Your June(ish) Roundup of Gear and Training News

What you need to know.

Jun 19, 2023

This month, we’re doing something slightly different. Usually, I send out a once-per-month (roughly) roundup of the interesting training and gear news, to save you time and brainpower.

But, since I just got home from the Female Athlete Conference, at which a number of new papers were presented and discussed, I thought I would instead highlight the key research that stood out to me from that.

And then at the bottom, you’ll get a few quick other highlights from the month.

Keep in mind, though: A lot of the latest science presented at an academic conference is either pre-publication or in-the-process of publishing—which means there sometimes isn’t a paper yet to link to and/or things might still later change slightly in analysis. So, I’m giving you here my general summary.

Things that stood out to me in training studies and news

From the Female Athlete Conference:

1. Concussions!

First, there was a consensus update presented from the international conference on concussion in sport—published later in the week—on the best protocols, diagnosis, and treatment. [This is important because it’s what trickles down and dictates how your doctor eventually will think about concussions.]

If you take nothing else away, take this: aerobic physical activity, that does not include head injury risk (ie. no contact sports, no outdoor cycling), is recommended as soon as 24-48 hours post-concussion. (We’ve known this for awhile, but they’re really re-emphasizing the power of light aerobic activity to help with concussion recovery.) In the first 24-48 hours, relative rest and reduced screen time is recommended, but after that there isn’t much evidence to support continued reduction in screen time. Additionally, strict physical rest post-48 hours is not beneficial. Athletes can also progress through the steps of returning to sport even if they have mild symptoms, as long as the symptoms do not increase post-activity more than 2 points on a 1-10 scale and the increase in symptoms does not last more than an hour. These steps can be evaluated every few days to every week: They include increasing light activity to then movements that are multi-directional to activity with some risk (ie. cycling) to increases in exertion and intensity to full return to practice to game/race.

(Keep in mind they’re defining light aerobic activity as 80% of whatever heart rate triggers symptoms.)

In terms of prevention, we still don’t know a ton, but:

mouthguards were shown to decrease concussion rates by 28% in hockey, and studying mouth/headgear in non-contact sports is worth thinking about
neuromuscular warmups also helped reduced concussion rates in rugby

Do concussions hit women differently?

Yes and no. There’s lots and lots and lots of evidence that women report more severe symptoms, that those symptoms last significantly longer than men’s, and that women more often have long-term lingering problems. But it’s not 100% clear why. Maybe they just play different sports without helmets, maybe it’s explained by biological differences like smaller axons and greater rotational force, or maybe women are whiners and simply report symptoms at higher rates (hah, no).

I talked to one researcher who said they surveyed all the records from their concussion clinic over a six-year period, and for the ~600 patients who presented within seven days of the initial event, women’s symptoms were still worse and lingered significantly longer (as demonstrated on a chart she showed me).

There’s evidence that women experience worse vestibular symptoms (dizziness, etc), there’s some possibility that if you get a concussion in the luteal phase of menstruation it can be worse (coupled with growing research around hormonal dysfunction caused by concussions), and there are certain biomarkers that women exhibit post-concussion—for example, women’s pupillometry (measurement of the pupils movement) is worse than men’s in that period, and female hockey players in one study showed changes in fMRI that the male players did not show (which suggests something happening from repeated low-level hits).

But. The official consensus statement, at this point, found that when you control for intervention—ie. when female athlete get initially treated as quickly as male athletes—many of those outcome differences disappear. Which raises a whole other question.

2. REDs is no longer RED—S

The big news in the update coming on relatively energy availability: We now officially pronounce it as “reds.” No hyphen. Huge.

Similar to the official consensus statement on concussions, there is an update coming this fall on how we define, diagnose, and treat relative energy deficiency. Most notably, it creates a more clear-cut way for practitioners to use general tools, like standard questionnaires, to identify high-risk athletes and then use primary factors (number of stress fractures, missed periods, obsessive exercising) and secondary factors (age, medications, genetic background) to determine what level of risk they might be at.

It’s most important, in this case, to remember that low energy availability is relative to energy expended and can affect everything: bone health, hormonal dysfunction, GI issues, recovery, motivation and mental health. Eating enough also has a protective effect, essentially eliminating many of the impacts of hormonal issues that women experience (for example, in menopause).

In that vein, there’s increasing evidence that 1. there’s a separate low carb availability effect (even if you’re eating enough calories overall) and 2. many times what we think of and have studied as over training syndrome was actually relative energy deficiency.

As much as I’m super bored of talking about this, because we’ve known the connection between not eating enough, missing your period, and getting hurt for a long long time, clearly it’s still a problem—since 42% of women and 17% of men running at the Boston Marathon had indicators on a preliminary screen.

3. ACL tears really don’t have to happen as much as they do

This isn’t huge for triathletes, but. It’s long been known (like for almost 30 years) that ACL tears happen more frequently in women (a lot more frequently), take longer for women to recover from than male athletes, and women more often have recurrence of injury. Why?

This is an ongoing massive problem for soccer, most notably. And gonna be a big problem for a number of teams at the World Cup this summer, with some key names out for surgery.

