Sports Science Applications for Athletes and Non-athletes

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I love the science of sports and performance.  Closely following the constantly-evolving body of literature on the topic is a vocational interest of mine, but I’ve been asked how pertinent this is to “the rest of us”.  For people like me, who are far from elite in our athletic pursuits, is this information worthwhile?  What about for the sedentary; should they be interested in the science of human performance when it comes to informing their health behaviors?  I would say, resoundingly, YES!  Let me tell you why.

In many developed countries, the medical specialty which we in the US call “Primary Care Sports Medicine” is actually referred to as “Sport and Exercise Medicine”.  Their concept of this specialty includes a focus on nutrition, sports performance, and exercise as a medical intervention.  This is certainly becoming more mainstream in American practice as well, but we lag behind other countries in this regard.  I consider myself a practitioner of Sport and Exercise Medicine.  I am fascinated by musculoskeletal injuries and their therapeutic treatment, primarily non-surgical.  But I also consider nutrition, and exercise to be paramount to the health and performance of any individual at any level of activity.

The exercise and sports performance literature teaches us what is required for a human body to function optimally.  It lets us determine the conditions and practices which allow us all to reach our goals.  For some, these goals are Olympic podiums, but that is a rare few.  This body of literature also tells us how we can ensure that we are able to excel at our daily tasks and maintain long-term health.  Much of exercise science is rooted in the prevention of disease and the maintenance of ideal bodily and cellular function.  These are the perhaps the most pressing health issue of our time.  Obesity, diabetes, high cholesterol, heart disease, hormone imbalances, dementias, and many cancers can be linked directly to lifestyles which impair our performance at a cellular level.  Sport and exercise science gives us the tools to address these dysfunctions, even reversing many of these diseases.

For a great example of this, look at the Washington Post’s fantastic article on the work the respected physiologist Inigo San Millan is doing at the University of Colorado.  Using tools which have been traditionally confined to Olympic Training facilities (VO2 and Lactate measurement), he is helping non-elite individuals improve their metabolic and mitochondrial function.  Interestingly, and quite related, Inigo and George Brooks have also recently published their “Lactogenesis Theory” regarding how impaired lactate metabolism may be a causative factor in many cancers.  If the mitochondria in the cells are not working well, disease states ensue.  Properly prescribed exercise is perhaps the most potent therapy for addressing such dysfunction.

When we understand what is needed for a body to function at its best and how to test those variables, we can then apply the same performance science to individuals whose goals may be a bit different.  Sure, an athlete must ensure that everything is optimized if they hope to stand atop the Tour de France podium.  But, you can certainly argue that juggling the challenges inherent to the daily life of a non-athlete is quite rigorous in its own regard.  Stressors come in all forms, not just long training sessions.  Knowing how and why you need to exercise, which diet supports your daily activities, and how you need to balance stress and recovery…these things lead to a life with greater vitality, much lower risk of chronic disease, and improved sense of general wellbeing.  If we can “steal” that from the athletically elite and apply it to our own lives, why wouldn’t we?  That’s one of the primary reasons that I practice Sport and Exercise Medicine.

To learn how sport and exercise science can be applied to help you be successful in your journey toward better health and performance, contact Podium today!  As always, we offer FREE 15-minute consultations with Dr. Sprouse to discuss whether our practice could be a good fit for you.

 

Health is the New Wealth!

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We've launched a new service at Podium!

Our Concierge Wellness Consultation includes everything needed to start your journey toward a healthier you.  I know that many consider Podium's services to be aimed at athletes, but anyone can truly benefit from addressing their overall health, fitness, and nutrition.  Wherever you are starting your journey and whatever your goal, Podium can give you the tools and information to help you succeed!

Our Concierge Wellness Consultation includes:

  • Extended consultation with Dr. Kevin Sprouse
  • Comprehensive panel of blood work
  • Measurement of your metabolic rate
  • Determination of your body composition (lean mass and fat mass)
  • Nutritional assessment
  • One month of secure messaging with the Podium team so you can quickly get your questions answered

Here's how it works.  You can also visit the dedicated webpage for more info.

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Testosterone Replacement in Athletes: Part 2

As this trend coincides with the massive increase in testosterone prescription, many unsuspecting athletes are doping.

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In recent years, prescriptions for testosterone in the US have skyrocketed.  There are now “Low T” clinics popping up in suburban strip malls across the country, and you can even find treatment online!  Prescription testosterone fuels a business which brings in over $2 Billion a year, yet there is debate over the appropriateness of the therapy.

