Join the team as they dive into the complex world of event sports medicine with guest Dr Darren Green. The team talk about the complexity of setting up a medical facility for major sporting events while tackling the challenges of extreme weather, hydration, injuries and cardiac incidences. Dr Green explains how medical teams work with event organisers to ensure competitor safety and gives practical advice on how participants should look after themselves to ensure they don't end up in a medical tent.

There's also a detailed discussion on the infamous 'Bum Clinic' used at the Absa Cape Epic so be warned that this podcast does include some graphic content.

Dr Green heads up the corporate events department for Mediclinic Southern Africa, which entails oversight of all medical support to major events, setting up the pre-hospital and field hospital infrastructure with niche expertise and ICU capability in remote sites.

Dr Green functions as the Chief Medical Officer for many international sporting events including the World Cup Rugby Sevens, British and Irish Lions tour, Cape Town Cycle tour, Epic and Cape Town Marathon. He is an Alumnus of the University of Stellenbosch, where he completed both his undergraduate degree in Medicine and four years of postgraduate training in Neurology and, more recently, finished off a master’s in Sports and Exercise Medicine at the University of Stellenbosch.

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It's a heart-to-heart on Spotlight today, as Gareth and Ross kick off by discussing a Discourse question about whether running marathons is bad for your heart? Ross describes five cardiac "risks" that have been documented, giving context and a bit of reassurance in response to theory that excessive endurance training is damaging to heart tissue. We then talk about maximum heart rate, and why it's an imperfect anchor for training prescription and a poor comparison between people. We shift from heart to brain to briefly discuss whether coaches should be sanctioned when players tackle poorly in rugby, and end off with a brief look at two teen phenoms competing in Australia last week, wondering whether their trajectories are inviting unreasonable pressure at too young an age.

Discourse

As always, Spotlight is inspired by your engagement in our Discourse community, and you can become a member by visting the Patreon site, and pledging a small monthly amount that gets you access and an opportunity to engage with, and learn from, fellow listeners.

Show notes

• Ian's question about heart risk from marathon running, and some excellent Discourse replies - Members only
• The research paper on troponin elevation after marathons, which kicked off the Discourse discussion at the front of today's show
• Good insight and discussion on whether too much exercise is bad for you?
• Here's that article i mentioned where Tim Noakes punched some holes in the theory that marathon runners would be protected against coronary artery disease
• Ultimately, sudden cardiac death in marathon runners is rare. Here's a review that explores just how rare, and explains the risks
• A Discourse thread on max HR and why it's a limited anchor and set ceiling for training prescription and management
• Here's a paper that describes that sub-max HR test that can be used to identify training adaptation, overreaching and early signs of illness by looking at HR recovery after exercise
• Compound Score revisited and re-explained - following last week's Spotlight, Ross shared more thoughts to explain the Compound Score. Here's that article, available to all, but initially on Discourse
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It's a bumper Spotlight in a bumper week of big sports news. To cover it comprehensively, Ross & Gareth are joined by Sean Ingle of The Guardian to discuss the election of Kirsty Coventry to lead the International Olympic Committee. We explore her path to victory, enabled by Thomas Bach's support, and how she might lead the organization through looming challenges, including the integrity of the IOC's bid/host city selection process, and women's sport. On the subject of women's sport, Sean also chats to us about World Athletics' announcement that it will introduce pre-clearance screening for athletes wishing to be eligible for the women's category. It's a move that forms part of Sebastian Coe's declaration to 'doggedly' defend women's sport. We explore how sex screening works, and issues it may raise, and solve.

We then shift to cycling to discuss a remarkable Milan-San Remo performance by Tadej Pogacar, showcasing superiority and versatility not seen in cycling for a very long time. It tees up the compound score, accounting for power output and performance in both absolute and relative terms. A few odds and ends thrown in wrap up a big show.

Show notes

To become a member of Discourse and be part of the conversation, including driving the content of these shows, here's your link to Patron (no wait, it's Patreon). A small monthly pledge gets you access to Discourse, and a whole lot more discussion that might make more sense than the pod! (sometimes!)

