Category: Sports Science

Tokyo Olympics Review: Part 1

It’s been a few days since the Olympic flame in Tokyo was extinguished. Possibly the most challenging Olympic Games of the modern era, or as I put it in my opinion paper published here few days before the opening ceremony, the first “Pandemic Olympics”.

The journey to the games has been difficult for everyone, athletes, coaches, support teams, sports administrators, organisers, broadcasters. Everyone struggled with changes in schedules, rules, regulations, possibility of cancellations and enormous challenges provided by the uncertainties of the COVID pandemic worldwide. Despite all of that, the Olympics happened, and as usual, it was an incredible show. With amazing stories, big surprises, old and new heroes and villains, disappointments and drama. I have a special connection with the Olympics, I watched all editions since I was a small chid, I have memories of Mennea winning gold in Moscow 1980, the Abbagnale brothers winning in 1988 sin Seoul (if you can’t understand Italian unfortunately you can’t appreciate one of the best live commentating of a sporting achievement on Italian TV with Giampiero Galeazzi). The Olympics for me have been the epitome of excellence in the sporting world and I was always fascinated about how individuals in different parts of the World strived for excellence even when the conditions they were in were less than optimal. As an athlete, I was never even remotely good enough to even dream about playing at the Olympics, and so my only chance was to get there as a professional. I feel privileged of having worked with Italian athletes first to get them to Sydney Olympics and later on with Team GB in Beijing, Vancouver (for the winter edition) and London in 2012 as well as having worked more recently with young athletes that went on to represent Qatar in 2016 and in Tokyo.

Every edition of the Olympic Games brings its challenges, and since I have been involved in sport, every edition draws the interest of the press in the build up mostly looking for controversial angles. There is in fact no hosting city that is immune from criticism for their construction plans, air quality, environmental issues, organisational challenges, transport issues, local socioeconomic policies, etc. Very rarely I read praise about how cities see the Olympics as an opportunity to improve the infrastructure, enhance sporting facilities, develop sports tourism and business and boost a nations’ morale. But I am no politician, and therefore I will not comment on those aspects. My only comment is that I think Rome missed a chance withdrawing from the Olympic bid for 2028. However, I understand the concerns, considering that my home country is marred with corruption (just look at the disaster of Italia 90 here) and with big events there is always the risk of unnecessary spending enriching the usual suspects.

Next up is Paris in 3 years, followed by LA in 2028 and Brisbane as recently announced (without a rival bid) hosting the games in 2032. So, what has been happening in this edition characterised by daily news about quarantine, vaccination and covid positives? I will analyse few aspects, and it may take me few blog posts. In Part 1 I will cover the preparation phase and a general analysis and commentary of the medal table. In other parts I will delve into some results/trends and specific sports aspects as well as covering some elements related to Sports Science.

“For the first time, Olympic teams will not have their families and fans travelling to support them in Japan, adding more complexities to the dynamics usually observed at the OGs. Mental health will affect the ability to perform of athletes and staff.”

(Cardinale, IJSMPF, 2021)

I will start with the self quote. Getting to the games was not easy for anyone. Different countries experienced different periods of closures of sports facilities since January 2020, cancellations of events and challenges with travel. Just look at the data of some European nations (below from my opinion paper) to see the challenge experienced by athletes and their coaching staff. On top of that, you had athletes that struggled to chase qualification opportunities with many being cancelled worldwide and exposure to COVID quarantine, isolation, repeated testing regimes and challenging travel conditions. This was not easy for anybody. To add more complexities, the impossibility for families and fans to travel and the strict quarantine requirement represented a high risk situation, which I knew would create additional challenges to mental health in the ‘pressure cooker’ of the Olympic bubble.

