Blood testing is one of the most important ways to improve performance, facilitate recovery, and monitor training. It’s a gold standard that validates, integrates, and calibrates other systems in sports training. Blood offers the ultimate data set, and testing quarterly can change your program. It’s one of my top three metrics for athletic development.
In this article, I explain seven important reasons to begin blood testing immediately. If you’re already doing so, I may expand your options for what to do with your athletes as a result. Most of the research is conflicting on blood analysis because it’s complicated and requires smart interpretation. And taken out of context, blood testing can be a waste of time and money and create additional problems.
What Is Blood Analysis In Sport?
A few millimeters of blood contains an amazing amount of information. While a blood test is slightly invasive, it’s pain-free and very quick, making it a great weapon of choice for better outcomes in training, nutrition, and rehabilitation. Tests draw a small amount of blood, enough to partially fill a shot glass, a few times a year.
The blood is analyzed by measuring biomarkers—measurable substances in the body—in a person’s bloodstream for patterns and reactions from training, lifestyle, and recovery. Some biomarkers represent long patterns over time while others are very transient and won’t show what’s going on with an athlete internally.
Blood analysis requires careful interpretation with clinical reasoning and coaching records to tease out fully the athlete’s information. Some biomarkers, like vitamin D, are easy to work with; others, such as hormones, are less clear and must be interpreted cautiously.
Staff commonly use the results to make better objective decisions about their athletes. By investing a small part of their budget, a coach and support staff can overcome major career issues for their athletes and get results they need.
Blood Tests Encourage Athlete Compliance
Elite sport is a serious business. And while I love working on trust and building relationships, accountability is paramount. Testing an athlete four times a year reveals the truth, hence my tongue and cheek joke calling it truth serum.
The test is not a quarterly punishment. It’s an objective, unemotional athlete assessment. We can learn if an athlete is compliant only when we have objective information evaluating their commitment to our requests to sleep and work hard work in the weight room, for example. Blood testing becomes the judge and jury on the data. This why I love biochemical analysis—it’s a cold and direct process.
The test requires a fasting period, which is easy if you eat your last meal the night before and get tested right before breakfast. It’s a simple but powerful step for an athlete—can the athlete follow directions and show up on time without excuse?Blood tests show a timeline of how responsible one is with their body, says @spikesonly. Click To Tweet
I’ve seen athletes make major life changes because of their test results: very few experiences in life are more revealing. Paired with simple genetics tests that explain one’s ethnicity, a blood test identifies what’s happening at that moment and shows a timeline of how responsible one is with their body.
Blood Analysis Helps Build Personal Connections
After we receive the results, the subsequent analysis requires many follow up questions that are sometimes very intimate, such as talking about medical history and heredity. Blood analysis can build a strong connection; the deep responsibility held by a coach or medical professional is extremely potent.
When a coach and athlete do their jobs, the entire experience involves working cooperatively. When you don’t know someone, learning to trust them and how much they care starts with action. While words are important, effort is powerful. Talking is part of connecting, and taking action follows through on those words.
After the blood test, take the extra step to analyze the data to demonstrate to your athlete that you’re going the extra mile. Athletes notice that extra care means we care. When we play a responsible part in the analysis, even if it’s answering basic questions, we build a connection by giving them the information. The athlete shares information about themselves, and the coach shares their expertise on what to do with that information.
To drive the connection further, show the data to the athlete and explain how the biomarkers trend. This builds more trust and confidence, and the athlete sees that we, who requested the tests, go through the same process. Regardless of which biomarkers we assess, building a connection comes from connecting the dots. And blood analysis does that.
Blood Analysis Increases Motivation
The testing process dissects the body’s internal chemistry into bite-size information that’s easy to understand when presented simply. Seeing the information and linking it to cause and effect can motivate an athlete to push their body, feed their body, and rest their body.Blood test #data shows cause & effect, which motivates athletes to push, feed, & rest their body, says @spikesonly. Click To Tweet
Watching an athlete make simple changes to conventional dietary advice, such as eating the right foods, provides a good example. An honest change in eating habits often shows up on the next blood test. The most obvious scenario is supplementation. If an athlete is low on their omega index or vitamin D assessment, you know they were not compliant.
When an athlete is compliant, and their blood test hits a sufficient range, they’ve achieved a goal and feel motivated to keep going. It’s great for motivating athletes to do things they normally would not do. Blood analysis creates a short- and long-term check and balance system.