Some interesting research in ‘Up to Speed’ suggested that when you measure lateral force and knee stiffness on a force plate, female soccer players were significantly worse in how they landed than male soccer players—but female dancers were not. This suggests it can be trained and that, potentially, in disciplines where the training was aimed at women from a young age those discrepancies disappear.

Which brings us to: For the love of god, there is a known protocol that has been shown to reduce ACL injuries over a season by as much as 70%.

Two last things:

I’m just going to sum up, out of all the pre-publication presentations, two that stuck with me and I think are fascinating. Keep in mind: These are conference presentations, not yet peer-reviewed papers.

One study looked at ovulation in women going through basic training, by taking daily hormone levels over the ten weeks. In short: just 41 of the 48 women ovulated during that time, yet 41% had regular periods. Meaning there’s more hormonal dysfunction happening than was realized. (This matters because it’s a leading indicator of bone stress injuries and other things.)

While I didn’t find the news particularly shocking—anyone who has been through elite-level Ironman training knows your body shuts down peripheral processes when it’s under extreme physical stress—what flummoxed the researchers was that the women had no signs of relative energy deficiency, were eating enough, had some disrupted sleep but still well over 6-7 hours/night, had some stress but no other external signs of hormonal disruption. So what caused this?

One possible explanation was found in a much older similar study of monkeys’ hormone levels and ovulation. When the monkeys had a slight energy deficit, there was about a 10% decrease in ovulation across the group. When the monkeys experienced stress (by being put near monkeys in another room they didn’t like), there was also a 10% decrease in ovulation, approximately. BUT. When the monkeys both had an energy deficit AND were stressed at the same time, there was over a 70% decrease in ovulation.

Obviously, there’s a lot of steps here to translate these results into a finding for humans. But what I took away was: Stress is not additive, it compounds—and your body knows.
There was also a study looking at the effects of the menstrual cycle, in normally menstruating women, on endurance training. They did this by measuring lactate threshold, VO2 max, and a 30-second all-out power test at three points: early in the follicular phase, 36-hours after ovulation, and mid-way through the luteal phase. They did this through multiple cycles.

The data was random.

In essence, there was no line or statistical analysis that could be drawn—even when there was a slight increase or decrease in one measure, the deviation was so large as to make the band almost meaningless. And what was more fascinating is that variability applied even if you narrowed down to look at one or two athletes: for example, two athletes would have opposite effects across a cycle; or one athlete would show a 15% change across phases, but then would be flat the next cycle. There were no changes that were repeated across cycles.

I find this fascinating for obvious reasons. It also completely aligns with my experience, which is that I’ve never been able to find a pattern. While it seems likely that, eventually, we’ll narrow down what the difference is between the sub-groups of athletes who have an increase in performance at certain points v. those who have a decrease, right now it made me just feel a little bit vindicated for never noticing, in myself, a replicable change that could be tied specifically to the cycle.

BONUS STUFF NOT FROM THE CONFERENCE:

Creatine has been getting a lot of good press lately—a friend even put me on it to help with brain health. It’s no longer just for gym bunnies; now for endurance athletes, too.
Wearing a hat filled with ice in hot temperatures improved 5K performance by 14 seconds in triathletes. Which seems meh to me, but I’m including it here since so many of us stick ice in our hats during races. Notably, the biggest impact seemed to be on the perception of heat.
You want to know what will definitely improve your running economy? Simple hopping!
A systematic review found very few elite juniors later achieved at the same level in senior competition. Maybe it’s time to re-evaluate talent identification in youth sports.

And the gear

Apple Watch 10: Now can connect with cycling sensors and smart trainers, and will connect with workouts on TrainingPeaks. Full list of relevant updates here. (Velo/DC Rainmaker)
Garmin Fenix 7 Pro: Garmin released an upgraded adventure “pro” version of the Fenix—my watch of choice—and the Epix. Besides the flashlight and new optical HR sensor, it’s mostly just a heavier duty version of everything. Triathlete did a side-by-side comparison of it with the earlier released Suunto Vertical. (TechRader/DC Rainmaker/Triathlete)
There are a few new bikes out: the $17,000 Felt IA 2.0 and you can actually buy a Cadex now. (I know you really could at the end of last year, but do you know anyone who had one before? I don’t.) (Triathlete)
Unreleased bikes at Unbound: The winners at Unbound rode a couple unreleased bikes—Ben has the details. And a full gallery of all the tech at gravel’s Kona, if you want to get into things like tire choice for mud. (The Ride/BikeRadar)
In-kit farings: More and more triathletes are shoving farings—sorry, “water bottles”—down the front of their jerseys for aerodynamic savings. Does it actually make you faster? (Ero)
I’m also getting somewhat curious about the Body Rocket on-bike aerodynamic testing system. (Body Rocket)
Research on supershoes continues, including ways to potentially run your own at-home tests to figure out which shoe works best for you and preliminary research suggesting greater gains in running economy if you don’t train in the supershoes. (Outside)
Strava announced a bunch of coming updates at its annual Camp Strava. Yes, that’s a thing. (Run Bryan Run)