Unfortunately, as I anticipated, I was right, and issues about mental health became prominent as soon as the games started also because of some high level athletes reporting publicly their struggles. At least, this OG will be hopefully a catalyst for change in the way athletes, coaches and staff are dealt with not only at the event itself but in preparation for and after the event. While the focus seems to be mostly on athletes, it is important to recognise that they are not the only ones struggling, they have a lot of people working for/with them which are under pressure and experience high levels of stress also because in many countries failure might mean job losses and financial consequences. I conducted a study during the Olympics in London 2012 with the support team, analysing perceived stress and general health and I can tell you that quite a few individuals do struggle in big events and there are rarely support systems in place in many nations to look after overworked, tired and stressed individuals. I might write more on that in another blog post but this is definitively an area I want to do more research on as I feel that coaching staff at times is neglected. On the athletes’ front, I am happy to see some new initiatives of value. For the first time in fact, I have seen the performance decompression initiative from the EIS for Team GB, and I think it is an excellent idea which I hope many athletes, coaches and staff will use. Post-games blues are not uncommon as already reported elsewhere, and I think in too many cases there is limited duty of care for athletes following the games and definitively almost none for staff. Also, nowhere I have seen considerations for the ‘ones that don’t make it’ to the games, and recent happenings are a sad reminder that we should not forget the athletes that don’t qualify, get injured, don’t get selected as well as the staff that is told that they ‘will not go to the games’. If we as a sporting community are finally openly talking about mental health for athletes, let’s have the same conversations for coaches and support staff. Elite sport is not for the faint hearted and it involves a lot of stressful exposure all culminating in the Olympic bubble, which at times I have described as the village of losers since most of the athletes getting in the Olympic village go home without a medal. I believe that success in sport can be achieved also by looking after athletes and staff, and recent public reviews of many sports programmes around the World are telling us that more needs to be done to safeguard every individual working in Sport.

COVID and the Games

As the games started, it was clear that many athletes had to drop-out due to the covid rules. Pretty much every nation had to deal with athletes and staff being dropped from competition due to a positive covid test and/or quarantine/isolation requirements. Some high profile cases did cost medals to a few nations, and while some seem to be genuine ‘accidents’ in some cases you really wonder how naive the athletes were in attending large gatherings before flying to Tokyo and/or how badly planned their travels were. Everyone had to deal with the ‘Playbook‘ which established the rules and regulations for COVID testing and quarantine. While I believe the rules are very clear and helped everyone in managing the situation, I think that in some cases decisions did not follow current evidence and I agree with the views expressed by my colleague and friend Dr Schumacher who is much more qualified than me in matters of infection control. Hopefully there will be lessons learnt and better policies will be developed for future events for as long as we will be dealing with COVID. The Global Health effort was immense during the Games and final data will come soon. For the moment, I think this event can be used as a model for future large sporting events.

Here is the IOC press conference on COVID at the Games.

The Medal Table

There were high expectations for Japan, due to the announced ambition of the host nation of a target of 30 Gold medals made in 2019 (one year before the original dates). The host nation boost has been well reported over the years and it is expected for a host nation to win more medals than in previous games. You can read an interesting article on The Washington Post here, and see all the data about medals of previous host nations. Few nations seem to be able to be consistently on the ‘up’ on the medal table at the moment, with Japan being one of them and NZ with a consistent growth. Important to note the fact that Team GB seems to be holding well from hosting the games in 2012 and possibly being the only nation to maintain similar leve of performance 2 editions after the home games (more on that later).

I have built a dashboard on Microsoft Power BI (by the way, did I say how wonderful this software is?) to follow and analyse results as they came and it is available clicking on the link below.

The Power BI report is available here

There are plenty of visualisations for the medal table and analyses of really high quality available for free on the web.

I suggest the work done by Gracenote (you can check their widgets here), the excellent work of the amazing data journalist @amyborrett available here, a nice dashboard available here, a tutorial on using R to visualise Olympic data, some great ideas here on Flourish and an amazing list of Viz options here. Last but not least a brilliant ShinyApp here.

But before going into some nuances, it is important to say that thanks to more new sports added and increased competitiveness, more nations have won medals in this edition. 93 NOCs have in fact won at least one medal of any color in Tokyo. Some curiosities: San Marino won the first medal (they won 3 in the end!), Philippines, Bermuda and Qatar won gold for the first time entering the special club of a small pool of nations able to win at least one Gold medal at the Olympics.

The US topped the medal table again, followed by China, with Japan in third place with 58 medals won (27 golds, so not far from the ambition). Australia made it back to the top 5, ROC is on the way down also due to the current Doping related bans (but I am sure there is more to discuss about this!). Team GB lost two places (due to the number of Gold Medals compared to Japan). Netherlands, France, Germany and Italy complete the Top 10 of this edition. Data on medals per capita are available here and here.

