Friday, 11 December 2015

Reflections about coaching, strength and conditioning and the emergenceof cargo cult science in sport

I have been thinking long and hard about writing this blog. Mostly because time to put in words what I have been thinking about in the last few months has been lacking but also because I wanted to reflect about what I have been seeing in the last 12 months and take stock.

For the readers, I am not having a go at any particular individual and/or association/group of people, I am just writing about my worries and they way I see things going.

Before getting into some details, it is important to understand where this reflection is coming from. It is coming from my personal career history, where I started and how my journey is going, and how things have changed during my journey.

When I started this career in 1993, right after graduating with my first degree in Sports Science, I was mostly a coach with an interest in the scientific applications of strength and conditioning. I was fortunate enough to have met Professor Bruno Cacchi who was the Head Coach of Italian Athletics which setup the first laboratory to study strength training in Italy in the then ISEF of Rome. What I learnt in the 4-5 years I was in that lab was to develop an inquisitive approach to training. Prof Cacchi was the most famous Italian track and field coach at the time and I remember him telling me that he organised the lab so he could learn more about what he was doing as he had many questions about the activities he did with his athletes on track. So he wanted to measure as much as he could and simulate sessions he was doing to separate the wheat form the chaff. Equipment was very limited at the time, computers were running MsDos and Windows 3.1. Very few laptops were available and the state of the art for our testing activities was the biorobot (the early version of Muscle Lab) and photocells mounted everywhere (with very basic software). My coaching was mostly on the track and on handball courts and I was starting to provide strength and conditioning support to various sports. What Prof Cacchi always told me was: "if we want to understand what we do as coaches we have to have a training programme, we have to know what the athlete completes and we have to assess how they progress". This lesson still drives me today but somewhat it seems lost.


This was taken in 1998 in Sportilia in a training camp with the Italian Handball NT

Despite the enormous advancements of sports science and the subsequent professionalisation of sports science specialists, things do not seem to get much better. I still see enormous improvisation in the coaching community, with far too many people not having a programme and a structured approach to assessing what works and what does not work. There is still a lot of improvisation in too many places. Coaches turn up and do something, completely unstructured, with not much clarity and knowledge over the implications of their sessions and unclear ideas about progressions. In many cases, I see coaches picking "sessions" in random order and with limited control over loading. This is why I believe we see many injuries still. Injuries are too many times the result of inappropriate loading patterns which is a consequence of poor planning and/or inappropriate training choices.

Scientific support in these cases is challenging, as most of the times it is only necessary to point out inadequacy of the training paradigms used. And there is no way sports scientists can help improving the quality of a training programme if there is no programme.

The other worry is the proliferation of cargo-cult science in coaching communities. The Internet is now full of courses, podcasts, articles, online access to content. Information is now available anytime anywhere. But sadly there is also a proliferation of coaching courses offered by various entities in different part of the World of dubious quality. International and national federations do offer coaching courses which should have some form of quality control/assurance, but clearly the big bucks are in courses and activities offered by private institutions and/or individuals. While I am a strong believer that knowledge comes form anywhere and confining it to rigid structures can be counterproductive, I also believe that somehow somebody somewhere should guarantee quality of the message. 

Well, in many instances I see a lot of pseudoscience and absolute rubbish being "sold" to coaches. Some of the terminology I hear makes no sense, and the mutterings of aerobic, anaerobic, power, force, CNS etc etc in random order really drives me insane. Not to mention the non existing definitions and /or observations and definitions that have no evidence and are totally non-sensical. If you have ever heard about "CNS session" you know what I mean. This is not a war on semantics, it is about making sure that the distribution of bullshit stops. Too many coaches are now convinced about things that do not exist and in an era of high speed cameras are still convinced they can see stuff that it is not there (I will call it the "Nessie Phenomenon" to pay tribute to the monster nobody can see in the North of Scotland). 

Training Philosophies are now turning into religious-like beliefs (are you a "believer" and a follower of coach X method? ) and this is probably the consequence of too many coaches teaching other coaches such beliefs not supported by evidence or sold on the basis of some athlete winning some medal somewhere. What I have rarely experienced is a coach which lectures about what they do (for real!) without too much philosophy but with evidence of what is the programme, what they assess and when, what are the typical changes in whatever indicators they have during the seasons and what evidence they use to predict performances for their athletes as the season progresses. Instead of this, I sit in too many lectures in which I hear about philosophies, I listen to non-existing pseudo-science, and I see few pictures or videos of successful athletes. But no idea of the content (what did the coach do? How was the load progressed? How progress was assessed, how did the coach "teach" the athlete", what did the athlete learn etc etc.).

