Monday, September 17, 2007

Sweat the Small Stuff: Blood Testing for Athletes

Alan Couzens, MS (Sports Science), CSCS, PES

After finishing my “A” race for the season, my mental outlook has shifted somewhat from looking forward to the races of the year ahead to looking back at what worked and didn’t work in the season just passed. I find this retrospective analysis to be a key process that is ignored by many self-coached athletes (myself included). It is often much easier, when things don’t work out to blame the plan and switch to a completely different approach, than it is to take responsibility, look back and evaluate how well you executed the plan. It is even more valuable to look back honestly on what were the true limiters to perfect execution. Was it an absence of quality sleep, poor nutritional choices or work conflicts that prevented you from adhering to your plan this past year? These factors are often considered the “extras” to training, the supplemental chapters that are in the back of the training books, the “small stuff”. However, in my experience, these factors come into play long before factors such as what % of threshold training you should include in your schedule or how many hours you should increase this year become relevant. In fact, all of these pages that make up the “front chapters” in your training books are almost entirely dependent on how much attention you pay to the chapters in the back of the book. ‘Small things’ like sleep patterns, regular stretching, optimal nutrition and regular medical screenings can have a BIG impact on your performance.

For me, 2007 was a frustrating year. After a nasty bike crash at the end of ‘06 left me in a wheelchair for 3 months, I was, to a large degree, starting from scratch. In January, I started walking, initially for a half mile, then a mile, then 2 until by March I was back into some semblance of a normal training week, swimming a bit, biking a bit, jogging a bit. Everything was progressing forward nicely. I was adding a couple of hours of training to my basic week every month and finally starting to feel like an athlete again. Until, at the end of April, I hit a bit of a wall. For the better part of a month, I was in a hole. I was sleeping 11-12 hours every night, struggling to get an hour of training in each day but feeling like I used to feel after an 8 hour training day. Something was definitely wrong. In the past, I would have blamed myself or my training plan. But, this time, I decided to go on the hunt for some real answers. I found these answers in a simple blood screen.

The important thing, that athletes so often forget, is that the absence of sickness and optimal health are not synonyms. In western culture (if growing up in your house was anything like growing up in mine), we frequently only go to the doctor when we are sick (or on the verge of death, if your father is anything like mine J However, a simple routine blood screen can provide a wealth of information to the athlete about a variety of health measures that may be seriously impacting their performance &/or their ability to regenerate after training

For instance, a few key markers with normal standards for male endurance athletes from the Australian Institute of Sport (note; these may differ from normative values in the general population, therefore it is important to find a doctor who specializes in sports medicine):

- Erythrocytes (5.21+/-0.46 mill/µl)
- Haemoglobin (16.1 +/- 1.4 g/dl)
- Haematocrit (0.47+/-0.04)
- Median Corpuscular Volume (88.6+/-3.0fl)
- Median Corpuscular Haemoglobin (1.81+/-0.1 fmol)
- Median Corpuscular Haemoglobin Concentration (21.1+/-1.3 mmol/L)
- Iron (18.1+/- 7.1 µmol/L)
- Ferritin (66.2+/-31.2 ng/ml)

Other measures that can be used as reliable indicators of regeneration from training load include: Insulin, cortisole, serum urea, creatine kinase, amino acids, immunoglobulins.

In my case, my serum ferritin levels, at 17 ng/ml were about a quarter of what they should be for a healthy endurance athlete. Serum ferritin is an important contributor to iron stores within the body and is, therefore, an important component in maintaining Haemoglobin within the blood. A drop in Haemoglobin of just 0.1% results in a reduction in VO2max of 1%. This is just one very important reason for an athlete to have regular blood testing performed.

In my situation, a simple bout of Iron supplementation enabled me to build my training by 7 hrs p.w. in the space of 3 months. Showing me, without doubt, that, in my case, the “small stuff” was definitely worth paying attention to.


TJ said...

Good stuff as usual Alan.
I'd just been giving this very subject some thought. I have, for the last few years, had a yearly check-up/blood screening around the first of November. This year, however, I'll be doing IMFL on November 3rd. Would having the screening soon afterwards be appropriate or should I wait a few weeks? I've heard the results can be skewed if done too soon after a long endurance event.

Alan Couzens said...

Hey TJ.

Thanks for the kind words.

I would definitely hold off. Nearly all of your blood markers will be skewed after an Iron-Distance event and if a doctor who is not familiar with ultra-endurance sports medicine takes a look at your creatine kinase levels, he'll probably pass out and then admit you :-)

Definitely save it for a good month after the race.

Have a great one!!