Blood Analysis Supports Health, Not Just Sport
When you spend time discussing how an athlete can manage life after sport, you reinforce the trust and connection between you. And while a blood test is not a disease screen, it does give information about one’s health and future medical needs.
A blood test can change a life and may save a life in the long run. In the short run, routine blood testing may catch something before it becomes a deadly problem. Colleges do routine screenings, and while far from perfect, the tests have helped some individuals.
Programs should not rely on routine screening, but avoiding them because they’re not statistically effective rejects the notion that we are caring for people’s health.Periodic blood tests can explain why performance and #recovery are suffering, says @spikesonly. Click To Tweet
For athletes who aren’t interested in the future and have a “win now” mentality, health is a platform for performance. Talking about health is a stepping stone to higher levels of function, like performance. It’s very hard to perform when health is compromised. Periodic blood testing can explain symptoms and problems when performance and recovery are suffering because basics are not optimized and managed properly.
If athletes can’t do the basics, it’s not worth skipping toward performance. Perhaps this section should have started the article as it’s the most important, but it was essential to discuss the first steps of how to connect with athletes.
Blood Test Biomarkers Improve Athlete Nutrition
The biggest challenge with sports nutrition is measuring it and managing it. Unlike coaching, during which a professional is present at the time of creating change, eating occurs away from supervision and support. A coach can oversee weight room and fieldwork, but a nutritionist doesn’t have the same luxury with an athlete’s diet.
Athletes are training on their own when it comes to nutritious diets. Education is important, but it’s the discipline and dedication that makes good nutrition difficult. Even a motivated athlete with good information may need to improve their habits, and blood testing is effective here.
The most direct and well-known step in sports nutrition is blood testing for deficiencies. We currently have multi-million dollar athletes who are impaired because they won’t take a supplement that costs pennies a day. Without naming names, a few programs are not taking advantage of their player collective bargaining agreements to provide blood testing properly. Other teams do amazing jobs and even encourage their athletes to elect to take a step further when required.
Athletes can make dramatic changes in nutrition by repeated testing when we implement the program properly. Nutrients are the easiest to test because the intervention is clear. In most blood tests, it’s easy to see when there is not enough or too much of a nutrient. It’s 2018 and we still see plenty of NFL teams dealing with vitamin D and omega 3 insufficiencies, even though research on injuries is crystal clear. And endurance sports are still plagued with anemic athletes failing to reach their potential.
We can tease out interactions that are more complicated than nutrient deficiencies. Metabolic panels, for example, show trends of the genetics and lifestyle factors that compromise the biomarkers. While it’s difficult to improve some biomarkers, the limits of someone’s genetics are not a major struggle unless they’re related to disease.
I see genetics as the frosting on the cake more than the eggs and flour. We can do a lot with a well-designed diet.
Correct Biomarker Assessment Enhances Recovery
Timing the blood test and choosing the appropriate biomarkers are essential to evaluating recovery. Recovery is not the absence of stress or strain. It’s the improvement of adaptation in the body, which demonstrates successful training. Most blood tests are performed in a futile attempt to detect overtraining or similar issues even though blood tests may not indicate overtraining syndrome. If both performance and biochemical evaluations show poor indices, a relationship may exist, although several athletes have medaled with compromised biomarkers. So why blood test for more than health and nutrition?
We’ll only see recovery when we match training and lifestyle factors and time the test properly. I don’t value research that dismisses the role of training details and nutrition in recovery when the researchers don’t see the detailed training program. I don’t think sport scientists are unaware of this—it’s just that cooperation among everyone is difficult during a study. Even the coaches who want the information sometimes fail to work collaboratively.To check recovery, blood test after the easiest week before working up to the next #loading period, says @spikesonly. Click To Tweet
I suggest testing after the easiest week before transitioning toward the next loading period. This provides the best chance to see if resting levels have been restored. When baseline values are shattered and elevated markers of inflammation and muscle damage linger, the recovery period probably wasn’t enough.
Even with good timing, we need to see the hard training records and testing. Without this practice data, blood tests are crude shots in the dark. Recovery is likely compromised when health data trends down, even if there’s not a medical problem. I don’t use general guidelines from the research because I have data on outside factors like lifestyle stressors and longitudinal data.