• Article by guest Sean Ingle on the big issues facing Kirsty Coventry as she enters the IOC fray
• Another by Ingle, this time on the process and dealings behind the IOC Election, including Thomas Bach's role
• Article on Sebastian Coe's announcement of World Athletics' introduction of pre-clearance testing for female eligibility
• Some analysis of the power numbers at the Milan San Remo race, as discussed on the podcast. Take the estimates with a pinch of salt - the high speeds introduce a lot of error
• Brief abstract that introduces the Compound Score in cycling, and how it has the best predictive power for race results
• More comprehensive research article on the compound score (needs access to journal for full read)
• The paper asking the question about "lactic acidosis", to which we all should know the answer
• The answer to the lactate question

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In this Spotlight, Gareth and Ross kick off by looking back at teen sprint phenom Gout Gout's latest performances, which continue to project a spectacular yet unknowable future. Across the Ocean, a young South African put down a teen-sprint marker of his own with a sub-10s performance, and we use those performances to discuss the nuanced, fluid and undefinable element of super-talents in sport. What matters, what doesn't, what is required for entry into the elites, and what makes a difference once there?

We also discuss whether the addition of the Sydney Marathon (among others) to the prestigious World Marathon Majors dilutes their equity, which presents a chance to discuss heat and performance related to both marathons and the currently ongoing Cape Epic. Finally, we chat concussion in the community game, in the aftermath of some misinformed perspectives raised by politicians in the UK about the concussion risk with lower tackle height in the game.

Show notes

Mel Breen wins the 2012 Stawell Gift race from scratch

Bayanda Walazas asymmetric running style

Discourse is our VIP community, and if you'd like to be a part of that conversation, receive Gareth's Caught my Eye newsletter, and to interact with fellow listeners, the way to do it is to check out this link, and become a patron of the podcast for a small monthly donation. Thanks for all your support!

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In this week's Spotlight, we swing the light from cycling to doping, via trans news updates and some success stories from our Discourse members. We kick off with a chat about whether we've been too obsessed with power numbers, and not talking enough about speed, as pointed out by Christoph Roodhooft of Alpecin's pro-cycling team. We discuss what it means to be an "economic cyclist", which allows Gareth to propose the concept of "physiological frugality", which we are 100% sure will take over from "durability" as the next-big-thing in elite cycling by 2027!

We also chat briefly about positive fuelling experiences shared with us by Discourse members, who've managed to push their energy intakes up thanks to the experts we've heard from on the pod. We check in on some controversial topics, including the transgender athletes in sport debate, where a new paper, a legal decision and an imminent IOC election are all in the spotlight, and finally, we briefly discuss Shelby Houlihan's own words about her doping defence in an interview with Letsrun.com.

Show notes

As mentioned, Discourse is our VIP Community where you can share bicarb recipes, tales of fuel success, and a whole lot more! You become a member by pledging a small amount on Patreon, which you can access here, and that will give you access to all the chat and sports science insights from members.

Links

• The GCN segment discussed on the show, giving rise to Gareth's concept of "frugality"
• The Handelsman & Bermon paper that is discussed briefly
• Full Decision in the Hamilton vs Telegraph press complaint
• This is the full, in-depth analysis I did for Letsrun on the Shelby Houlihan decision, including the wrong application or misunderstanding of the Technical Document, and the carbon isotope ratio analysis that refuted Houlihan's arguments
• The interview Houlihan did last week with Letsrun, as alluded to by Gareth in the podcast

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On today's Spotlight, we ask why runners are racing faster than ever? The same could also be said of cyclists, and we use an intriguing article by Amby Burfoot to explore and discuss the possible contributors, ranging from super shoes to the "Bannister effect". It leads us back to ground we've covered before (shoe tech, carbs), some areas we have yet to cover in detail (bicarbonate), and down some dark alleys that may contain the future (and possibly present) of doping methods.

We also talk about technology in sport, and about which sports have seen the biggest, fastest leaps as a result of innovation, taking a quick tour of some other devices that have 'recalibrated' sporting performances and human limits.

Finally, we discuss some of the science and performances in the Zwift Academy 2025, the latest iteration of a competition to identify and recruit aspirant cyclists into two professional cycling teams. We explore the tests used on the show, their value, and how hugely confounded the talent prediction is, even in a sport as measurable as cycling.

Show notes

As mentioned, Discourse is where it all goes down, and here's where you click to become a member for a small monthly donation. Sign up as a Patron, and you'll have access to this community, and all the fascinating insights shared by fellow listeners

Links

• Sean Ingle's article on that four-minute mile projection
• Amby Burfoot's intriguing thought experiment canvassing opinion on what is driving faster running performances
• The paper mentioned on the show describing novel drugs to "manage classical heme disorders" - not a huge leap to performance enhancement, but the molecular switch approach to doping may be a concern
• The podcast we once did on technology in sport - includes klapskates, swimsuits, and bicycles
• The BBC article on the increasing prevalence of obesity and overweight
• The Lancet study described in the BBC article
• The first episode of the 2025 Zwift Academy, the rest can be found on the same channel
• Some normative power output from elite men, and elite women's cycling. Compare yourself to the pros. I'll put the summary tables up on Discourse for members

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In this Spotlight, Ross and Gareth become "bros" to discuss and critique a recent paper that forecasts a sub-4 min mile in women (specifically, Faith Kipyegon) if drafting strategies were improved. Ross explains his skepticism and reaction to straw man arguments in media about the paper, and the framing of the seven second improvement required as a "mental barrier". This ushers in a new segment for the show, "Grinds my Gears!".

