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VO2 max

Is VO2 Max Testing Still Important in Sports?

VO2 MaxBy Carl Valle

Is the VO2 max test dead or is it making a comeback? Is it overrated, overemphasized, and a waste of time, or is it perhaps more valuable than we thought?

What I believed would be a very vanilla article may be the most surprisingly controversial topic of the year—for good reason. Although the VO2 max test is nearly 100 years old, it is still a confusing talking point in sports performance, even in endurance sport. Recently, there has been a resurgence in all testing in applied settings, mainly because technology is improving the portability of testing and our understanding of the limits of interval training. If you work with athletes or even just want to know more about VO2 max testing and what it means for health and wellness, this article is for you.

What Is a VO2 Max Test and What Does It Mean?

The VO2 maximum test has a long history, but don’t let that be either a knock on the measurement or a reason to worship it. It’s not dated—it’s timeless for good reason. The test is a straightforward assessment and valid measurement in sport and health. A.V. Hill, a genius ahead of his time, invented VO2 max testing a century ago, but it wasn’t until a few decades later that the process became refined enough to trust the data.

The #VO2max test is a straightforward assessment and valid measurement in sport and health, says @spikesonly.CLICK TO TWEETAfter World War II, the science and technology finally converged properly, and even today you have to calibrate equipment and be aware of ambient conditions during lab testing. There were pioneers a few centuries earlier, including French scientist Antoine Lavoisier, who shaped the value of gas analysis from his experiments. Unfortunately, his efforts were short-lived as he was executed, along with 27 others, for accusations that seemed a little bit dubious. Regardless, for years afterward, his revolutionary work helped shape the future of sport science and exercise research.

Now that the history lesson is over, let’s get into the test and what we can learn from it. I will start with the value of the information and then explain how it’s tested in some necessary detail, and leave the small nuances to the sport scientists. The first point is that VO2 max testing scores are easily summarized as the following:

“VO2 Max functionally represents the maximal amount of oxygen that can be removed from the circulating blood and used by the working tissues during a specific period.” –Better Training for Distance Runners

Now comes the tricky part. How does that information help? Like any test, its interpretation and meaning to a coach or athlete requires a little homework. You can’t expect any test to be a perfect predictor or solution for athlete performance, but the data provided by solid testing does add information that can be useful if you know what you are doing. You can attack a valid measurement and make straw man arguments about its limitations for any test if you want to abuse rhetoric. It’s expected that a comprehensive holistic training program will look at every piece of information and make better choices, not solve all of the world’s problems.

VO2 max testing provides a number that adds another dot to the coaching “Impressionist painting,” but doesn’t unlock what to do in training outside of a ballpark idea of potential. Still, having an accurate understanding of an athlete’s physiology with a rate limiter measure allows a coach to start building a model to see where they can exploit performance. If you have an athlete with a terrible score and they need to play 90 minutes in a football match, you must address the issue. If an athlete has average scores and poor speed and power, a lot of work needs to be done, as skill can only go so far on a sub-par frame.

Oxygen Transfer
Image 1. Many athletes don’t need great oxygen utilization rates to succeed in sports, but you must consider how they repeat power when designing training. Think about recovering from the workload of training during a season rather than from just a single sprint.

Testing an athlete’s VO2 max isn’t hard—you just need to choose a stationary device such as a bike, treadmill, or even rower, and throttle up the speed to the maximal rate that can be sustained for a short time. Using gas exchange analyzers, a short test can identify the rate of oxygen use based on the athlete’s mass. Note that each exercise mode is unique, and mass doesn’t mean muscle, since body composition is not expressed in the score. Many film enthusiasts have seen simulated testing in movies from the 1980s, including Rocky 4 and American Flyers. Please don’t fault me for showing the videos, as the sport science is more like sport science fiction based on the machines and protocols shown!

What Are the Common Arguments Against VO2 Max Testing?

