to record the Moxy data.  I should be able to send the heart rate data to you though if you are able to integrate it into the Moxy data.  In the future this won't be an issue as I'll have a compatible monitor available. 

2. This assessment wasn't to failure.  He was working hard at the end, but he could have gone another step.  We had pre-determined the end point of the workout and he had reached it.  The work intervals were as follows: 5.8mph, 7mph, 8.2mph, 9.4mph, 10.6mph for each of the 5 minute steps.

3. The dip you see in Sm02 of the deltoid right at the end of each stage is due to the athlete grabbing the treadmill hand rails and hoisting his legs up to get his feet off of the treadmill.  During the rest periods he was simply standing with his feet just outside the belt which was kept running during the test.  

My "wish list" for this type of assessment is this:
 - good, reliable data 
 - data that is relatively easily interpreted so that it's actionable 
 - time for assessment realistically needs to be 30 minutes max and 15-20 would be better.   I have too many athletes to run each one through a true 5-1-5 workout, and I question the need to take a soccer player through such a long assessment when a half is 45 minutes long
 - a non-maximal test so that I can conduct it in-season in which we are rarely training farther away from the next game than matchday+4  
 - due to weather constraints, we are limited to indoor assessments at this time of year.  We do travel to warmer weather climates for pre-season training but we don't have time for extensive testing at those sites   

Juerg - although I've more than one question regarding what you've written so far, can you comment on the deltoid drop in Sm02 during the last 5 minute step?

Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
First  of all ,
Thanks  to the flood  of  email after I started this preview. It is  fun to see how many people suddenly start to think more physiologically than performance wise  and  we will be able to combine this easy  as we go along .

performance needs  physiology  and physiology creates performance.

Now a great feedback from Ruud. He  suggest  that we  keep on this preview  simply the steps  going I explain as we go along  and not  additional answering of  questions.
 So  for that  which is  crucial for me  getting great  feed backs  I will open a  Preview  question  thread  so  there we  can go  back to individual   feedback  like the great  once  from Dan   our  soccer coach.
 Hope this makes  sense and I like t just to start that section now.
Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Part 4:
 Short recap where we  stand.
Discussion of a  step test  from a soccer player.
 The step test is a  5 min load  1 min rest  and a new  5 min load.  and so on.
Here the  SmO2  picture  to review. smo2  all leg only.jpg

Discussion point  1  from different  team coaches on the test  choice :
 Point of  questions:
 Length of the test if  5/1/5.  for sports like Ice hockey  basket ball volley ball and  even soccer.
 In  a-cyclic sports  if there is a time limit before a season we make only a RIP
 Duration of most  RIP  is  +- 15  minute per player. We  can test  easy 8 player  at  one time  so 32 players in one hour and sport specific load.

 When would we  do a  TIP. End of the season   and based on some real  game specific  MOXY assessments  to have  an idea, by what  intensity   and how  many minutes   the player is  actually in what energy supply  level.

 The RIP  gives me as a coach ideas on duration and position my player  can  sustain the best.
 The TIP   I use in the off season to  get rid  or improve the limiters  ability  so I can move most of the   lower intensity  situations in a game into a  ARI or STEI intensity level.
 This will allow  me  to   mini9maize the   energy use  and have it ready  for the game important  HII  situations.   See  picture  below
 In our discussion we have a  step test  of  5 /1   and new 5 /1 Is that good or  bad.
 None  of this . It is up to the coaches  to decide  what they like to get out of  an assessment    and  how much time they like to invest  for specific  needs of  a player in the contest of the  whole team approach.
 So here just shorty different options.
 a) 3 min classical step test  but only using MOXY  and HR.

3 min nirs.JPG 

 This is a picture  form many years  back with the great  NIRS  system  of Artinis ( Portamon)
 Yellow is tHb,
 Purple is  Hb Diff. which shows a  similar trend  as  the SmO2  of MOXY
There are some reasons  why we where not using TSI %
3 min test have the so often discuss limitation of the physiological  systems time lag and as such will have limited information's for training intensity planning.
 In this case you can see, where we most likely  start to hit the  FEI  /HII  intensity. Look at the tHb reaction ( yellow ) and than combine it with the relative   " smooth"   steady dropping  Hb diff  ( purple. So we have a kind of  four intensities  with a 3 min test  with some overlapping open questions.
 Below  a  proposal of this three minute  assessment.
3 MIN steop test  zoning prop.jpg 

Now some people prefer a 5 min step test  due to the discussion, that the 5 min will allow  in many cases  a proper adjustment of the potential compensation different physiological systems  may be able to  do, if  time allows.
 In a  5 min step test you may  choose  slightly  bigger steps  so even with the 5 min the overall test time may be close  to the 3 min  smaller step  increases .
 Below a  " zoning " proposal  from a  5 min step test using a MOXY )
5 MIN step test  zoning prop.jpg 

