https://doi.org/10.36866/pn.86.33

Q&A: PN speaks to… Steve Ingham

As Head of Physiology at the English Institute of Sport (EIS), Steve Ingham’s job is to apply physiological knowledge to the elite performer. He has previously worked towards the Sydney, Athens and Beijing Olympic games with the likes of Sir Steve Redgrave and Sir Matthew Pinsent as an applied practitioner, before taking over the Head of Physiology role where he and a team of 16 hands-on physiologists work to hone the performance of athletes across a variety of sports from track and field athletes, rowers and cyclists.

Which sports do your team focus on and why?

The EIS has a whole host of science and medical teams working with almost 1700 athletes across many sporting disciplines. From the judo team, which, as a contact and combat sport, prioritises physiotherapists and strength coaches, to archery, which depends heavily upon biomechanists to look at technique. My team work predominantly with the ‘top five’ physiological sports – swimming, athletics, triathlon, rowing and cycling. We focus on these, as our ability to have an impact and improve performance is far greater than for sports that are determined by technical skill or strength, or that are relatively low intensity.

What was the Institute of Sport set up to achieve?

Sports science delivery has been around for 25 years or so. The forefather of the Institutes of Sport was the British Olympic Medical Centre at Northwick Park Hospital, which was set up by Craig Sharp and Mark Harries – the Centre was established in response to the Los Angeles games in 1984, where it was deemed that the medical support for athletes was insufficient. By the mid 90s, there was a systematic review of the UK’s provision towards performance sport, which identified that our provision for high-performance sport lagged behind a number of other nations. After a wave of political discussions the Institutes of Sport were set up, first in Scotland then Wales and Northern Ireland, and last online was the English system which has networked sites across the country, the three main sites being Bisham Abbey, Loughborough and Manchester.

How has sports science or exercise physiology research, and how you apply it, changed over the years?

Sports science is a relatively embryonic discipline that is progressing and evolving very quickly. There have been a number of system changes over the years; at the beginning it was very much research oriented, where Olympic athletes were seen as somewhat of a curiosity, with unusual physiological function behind their ability. We weren’t really geared up to apply physiological research at this time as the basic knowledge was lacking. Sports-specific ergometry and testing systems soon followed in order to acquire ecologically valid and meaningful data.

It hasn’t been until very recently that we have really found our feet and that the sports themselves are recognising the innovations and the real performance differences that can be made with our input. The EIS had to really prove itself when it first started out in 2002, which it did in the run-up to the Beijing games where 100% of the UK Olympic gold and silver medallists were supported by us.

How has the focus changed from understanding the basics of athletes’ bodies to application of that research knowledge?

The balance between research and out-and-out support has shifted over the years. Physiological knowledge as it is published in the literature and reported in exercise physiology textbooks, is not based upon elite observations and so what might work as a training intervention for sedentary people or diseased groups won’t necessarily translate to someone who is already doing 20 plus hours of training each week. Applying what seems to be fundamental knowledge blindly or incorrectly to these groups is where scientists became unstuck very quickly in the early days.

You really need to work with an athlete, to understand the nuances of what, for example, high-intensity, low-intensity training, recovery or adaptation can do for them. Things have changed a lot, we [exercise physiologists] are now embedded within sports and are able to talk with a greater degree of confidence. We don’t necessarily call on a swathe of ‘elite literature’ in the decision-making process – we are much more dependent upon our own measurements. But these observations provide really good, objective data which enable us and the coaches to evaluate progress, and through deductive reasoning or first-principles physiology, to change strategy.

You say you are now ‘embedded’ within sports – do athletes welcome the possibility you offer them in improving their performance?