We also learn from a Discourse member, @pauliuspeciura, about how to execute a textbook heat adaptation strategy for a race he participated in recently. We talk about the physiology of heat adaptation, and how to implement a downscaled, but necessary approach to heat in your next race. We also briefly touch on two bits of news, one concerning an increasing lack of physical activity in children in the UK, and other a peculiar, though not unique, explanation for doping contamination in the recent case of triathlete Imogen Simmonds*

*Ross mentioned a USA Sprinter who was cleared of a positive drug test after using "passionate kissing" as a defence. That was Gil Roberts, not Derrick Brew as mentioned (article link below). Roberts, incidentally, got cleared of this positive result in 2017, but then had another doping violation in 2022 (16 month ban) and then another in 2023, and is now serving an 8 year ban!

Show notes

Spotlights are inspired by Discourse, and then the discussion continues there after! If you want to become a member of that community, here's the link to Patreon, where you sign up, and then it'll direct you to the Discourse Platform where the floor is yours!

Links

• Article in the Guardian that talks about the decline in numbers of PE Teachers in Britain
• A paper in the BJSM on the physical activity issues and the need to optimize social factors
• Imogen Simmonds' post on the doping positive for Ligandrol. Time will tell whether there's more to it
• The news piece on Gil Roberts and the passionate kissing defence
• Discourse Member Paulius Peciura discusses his heat adaptation strategy and race outcome here - Note: Discourse members only
• The paper analysing Kipyegon's World Record, postulating the sub-4 is possible with a massive 75% drafting benefit
• The New York Times piece on the sub-4 theory that contains the quotes that ground Ross' gears!

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Dr. Stephen Seiler is arguably the world authority on endurance training, and popularized the concept of polarized training. But a new paper has revealed some fresh insights into training polarization which suggest that the training structure may only be suitable for certain types of athletes. Enjoy this deep dive into one of the most-discussed endurance topics as we break down the theory, look at the results of this ground-breaking systematic review, discuss how the results can inform training protocols and what future studies are needed. Seiler is an exercise physiologist and Professor of Sports Science from the University of Agder in Norway.

SHOW NOTES

THE PAPER ON Training Intensity Distribution Intervention will Produce the Greatest Improvements in Maximal Oxygen Uptake and Time-Trial Performance in Endurance Athletes? A Systematic Review.

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This week's spotlight turns to the indoor tracks and roads of the world, as we discuss the continuing recalibration of running performance. Every USA Men's Indoor distance record was broken in the course of a week, with two world records among the performances. One of those world records didn't last the week, as Jakob Ingebrigtsen broke it in France. Then on the roads, Jacob Kiplimo took the half marathon into a new galaxy with a sub-57 performance. The two-hour marathon is now clearly within reach. Gareth and Ross discuss those performances, and inspired to some Discourse, look back at a 2008 paper that analyzed race-horses and greyhounds to make predictions about how fast humans can still run. We check in those predictions to discover how shoe tech has moved some events ahead of the curve.

We also shine one last Spotlight on the Janik Sinner three month ban, elaborating on a few matters that arose since our previous emergency Spotlight, and explain why some of the vilification of anti-doping's process may be unwarranted, and in some instances (Tim Henman!) completely detached from reality!

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For more conversation and insight, join our Discourse community where fellow listeners, experts and enthusiasts offer thoughts and opinions on this issue, and many more sports science topics. Membership requires that you become a Patron of the site, here, with a small monthly pledge to become part of our VIP community

Show notes

The Mark Denny study using horses and greyhounds to predict human limits, as discussed

The Iga Swiatek Reasoned Decision, where Points 40 and 41 explain No Fault and Utmost Caution principles

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Dr Joe Warne is a former international athlete and the key instigator of the Sports Science Replication Centre at the Technological University in Dublin. Having also worked as a performance coach Warne has spent hours both testing and working with modern tech devices with a key interest in finding out how reliable and trustworthy the data is. In this interview, the team discusses the metrics you can best trust, how to interpret the data you get correctly, and what the future of wearable tech and exercise data could be.

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