Pricking up their ears
Now the U.S. is trying to catch up with the Communists on yet another front—sports medicine. This time the front-runner is not the Soviet Union but East Germany, which has made spectacular use of advances in nutrition, physiology and pharmacology to win Olympic glory out of all proportion to its population of 17 million. Taking a dim view of the U.S.'s own sports-medicine efforts, which have run largely to taping ankles and treating the sniffles, the President's Commission on Olympic Sports has called for a coordinated program to "apply lessons of the laboratories to achievement on the field." Our doctors, in other words, must beat their doctors.
The U.S. sports-medicine forces embarking on this mission are fragmented, freewheeling and given to all sorts of conflicting approaches, which are left to coaches and athletes to somehow reconcile. This was evident at the recently concluded AAU convention in Columbus, Ohio, where the agenda included a demonstration of a lactic acid-testing system that has attracted the particular interest of the U.S. swimming community. As explained to coaches and physiologists on the pool deck of Ohio State's new Mike Pepe Aquatic Center, GDR doctors use computerized blood-test results to determine each athlete's most efficient training pace. The procedure is said to have taken much of the guesswork out of training and contributed greatly to the GDR's Olympic successes (40 gold medals, second only to the Soviet Union's 47 at the 1976 Summer Games).
At least five U.S. swim coaches plan to evaluate the East German system this winter and compare notes on the results, though plainly some will do so with foreboding. For example, 28-year-old Mark Schubert, whose Mission Viejo (Calif.) Nadadores are the nation's No. 1 swim club, says he will try the GDR system with some of his swimmers but will also be applying his own "intuitive" judgments. And Brad Glenn, coach of the Huntsville (Ala.) Swim Association, says fretfully, "I'm going to try it, but am I going to panic in midseason?"
This foray into the unknown is loosely orchestrated by Dr. G. R. Greenwell, the 51-year-old chairman of the AAU sports-medicine committee. A onetime diver at the University of Louisville, Bob Greenwell is a trim, garrulous fellow who last year gave up the general practice he had maintained for 20 years in Brandon, Fla. But being a doctor was only one of the things he had been doing in Brandon. He still runs a club for swimming, tennis and diving that University of Michigan Diving Coach Dick Kimball has used for years as a summer camp, training stars like Olympic gold medalists Micki King, Phil Boggs and Ulrika Knape there. Greenwell recently opened a cardiac disease-prevention clinic on the club premises and also owns an 18-hole golf course nearby.
Then there is Greenwell's AAU sports-medicine chairmanship, a position largely overlooked until he assumed it two years ago and set out to make something of it. In September of 1976, Greenwell read an Associated Press story in the Tampa Tribune-Times that mentioned Dr. Alois Mader, who, before he defected from the GDR to West Germany in 1974, had been the top sports doctor at Chemie Halle, home club of now-retired swimming star Kornelia Ender. The story quoted Mader, currently an assistant professor at West Germany's Sports Medicine Institute in Cologne, as saying that in 1973 he had accurately predicted some of Ender's future performances on the basis of blood samples taken from the earlobes.
Anxious to hear more, Greenwell invited Mader to speak at the 1976 AAU convention in Phoenix some weeks later. Mader accepted, and told his American hosts that the East Germans had achieved a breakthrough in training for competition in certain categories of sport, and for stamina development in all sports. GDR doctors had concluded, he said, that participants in repetitive-motion sports that can be programmed to maintain a constant pace, such as swimming, rowing or flat distance running—as opposed to stop-and-start activities like basketball, boxing and tennis—should largely avoid intense, high-speed anaerobic exercise. Anaerobic exertion, because it requires more oxygen than can be utilized efficiently by the body, causes severe oxygen debt. Therefore, in sports where performance is related primarily to stamina, athletes should train primarily in the slower, steadier aerobic range of exertion. The East Germans believed that this shift of emphasis from anaerobic exercise would lead to better performances and also reduce the risk of injury and illness. The trick was to determine each athlete's anaerobic-aerobic threshold.
Mader said it was he who devised the method that the GDR medical sports brass ultimately adopted and use to this day. As Mader explained it, the procedure is based on measurements of lactic acid, which builds up in muscle cells during exertion. (At the 1976 East German swim championships in Berlin, a SPORTS ILLUSTRATED writer watched swimmers being led into a poolside office, where white-uniformed technicians drew blood, presumably for lactic-acid measurements, from the earlobes.) When acidity reaches a certain point, muscles will no longer produce energy. Blood is taken from an earlobe, which yields easily accessible and accurate samples, before a workout and again afterward, at intervals of one, three, five, seven and 10 minutes. The athlete then performs the same workout at a slightly different pace, and another series of blood tests is conducted. The various lactic-acid readings go into a computer, which pinpoints the anaerobic-aerobic threshold and delivers a printout detailing the optimum training pace and predicting the optimum competition pace to be maintained throughout a given race. After the athlete trains at the prescribed pace for a few weeks, his tolerance to lactic acid increases; he then undergoes the blood-testing procedure anew to determine a stepped-up regime. For American athletes, many of whom do a lot of anaerobic work, Mader's message was clear: they are often overtrained.
