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Thursday, June 02, 2011

ACSM Day 1: Is sports science stagnant?

ACSM Day 1: Is sports science stagnant, or just some of its people?

Day 1 of the meeting of the American College of Sports Medicine has come and gone, and I have to say that I have been fairly disappointed in the standard of the science, the quality of the presentations and the overall quality of the meeting so far.

I hate to come across as negative (and I must point out that Day 2 has already been much better - a great talk on Specialization in sport in children, but more on that later), and perhaps I’ve just been unlucky with my choices, but on the first day, I did not leave a talk feeling that I’d heard anything new.  Overall, my impression is many areas of sports science are treading water.

Or maybe my expectations are simply too high. To give you an idea of how that expectation is set, ACSM is the largest gathering of sports science and sports medicine in the world. Such is the demand to present, that parts of the meeting are planned two years in advance – I’m here in Denver because back in 2009, I agreed to present in a highlighted symposium on pacing and fatigue.

Those highlighted symposia, together with special lectures, are the “focal points” of the meeting. These are the gatherings where world-leaders prepare a series of talks on a specific topic. I guess you could call them “state of the art” (in fact, this is literally what some of them are called).

And so my expectation is to hear the very latest research on a given topic. One of the most published researchers in the world is going to present data, theories and evidence for the latest thinking on a topic. So if a symposium is on overtraining and its effects on performance, muscle, immune function and hormone responses, then it should present the research since the last meeting. Sure, it may require a historical overview, explaining how our understanding of overtraining has evolved.  It may even involve presentation of theories from the 80s, the 90s. But then the focus should be on latest thinking, recent research.

Looking back to the 1990s, but never moving forward

That seems not to happen. The number of times I heard theories put forward that date back to 1990-something was astonishing. In my opinion, the only time you should present a theory or a model from the 90s is to a) prove or disprove it with your very next slide which is on the very latest research, or b) make the strong point that nobody has done any research on the topic since the 90s.

No model or theory from a decade or more ago should be presented and left there. I was studying for my Honours degree in 2002, and if a “state of the art” lecture in 2011 presents the same information I did in my honours degree, it is because the science has failed to move forward.  

No theory should stand there for a decade unchallenged. A quick flashback to 1996, for example, reveals that:
  • I was 15 years old;
  • Belayneh Dinsamo held the marathon world record in 2:06:50, and;
  • Prof Tim Noakes gave the keynote address at ACSM and presented a theory based on AV Hill's work that the heart was protected by a “governor” (Hill’s word) during exercise.
Times have changed – I’m no longer 15. That time of 2:06:50 makes Dinsamo 112th on the all-time list (incredible, I know...), and the theory that the heart is protected has been modified numerous times through about ten different review articles, with hundreds of research studies on performance and the brain, and now includes peripheral regulation of muscle contractility along with theories from around the world that refute and support the concept of central regulation of exercise.  The current theory may not be 100% accurate, but it's different.  It has evolved, which is how things should happen.

Same conclusions, a decade on

But what I saw a great deal of yesterday is pretty much identical to what I saw the last time I was at ACSM in 2005. Or the last time I was at the European equivalent meeting in 2004, or at the South African equivalent meetings.  In fact, what was presented yesterday looked remarkably like the material I was lectured on during my under-graduate and Honours courses in Cape Town over a decade ago.

I remember a guest lecturer at the University of Cape Town in 2004 presenting her theory on overtraining, and that dated back 3 years at the time. Yesterday, that same theory was presented, now dating back 10 years, but it was equally unresearched, unproven, unchallenged.

Children in the marathon - going in circles, back where it began

The result of this is that the conclusion of every single talk that I went to today is identical to the conclusion of the same talk perhaps ten to fifteen years ago. One presentation did a perfect circle. It was called “Too young to run?” and was supposed to tackle the issue about children running marathons. 

It began by showing the recommendations on children in marathons from a 1991 review.  Then it presented some very basic data from all of two studies (the only other data in the presentation was when one of the speakers mentioned that his grand-daughter was six months old).  One hour later, it concluded with the same advice as the 1991 paper.