The worrying aspect is when coaches are also encouraged to branch out to other professions providing therapy, nutritional advice, medical advice, interpretation of clinical examinations etc etc. This is unacceptable and dangerous. This is the reason why sometimes athletes may fail a doping test and/or might delay rehabilitation following an injury and/or develop an injury. Coaches should be great at coaching and teaching as well as creating positive environments for athletes to improve. Everything else should be left to specialists, people that know what they are doing. Having a coaching philosophy is for sure a good idea (anybody needs a vision/beliefs/ways of approaching a problem), but at the end of the day sport performance is brutally simple, it is in fact about getting better and trying to be better than others. 



Philosophies seem to permeate the development of the strength and conditioning community as well. When I started, it was pretty clear to me that my job was to try to make people stronger, faster, more flexible, I was driven by writing content and assessing outcomes and trying to understand what worked and what didn't. In my view after having seen quite a few lectures/presentations from strength and conditioning specialists, I hear a lot about philosophies but I rarely see content and I mostly see poor or non-existing outcomes. I fear the scientific approach is gone (and for science I do not mean the one you do to write a paper, I mean systematic approaches to documenting what you do and measuring some outcomes). While I see all this, the era of Big Data is upon us. Everyone talks about it, but many are struggling to see where the big data are. To me the biggest data still missing are the ones related to training content, what is planned vs what is executed and how things progress. I am also interested in knowing about technical development, how we should teach things to athletes and we should assess if they develop technically. In the Athletics World you hear a lot about techniques and how coaches "see" technical errors in sessions and in competition. What I am stil struggling to find is evidence about how true are such errors and most of all how and if such errors can be corrected. This to me is the art of coaching, but we can now build the evidence for it and we should strive to understand this aspect more.



Sports science is evolving, we have more devices, more information, more ideas. However we are still lacking easy, simple, non-invasive ways to understand more about the implications of single training sessions as well as the effectiveness of different training schemes. We have to still rely on invasive approaches in physiology and some of the approaches in other aspects of science are not practical in the real world (have you ever tried to play table tennis with an EEG cap and wires?). So this is where the biggest gains will come, in the ability to understand more what happens in the real world moving the labs on the field as much as possible.

So this is my pledge, I will try to understand more, learn more and try to develop better ways to work in sport. My advice to you working as a coach, as a strength and conditioning specialist or as an "ologist" with athletes at any level is to avoid the "Nessie Phenomenon" and try to critically analyse any information coming your way. Do not accept what you hear or what others tell you. Go and find the information, try things yourself, try to assess what works and what not, document your experiences, reflect. Only in this way you will be able to separate the wheat from the chaff.

We are exposed to B--sh-t every day, and there is science about it too, just read this paper and hopefully you can find a way to use appropriate filters.




Monday, 2 November 2015

From Protecting the Heart to Improving Athletic Performance - the Benefits of Local and Remote Ischaemic Preconditioning


This review was also finally published. This is the second output of the last collaboration we setup with the Olympic Medical Institute before its closure. With colleagues from the Hatter Institute in UCL we started questioning the protocols employed in the clinical setting and in the sport setting for remote ischaemic preconditioning. Our first paper was a pilot study to look at the dose-response of common methods, this one is a comprehensive review on this topic with the hope that more and better studies are designed to define safe and effective protocols.
The abstract is below, you can access the article online here.

 2015 Oct 19. [Epub ahead of print]

From Protecting the Heart to Improving Athletic Performance - the Benefits of Local and Remote Ischaemic Preconditioning.

Abstract

Remote Ischemic Preconditioning (RIPC) is a non-invasive cardioprotective intervention that involves brief cycles of limb ischemia and reperfusion. This is typically delivered by inflating and deflating a blood pressure cuff on one or more limb(s) for several cycles, each inflation-deflation being 3-5 min in duration. RIPC has shown potential for protecting the heart and other organs from injury due to lethal ischemia and reperfusion injury, in a variety of clinical settings. The mechanisms underlying RIPC are under intense investigation but are just beginning to be deciphered. Emerging evidence suggests that RIPC has the potential to improve exercise performance, via both local and remote mechanisms. This review discusses the clinical studies that have investigated the role of RIPC in cardioprotection as well as those studying its applicability in improving athletic performance, while examining the potential mechanisms involved.