A lot of great coaches have valid points that testing won’t make everyone better or that those with the best test numbers are not the best performers in sport. I have heard every single argument, and even piled on arguments myself to accelerate the process of making sense of what to do with conditioning. I have compiled the best points here so I can share them and explain where they go wrong, as my contention is some testing is valuable.

The most common point I see is dismissing endurance entirely with the nuclear option; meaning, if you destroy everything related to aerobic sports, then VO2 max testing goes away as well. I am more than aware of high-intensity training creating physiological benefits, and outlined very granular adaptations from altitude training to blood chemistry and even to mitochondria. Yes, an athlete or even a fitness enthusiast can sprint their way to serious improvements in oxygen utilization, but that approach has limits.

Aerobic training, or continuous exercise that forces an athlete to push their cardiovascular system to adapt, is helpful for team sports. I wouldn’t have shot putters run cross country, but a soccer player jogging a 20-minute run isn’t the end of the world. Low-intensity continuous cyclical work can’t be recreated by junk circuits. Having a heart rate elevated for a period of time could just mean you are out of shape, not improving your ability to transport oxygen systemically. The direct measurement of a program during a season is the only way to truly know how endurance is improving, be it “work capacity” or GPP.

The direct measure of a program during a season is the only way to know how #endurance is improving, says @spikesonly.CLICK TO TWEETAnother point is that VO2 max tests are highly connected to genetics and are difficult to change from training. True, just like jump tests and speed tests have a relationship to talent and perhaps fiber type, so does a physical test. VO2 max tests are performance tests, as you can’t have great readings without performing in some way. If you have a monster athlete with a high VO2, then the goal is to find out how to take advantage of the talent and that may mean letting go of conditioning if they are in other sports outside the endurance realm. If an athlete is fast and has a great ability to express strength, it doesn’t guarantee they will be the next superstar athlete, as skill and other factors make up performance, but knowing that information can help a coach design better training.

Mitochondria
Image 2. Mitochondria naturally adapt to keep up with the pace of demands over the course of training and competition. Currently, the use of indirect methods of estimating output is growing with elite sport.

Many athletes who have succeeded on conditioning tests do better than athletes with great VO2 scores on shuttle runs or Wingate tests. Muscular strength and other qualities do factor into field tests, and I will cover that in this article, but we are talking about a specific ability for the body to move oxygen effectively. How effectively, such as running economy and mental factors, does come into play, but in order to solve for “x” sometimes you need to know “y.”One number isn’t going to make or break an athlete—even multiple numbers are likely not enough—but dismissing something using a debate club approach doesn’t help the field grow. My only request is that those who contend they have superior or excellent conditioning programs explain why with reasonable and direct evidence. Otherwise, it’s an ego-driven process where talent just makes everyone look good.

Now to my own points. Inconvenience, low motivation, and expense are reasons why I don’t love the test. To me, it’s not exciting and not something for which I wake up in the morning with passion. It’s a responsibility I outsource because I am not an exercise physio or sport scientist, but if I have the data I value it because it does serve a purpose. Plenty of training programs have succeeded without knowing how an athlete utilizes oxygen directly. Still, if you can get both sets of information (field tests and lab tests), the process runs far more smoothly.

How Can Coaches Use the Information More Cleverly Now?

It’s fair for coaches to ask if they were to add the information, would they train athletes better or differently. It depends. If you are not a fan of testing or profiling athletes, then physiological testing is a waste of resources. Some coaches remain stubborn, no matter how much advancements change sport science and coaching methodology. I don’t blame someone for just not wanting to spend their entire day looking at journal articles or textbooks, but if you are trying to win, individualized workouts matter now.

One way to evaluate a program’s effectiveness is to see how many individualized factors it has, says @spikesonly.CLICK TO TWEETThe best way to evaluate the effectiveness of a program outside of the relationships and coaching ability is to see how many individualized factors exist in a program. If you profile athletes and then resort to group workouts that copy everyone’s training, it’s likely you are in a setting where science is “seen but not heard.” Not everyone can tailor every detail of a program, so don’t feel guilty if everyone doesn’t have a perfectly individualized workout. Just put in the best effort you can and utilize strength and documenting software please! If you need it, SimpliFaster reviewed software in their Buyer’s Guide less than two years ago and the information is still current.

