Blood, sweat and fears Part VI...

Not everything that can be counted counts, and not everything that counts can be counted. Albert Einstein

Continuing the theme of discussing things that are partially rehab related but worthy of wider interest and consideration, a recent article on Rating of Perceived Exertion (RPE) got me thinking (yep, I know that's always dangerous isn't it!). People often turn their nose up at RPE; afterall all it's been around for ages, it's really simple, doesn't involve tech and therefore it can't be of much use... or can it? In an age where we are obsessed with technology and gadgets it's actually quite refreshing to consider something really simple. If we are so inclined we measure everything from how well we slept, how stressed we are, how many steps we took and where we took them GPS tracking and then we share this to compare and contrast with others and put it out there for debate, encouragement, motivation or just to swell our egos. Ultimately technology does everything but run, cycle or walk for us. This does seem somewhat ironic given it is that same modern technology that has us tied to our desks and enables us to lead such sedentary lifestyles too. Does any of this sound familiar? The chances are you have a Strava account, no? Just saying...!

Wearable technology - nothing new but ever advancing

Don't get me wrong, I embrace this technology as much as the next person and I'm always interested when another gadget is launched, but often from a point of view of can it really measure that metric accurately, does it add anything to a previous iteration or more importantly can it add value to health, wellbeing or training. There are perhaps two groups of people out there - those that like to track information and those that don't. For those that don't the challenge is to get something down on paper, for those that do the goal is to keep track of what is actually meaningful and think about how it adds to the bigger picture.

RPE makes things naturally simple (unless you overthink it). It's literally rating how you feel when you cycle, run, swim, sprint, canoe... Harness that memory - the sooner this is done the better, I'm sure we can all relate to struggling through a really tough session on our hands and knees but after a hot shower, a cup of coffee and a slice of cake we're rejuvenated enough to think that it wasn't that bad afterall.

RPE on a 1 - 10 scale

There are several iterations of RPE scoring out there and there is nothing wrong with choosing one over another - as long as you are clear about what the numbers relate to and use them honestly. I've previously used the Borg Scale of 6 - 20, which primarily maps against heart rate - 6 = a resting HR of 60bpm (so no exertion) and 20 = a maximal heart rate of circa 200bpm (maximal exertion). I have found that people often struggle to report an accurate number against this, especially if they are new to exercise, find it hard to quantify how they are actually feeling or are perhaps embarrassed at how hard they are finding it.

Professor Carl Foster put forward a range from one to ten, which for some might be simpler. For example on a scale to one to ten, easy exercise would be around one to three, threshold would be eight to ten, and tempo and Sweetspot would been the middle. Obviously this will change over time - when you are starting out and perhaps attempting tempo for the first time it might actually feel like eight out of ten or even higher. The key is what is normal for you. The simplicity of RPE means that you can track it alongside other variables, for example power output, heart rate or pacing in running. If after a twelve week block of training your heart rate is 10bpm lower for a given power output and you are reporting two points lower on the RPE scale then you've achieved some aerobic adaptation.

Achieving flow state 

It might also change how you feel out on a ride, especially during the off season, its a nice opportunity to bank some base miles and build your endurance back up without constantly having your attention pulled to your Garmin every couple of minutes. If you know that an endurance session should feel like one to three (realistically nearer three) out of ten then the odd glance to check that your heart rate is where you would expect it to be should suffice. Why not give it a try; go and see if you can find that flow state, enjoy pedalling in your surroundings and appreciate what is happening around you rather than making yourself unnecessarily 'busy' by watching the numbers. It's a really important skill to be able to ride on feel, practice pacing and appreciate the art as well as the science of a good session. Afterall, there may be a day when technology fails you - the only lost session is the one that you didn't do. Yes, it's disappointing not to have that data to reflect on, especially if you think that you executed something particularly well or nailed every interval but your body still did that session and nobody can take those physiological benefits away from you!

Exploring new places is a great way to put riding to RPE into practice

Blood, sweat and fears... Part V

Storms make us stronger, Bear Grylls

To supplement, or not...

Given my recovery is taking far longer than I'd ever anticipated I thought I would continue the theme of sharing tips and nuggets of information that either I've come across, found useful, researched or where I've at last started to implement my professional skills on myself. Yep, you know that well known phrase 'do as I say, not as I do'? Well, I'm as guilty as the next person of looking after everyone else and dishing out helpful advice when actually I should be taking my own advice! Did I hear some of you say at long last?!

I'd like to have a brief delve into nutrition and supplementation... A contentious subject at the best of times but also a really interesting and important one. Not least because we all eat food so therefore we are all experts, uh hm! I came across this nice little infographic, below, a while ago and although I would add 'Performance Nutritionist' alongside 'Dietician' (if not substitute where sports nutrition is concerned) it sums up the issue really nicely. If you wanted professional advice or assistance on almost another other issue you would seek out the appropriately qualified 'expert', however it comes to nutrition and it seems that we mostly take leave of our senses. 'My friend says', 'that magazine article', 'the Sunday supplement reported' and so on. Unsurprisingly, along the way the right information gets lost or diluted. Don't get me wrong there's a place for anecdotal reporting and supporting others through shared experiences but it's always best to check with the right sources first. Anyway, the purpose of this post isn't to have a bit of a grumble about all of the poor information out there, it's to share some useful information to consider in times of illness or injury.