 Now in all  step test we  can see nice the different reactions  of SmO2  and tHb  .
 What we  have  more difficulty to see is  what   the potentially  limiter may  which creates the    " ending" of the  test.
 That's where we  prefer  to make a  5 min step test  and if you not like to repeat the same load  2  times  you can make a 5 min step test  1 min rest  followed  by another 5 min  load  but now  already higher load.
 You add really only  5 more minutes  to the total time  and as such really minimal   time increase but the  benefits  than in many cases  you can see what limits the   athlete  from  pushing a higher performance  . This than allows you not just having a zoning but actually a  control over   at what intensity you start   pushing the limiter to its highest still acceptable performance  and  by what  or in what zoning you start to   use a compensator  to support the limiter if possible..
 Below  a   picture  of our  soccer player   with Zoning and   SmO2  and tHb included in the graph.
5 MIN step 1 min rest test  zoning prop.jpg  

The  " zoning" takes into account the SmO2 trend  in combination with the tHb  trend in  all this cases.
 If you like to start easier  you can take just SmO2 trends.
 If you choose  SmO2  trend you  have it easy to find three  zoning.
 ARI   if SmO2  is increasing during the load d and or    reaches the highest level and stays  there.
STEI  if  SmO2  is  flat  so   balanced  delivery and  utilization  of O2.
 FEI  and HII ( depending i the step length )  are dropping as  an indication of  more O2  use than   delivery.
 ( Exceptions  are always  possible.)
 Once you add tHb  you will have to  think on   some additional options , which can explain  or    show the   importance  of blood flow in relationship to  SmO2 trends. For that we  will come back in part 5  a or later. T Next up is to follow our soccer player   info  and explain where the Limiter may be .

In any case you have a very fast  and easy physiological test options  without taking blood  and or cleaning masks  and it all can be done in the field  fast  and with   a lot of athletes  at the same time.
 A  decent  not optimal VO2  equipment will cost you 10'000 $  +  for one athlete  to test at the same time.
.Blood testing may be out of different physiological reasons and organizational reason  and a  part of the past . So  why not step into a  potential future.
So stay tuned.

Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Part 5
 Soccer player  step test with 5 min load  and 1 min rest.
Short reminder.
TIP ( training intensity profiles )  for  team sports  like soccer are used  to design individual training programs for this athlete.
What we  have in team sports  is an all out situation forced upon us  often due to the game. Than we have  " recovery " situation, which are a part of the game but often without  ball. Nevertheless this  parts can be at least as crucial as the situation  with and around the ball. Reading the game  without ball.
 Optimal would be, that in the many situations where we  do not go all out we  are able to work as efficient as possible, meaning we  can recover the overload  from the all out.
So in our case discussion the question is, what is the limiter in the  slower  and less intense loads  and what would inhibit therefor the fast recovery as  the limiter has to recover  and if  we  push far above limiter he compensators  have to recover as well, to be  very effcient in the all out situations.

1. We discussed: 3 min step test  work but  many open questions for limiter and compensator  due to the forced  fast change in loads  and lag time   can't be  used
2. 5 min step test work better  but  SmO2 alone   has limitation to answer our questions
3. Dan's version with a 5 min load  1 min rest  and new  load is a great time compromise  to our TIP 5/1/5 idea.

SmO2 alone  gives us  " zoning" but limited  feedback on limiter. Dan added  tHb  and  the 1 min rest  and we get much more feedback.
 Than we as well got HR in this case  which supports many answers  we get out  of SmO2  and tHb . let's jump into that.
 below we look  at SmO2  and tHb. I added  some lines to it
smo2  thb  plus lines.jpg 
what we look for ?
a) tHb is steady increasing over the  full assessment. Not just during the load, but as well in the 1 min rest. This indicates a steady increase in blood flow  ( volume ) in the tested area. And it indicates, that when we stop for one min we have an immediate increase in tHb due to the lack of  muscle contraction, so  compression is gone but CO is still high. As soon we load again compresion outflow  and than " readjustment of blood flow  during the load  and steay slightly increase, indicating that the CO  is overruling a bit the compression.
 What is interesting is the  very clear increase in tHb  at rest and even more towards the end of the assessment.
- the increase during the load  without reaching a plateau  could indicate a steady increase in CO  during the load as well and no " steady state"
Are the  loads  time to short  ( 5 min ) would we see a balance reached  in a 5/1/5 ?