Modeling. Yep, I am bringing it up ad nauseam. Modeling performance with more granularity matters today, as it’s not about marginal gains—it’s about adding up more worthwhile changes than the other guy. Talent and environment are more important than coaching, I admit that. Still, if your job is to take care of the 5%, then max out what you have.

Specifically, I care about profiling team and endurance sport to see their capacity to handle work through aerobic contribution. By adding in biomarker testing and even sonography of the heart, you can see if workouts proposed by scientists or leading coaches are making a difference. In my experience, the “in the wild” transfer of training is always disappointing. Instead of blaming yourself for not replicating the workouts, just ask how realistic is improvement from training.

VO2 Infographic
Image 3. Heart, blood, mitochondria, and other factors are adaptations that coaches must investigate to maximize athlete ability. It’s important to think about variables in conditioning that factor into the end of games and end of seasons.

Running economy and biomechanical factors affect biochemical reactions. I detailed the Moxy Monitor previously, but if you are going to test an athlete, add in more information since you have the time anyway. The ability to sprint is very power-oriented, but great runners who are gifted with sprinting talent seem to be better overall. I am in favor of neuromuscular development of the nervous system, but an athlete who can run well and has a good sprint program blossoms. Several programs have made a big impact on sprinters from just sprinting, but look at the successful programs where running is a part of the equation or winning formula.Running economy has sparked many sprint programs to think about sprinting economy, and efficiency can show up with various tests outside of VO2 max testing. If you are in soccer or endurance sport, you should consider running economy. Not everyone can walk around like Lionel Messi, so think about the difference between capacity and efficiency.

Who Can Provide Testing for Teams or Athletes?

I am not the person to share how best to do a VO2 max test. I am likely the person who will be there with a bucket if someone needs to puke, but I am not proficient with laboratory testing of endurance qualities. What I can do is get familiar with the standards of quality testing and get into good habits for the future. Those with years of testing experience gives me a reason to sleep tight at night because they know when a value may be off.

Today, there are plenty of options for coaches, ranging from volunteers at small colleges looking to help teach students to investing in the equipment directly. In between this is an emerging option: outsourcing to boutique options such as Dexafit and other small facilities. Down the road, I expect more and more facilities to expand services privately or with partnered hospitals and clinics to give more athlete care. VO2 max testing isn’t just for athletes—it’s for all populations that need to be fit and healthy.

VO2 max testing isn’t just for athletes—it’s for all populations that need to be fit and healthy.CLICK TO TWEETIf you are getting a conventional test done by a university, see if they have a portable machine that can be used with a field test. There are now a few systems that assess athletes outside of stationary machines, as on-the-field measurement is available with mobile systems. A field test with a few added measurements is gold. Not only is the information directly valuable, but the data can help convert simple speed and time measures into more useful summaries of what is going on internally.

You may not need to test a team, but a representative from each of the different profile groups you have works well when athletes are not engaged. Not everyone is going to buy into lab testing, even if it is designed to protect their brains or risk of dying from cardiac event. Thus, conducting a few experiments with athletes who are cooperative helps reduce the guesswork, but does not eliminate it entirely.

Can Field Tests Predict VO2 Max Scores Accurately?

If you made it this far in the article, you are likely an independent thinker and you trust yourself. It’s tempting to reach out to specialists or experts in endurance sport to get their opinion, but do your own homework so you are not biasing your curiosity. I made that mistake, asking a few dozen physiologists their opinion and getting a continuum of viewpoints, ranging from testing is useless to everything must be guided from one number. Honestly, wait until after you are informed to ask better questions, as my second round of investigation revealed clever ways to test so the information is useful.

I am in love with field tests, so when I was told that I needed lab testing for team sport athletes, I was suspicious of the motives of those twisting my arm. Over the years, I did my homework and saw relationships that were strong enough for me to tell myself that I didn’t need an athlete to be on a treadmill to help them get fitter for a game. I was wrong twice.

