Remote ischemic preconditioning

[Red Rick]

Basically, this is a technique where you put on a cuff and restrict blood flow repeatedly for a few minutes before exercise, and there's evidence that it improves performance, even in elite athletes. I didn't dig too deep into this, but I stumbled upon this in an exercise physiology course. I asked a buddy of mine who knows lots about training and how competitive riders train, and he'd never heard of it.

Do any of you know more of this, and whether this is used in pro sports? Seems like it could be quite good to do before a time trial. Marginal gains and all

http://www.ictherapeutics.com/pdf/St-Michel_RIC_Maximal_Athletic_Performance_Swimmers_2011.pdf

 

[More Strides than Rides]

From a technical standpoint, the study is starting with a big assumption:

Exercise performance in highly trained athletes is limited by tissue hypoxemia and acidosis, which may therefore represent a type of ischemia–reperfusion stress modifiable by RIPC.

It seems like the authors (from clinical hospitals) have a Doctoral understanding of medicine and techniques, Bachelor's Degree understanding of exercise and performance. Performance is limited by the inability of the body to meet the high demand for oxygen, not hypoxemia (low oxygen in the blood). The authors brought up swimming because there is the unique need to hold your breath, but I don't think any competitive swimmer is actually "holding" their breath, or really breathing any differently than a runner pairing their breath with strides, for example. They also made a very loose connection between the kind of hypoxemia that this technique can mediate, and the fatigue in athletic performance. Merely citing Noakes is not enough to say that this hypoexmia is THE limiting factor, expecially when most of his work on fatigue is about other, much bigger limiting factors.

As for the observed performance boost in the trial, that may come down to the constraints of the experiment. Were athletes allowed their normal warm up? If this was controlled, ie: everyone got no warm up, or if it was the same warm up without any intensity, then the stress of the procedure might have been enough to mimic the stimulus of harder surges or reps that athletes do before racing, giving them a boost over the control group. That's just my speculation. (Maybe an analogy I'm trying to draw would be to test the performance benefits of being late to your race: I expect that the hormone response to the anxiety,(increases in blood pressure, heart rate, etc) would mimic a more traditional warm up showing a performance boost over athletes who didn't warm up). There are a lot of things that effect performance, and I'm not sure the experiment here had the best design to isolate if this technique and mechanism was the real source.

EDIT: It's been discussed on the forum before, but this technique might mirror what many Paralympic athletes do before a race. Intentional abuse of paralyzed limbs can still trigger the stress response, without the pain, that leads to a performance enhancing effect. This technique may be triggering that response, rather than the "ischemia–reperfusion protecting factor" being the actual performance enhancing mechanism as cited by the authors.

 

[Red Rick]

Yeah, I thought about the warming up thing a bit. It seems pretty impractical, and it's more clinically (i.e. not this clinic) relevant.

 

[doperhopper]

maybe these yellow bracelets can be used to restrict the blood flow, even during the stage