KEYWORDS: 

Acute kidney injury; CABG; Cardioprotection; Exercise performance; Ischemia-reperfusion injury; PCI; Perconditioning; Postconditioning; Remote ischemic preconditioning; Sports
PMID:
 
26477661
 
[PubMed - as supplied by publisher]




Tuesday, 20 October 2015

New systematic review and meta-analysis



I realised I have not written much on this blog since our activities started at Aspire Academy. This is clearly a sign that we have been very busy at work but also that the only time I had to write it has been spent writing scientific work. As a department we are doing very well not only because our service provision improves on a daily basis but also because we are starting to produce a lot of applied scientific papers which I hope can help the coaching and sports science community Worldwide in improving the support to athletes. We have quite a good number of articles already published, a few in press and many submitted which means that by the end of 2015 we might be able to make a significant contribution to our willingness to learn more and share the learning.

The most recent effort is an extensive systematic review and meta-analysis on the topic of cold baths in adolescent athletes. This was triggered by the fact that many coaches and sports scientists working with young athletes tend to replicate processes and procedures observed in senior athletes without questioning appropriateness and effectiveness. Our conclusions are pretty clear: there is no evidence of benefits of such interventions in adolescent athletes and there are a lot of unanswered questions when it comes to the implications for such recovery practice to negatively affect training adaptations. So as usual, there is a need for more and better studies to understand this with all the limitations of conducting studies in a youth population.

The article is free and completely accessible online. The abstract is below.
If you are interested in reading it, just click here and download the PDF.

Abstract

Recovery and regeneration modalities have been developed empirically over the years to help and support training programmes aimed at maximizing athletic performance. Professional athletes undergo numerous training sessions, characterized by differing modalities of varying volumes and intensities, with the aim of physiological adaptation leading to improved performance. Scientific support to athletes focuses on improving the chances of a training programme producing the largest adaptive response. In competition it is mainly targeted at maximizing the chances of optimal performance and recovery when high performance levels are required repeatedly in quick succession (e.g. heats/finals). In recent years, a lot of emphasis has been put on recovery modalities. In particular, emphasis has been placed on the need to reduce the delayed onset of muscle soreness (DOMS) typically evident following training and competitive activities inducing a certain degree of muscle damage. One of the most used recovery modalities consists of cold-water immersion and/or ice/cold applications to muscles affected by DOMS. While the scientific literature has provided a rationale for such modalities to reduce pain in athletes and recreationally active adults, it is doubtful if this rationale is appropriate to aid training with adolescent athletes. In particular, since these methods have been suggested to potentially impair the muscle remodeling process leading to muscle hypertrophy. While this debate is still active in the literature, many coaches adopt such practices in youth populations, simply transferring what they see in elite sportspeople directly; without questioning the rationale, safety or effectiveness as well as the potential for such activity to reduce the adaptive potential of skeletal muscle remodeling in adolescent athletes. The aim of this review was to assess the current knowledge base on the use of ice/cold applications for recovery purposes in adolescent athletes in order to provide useful guidelines for sports scientists, medical practitioners, physiotherapists and coaches working with such populations as well as developing research questions for further research activities in this area. Based on the current evidence, it seems clear that evidence for acute benefits of such interventions are scarce and more work is needed to ascertain the physiological implications on a pre or peri-pubertal population.
Keywords: 
Recovery; Ice; Cold; Youth; Adolescent; Athlete; Elite

Saturday, 29 August 2015

New season new activities

So, here we are again, after the summer break the new sporting season is about to start in Doha. The development of activities at Aspire academy is now moving faster than ever. We are starting an exciting project with the Qatar Athletics Federation to work closely together to develop talents as well as establish a sustainable structure to integrate coaching, science and medicine. Since September all QAF athletes and coaches will be training at Aspire and we will be working together to realize this vision and be ready for Doha 2019 and beyond. This project really excites me as I can see this being a true legacy project for the state of Qatar and I am proud to be part of it. We are also contributing to the international community with a conference, which has now become an annual event. In fact, after the success of last year’s conference we have organized another event on coaching young athletes with some excellent speakers and are looking forward to welcome all our coaches, and many coaches from around the World to attend as well. The details of the conference are available here. It is a very exciting time for the academy as two of our former students are participating in the World Championships in Beijing and one of them can hopefully bring home a medal (fingers crossed Mutaz and coach Stan!).



