Bartecchi: Enhancing athletic performance

Whether it’s to improve athletic performance for health reasons or for acquiring trophies, prestige or wealth, ScienceDirect journal notes that one of the most sought out endeavors within the athletic community involves identifying variables that foster enhanced athletic performance. The journal article notes that an individuals physical attributes are important, as are environmental factors (accessibility to gyms, family support, quality coaching, proper diet, etc.). Also important are some psychological factors such as confidence, competitiveness, aggressiveness, determination and the commitment to practices, hard work and sacrifice.

However, athletes at all levels would like to have shortcuts that would allow them to attain their goals with less effort. Acclaimed tennis player, Novak Djokovic , during a shirt change at the recent Wimbledon final, was found to be wearing a chest patch (Taopatch). Science Times magazine notes that a review of the mechanics behind the “nanopatch” by the debunker Harriet Hall, MD, suggested that the patch was “pure pseudoscience gibberish.” Djokovic has also supported other pseudoscience and wellness trends.

Kinesio tape, since its arrival in the mid-1970s, those colorful tapes have been noted on a variety of athletes covering a variety of areas of the body. The USA Track & Field Association is surprisingly endorsing kinesiology tape to improve cell oxygenation. Scott Gavura, BScPhm. Notes that in spite of its use by amateur and pro athletes, despite multiple debunkings and successful class action lawsuits, it is still popular with some athletes.

Cupping, a form of alternative medicine in which glass cups with suction increased inside by heat or pressure, are placed on the skin at areas of injury or soreness. The suction creates blemishes/bruises on the skin which is purported to stimulate “energy flow”. Olympian swimmer Michael Phelps popularized the treatment at the 2016 Olympics, according to Dr. Nick Tiller, a researcher at the Institute of Exercise Physiology and Respiratory Medicine at Harbor-UCLA Medical Center. Cupping hasn’t been accepted by conventional science and medicine, and when tested in controlled studies, has not been found to work. I, personally, have viewed cupping treatments during my many medical visits to Vietnam and agree with its lack of any effectiveness other than the possibly of a placebo effect.

Cryotherapy – Dr. Tiller describes whole-body cryotherapy as the theatrical pretense that is at least part of the appeal - athletes probably feel rather special stepping inside a tub worth a quarter of a million dollars. The major premise of this treatment is that it facilitates recovery by constricting the body’s blood vessels and reducing blood flow to inflamed muscles and joints. Tiller feels that whole-body cryotherapy is expensive, largely unproven and a potentially dangerous intervention that detracts from more effective and economic forms of recovery.

Electric muscle stimulation (EMS), according to Dr. Stiller, is when muscles are made to contract involuntarily, on the premise that they can be trained without the time or effort usually associated with “working out”. Soccer star, Cristiano Ronaldo, is its brand ambassador. Tiller notes that there is no evidence that EMS is effective in the absence of use of accompanying, regular strength training. There is also risk of illness or injury with these devices, according to the FDA.

Beet juice, also known as beetroot juice is the example that I will use to cover and expose the unbelievable number of supplements found on the internet, in newspapers, magazines and on TV, that claim to enhance athletic performance, almost all of which have little if any consistently proven value, proof of safety or FDA approval.

According to the US Dept. of Defense, Nitric oxide is a gas that is naturally produced in the body, that increases blood flow by relaxing blood vessels. Because of this effect, it is commonly claimed to be present in pre-workout supplements that promise to boost strength and endurance. However, these supplements cannot contain nitric oxide because it is available only in a gas form. These supplements actually contain “nitrates” found in amino acids. Beets are commonly used to provide nitrates in these supplements, in a powder or liquid form. Researchers at Penn State U. did not find the improved muscle oxygenation during exercise did occur during the consumption of nitrate-rich supplements such as beetroot juice. Also, an article in RunnersConnect magazine mentioned studies that claimed that beetroot juice had no effect on 3 different groups – cyclists, kayakers and runners.

Alice Glass, MS, RD, CSSD, sports dietitian at the U.S. Olympic Committee recommends “staying clear of any supplement that advertises to be a nitric oxide booster.”

Research on whether nitrates can really improve performance is mixed according to the U.S. Anti-Doping Agency (April, 2022). In adults it has been unable to fully prove whether nitrates can truly improve performance in any measurable way. Studies on this subject have been “problematic." In spite of recent over-enthusiastic praise, for beetle juice’s ability to boost physical performance and stamina, by the Cleveland Clinic, which has a history of support for alternative medicine treatments. Lesser devotees to alternative medicine treatments haven’t been as supportive. For those who might like to take advantage of foods rich in nitrates that may offer slight improvements in oxygen uptake and muscle efficiency, they might try arugula, celery, carrots and rhubarb as well as beets.

On the positive side, Alice Glass states that caffeine can be beneficial for athletes who tolerate it well, but is against supplements or energy drinks which often fail to provide the actual caffeine dose and often, energy drinks can contain hidden sources of caffeine or other stimulants. While caffeine can be safe, it can be abused and lead to cardiac side effects according to the Journal of the European Society of Cardiology.

Dr. Nick Tiller suggests that there is little doubt that the culture of high-performance sport may be allowing pseudoscience to breed unabated, generally unchallenged by athletes, coaches and scientific support staff, all on the justification of important placebo effects. The worldwide health and wellness industry, worth an estimated $4 trillion, has become a breeding ground for pseudoscience and quackery according to Dr. Tiller. For those interested in further reading on this subject, I would recommend the book by Dr. Nick Tiller – "The Skeptic’s Guide to Sports Science," which scrutinizes the health and fitness industry.

Dr. Carl E. Bartecchi, MD, is a Pueblo physician and clinical professor of medicine at the University of Colorado School of Medicine.

This article originally appeared on The Pueblo Chieftain: Bartecchi: Enhancing athletic performance