So no balance in tHb  and question of a  not balanced  CO. Where can we find a potential answer?
CO = HR x SV, so  we have an easy  way to look at one part of CO  , which is the HR.
 If CO is  steady increasing during the load  than we either  would see a steayd increase in HR    or we would we see a  stbale HR  when SV  increases. This  would be possible in many cases  at the start but the SV  most often reaches a maximal situation before theh HR( as usual not  really always )
 Okay so lets see SmO2  and HR
HR  and SmO2.jpg 
What can we see. ( this is not a critic on anything just what we see.)
- a very fast  jump in HR  at the start to 150 +  in a speed  of  5.8 mph . This is a very high HR indicating  a potential very  young player or  and a cardiac system , which reacts over  HR rather than SV. - We have with exception of the second last load , never really a tendency of a  HR plateau, indicating a steady  "compensation" of  blood supply over HR despite 5 min long steps.
A very high end HR and based on feedback  the athlete believed  that he  could have gone  one more step.
Possibel anser to the tHb trend. The  increase in tHb during the load  was  created by a steady increase in HR  which is  one part of  the CO.
Question:  Could it be possible , that the HR  had to go up to compensate  for a dropping SV  to maintain the CO ?
Answer  Yes , but if   CO would be stable, than tHb  would be stable.
Now interesting is, that tHb in the one minute rest  goes  always up as well. Now look at the HR  at rest  and whether it drops efficient or not ? What can you see ?
Despite the rest  CO  ( HR ) stays  high or    higher in each following 1 min rest?
 Why ?
So a higher  HR   and as such a higher cardiac work will ask  for more O2  at rest.
 The higher CO  ( tHb ) indicates a good delivery of blood but on cost of a relative  poorly option to recover the cardiac system. So  when we look the " recovery " trend in SmO2  in reloading the muscels  with O2  what can we see.?

1. SmO2 never reaches  ( in contrast to tHb ) the resting level, in fact with exception of the first step , where we have after the initial alarm phase a  rebound to a  slightly   higher SmO2 ( still not as much as  by doing nothing ) in each 1 min rest we never  ever  reload  the SmO2  back to the previous level despite a  stop in activity.
One  already mentioned reason  a very  still high cardiac activity.So  is the cardiac  reaction a compensation for something or is it a limitation  of  the system itself?
 What is the reaction, when we  hit a cardiac limitation limitation?

Yes tht is the  the most likely proper answer. So as we ruled this  out  or pushed it in the back ground the next question is  for who is the cardiac system compensating?
 Look again. A  very nice increase in tHb  due to CO  higher but what could increase  tHb as  well? Vasodilatation. What creates a  great vasodilatation in the systemic  picture?
Yes if that was the answer, than who creates this  situation of a high CO2.
 If this answer  is ???? than we know  why  besides the additional O2  use  from the cardiac system the SmO2  drops steady in the 1 min rest. O2  disscurve shift to the ??
 What other easy feedback tool could be used  to confirm this?

 Now you have your limiter The respiratory system.
 What problem do we have in soccer, when the respiratory system is the limiter .
 This athlete   has to  improve his respiratory ability   to  be able to maintain a  high intensity and stable core situation.


Study Participant
Posts: 45
Thank you Juerg. That was a fantastic demonstration and explanation of respiratory limitation using a real world example. It was very much appreciated, as I was certainly getting lost in some of the other discussions at times. Would you be so kind as to show us one example of a cardiac limitation, and another with a clear peripheral limitation?
Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Part 6
First of all , Thanks so much. I got 23 emails following the post above  with answering the "hidden" questions with the result  that I can retire now as all of them where  right or  let me more careful, thought  into the same direction as I  so  agreed  which does not mean that we are  right.
 The common question of all at the end  was. :
 Can you make a  simple summary ( true not cook book , but a guidance).
Well most of the regular readers  know how messy my brain is,  but sure I  can try  and hope it makes sense.
Summary of the  5 min step test  with one minute rest of our soccer player example.
1. tHb trend:
tHb is an indication of blood  flow  (perhaps  we could use the word  volume as well ? )
Rest 1 min to get a baseline before you start. This is the resting information of  blood flow ( volume ) in the MOXY test area.
a) tHb drops immediately when we start loading ( most common seen reaction )
Indiaction of  an increase in mechanical pressure due to muscle contraction, reaction immediate as it is a local reaction (lag time is seen sometimes in the 1 min rest  if the BP  has to be protected , this  most often in top endurance athletes  or  cardiac patients ?? why this 2 extremes ? World class cross country skiers or rowers or triathletes  or cyclists have an incredible vasulcarsiation of their muscels  and an incredible mitochondria density. In sports like cross country  or  rowing this applies to the whole body .
 Now that's where 5/1/5  or any test with a 1 min rest has some advantage in bio feedback's.
 During the load the mechanical muscle compression will keep the  blood volume somewhat acceptable so BP  is stable  but  often actually increases  during load. So no risk of a too low blood pressure. But as we go very hard  and we open a lot of  capillarisation  for more blood flow ( volume )  and we than suddenly stop   and we add a  respiratory limitation to it  so high CO2  as well ( vasodilatation additional to the  decompression in the rest period we may have  a far to big area  where blood  can go to but it can't maintain the needed blood pressure  and now we will have a reflectory  reaction  with a  vasoconstriction  so  at the 1 min rest we may see a  drop in tHb  with a lag time rather than the usual increase  due to lack of compression.
Sorry got lost again.
 So initial drop in tHb  followed  with a decompression   so increase in tHb  and  if  the first load is not to high  a steady increase in tHb during load  due to a steady increase in the first step  of HR  ( CO ) Now we would expect , that under load  ( higher CO  and higher RF  so possibly  higher CO2    perhaps ) tHb  or the blood flow  ( volume ) in the working area  will increase above the resting blood flow ??? So if that is the case the  increase  above  the resting tHb  can be used over time as a change in capillarisation. We have clients where the tHb  does not go above  rest level  and 3 month later it goes  nicely above. The tredn in tHb duirng a load as well can give over time a feedback in craidica out put changes.  How  would that look . Think the two opposing "forces"  compression due to  mechanical compression  and vasodilatation due too  ???