Our service delivery to Aspire athletes and coaches keeps improving and we are introducing more detailed monitoring and reporting activities to be able to influence practice and document the coaching approaches being used in our sports. The centralized database has now been implemented and more minimally invasive and wearable technologies  are being developed and deployed to understand more about coaching young athletes. Our applied research activities are continuing and we plan to submit more papers to describe our work as well as challenge current practice on young athletes. I promise to use to blog to keep everyone up to date as well as working with Aspire to communicate through our social media/website channels a bit more about the activities we conduct.

On the science front, we have also decided to make sure we have an annual scientific conference after the success of the Talent ID one we organized last year. This year our focus is on training monitoring and we have some amazing speakers confirmed as well as a great-exciting programme. The conference is completely free and all details are available here.

This is a great opportunity to learn and network as well as a excellent chance to come to visit us, see our wonderful facilities and possibly talk about collaborations and/or bringing your athletes in Doha for training camps.


So, as you can probably gather from my writing, I am looking forward to this sporting season and I hope to meet/see many of you in Doha at one of our events and/or at one of the many international competitions hosted by the state of Qatar.

Saturday, 4 July 2015

Money making conferences and speaking invitations

I am getting increasingly annoyed by some invitations I received to speak at conferences. Over the years I have been fortunate enough to be invited in more than 20 countries to talk about my research/my experience/my work in a variety of settings. I gave talks in scientific conferences of big organisations like the American College of Sports Medicine or the European College of Sports Science. I spoke at coaching clinics organised by Olympic Committees, National Federations, Coaching organisations. Finally I spoke at industry events, or educational events for coaches/sports scientists. For me receiving an invite is a great honour and a big responsibility. I feel proud of the recognition and some time apprehensive about the task. However I tend to accept most of the requests provided I have also an opportunity to learn something and/or matches the requirements of my employer. Every time I have been somewhere to speak, I have always learnt something new and/or made new connections/friends and these have always led to some exchange of information/experiences/ideas which is great. Thanks to this, I have been in so many places I would have never been to, met some amazing people, learnt great things, tried new food and drinks, discovered new cultures/ways of living, seen incredible facilities and sceneries.

(This is me speaking in Campinas in Brazil few years ago. 
Great conference, met so many great people and had a brilliant experience)


However recently I keep getting invites from organisations/companies organising conferences to make money. Organisations which charge a fortune to attendees. And they first send an invite to be a keynote speaker and then they pretend I should pay for the pleasure of speaking at their conference.
I am sure I am not alone in this. Recently, speaking to other colleagues this seems to be happening more and more to many. This has to stop, and the only way to do it is for people to say: "No, I am not coming. If you want me to speak at your event/conference you will have to pay for the costs (travel/accommodation/etc)".

Let me make this clear. I am not talking about invitations to speak at a conference of respected scientific societies of which many of us are members. In such events you go to share latest findings or discuss your research between peers (albeit I still think even in such cases travel grants should be provided). I am talking about clinics and conferences which charge attendees large sums. In that case you are going there to educate the attendees and teach (hopefully) something or share your knowledge and experience. Travelling costs money and time. So anybody invited to speak at a conference should have at least their costs covered.

But I am pushing it a bit more. Preparing a lecture or a workshop requires time and effort, travelling to and from the conference requires time and effort, acquiring knowledge requires time and effort, delivering the content requires time and effort. Why such time and effort should not be rewarded?

Former athletes/celebrities/CEOs/politicians charge very large sums for a dinner speech. Speeches which are an account of their experiences and accomplishments. A way to transmit knowledge and experience. I have been in many of these speeches, some exciting and well prepared-rehearsed with great material to show, some absolutely plain boring with not a single picture/video/presentation in sight. All well rewarded and for sure, with the travel costs covered. All well deserved.

But if this is the case, why sports scientists should accept to be invited to speak at an event, make the event (you can't sell a conference without speakers...can you?) and be asked to pay for the pleasure, while the organiser makes cash? A recent invite came form a conference charging participants  somewhere around 1000 USD each. Apparently typical numbers are around the 200 mark. So, once the organisers have paid the conference venue and few coffees and biscuits, how much are they making? You do the math. It would be great to have some views on this. I think that people's time is precious and should always be rewarded and it's up to each individual to decide if they want to "donate" their time to any cause (speaking to conferences included as I have done many times). Preparing a talk requires time and effort. It's a job, so to me it should be considered work.

This issue seems to be typical in other fields as well (see a great blog here).

So that's it, you know it now. If you want me to talk at your event, make sure you can cover at least the travel costs. If not, don't bother to email me, as from now on the replies will not be polite.




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