How to Monitor Athlete Health

Maximizing ROI on invested time for health Geoff Yang (GY): Dustin Nabhan, people investing time in their health goals but not always in the right places. When you work with elite athletes, how do you maximize their ROI? Dustin Nabhan (DN): It starts with quantified goals & rigorous measurement. In professional sports, we don't guess. We assess relevant systems and performance inputs: strength, power, nutrition, recovery, body composition, etc. Then we allocate time and resources to the areas with the biggest gaps. The same logic applies to anyone serious about performing at the highest level. GY: Most people aren't getting that kind of assessment? DN: Right, and that's the issue. You need to set goals, assess where you are, build a plan, and measure your progress. Without that, you're guessing. You might spend 5 hours a week on cardio, but if your aerobic fitness is already in the 85th percentile for your age/gender while your muscle fitness is in the 40th, you're overinvesting in a strength and underinvesting in a weakness. That imbalance may show up as injury, lower energy, lower performance, or accelerated aging in the systems they've been neglecting. GY: That's essentially the idea behind our Healthspan Domains™ model. DN: Instead of treating "health" as one thing, we break it into eight measurable domains: aerobic fitness, muscle fitness, body composition, bone, balance, movement quality, cognitive health, and blood biomarkers. Each domain is scored on a percentile basis for your age and gender. So we’re not comparing a 25-year-old female triathlete to a 55-year old male C-Suite executive. GY: Why does that matter? DN: We’ve seen conceptual curves showing healthspan vs longevity. But the question is: where are you on that curve? How do you go from a subjective assessment, like "I'm in pretty good shape," to something predictive of how you’ll perform and how you’ll age?  When you see you’re in the 83rd percentile for bone density but the 41st for body composition, the conversation shifts immediately. You focus on "how do I move this specific number?" That's a much more productive mindset. GY: So how does this change a time-strapped executive's approach? DN: It becomes a resource allocation problem, which is something executives understand. If you only have 3 hours, invest it where you get the highest ROI for your goals and health. That might be changes in training, nutrition, or sleep.  The domain scores act as a filter. They tell you: here are the 1 or 2 areas where investment will generate the highest return. The Apeiron Life team then builds protocols around those gaps — specific, measurable, time-efficient. Then add optimal frequency and sequencing and multiply it all using technology, supplements, biohacks. GY: Focus moves outcomes. DN: Exactly. In professional sports, we set the goal, measure what matters, focus effort where it counts, and let the data do the prioritizing.  That's how you get the most out of limited time.

🚨 University of Arizona Football | Performance Systems Overview (2022–2023) During the 2022–2023 season, we had the opportunity to build out a truly integrated performance system at Arizona — blending objective monitoring, individualized training, and collaborative decision-making to support player development and availability. Here’s what that looked like behind the scenes: 🔧 System Components – Developed a centralized Athlete Management System (AMS) – Integrated force plate CMJs on GD-2 and GD+1 – Mapped GPS data to every drill in practice by volume, intensity, and density – Built a stoplight readiness model (Red/Yellow/Green) based on force, asymmetry, and wellness inputs – Weekly 1080 Sprint profiling to target individual acceleration deficits and monitor trends 📊 In-Season Monitoring Strategy – Combined neuromuscular data (jump height, RSImod, asymmetry) with GPS and workload trends – Used CV% and SD thresholds to flag meaningful fatigue changes – Adjusted pre-practice prep, lifting intensities, and recovery based on G+1/G-2 trends – Created individual and positional reports shared daily with performance and coaching staff 📈 Results – Logged 31 new top speed records – Saw a 35% reduction in soft tissue injuries with minimal hamstring-related time-loss – Aligned training with the competitive calendar: Winter → Spring → Camp → Season → Postseason – Worked closely with the Performance Director to manage daily decisions around practice structure and player availability 🎯 Takeaway What made the difference wasn’t any one piece of tech or protocol — it was the ability to tie together force diagnostics, GPS load, sprint data, and on-field context into a unified decision-making system. Building that bridge between data and action is where the real impact happens. #SportsScience #AthleteMonitoring #PerformanceAnalytics #SpeedDevelopment #InjuryPrevention #CollegeFootball #ForcePlates #GPS #1080Sprint #SpellmanPerformance #ArizonaFootball