The first thing about testing on the field and testing in a lab is that gold standards sometimes explain why other data sets may influence great performance tests. Just like a force plate explaining how a peak jump height is formed, a VO2 max test explains why great performances on field tests are succeeding at the cellular level. For example, a simple beep test can replicate a solid estimate of VO2 max, but it is too sensitive to running and cutting economy, surface type, and pacing to confidently use as a replacement. Second, while I agree that you shouldn’t base your decisions only on lab tests, inclusion of both testing types really explains what is going on.

VO2 Max Field
Image 4. Field tests are great, but without physiological tests they just represent the result of many variables instead of teasing out specific ones. Here, the two yellow dots represent the same oxygen transfer and utilization, but a far different total in running distance. (Modified from Krustrup and Bangsbo)

Continuous running tests are not for everyone. I would not expect an offensive lineman to run fast for a half hour, and some speed athletes look terrible even if they are on a track team. Running, even if not at a sprinting speed, is still a skill. Like the weightlifting argument that the movements are competitive, I do see the point that we need to be orthopedically and skill specific, not just sport specific with testing. I think the skill of running for 20 minutes without looking broken is important.Over the years, I have witnessed plenty of sport athletes become good runners while their speed and power improved. If you find jogging, a natural way of locomotion, to be a minefield of injuries waiting to happen, rethink the term “resilience” and ask how sprints are going to be much safer. Nobody needs to be the next Steve Prefontaine, but like swimming, the basic ability to run a good mile or sustain a fitness ride on a bike for an hour shouldn’t be a scary endeavor.

Experiment with Testing for Yourself

You can do a lot with physiological testing, as more information can be found from different tests and additional measurements. By no means am I suggesting that you need to measure everything to be credible, but if you have strong opinions on a matter you need reference points. Evidence is evidence, and opinions are all welcome provided that some sort of evidence or good points are brought forward.

There are opportunities to outsource or invest in #VO2max testing and the technology improves daily, says @spikesonly.CLICK TO TWEETMy recommendation is to do a simple maximal test or submaximal assessment to develop awareness of what is possible with direct information. I use both field tests and laboratory tests to problem-solve, and I recommend a combination to everyone I talk to. There are plenty of opportunities to outsource and invest in lab testing, and the technology is improving every day. As someone who has seen the benefits of VO2 max testing firsthand, I advise you to get data to improve your view of what is happening at the physiological level with yourself or your athletes, and experiment if you can.

VO2 max

VO2 max (also maximal oxygen consumption, maximal oxygen uptake, peak oxygen uptake or aerobic capacity) is the maximum capacity of an individual’s body to transport and use oxygen during incremental exercise, which reflects the physical fitness of the individual. The name is derived from V – volume per time, O2oxygen, max – maximum.

VO2 max is expressed either as an absolute rate in litres of oxygen per minute (l/min) or as a relative rate in millilitres of oxygen per kilogram of bodyweight per minute (ml/kg/min), the latter expression is often used to compare the performance of endurance sports athletes.

Measuring VO2 max

Accurately measuring VO2 max involves a physical effort sufficient in duration and intensity to fully tax the aerobic energy system. In general clinical and athletic testing, this usually involves a graded exercise test (either on a treadmill or on a cycle ergometer) in which exercise intensity is progressively increased while measuring ventilation and oxygen and carbon dioxide concentration of the inhaled and exhaled air. VO2 max is reached when oxygen consumption remains at steady state despite an increase in workload.

 Fick equation

Main article: Fick principle

VO2 max is properly defined by the Fick equation:

\mathrm{VO_2\; max} = Q(\mathrm{CaO_2} - \mathrm{CvO_2}), when these values are obtained during an exertion at a maximal effort.
where Q is the cardiac output of the heart, CaO2 is the arterial oxygen content, and CvO2 is the venous oxygen content.
(CaO2 – CvO2) is also known as the arteriovenous oxygen difference.[1]