b) tHb increases  at the start  and than may drop  or keep increasing. The immediate increase would indicate  2  opposing ideas .
- a very fast  and strong  CO  or  vasodilatation  at the start.
- b an immediate venous occlusion ( outflow restriction due to the start  and the  hard  compression of the muscles.( initial hard eccentric ina running test  before you  get a smooth  stride   and impact from the treadmill which moves towards you . On a bike or rowing erg the initial inertia  of the equipment which asks  for a harder  contraction  compared to a little bit later when it moves  smooth. We may see this in our  case, as well , when the running start speed  is  very inefficient but you still run so you my see a  drop in tHb  despite low speed and than  an opening   up of tHb  once there is a more efficient  stride ( or in cycling if you look for optimal individual RPM )
Summary tHb.
 A steady increase in tHb  and for sure a  steady increase of tHb in the one minute rest  indicates  an increase in blood flow  ( volume). 2 reasons: increase in CO  or less drop in CO  at the one minute rest  plus a vasodilatation over CO2  due to a respiratroy reaction.
Now  rule out muscular limitation in this case:
 Increase during load  can be  as explained  above  or a  start of  an outflow restriction due to  muscle compression ( weak maximal strength )  or  small capillarisation. So we see as in this example an increase in tHb  during load.
But  when we stop we will not see an immediate increase in tHb  as we have here but rather   first an initail drop in tHb  due to compression outflow.
So later how you separate  between muscle strenght  or  capilarisation  limitation.
Now  support  respiratroy limitation.
 You need now to look at  SmO2. A SmO2  tredn in te rest situation  which drops  in each  new 1 min rest indicates a porblem  with reoxygnataion. Most common   reason is a O2  diss curve shift to te right  due to CO2  situation ( hypercapnia ) this lack of reoxygenation is thna as well  supported  with a  suddent drop in SmO2  at the end of a  test in the last hard  load in the muscle but as well in the noninvolved muscels  . ( great to see in this example  we discuss ) Last but not least

 Soccer example.
 I argued , that the assessment  was forced  to end due to a respiratory limitation. Too high CO2.
 This is the greek materialism.
 Unseen real  and unreal seen.
The respiration limitation we  can see, but I  argue  that this is not his limitation it is the result of his limitation. His real limitation is unseen  but real.
 Capillarisation and mitochondria density.
 Now this is NOT a critic on this soccer player as  he may be the best  soccer player in his team, but his  ability to run relative high speed  clearly in a very stable O2  dependent  ability is  very poor . 150 Hr  by 5.8  even if he is not  20 years old perhaps  is a very  slow pace  for trend we see.
 So  he  will create  realtive fast in just running the probme of  O2  utilization due to delivery  and  mitochndria  density limitation. This will create very early inan incrase in H +  which thna asks  to eb removed over lactatae  and  respirations as  one  option. If  now the respiration is not  well trained as well  he simply will get hypercapnic  , H + increases  and he stops  splitting  ATP  and  tried to use O2  for refueling.
 practical suggestions.
 2. options. In season  work on respiration to increase VE  so   higher output of CO2. In the off season keep respiration integrated in a  capillarisation and mitochondria density workout  soccer specific  so  avoid  too much STF  workouts  to not loose the sprint ability  but increase the FTF 1  type of  oygenation ability  with MCT   1  and MCT 4    development.


Development Team Member
Posts: 49
Thanks for this Juerg! Just gotten around to reading through it and its been really enlightening
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