“Science and wisdom have their place and finding that balance is important – both should be judged on their merits and none should be taken at face value”
A conversation kicked off in a Facebook forum recently on the merits of ice baths for recovery. The usual pros-and-cons were argued and personal perspectives given.
Ciarán Power even waded in. He hadn’t used them when he was a professional, rubbing shoulders with Marco Cipollini in the sprint trains, but now that he’s back in the more humble domestic ranks he thinks they’re the best thing since the discovery of watts by cyclists.
This reminded me of some research I had done a while long ago on the merits of ice baths versus hot baths for recovery: when you pass 60 it’s definitely time to start clutching at any straw for that marginal recovery gain!
However, deep down, I was half-hearted about it and I knew that I would probably keep looking until I found a study that favoured hot baths, and would look no further then.
One vein of investigation proved promising – the use of Epsom Salts in hot baths – and various recuperative claims were made about the effect of magnesium sulphate which is the ‘active ingredient’.
In the process I came across an interesting and related topic which claimed that this shouldn’t work as, from a clinical perspective, the skin barrier should not allow the magnesium sulphate to penetrate. Yet, blood tests showed that levels of magnesium in the blood were increased after immersion.
Various theories were put forward – for example, that absorption occurred through the anus, but neither could this account for the levels of absorption. However, I digress.
My main point is that this was an illustration of ‘weak science’, and this becomes immediately obvious when you can quickly find different ‘studies’ producing conflicting results. You can quickly find ‘science’ which ‘proves’ the hot and/or cold baths do or don’t work.
I wasn’t surprised in this instance, for a number of reasons.
Firstly, science can’t explain everything. There is no good body of science, for example, which proves that regular massages will make cyclists go faster. Does this mean that cyclists are wasting their time because they are not relying on ‘cutting edge science’?
Of course not, and this is an example of collective wisdom, built up over generations, topping science.
A second reason is that good science costs a lot of money, and the main sources of funding for large-scale quality research comes for major health issues, for commercial reasons from multi-national pharmaceutical companies, and such like.
As the recovery of knackered old cyclists isn’t on any major health agenda, and nobody is going to make a lot of money out of selling either hot or cold baths, it’s not surprising that really definitive science on this issue is difficult to find.
So, what should I make of Ciarán Power’s advice on ice baths? Should his level of wisdom outweigh the lack of convincing science and persuade me to take that icy dip a couple of times every week?
This question, of balancing science and wisdom, brought to mind another topic that I had also been looking into recently – the more serious issue of arterial fibrillation in older cyclists. Speculation is mounting that long-term exercise in endurance athletes, in both volume and intensity, can produce changes to the heart including a higher risk of cardiac arrhythmias. These are problems with the electrical impulses which co-ordinate the operation of the heart muscles.
We all keep a kind of dark locker at the back of our cycling minds where we shut away inconvenient thoughts, such as the possibility of being hit by a car or the cost of that last set of wheels. As one gets older, thoughts of the ticker deciding it’s had enough of this craic and suddenly quitting are also consigned to this inconvenience-locker.
Yet, every now and again, these thoughts start knocking at the door, so to speak, and the time came when I decided it was time to let this one out and try to understand this particular issue.
Before I started I suspected that the science would be weak on this also, and this might seem surprising given its importance. I can explain this by describing what a really good study on the issue might look like.
You would take a large population of cyclists in their 20s – a thousand would be a good number. You would have ruled out as many variables as possible, such as family histories of cardio problems, genetic variations, and so on.
Then you would prescribe them a dose of high volume and high intensity exercise for 40 years, and control as many of the variables as possible, such as diet and general life stress.
You would also need a ‘control group’ – more than one would be even better. So, you would include a similar sample with a medium volume and intensity dose, and a third which would remain relatively sedentary.
After the 40 years you would analyse the results, seeking clear differences between the three groups, and if obvious and consistent patterns of difference were discovered you would then have really good science.
If the findings were repeated by a number of other similar studies you would then have ‘a body of scientific evidence’ building up, and you could have very strong confidence in the claims being made.
You can now see why this particular type of science isn’t available on this topic.
So, in the absence of this type of solid data on the potential of cardiology risks posed by cardiac arrhythmias to older scientists, should I cut my risks and quit, or revert to the vagaries of ‘wisdom’? And, if so, where would I find this wisdom?