Aside from what I see as the frequent medical impropriety involved in this Low T popularization (see last week’s post), there is another very real concern which impacts recreational and elite athletes.  Today it is common to see many active individuals remaining competitive into their fourth, fifth, or even eighth decades!  As this trend coincides with the massive increase in testosterone prescription, however,, many unsuspecting athletes are doping.  Sure, “doping” might be a harsh term for a recreational runner who is only taking the medication recommended by his doctor, but it is a technically accurate characterization.  That said, I think the vast majority of these athletes are doing so without any knowledge they have broken a rule.

Many Americans will enter their local 5K or marathon this year.  They will sign up for triathlons, duathlons, and bike races.  For those races sanctioned by a national governing body (which is the majority, even on a smaller local level), the athlete agrees to abide by the United States or World Anti-Doping Agency’s (USADA or WADA) code pertaining to banned substances in competition.  If you have a racing license, buy a one-day license, or sign a lengthy form to enroll in one of these events, chances are very good that you are agreeing to abide by this code and to be drug tested if requested.  If you look at the number of people participating in these sports, and then cross-reference that against the number of prescriptions for testosterone, you can bet there are significant numbers of athletes in violation of this code.

Simply having a valid prescription for a banned medication is not sufficient to permit its use during competition, and as the code is written, the onus is on the athlete, not the doctor, to know the rules.  Honestly, most doctors are not aware of the anti-doping rules, but any certified Sports Medicine specialist should be able to help you navigate the process.  

If you do require the use of a banned medicine but wish to compete on a local or national level, you may need to file for a Therapeutic Use Exemption (TUE).  This is a process by which a panel of specialists reviews your case and decides whether use of the medication is warranted under the WADA code.  In 2016, USADA added a special process for “Recreational Competitors”.  Application for a TUE does not guarantee its approval, and with approval comes an agreement for further follow-up testing throughout the course of the TUE’s validity.

So, what do you do if you are an active, competitive, or even non-competitive recreational athlete who is on testosterone replacement treatment?  First, I would suggest you stop competing at any level until you investigate your responsibilities under the anti-doping code.  You should talk with your doctor and/or a knowledgeable Sports Medicine doctor.  

It’s unlikely that your prescribing doctor is a Sports Medicine specialist, as most do not prescribe testosterone replacement.  I believe it creates an apparent conflict when a doctor routinely treats athletes and also commonly prescribes substances banned for athletes.  However, I often consult with elite and recreational athletes regarding their prescribed medications and their duties under the anti-doping code.  Any Sports Medicine specialist would be happy to help explain the system and process.

To be clear, it remains highly unlikely that a recreational athlete will be tested at their local race, but it is starting to happen more frequently.  Studies suggest that doping is now more prevalent in amateur sports than in professional sports, so testing resources are being deployed on the amateur level.  Much of this type of testing is focused on national-level events or athletes for whom there is reason to suspect cheating.  (Hopefully your 10K age group rival isn’t calling the anti-doping tip line and complaining about you!)  A positive test and the ensuing public embarrassment would be devastating to anyone.  But more than the risk of public humiliation, I believe most people truly want to compete within the rules.  To the extent that these athletes are breaking those rules, I think they are probably unaware.

At the end of the day, the problem of testosterone therapy in recreational sport is a multifaceted one.  There is a very high likelihood that the medication is inappropriately prescribed.  Finding and treating the underlying cause for the low testosterone should be the primary objective.  When testosterone therapy is warranted, ensuring proper adherence to the rules of competition is paramount.  We all want healthy athletes and clean sport.  A knowledgeable medical advisor can help ensure both. 

WHOOP Article About Dr. Sprouse

WHOOP makes one of the most advanced tracking bands on the market right now.  They recently posted an article about how Dr. Kevin Sprouse uses this technology with his patients around the world.

Many doctors struggle to figure out how best to motivate their patients to engage in daily physical activity. Not me.

As a Sports Medicine physician, I work with elite and professional athletes from multiple disciplines, as well as many hard-charging “weekend warriors.” The vast majority of my practice consists of advising and treating this demographic. I’m also the Head of Medicine for a World Tour professional cycling team, with athletes scattered across the United States, Europe, Australia and South America. Whether they are cyclists, triathletes, runners, golfers, obstacle course racers, baseball players, CrossFitters, or athletes from any other sport, my patients tend to go hard.

In working with this driven athlete population, I focus not only on injury and illness treatment, but also on health, performance, and injury prevention. When I order blood tests, I’m often not looking for disease. Instead, I’m looking for early signs of imbalance, dietary deficiency and physiologic response to training stress. I evaluate lactate threshold profiles, continuous glucose monitors and training logs.

In my opinion, you can’t separate health from performance. A healthier athlete performs better, it’s that simple.