The convoluted path that people take for nutrition advice

As athletes and in particular cyclists, weight is never far from our minds - the better our power to weight ratio the faster we will be... However in times of injury or illness weight is often pushed even more to the forefront of our minds given the main device for weight maintenance - exercise - might be limited or totally off limits. You might feel that there is a need to restrict what you are eating, particularly carbohydrates*, count calories, change your food habits etc in a bid not to lose the athletic physique that you've worked so hard for. However, whilst it's important to be mindful of your diet overall, you probably don't need the added stress of something else to worry about. The most important thing is to ensure that you are giving your body as many nutrients as it requires to heal, so at its simplest don't underestimate the 'eat a rainbow' a day message.

*It's really important not to completely relegate carbohydrates from your diet. Carbs are often seen as the enemy and are the first nutrient to be reduced or removed from the diet during a period of injury or reduced training in fear of gaining body fat. However, this is actually counterintuitive as chronic energy restriction and/or energy deficit can inhibit the bone remodelling process - potentially increasing the period of injury time. This isn't to say that tracking diet and weight isn't important, especially in long term injuries when training might be disrupted for many weeks or months, just that it should be carefully managed. The body needs the right fuel for the work required, so perhaps eating good quality carbohydrate sources would be better than a surplus of lower quality foods (yep sadly that's the biscuits, cakes etc).

A rainbow a day will provide a diverse range of nutrients

I am very much an advocate of a food first approach and by that I mean if you can fill your diet with as many different sources of energy and nutrients before you consider supplementing then you are likely to be better off. A simple rule that I like to use is that if there is an ingredient on the packet that you've never heard of or can't pronounce then the likelihood is that your body won't be able to process it. If you just can't be bothered to eat fruit or vegetables on a regular basis then supplementing  Multi-vitamins isn't going to help you! Equally if you are supplementing with x, y and z because your teammate does then this isn't really an appropriate rationale either. Half of the reason that nutrition is so complicated is that we are all different, have different needs and respond in different ways.

There is an excellent quote from Professor Ron Maughan on supplements:

"If it works it is probably banned and if it isn't banned it probably doesn't work!"

This is a pretty good place in which to start considering supplements, so it's always best to err on the side of caution/cynicism in this area. However, there are occasions where there is evidence for efficacy and supplements can be a useful addition - both to athletes in our diet and nutritionists in our toolkit. 

For me this mainly falls in to two areas - 

• To correct a deficiency (Vitamin D or Iron status)
• To prevent illness (pre/pro biotics)

However, before I go any further, there is one logo that you always need to be mindful of if you are competing at any level:

Things to consider when you are injured

Vitamin D3
Living in the UK we are unlikely to see adequate sunshine through the bulk of the Winter months and as cyclists most likely do not do a huge amount of weight bearing exercise. The absolute way of qualifying this on an individual level is to have frequent blood tests (baseline - supplementation - follow up). Or, you could consider a good quality Vit D3 supplement (1,000 iu or 4,000 iu depending on your starting levels) as a precaution. The recommended dose for athletes is at the higher end of the scale.

Calcium
This can be consumed in the diet from dairy products and dark green leafy vegetables. However, if your injury involves a broken bone for example, the body is trying to remodel this in addition to normal bone turnover. It might be wise to consider a calcium supplement in this instance - depending on how rich your diet already is in calcium.

Collagen
Research shows that collagen can support bone, tendon and ligament remodelling by increasing the availability of collagens within the body. There are no known negative side effects if you wanted to consider this. Recommended dose: 15mg per day (ideally 1 hour before high intensity exercise, but if your athlete is injured and not taking part in high intensity exercise then any time of day will be fine).

Vitamin C
This can support collagen formation. Consuming foods such as dark green leafy vegetables, kiwi fruit, melon, pineapple, bell peppers, sprouts etc is likely to be beneficial. If the diet is lacking in Vitamin C then a fallback could be to supplement at 1 - 2 grams per day. Remember, food first though!

I have no allegiance or declaration of sponsorship from Healthspan but their elite range of supplements are reasonably priced, contain what you need (rather than a load of baking agents) and importantly are batch tested and Informed Sport trusted. As time has gone on, even with a mostly well balanced diet, I have been supplementing Vit D3 and collagen alongside a balanced diet to try and support my body to heal.

If you are unsure please consult an appropriately qualified professional (not your mates, unless they are suitably qualified!) Sadly, many GPs may not be able to give appropriate advice to highly trained athletes in this area, you are likely better consulting an experienced Performance Nutritionist working in your field.