If I was getting symptoms of electrical problems with my heart and was referred to a cardiologist in Ireland – hopefully it would be one who specialised in electrical rather than plumbing matters – could I expect that he or she would be ‘wise’ on this? That is, in the absence of strong science, would they have dealt with enough volume of patients to make the links and judge the relationships between a particular type of life-long exercise, and a particular cardiology problem, in a particular age range?
It seems unlikely. [But perhaps I’m making that judgement with a certain bias. A consultant cardiologist I was referred to by my GP for a regular stress test in my mid-fifties said to me, before testing, that ‘it might not be wise’ for a ‘man of my age’ to be doing such intense exercise and to keep my heart rate below 150 bpm! After a little probing on the quantifiable evidence of increased risk, I concluded that he was speaking from neither science nor wisdom, but just lazily covering his pin-stripe suited ass. The wisdom developed from this encounter was not to avoid consultant cardiologists, but to go to ones who normally deal with athletes as opposed to sick people. However, I digress yet again].
So, to get back on track on the sources of wisdom on cardiac arrhythmias on older cyclists: Take a place like Boulder in Colorado which is a mecca for endurance athletes and where a lot of the high-octane, alpha-male type of athletes go to ‘retire’ – i.e. to purse their life-long passions with even more dedication (or fanaticism, depending on your point of view).
In places like this you have a relatively high concentration (‘sample’) of older athletes who had been giving both life and sport a lot of wellie for many decades. Here, the cardiologists – of the electrical variety – began to notice patterns and links between certain types of older athletes and problems with the electrics of the heart.
By listening and discussion with them they noticed certain connections – e.g. that general life stress, in addition to the stress of the exercise, may be a contributory factor – and that certain lifestyle modifications can help manage the problems.
This accumulated knowledge is wisdom rather than science – it is not ‘proven’. Does that mean I should discount it? Of course not. [On the other hand there is plenty of both science and experience on plumbing problems with the heart and the best local source of advice on keeping the pipes clear is probably your local GP, provided he or she is not of the ass-covering variety].
Finding the Balance
In summary, the main point being made is that both science and wisdom have their place and finding that balance is important. Both should be judged on their merits and none should be taken at face value.
The approach taken by A1 Coaching to high intensity training, especially in the ‘off’ season, is an example. Derided initially by some, the source of the approach came from that mixture of science and knowledge. With further experience more wisdom develops – what works best for whom – and final judgements are made by the outcomes achieved. Nothing is taken at face value.
Therefore, when we read advice on training based on ‘the latest scientific evidence’, or on journal abstracts gleaned from the internet, there are certain questions we should pose.
Ideally we should read the original papers and make judgements on the research protocols used the review of previous literature on the topic, the conclusions drawn and claims made, and such like. Alternatively, we should have strong faith in the source of the interpretation of the study. Ultimately, we are looking for a body of corroborating studies built up over time – that ‘body of scientific evidence’.
The same applies to the wisdom on what works in training. For example, I have no doubt that, given his experience, Ciarán Power is ‘wise’ on the issue of recovery and what works for his body – if he says ice baths help his recovery then they do.
But, does that mean it would work for me? That’s another question which neither Ciarán nor the science can answer definitively.
This raises yet another variable – the individuality of response to a particular exercise intervention. Too many athletes and coaches jump onto the training techniques revealed by the latest national champion thinking they will be transferable.
Therefore, in summary, when listening to ‘advice’, judge carefully from where it is coming.
Based on all of this, have I decided on hot or cold baths as the recovery-straw to clutch at?
I’m sticking with the hot ones with the mysteriously-acting magnesium sulphate, mainly because I like them. If they do help my recovery then it will be a bonus [in addition, of course, to the interventions that we do have good science on, such as the use of protein].
And what about my cardiology risks? I’ve put that firmly back into the inconvenience-locker for a while as, judging by what wisdom I can access on the issue, I don’t quite fit the profile of the older athlete at risk, at least concerning electrical problems.*
It’s all a matter of proportion – the risks from cars and cleaning the gutters carry a much greater risk.
*[For a very good, readable overview of this topic see ‘Cycling to Extremes’ by Chris Case from VeloNews – http://velonews.competitor.com/cycling-extremes].