Testosterone and cortisol ratios, even free testosterone and other markers, offer starting points, not a confirmation or diagnosis. The number one problem with blood testing is that everyone expects a binary answer when we’re really just receiving extra clues. Regardless, a full panel along with seasonal records is enough to know when rest is adequate and other factors outside the sport may be the culprit.
Blood Testing and Analysis Maximize Performance
Performance embodies more than a list of biomarkers—it comes from an interaction of skill and biochemicals. Blood draws and physiological tests don’t give us enough information to tell what makes an athlete great or how to make an athlete better.
Still, if an athlete is healthy, eating right, and not overdoing their training, they have a better chance to perform better. Every coach wants improved performance, but achieving this requires an athlete who is healthy and mentally ready. Blood testing helps coaches elicit performance when athletes are free of such barriers as nutrient deficiencies and problems away from the track or field. A clean bill of health and perfect scores on blood tests do not guarantee an athlete will reach the podium or win a championship, but it does rule out wellness as a limiting factor.
When the body appears healthy, coaches can push athletes harder, knowing they have some evidence that they won’t sabotage the body acutely and in the long term.The priceless benefit of #BloodTesting is knowing when I can push an athlete harder, says @spikesonly. Click To Tweet
The priceless benefit of blood testing is knowing when I can push an athlete—not optimizing hormones or minimizing stress markers. When data shows that the athlete is free and clear, we have a window of time to push harder when we otherwise may be too conservative.
Other than red blood cell metrics for endurance athletes, blood testing doesn’t connect well with performance related to team and speed and power sports. There is no clear cause and effect with a soccer player or a javelin athlete, for example. But it does help us push our athletes harder appropriately.
A Blueprint for Biomarkers
So I don’t leave you in the dark after recommending biochemical analysis, I’ve created an easy set of guidelines to follow.
Start With the Basics
For an inexpensive start that also avoids pushback, get basic metabolic and CBC (complete blood count) with vitamin D and ferritin tests. Expanding to other markers like additional nutrients, inflammation markers, and hormones requires more expertise and interpretation.
Involve Every Staff Member
Involve everyone in the blood testing process from medical support to the team chef. At lower levels, athletes have to take on more responsibility for their own bodies, and parents can play an important part in the process with youths.
A sport scientist, sports medicine professional, or experienced coach—someone who knows what health norms are for athletes in heavy training— must decide what steps to take after receiving the data. Several athletes have seen electrolytes and creatinine kinase temporarily elevated after heavy training only to have their primary care physicians stop the training due to a possible medical condition.
Combine Biomarkers with Training and Recovery Records
Remember that the best way to work with biomarkers is to overlay corresponding data that may interact with the biomarker data points—this means training and recovery records.
The hardest part of testing is periodic retesting when those involved don’t value the data the first time around. Each subsequent test then becomes a pain or seems unnecessary. Also, some staff members don’t want to be confronted with bad information; changing deep behavior is a struggle and a burden to many, and ignorance is bliss when they’re in a comfort zone.It takes 1 test to screen, 2 to see an intervention, 3 to see a trend, & 4 to see a seasonal story, says @spikesonly. Click To Tweet
It takes one blood test to screen, two tests to see an intervention, three to see a trend, and four to see a seasonal story. Every biomarker connects to nutrition, health, performance, or psychology. When you ensure the data is shared properly (confidentially), an entire team or single coach can easily make the right changes to manage athletes.
My final suggestion is to test yourself. If you’re not comfortable with blood testing, you need to be. It’s powerful and it’s part of fulfilling your responsibilities for athlete welfare. Athlete’s careers and lives are on the line. Blood testing can help an athlete get better in their respective sport, and it’s an important part of preparing them for later in life.
Start Blood Testing Now
Don’t wait for next year, test next week. The easiest way to start is with a routine screening so you can then focus on retesting at least quarterly and avoid the one and done philosophy. Athletes trust their team and private staff if they feel that the people involved can help them.
Expertise is valuable. And even if athletes don’t like you or trust you, they want reasonable applications based on experience. Blood testing won’t turn an average Joe into a pro, but it will end arguments quickly when handled properly.
I’ve used blood testing since the late 1990s and it works. It also requires coaches to be on the ball administratively, requiring us to be vocal and organized. The biggest obstacle to blood testing isn’t the analysis. It’s the politics of who is in charge and who directs the interpretation. Be firm and don’t give up. Even now in 2018, professional teams are struggling to do the basics. Be proactive and firm.
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