The only “addition” is that marathons need to rethink allowing children to run because there is a risk they’ll get lost or trampled and the administration may be liable - so clearly, litigation has moved on, but not the science.  At least according to the presenters.  So therefore, advice to disallow children from running marathons should be made for administrative reasons, and not medical reasons.

One hour, almost no data, and that was the result.  Absolutely disappointing.  No discussion of the evidence of children and their responses to endurance exercise. No discussion about children and resistance training, no mention of the work showing that early specialization reduces chances of later success in sport. Just bald assertions, opinions and a conclusion that frankly could have been read in a Runnersworld magazine from 1994.

It turns out that numerous sporting bodies do have guidelines for maximum running distance in children - the IAAF and IMMDA, for example - but neither of these was even mentioned.  This came up in a discussion that started on our Facebook page, and the irony, having joked about Runners World above, is that the latest version of the magazine in the UK has a piece called "Are the kids alright?", dealing with this very question!

And let's be honest, it's a tough question - there's no obvious, direct evidence to answer the question of how far children should run.  However, there is plenty of indirect evidence of how children respond to different types of training, and there will be a physiological basis that at least allows one to form an evidence-based opinion.  It may not have proof, but there is evidence.  Sadly, that evidence was conspicuously absent in the symposium, which didn't even mention that some organizations have made recommendations.  It was very poor - you are better off reading the latest Runners World than listening to "world leaders" in the world's biggest conference.

The physiology of overtraining - inching forward

Exceptions are few and far between.  The other sympsoium I went to today had some very interesting data, and some very good presenters.  And, it must be said, some interesting advances from some of the presenters.  It seems that there are some new discoveries on overtraining in resistance training and also the search for markers of overtraining.  One of the primary advances seems to be the discovery that overtraining in the military leads to a desensitization of the hormonal system, where luteinizing hormone levels rise but testosterone levels fall because the testes are not responsive to the signal from LH.

The only problem is that this is not actually new - evidence from the talk was pretty clear that as far back as the early 90s, it was already known.  The only difference is that technology has allowed continuous measurements of LH, and so it's now possible to see that its levels are raised, where before, there was some misleading data.  But the concept of desensitization or "endocrine system fatigue" is not an advance. 

The end result is that many areas of sports science resemble a TV soap opera – one of those shows that you can neglect to watch for months and then tune in and understand the plot and all the characters, because the increments by which knowledge grows are so marginal.

Sports science is evolving, it's just some people within it are not

Having been relatively negative so far, I will say that so far Day 2 has been much better, and there are still talks on barefoot running to come, and I have hopes of some innovative thinking.  More to come on those in the next post.

So there's no doubt that many areas of sports science are "stuck" in old thinking.  The classic one is fluid balance and thermoregulation, and again, there is this huge dogma about heat and dehydration that should really have been disposed of many years ago.  That's just human nature, refusing to move with the evidence.

But there is without doubt much growth in knowledge, and in very specialized areas, sports science is not stuck on a treadmill.  I still think it's way behind other sciences and it's astonishing how little we know about training and performance, about children in exercise, about weight loss and metabolism.  But within these very specialized areas, there is growth, and at the leading edge, things certainly look different to what they did say 10 to 15 years ago. 

That this does not come across is an indictment on the speakers at ACSM.  Perhaps it is time to realize that the "expert" is not always the best person to take the science forward, and that people stagnate, not science.


P.S.  If you are here in Denver, feel free to say hi if you see me wandering around!  Oh, and follow us on Facebook to get the quick thoughts and opinions from the meeting, in case I don't have time to share more detailed thoughts!


BCC said...

On the topic of kids running: I have four boys, ages 3, 6, 9, and 9 (twins). I like to run; they like to run. I don't encourage them to run much outside their normal play, because I am paranoid about burning them out from running, mentally or physically.

But, the older three are starting to take an interest in what place they come in during 1 mile "fun runs", are are starting to ask about training.

So, the question arises: how much can I safely let them run?