USA top medal table again

Many nations have benefitted from multiple medal winning athletes in events where this is possible (e.g. Swimming, Gymnastics, Athletics). And the US swimmer Caeleb Dressel was the most successful athlete with 5 Gold Medals continuing the tradition of multi-medalists in US Swimming.

Tokyo top 10 athletes

World records were broken 22 times in this edition, with most records beaten in Track Cycling.

where world records were broken

So, lots of exciting things to talk about when ‘dissecting’ the medal table, looking at specific events and commenting on different nations’ results.

Stay tuned for the next parts!

Data and Dashboards Part 2

Following up on my previous post on sports technology I have been using and data visualisation/analysis platforms, I want to share more information about various data visualisation options I have come across recently.

Anybody involved in sport at any level is now recording some data in training and/or competition thanks to the smartwatches most people wear, mobile phones and related apps and wearable technologies such as rings and bracelets capable of recording various aspects of performance.

In recent months, the Oura ring received a lot of attention due to its implementation in the NBA bubble. The ring is capable of measuring activity, sleep and heart rate variability by means of pulse oximetry. You can read the PhD thesis of Dr Hannu Kinnunen here. I met Hannu years ago when working on a project with Polar on the RS800 and he always had some creative ideas about wearable technology and algorithm development, so I am very happy to see his product getting so much attention. I don’t wear rings, but it is definitively on my list to try it.

The other wearable receiving a lot of attention is the whoop strap. Similar technology in a bracelet format. Validation studies are starting to be published, and it seems that Whoop is reasonable in measuring sleep as compared to polysomnography. It seems to be quite accurate also in assessing heart rate and respiratory rate.

Thanks to improvements in data processing of mobile phones and quality of sensors placed in them, there has been also an increase in the development of apps capable of assessing ‘readiness’ to train by measuring heart rate variability parameters. As a long term user of the HRV4 training app, I can say that this simple tool developed by Dr Marco Altini is fantastic. Pretty accurate as indicated by validation studies and now well used in the field (see an example here and one here) it provides good quality data in a simple manner also with the possibility to monitor different athletes with the coach app. Marco has really done a great job with this app, and the data generated are useful to drive programmes also with athletes coached remotely. His latest work (the Heart Rate Variability Logger app) to estimate the aerobic threshold non-invasively has been recently featured in the British Journal of Sports Medicine. I have not downloaded this app yet, but will do soon as I plan to run more and want to use the data to drive my program, hoping that the calf muscles behave.

I have tracked morning Heart Rate data for a number of years now, and can say that for me it is a way to track training and non training stress very well. Alterations in morning Heart Rate and HRV indices are affected by many factors, however form my own personal experience, I know that when HR is high and RMSSD is low, there is something brewing and I need to put the foot off the pedal. In 2017, Xiao Li and her colleagues at the Snyder Lab at Stanford University published a paper showing that tracking heart rate among other physiological signals in daily life can give warning of sickness onset. It’s a great paper, based on a careful examination of data from over 250,000 daily measurements among 43 people. Fascinating paper which shows how, thanks to technology, we are moving towards the ability to be able to truly personalise health and training interventions also form remote by having relevant data to use. There are now a number of studies recruiting individuals worldwide to share their wearable data to understand more about flu and COVID-19 symptoms. One of them is here https://quantifiedflu.org and it is using data from a number of wearable technology. If you are interested, have a look at the page and take part!

On a personal level I am very interested in using my scientific training to answer personal questions, and I really like this framework recently proposed by Gary Wolf and Martijn De Groot which was based on a previous attempt by Li et al. more than 10 years ago (see picture below).

A Stage-Based Model of Personal Informatics Systems by Ian Li, Anind Dey, and Jodi Forlizzi

As indicated in my previous post, one of the challenges to the use of multiple technology platforms is the ability to put all the data in the same place and be able to visualise them to make inferences. I have shared some examples before, but what is truly missing is the ability to simply visualise everything you measure without using time consuming processes involving downloading of data in .csv format and/or complex API connections, hours of R-coding and expertise in various domains. Thankfully, there are some free solutions appearing which are promising and can provide simple ways to integrate data.

The first one I want to talk about is the Habit Dashboard. This personal health analytics platform integrates data from multiple apps and allows the user to access a comprehensive view. Both the graphic and tabular formats are good and data streams sync very easily.