We have to make the case for ideas. If you have somebody who is on a course for an Olympic games, the pressure associated with performing in a final and perhaps potentially achieving a medal-winning performance is very high. Athletes, through time and learning, become very selective. Through the inevitable series of wins and losses, comes a predilection on what has been performed in the past that led to previous performances. In the past we, the scientific community, have been guilty of throwing up ideas which have no real relevance or that haven’t been tested with elite athletes and pushing them in front of coaches – ‘It’s the next big thing, it’s the next breakthrough’ – but they have not always come to fruition, so there is an understandable degree of cynicism. I don’t think it’s overly arrogant for an athlete to say ‘I’m the only one in the world who can triple jump 18 metres or throw my body over a bar 2 metres high, so is this idea going to work for me?’.

We have to have a good idea: for example, when telling an athlete to stay hydrated when they want to stay light, does not necessarily make sense. The concept of threshold training is one particular example (the point at which lactate and associated acidosis begins to accumulate in the blood, with increasing exercise). According to the research done on this area, this intensity is very potent at improving fitness. For years and years sports scientists have been prescribing this type of training – but the reality is that elite athletes use threshold training very little indeed – if you do too much of it, it can lead to excessive fatigue. Before introducing an idea to athletes we ensure that we have really explored their application. Have they worked in other sports? Is evidence anecdotal or are there field-based measurements? Then you take it to the coach and the athlete – that’s when the discussion and brainstorming can begin.

These days, most coaches are equipped and educated to understand our world; however, communications skills are key in order to describe our proposals in very basic terms and then progress the technical explanation if needs be. There is no guarantee though, even for the most legitimate idea. We need to be prepared for a coach or athlete to reject it if it does not fit in with their programme.

There’s also a time and a place. Right now we are in the last phase of the Olympics and Paralympics, so this is not the time to is say ‘Let’s scrap that and try this!’. Change and innovation are best placed in the post-Olympic period – when we have two years where we are trying and testing new ideas. The third year is refining these plans and in Olympic year there should be very few changes in strategy – just a bit of fine-tuning.

How do you develop your ideas? Do you cherry pick published research to see how it may work for elite athletes?

There are two approaches to it: the interpretation of new breakthroughs and the testing of coach’s ideas. It has been described in Darwinian selection terms where a coach and athlete are continually trialling and testing, accepting and rejecting practice and developing their system through trial and error. If they do a session too many times or if they over-work a certain component, that idea gets rejected from the practice pool fairly quickly, as they start to fail. If a coach says ‘what about this?’ we can go back to biological first principles to assess whether it makes sense or not, is it stressing the body in different ways? Then we can trial it for a period of time to get some measurements and reassess to see whether it has improved certain physiological capabilities.

The other approach is the interpretation of new breakthroughs, new data that are reported. There may be a nugget of information that might make sense – it might have some emerging responses from sedentary or recreationally trained athletes, so we can trial that. Looking beyond the P value is another aspect of using research. It is unconventional but it is actually at the very heart of applying knowledge to elite athletes. Just because P, for example, might equal 0.08, it doesn’t mean that it not relevant, it just doesn’t comply with pre-set alpha levels of probability. We need to interpret results and see whether we could use it as a concept; for example, scientific studies are looking for a large percentage change, but in elite athletes, we are looking for very small percentage changes, but we are looking for those changes to aggregate over time.

Has funding increased to reflect the increased dependence in sports science and what it can offer?

Following the announcement in 2005 that London would be hosting the Olympic and Paralympic games, £600m was made available for the preparation of the teams. The last cycle (four-year period running up to the games) for 2012 has had £300m invested; an unprecedented level of funding in the UK – but this doesn’t just cover science provision, this covers everything from athletes equipment, to their training facilities and everything in between. We traditionally work in cycles, working up to a games and then afterwards we stop, re-breathe and go again, but now we are starting to plan much longer term, which is the first time in my experience we have been able to do that.

The good news is that UK Sport – in looking for a legacy to the London Games – has secured similar levels of funding towards Rio 2016. This will hopefully prevent the ‘drop off’ in performance seen by host countries such as Australia and Greece in previous years.

Do you think London hosting the games has inspired more to take up exercise physiology?

Sports science is one of the most popular courses at university. Approximately 15,000 undergraduates come out with a sports science or related degree each year. It is a very multidisciplinary degree combining science, mathematics etc., and graduates are very employable.

