According to applied physiologist Dr Brian Moore, and Dr Andrew Hodgson, Consultant Physician (Haematology) – co-founders of the Irish company ORRECO – one of the most difficult elements of competing in sport at a world class level is to balance training hard whilst ensuring adequate recovery. Dr Moore and his integrated team of high performance practitioners advised Olympic medalists and competitors at the last three Olympic games, and will do the same at the London Olympic games this year. CLi spoke to Dr Moore and his team to find out more about ORRECO’s mission and the methods it uses to help athletes reach peak performance without overtraining.
Q. Could you first tell us a little about your company. What inspired you to set up ORRECO and what did you hope to achieve? Briefly how does the company operate?
ORRECO was founded with the aim of joining the disciplines of clinical and sports haematology to deliver a unique proposition for world sport. We facilitate blood and saliva analysis for some of the world’s best athletes from an administrative base on Ireland’s western coast – the Innovation Centre at the Institute of Technology, Sligo.
Analysis occurs through a global network of partner laboratories that are located close to training (altitude, warm weather) and competition (World Cup, Championship, Olympic) venues. Results are reported in real time through our software solution DAVE (Download, Analyse, Validate and Export your results) to allow team physicians, coaches and performance staff to review information immediately and compare the results to an athlete’s performance. We cross-reference the results with training and competition data, (e.g. speed and power, GPS tracking) to understand the individual’s adaptation to training.
Recognising that testing and result reporting are just one part of the solution; we also provide a consultancy service for elite athletes and their teams. Our performance staff assists in interpretation and comparison of results against sports-specific reference ranges, as well as provides practical guidance and interventions where needed. This includes nutritional support, training-plan modification and more. Rather then rely on one specific biomarker, we use multiple assays that are aggregated by our bio-statisticians and map the athlete on a range from ‘well’ to ‘unwell’, and, from ‘peak performance’ to ‘over-reached’ or ‘over trained.’
Q. Tough training programmes are integral to sporting success, but what are the main problems that can occur if athletes over train?
We know that in the elite sport world, very small margins exist between defeat and victory. To succeed, an athlete must train extremely hard, and there are situations when a training programme requires an athlete, player or squad to be selectively overreached or overloaded for a short time period. With a subsequent, controlled reduction in training volume, a super-compensation occurs, allowing for a positive adaptation to the intense training dose and overall improved performance.
However, if athletes train too hard for too long in their pursuit of success, they will eventually fatigue and follow the performance continuum [Figure 1], which leads to injury and increased frequency of illness, such as upper-respiratory tract infections, immunosuppression, disturbed sleep patterns and depressed mood states. Biomarker analysis can help navigate the fine line required to balance adequate load with sufficient recovery.
Q. How did you establish which biomarkers were the most important for monitoring athletes in training and how do you carry out analysis of these biomarkers?
Our starting point is leveraging clinical markers that are routinely used for general health and wellness. In the context of training, we rely on biomarkers found in blood and saliva that are known signs of a normal process (e.g. adaptation), abnormal process (e.g. maladaptation), a particular condition (e.g. under performance syndrome) or disease (e.g. infection).
Biomarkers may be used to see how well the body responds to an intervention/process (e.g. training modification), a treatment (e.g. recovery solution) or a stress inducer (e.g. game, match). Our specialist team includes former speed and power coach to the New Zealand ‘All Blacks’ and Americas Cup sailing team, Dr Christian Cook; the first team physiologist to Real Madrid, Dr Carlos Gonzalez-Haro; the former Director of the Australian Institute of Sport Haematology Lab, Robin Parisotto; and Clinical and Performance Nutritionist to the British Olympic Team, Nathan Lewis (MSc). We have significant collective experience of applying, analysing and interpreting biomarkers across a range of elite sports at the very highest level of world competition. We facilitate analysis of markers that have been applied and validated in the world of elite sport. Our combined experience of working with thousands of elite athletes and monitoring them at key times during the season means we can discern trends that are consistent with either peak, or, at times, underperformance. We are especially interested in athletes’ cell counts, inflammatory markers, trace metal status, immunoglobulins and hormonal profiles.
Q. Are you satisfied with the methods and equipment used?
We are constantly looking for improvement and searching for markers that can give us objective information about an athlete’s response capabilities and/or status. For example, we utilise the routine parameters, including the differential WBC, haemoglobin and reticulocyte counts, available on the Siemens Healthcare Diagnostics ADVIA 2120 Haematology System, to give us rapid insights into an athlete’s health and wellness. We also rely on additional parameters available on this platform, such as the cellular haemoglobin of the reticulocyte (CHr) and the percentage hypochromasia of both the reticulocytes and mature red cells (%hypor and %hypom). These parameters are also routinely utilised in renal medicine to deliver specific information about the quality of erythropoiesis.
Historically, we would have used ferritin to assess the iron stores, but given the acute phase response of the parameter, we interpret the result in concert with the white cell counts and creatine kinase (CK), as we know the parameter is elevated in infection and inflammation. This information is especially important when an athlete is undertaking altitude or endurance training, as we can ensure enough iron is being made available to the developing red cells and they benefit from all their hard work. We can also pick up a functional or pre-latent iron deficiency before it impacts upon performance and track the responses to prescribed iron supplementation. Thus, in addition to looking for new techniques, we also seek to apply established principles in new ways.
Q. How do you see the future for sports medicine in general and ORRECO in particular?
As explained by our colleague, Dr Bruce Hamilton, sports medicine is no longer focused on just treating injury and illness in athletes. Increasingly, early recognition and prevention of injury and illness is the goal. Particularly when working with elite athletes, being able to identify athletes at risk of developing problems is a constant challenge, and vast amounts or research and resources are being directed at this task. Despite this, we are only just beginning to understand the risk factors behind even common injuries (e.g. hamstring muscle strains) and techniques that may be used to prevent them. Similarly, while illness and fatigue have been recognised as significant limitations to elite athletic performance for many years, to date, the understanding of risk factors and the ability to identify athletes at risk has been limited by both our knowledge base and our technical ability. The goal of tools, such as those developed by ORRECO, are to facilitate the identification and prevention of illness in highly tuned athletes, thereby allowing them to compete to the best of their ability. This is consistent with the aspirations of modern sports medicine around the world.
By integrating sports haematology and biochemistry with knowledge and expertise in clinical and performance nutrition, applied physiology, speed and power physiology, biostatistics and cellular nutrition across our team, whole avenues of possibility open up to performance science in general. ORRECO aims to provide a global resource for real-time sports haematology and biochemistry results for athletes training and competing around the world.
For more information go to www.orreco.com. An introductory video can be seen at http://vimeo.com/41485500.
Siemens Healthcare Diagnostics