Greenwell brought Mader back to the U.S. last April to get more details and also visited him in Cologne, where he is still doing research in the blood-testing method. Meanwhile, the AAU's medicine man coaxed the necessary blood-analyzing equipment out of manufacturers and found a computer to use. With Mader as his German connection, Greenwell became an unabashed proselytizer for the lactic-acid procedure.
"Our approach to training has been to go till it hurts and then keep going," says Greenwell. "According to Dr. Mader, the acid imbalance within muscle cells, to which lactic acid is the major contributor, is the weakest link in the metabolic process. When acidity becomes excessive, the athlete can no longer produce energy efficiently, which is why limits should be set on training. All this has long been known to physiologists and biochemists throughout the world, but the East Germans were the first to devise formulas to determine limits. As I see it, this has been a major key to their success."
It is not surprising that the lactic-acid procedure has caused its biggest stir in the U.S. among swim people. They are notably receptive to technological advances—and to gimmickry—and their interest in East German methods has been fueled by that country's dramatic and overwhelming domination of women's swimming. Of course, not everybody is inclined to accept the blood-testing procedure as worth the bother. Despite lactic-acid testing, East Germany's men swimmers have not dominated anyone. "Our men are the world's best, and a large chunk of their work is anaerobic," notes Bob Bartels, an Ohio State physiologist and the school's former swim coach. "Are we supposed to abandon what we're doing, just like that?"
In his eagerness to spread the East German gospel, Greenwell rather tends to oversell Mader's methods. He will carelessly refer to the 43-year-old Mader as the former head of the entire East German sports-medicine program, a considerable exaggeration. He also brushes off other explanations often put forward for East Germany's sporting successes, including advances in selection of athletes, weight training and technique.
One person who is troubled by Greenwell's narrow focus is Dr. Irving Dardik, the New Jersey vascular surgeon who is chairman of the United States Olympic Sports Medicine Committee. The 41-year-old Dardik oversees medical research at the USOC's new training center in Squaw Valley, Calif. (SI, Aug. 22) and Colorado Springs. He has promised thorough research into such matters as blood doping and steroid use, but he declined a request by Greenwell that the two of them collaborate on lactic-acid testing, at least until the whole Olympic program is worked out.
"We do plan to review the lactic-acid business," says Dardik, who has also visited the Cologne Sports Medicine Institute, "but I suspect you can find out the same things by measuring oxygen consumption or running treadmill tests, which we're doing. You can't take one thing and say that's the answer. The guy's a promoter."
To which Greenwell responds, "I don't feel we should ignore other possibilities. Until we test it out, we're guessing. We have followed oxygen-consumption test procedures and tested oxygen-transport capabilities without showing any tangible success. How long will we continue in this one area before we look into other possibilities? I can find more positive results from lactic-acid testing than from oxygen transport. Taking the oxygen measure does nothing to change or improve a training program."
Dardik's approach to sports medicine has also been questioned. He has yet to announce a single appointment to his six-month-old committee, and he will not say how his wide-ranging research is coming or when he is going to announce the results—though, granted, physiological profiles have been compiled on the 500-odd athletes who have trained so far in Squaw Valley, and some intriguing biomechanical work is under way. Included are plans to experiment with Herman Frazier, the 1976 Olympic bronze medalist in the 400-meter dash, as a bobsled starter. "Dardik wants to be the whole show," says Bob Greenwell, counter-punching. "He's afraid that if anybody else gets involved, it will lower the height of his own pedestal."
It was a thoroughly upbeat Greenwell who set out to demonstrate the East German system before AAU convention-goers at Ohio State, where he planned to conduct lactic-acid tests on three Ohio State swimmers. Greenwell drew the first series of blood samples. Unhappily, things went wrong because of the technicians' unfamiliarity with the new equipment, and the tests had to be scrapped. Greenwell shrugged. "At least we showed people how to draw the blood," he said.
The coaches who plan to try the lactic-acid procedure have been scrambling to borrow the necessary lab instruments and computers—all the gear could cost more than $40,000, though the first-stage blood-testing equipment alone would only be around $5,000—and to obtain volunteer technicians. Some critics argue that whether it winds up helping or not, the GDR system smacks of an effort to create bionic athletes. But Mission Viejo's Schubert says, "I think these tests may show that we do overtrain some of our athletes. But then we may be under-training others. The point is: training is an individual thing and this could help us tailor workouts to suit each athlete."
Schubert is a go-getter who was in touch with Mader even before Greenwell came onto the scene. In gamely pushing ahead with the experiment, he evinces the sort of scientific spirit that may keep the U.S.'s budding sports-medicine movement from dissolving. "Some people say the lactic-acid tests probably won't help," Schubert says. "Well, how do we know unless we try? We've got to start testing the validity of some of the things other countries are doing."
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Dr. Greenwell is the No. 1 U.S. proponent of the test, which measures lactic acid in muscle cells.
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