The Missing Piece in Designing Your Training Program – the Autonomic Nervous System. Part 2: Assessment

In our last installment, we reviewed the mechanistic effects of both good and bad autonomic balance. We discussed how constantly leaving your athletes in a state of sympathetic dominance will cause your training program to underachieve and absolute level results to decline either acutely, chronically, or both.
Here in part 2, we'll elucidate assessment strategies for ANS balance. For the coach or clinician, some methods are highly practical while others are a bit more complex. For the sake of practicality we'll stick with the “low tech” versions I believe will fit most people’s setting best.
Breathing Assessment
As was mentioned in part 1, respiration maybe our only conscious link into autonomic functioning. So why wouldn’t we invest time into getting it right? Breathing includes both biomechanical and biochemical interactions. The latter may consist of laboratory assessment as we’d mostly likely have to monitor CO2 levels to ensure the athlete is only breathing with the requirements of metabolism during a given task and not overbreathing. The former however is much simpler in that biomechanical respiratory mechanics are much easier to assess. In fact, Patrick Ward has already done this for us:

 
Autonomic Assessment
To be clear, our current understanding of ANS outputs in terms of assessment is still equivocal. More research is still needed. Neurocardiologists, exercise physiologists, coaches, and others have collaborated for years on the best way to assess and regulate ANS outputs in the sporting context. Since the ANS regulates a number of biological processes, it only makes sense that those same processes are what we monitor to give us insight into and ultimately manipulate, ANS functioning. This is called biofeedback and it’s an area where we could easily spend quite a while doing multistep multivariate assessments in a laboratory. Some of the most technological methods include blood work, heart rate variability, baroreflex sensitivity, and blood pressure analysis. Although it’s healthy to appreciate what’s out there and to know there’s always something better, I’ll just get right to the simplest method that my colleagues and I have found most objective and useful. Please note that there are no universal rules here. The finer details do not matter as much as the consistency of the data you collect and apply to your training program. I deem the orthostatic heart rate method to stand above the rest in logistical and monetary practicality. Below are step by step instructions for taking an orthostatic heart rate (this is best done in the morning after waking):
          Lay supine and relax for 3-10min (logistics will determine how long you spend here)
          Record heart rate for 1min
          Stand up
          Wait 15 seconds then record heart rate for 1min
          Plug both readings into the following formula: (StandingHR SupineHR) = #
          Compare the end result to Vladimir Issurin’s recommendations:
o   0-6bpm fluctuation in waking hour heart rate is normal.
o   6-11bpm change means you are not recovered completely
o   11-16bpm changes means you are really not recovered and need rest
o   16+bpm change means you are overtrained
Again, there’s no unequivocal way to test this though some biofeedback markers are better than others. Methods like temperature (www.biodots.net), respiration (www.t2health.org), and estimated HRV (www.BioForceHRV.com …wwwwwwww) can be used as well although you should be fine with the method I described above.
Now What?
So, once you’ve established the client/athlete does in fact present with dysfunctional respiratory biomechanics and/or an increase in sympathetic tone we need to program specific initiatives that will elicit a specific adaptation to various bodily structures and systems. Effectively, staving off the negative implications discussed in part 1 of this series. Stay tuned for part 3 as there are a number of practical options to choose from.

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8 Comments

  1. Thanks for the info coach.   I agree that the ANS is key to performance, but I also believe that it will only tell us CAPACITY.   Agreed, that if your sympathetic is ramped up too far (or you are really really parasymp)-you have issues, but it will still only guide us as to the AMOUNT and INTENSITY of work–not which exercise to do on that day.     So I would be interested in may a part 4 on how you would select an exercise for a particular day/athlete.

    Have you use the HRV app from ithlete?
    I look forward to part 3 and your approach on what to do on training days that are "recovery" based.
    I believe that biofeedback/autoregulatory training is the best way to go by far.  I've been using this approach for about 3.5 years now and it is amazing.
    Rock on
    Mike T Nelson PhD(c)

  2. I’m waiting for the ithlete to come out for Android at the end of this month but I am aware of its use. Very practical.

    As for the capacity vs. exercise selection comment I disagree and a agree. Relative to respiration there’s certainly a number of specific exercises we can program from the get go to stave off biomechanical and biochemical ills. The part I agree with you on is that ANS biofeeback, such as orthostatic heart rate, is simply a guide to alter or elimate the training stress that day.

    Additionally, another perspective is that instead of looking at the assessments results acutley we could act a bit more prophylactically and program “recovery sessions” over the long haul that will enhance parasympathetic capacity (think: cardiac output training and increased left ventricle diameter). I believe enhancing an athletes ability to recover will certainly effect the ANS. Part 3 to come!

  3. Don't know where the other post went…I actually do 🙁
    Here are some other ways to consider in assesing the ANS:
    Morning heart rate variation. If your waking pulse is +-2-3 beats off your normal, then you are fine. If it is +5, then you are tired, if it is +10 you are overtrained.
    Morning grip strength – if it's 5% less then you are tired, if it's 10+% less then you are overtrained.
    Also found at Thib's work at T-nation.com:
    Heart rate after cold immersion: This is another effective way of clueing us in on the status of our nervous system (specifically its excitability). It consists of comparing two different heart rates one after the other. You take the first one sitting down (relax for 1-2 minutes before measuring your pulse). 

    Afterwards you dip your right hand up to the wrist into very cold water and keep it there for 45 seconds. You then immediately take the second measurement. Finally, calculate the difference between both. 

    A sympathetic nervous system with normal function should lead to an increase in 4-8 BPM under cold conditions. If the increase is above 10 BPM, it indicates sympathetic overactivity which might mean a potential basedowic overtraining state (too much high intensity work). 

    Post-workout heart rate: After a training session, heart rate should gradually go down toward baseline level. One hour after a workout, a 10-20% elevation compared to resting heart rate (RHR) is desired. 

    If the heart rate is more than 20% above the RHR, it indicates that the workload was excessively stressful on the body and nervous system. If the heart rate is elevated by less than 10% above the RHR, it means that the workload for the session was below the capacity of the body to tolerate training and that future workloads can be higher if maximum results are desired.

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