The funding that comes in to sports and exercise departments is predominantly around exercise sciences – looking at diseases, cardiovascular risk factors etc., in order to see how exercise can improve the outcomes for these groups. Very little if any real funding is looking at elite groups. For us, it is a shame that no-one is properly funding this, as it means we don’t have the knowledge base, which is essential to drive our high-performance agenda. It also means that sports science graduates aren’t necessarily equipped to become sports scientists – so we certainly have trouble recruiting (although admittedly we are looking for a very small proportion of people from the overall pool), we struggle to find scientists with the vocational skills of working with athletes. Most courses aren’t really developed to be vocational which is something to be lamented.

Do you think this might change after the Olympics?

I don’t think it will be the Olympics that initiates a change – employability and student fees will drive it. A number of universities have approached me to look over their courses as they re-validate them to make them more applied, but that is three, four, five years down the line.

What discovery has changed sporting performance the most?

There isn’t a single discovery that has changed the landscape. There are many areas of interest that we think could have a large impact on performance; however, for whatever reason – logistical issues or means for testing – they just haven’t, yet. In some cases it can take a long time: one example that we’ve been working on for about ten years now is the concept of manipulating warm-ups prior to an event. At the beginning of the 2000s, it was clear that ‘priming’ the system could improve performance. However, coaches and athletes were and are very protective of warm-ups – they don’t really want to be tinkering around with them. There was a reluctance to change their practice.

We then observed what different groups were doing and found that sprinters were warming up in similar ways to endurance athletes – which didn’t make sense. We received some funding to do research – to trial different warm-ups. We were able to study high-calibre elite athletes in a performance setting – a time trial – coupled with measurements of the underlying physiology. The data really spoke for themselves; priming improved 800 metre running performance by about 1% – which is a very large margin for a high-performance athlete group. We put that in front of coaches and they immediately responded primarily due to the respect of the calibre of athletes involved.

The practice of priming the warm-up is now embedded in all of the physiological sports – cycling, swimming, rowing, etc. As a practice change, it was held off and resisted for a long time – but just that one study has led to a much higher-level conversation with coaches. Our job is sometimes a tricky sell, but with some good data behind it, we are able to apply it.

Is scientific intervention spoiling the concept that sporting achievement is based on natural ability?

There is something that appeals to us about pure effort as opposed to over-engineered sports. At the heart of any sport, athletes are running and jumping about, and we are cheering about it. It’s fair to ask whether we should be ploughing the resources into something more worthwhile. It is an idea I wrestle with.

I think we have a natural impatience for progress – that is the heart of it. We have a yearning for progress and continual improvement. Humans have this inner tendency to want to see our tribe do better than the next tribe. There will always be a natural competitiveness between groups, which is probably why we, as nations, are so immersed in it.

Yes, we are focused on sporting achievement, but in doing so we are not only advancing the boundaries of human performance, in doing so we are understanding how the body and mind respond to work and stress. That, as a celebration of what we know and how we are progressing, I think, is just as meaningful as us going to the moon – as a means of discovering many other things.
In the future, I think you will undoubtedly see a much greater ‘performance culture’ coming to Olympic and Paralympic sports, and this will filter down to all sports.

I think the notion of sporting competition with a purely level playing field is a redundant point – attempting to ensure everybody is treated with the same conditions in each country, in a sterile environment, give athletes the same shoes and the same running surfaces and so on. It is both unfeasible and undesirable to most, and as much as science can give advantages there is also an element of levelling the playing field with science. Ultimately, you will always get people who dominate and they will dominate independent of science. When I had the honour of working with Redgrave and Pinsent, they were just phenomenal – they were going to get a gold medal independent of science input, I am sure. Usain Bolt doesn’t need an aerodynamic suit, he doesn’t need that level of advantage, he will still win with a flappy vest! And that is the beauty of it. People can transcend human performance with pure natural talent.

For more information on the EIS, visit: www.eis2win.co.uk.