There are also alternatives like building your own dashboard with Google (see how to import Strava data in Google forms here), Grafana (link here) and Power BI (link here).

Last but not least, an excellent tool developed by John Peters in collaboration with Prof. Stephen Seiler to be able to analyse endurance training sessions and competitions. EnDuRA (Endurance Durability and Repeatability Analyser) can be found at http://endura.fit and you can import Garmin data (FIT and TCX format activity files either as .FIT.TCX.FIT.GZ). And if you want to read more about the concept of ‘Durability’, this recent review is a must read for anybody working with endurance athletes.

New tech, data and dashboards

I have been playing with new technology recently and wanted to share some of the experiences. Also, I have been looking at the usual issue of visualising data from multiple sources and identified few open sources/free resources which may be of interest for people training for specific events and/or coaches trying to look for solutions to help their athletes.

Let’s talk about technology first. I was able to try a continuous glucose monitor (CGM) few months ago and I found the experience very interesting and helpful in modifying some nutritional habits.

Thanks to https://www.veristable.com I received a free CGM and was able to use the VERI app to track my sugar levels for 14 days. [Disclaimer: I am not involved with a company and I have already disclosed I received the sensor and app for free as a trial user].

What is a CGM?

A continuous glucose monitoring system, or CGM for short, is a small device that continuously monitors your glucose levels in almost real time.

To use a CGM, you need to insert a small sensor the size of a coin, in your arm. The sensor has a tiny cannula penetrating the top layer of skin that is able to sample glucose concentration. An adhesive patch holds the sensor in place, allowing it to take glucose readings in the interstitial fluid (the fluid that surrounds cells in the body) throughout the day and night.

A small transmitter connected to the sensor allows the system to send real-time readings wirelessly to a mobile phone to display and record your blood glucose data. Some systems come with a dedicated monitor, and some now display the information via a smartphone app. 

If you want to see how you can wear such a technology, see the video below.

I did wear the sensor on my left arm.

Wearing the CGM sensor on the left arm

The app works really well and to sync data you just need to get your phone close to the sensor to download the data. I managed to use it while swimming (with a wetsuit since it was winter here, so the sensor was covered but it is water resistant), running, biking and/or in the gym when lockdown rules allowed.

Here are a few examples of how my glucose levels change with food

Classic Italian breakfast with Cappuccino and croissant triggers a bit of a higher glucose response
Sugary cereals and cappuccino (with no sugar) definitively need review.

I analysed a lot of food choices and also checked my levels on long rides playing a bit with my on bike nutrition. This is definitively a useful tool even if you are not diabetic if you are training for an endurance event and want to know more about optimising your nutrition, in particular in between training sessions or on long rides/runs.

If you want to read some science about it, this paper on CGM measurements during Ultramarathon is definitively a must read as well as this paper on CGM measurements and individual responses in exercise-induced hypoglycaemia.

Being exposed to the heat while training here in Qatar quite a lot, I also bought a Core Body Temperature Monitor. This is a thermal energy transfer sensor (details here https://corebodytemp.com/blogs/news/the-technology-behind-core-thermal-energy-transfer-sensors). I can see the data in real time on my Garmin bike computer or Garmin Fenix watch and it helps me with managing how I am coping in the heat (I don’t do well in the heat…). The kit was reviewed by DC Rainmaker before (link here so you can read the details), validation studies not there yet (here are links to the validation page of the company) and I plan to take a core temp pill to check it out in the next few weeks. It looks promising, however I would really like to see how it behaves with temperature change, also, quite expensive, but if accurate enough, it may be a good gauge on hot days.

Here is what happens on a 65Km ride in the heat with two water/cooling breaks (temperature reached 38degrees Celsius that day!).

Heart rate and Core temperature recorded in a 65Km ride, note the two water/cooling breaks at km32 and 45.

Finally, I have been looking at dashboard software solutions mostly to better visualise my data but also to look at options for remote monitoring of athletes.

The first is Intervals.ICU which integrates very well with Strava.

The other one is Runalyze, which I am using to look at my running activities. This dashboard/analytical tool offers some prognostic options (but as usual, not sure how good they are, will need more time and more running to really evaluate it, so wish me to stay injury free as long as possible to test it).

I have been playing with a few more, I will share them in my next post.

Stay tuned.