J is a 52-year-old Master's runner who is disciplined, data-driven, and committed to staying healthy and competitive. He recently started a statin after a high calcium score, full preventative cardiac work-up, and strong family history. The labs improved but his performance tanked. Muscle pain, low energy, and a surprising drop in testosterone. As a clinical sports pharmacist, I see this more often than people think. Statins can be lifesaving but in athletes, especially Masters athletes, we need nuance, monitoring, and individualized plans. At his 12-week check-in, he noted that he had deep muscle soreness disproportionate to these workouts, persistent fatigue, decreased libido, and his body just felt heavy and slow. A follow-up lab panel showed something important: Total testosterone and free testosterone had dropped significantly. CK is mildly elevated. Cholesterol and LDL were trending down Statins are lifesaving medications—and for many athletes, absolutely appropriate. But they’re not zero-impact on physiology. Statins can affect mitochondrial function by reducing CoQ10, an important component of the mitochondrial electron transport chain responsible for cellular energy production. In athletes who rely on efficient energy systems, this may translate into slower ATP production, increased oxidative stress, and symptoms such as greater muscle soreness or reduced power output. Muscle-related symptoms, especially myalgias, are also occasionally seen, particularly among endurance and Masters athletes. While many athletes tolerate statins well, others notice changes in recovery, muscle fatigue, or lingering soreness. Cholesterol serves as the backbone for steroid hormone synthesis, including testosterone. In certain lean, highly active individuals, significant reductions in LDL cholesterol may coincide with modest declines in testosterone levels. Steps taken to help J: Switched statin to a lower-myalgia-risk option Added CoQ10/Ubinquinol Assessed training load + fueling (masters athletes often underfuel unintentionally) Monitored hormones + inflammatory markers Discussed alternatives: bempedoic acid, ezetimibe, PCSK9 if needed Reinforced: longevity and performance can coexist Within weeks, the muscle heaviness improved—and most importantly—J. felt like himself again. Questions for my community: 👉 Have you ever had a medication that improved labs but worsened performance? 👉 Should we be screening for testosterone + recovery markers in Masters athletes starting statins? 👉 What tools do you think are missing from the athlete–clinician conversation? Longevity and performance are not either/or. Athletes deserve both. #sportsmedicine #pharmacy #sportspharmacy #mastersathlete #athletehealth

Obsessive HRV Monitoring… Instead of viewing a short spurt of low HRV as a cause for concern or immediately resorting to adaptogens or supplements, ask how is your athlete feeling first—without intervention. In my experience as a practitioner and working on a surgical floor for years, the rule is to “Treat the PATIENT, not the MONITOR.” HRV Can Decrease During the Supercompensation Phase—AND THAT’S OK. Why? ✔️ The body is still adapting and mobilizing resources for repair & growth. ✔️ Sympathetic drive (fight-or-flight) may still be elevated, even though recovery is happening. #gutbrainaxis ✔️ This phase is where gains are made—muscle growth, strength, endurance, and neurological adaptations. What to Watch For: ✅ HRV rebounds after recovery → Healthy Adaptation. 🚩 HRV stays low for too long + symptoms (fatigue, low motivation, poor sleep) → Non-Functional Overreaching or Overtraining. During supercompensation, oxidative stress is part of the adaptation process. The mistake mist people make is blunting it with high-dose antioxidants or IVs (like vitamin C & glutathione) which can reduce training benefits. Instead, support recovery by regulating sympathetic tone: ➡️ Vagal nerve stimulation → Activates the parasympathetic system to balance stress & recovery. (Can do this using a electric toothbrush and stimulating side of the face, cranial nerve X), humming, gargling, breathwork ➡️ Support gut brain axis→ Through probiotic rich foods and supplementation (e.g., Lactobacillus plantarum + Bifidobacterium longum). I would also get curious if there is a pathogen through *gut pro testing”. Inflammation can impact HRV. ➡️ Omega-3s → Seafood (wild caught salmon, sardines), supplementation, this can reduce neuroinflammation, support HRV, cognition, and cellular recovery. #functionalsportsmedicine #gutbrainaxis

Most endurance athletes don’t break down all at once. They drift there—quietly. Performance holds. Wearables look “green.” Training continues. Meanwhile, six biomarkers are already signaling a problem: leptin ↓, T3 ↓, testosterone ↓, estradiol ↓, IGF-1 ↓, cortisol ↑. That’s Low Energy Availability (LEA)—the root driver of Relative Energy Deficiency in Sport (RED-S). And by the time symptoms show up (amenorrhea, stress fractures, hormonal collapse), you’re months late. In our latest research, we break down: • Why leptin drops within 24–48 hours (your earliest warning signal) • Why T3 and IGF-1 are slower—but more dangerous—lagging indicators • How cortisol quietly suppresses recovery and adaptation • And why ~16.5% of male endurance athletes meet criteria for biochemical testosterone deficiency (per Dr. Anthony Hackney) The key shift: from episodic blood testing → continuous physiological intelligence Key Wearables (WHOOP, ŌURA, Garmin, Polar) already capture: → HRV suppression → Rising resting HR → Sleep fragmentation → Menstrual disruption signals Individually? Noisy. Combined + contextualized? A real-time early warning system. This is where the future is heading. A three-tier model: Universal wearable screening Targeted biomarker panels AI-driven integration across physiology, nutrition, and training load → Sensor layer → Intelligence layer → Coach/Practitioner decision support The implication isn’t just for elite athletes. This applies to: • High-performing executives training for Ironman while fasting • Military populations • Corporate wellness programs • Anyone pushing output without matching energy input As Dr. Nicola Keay puts it: the body always prioritizes survival over performance. The question is whether we’re paying attention early enough. 👉 Full article below and here: https://lnkd.in/g64rpyy2 #REDS #LowEnergyAvailability #SportScience #EnduranceAthletes #WearableTech #Biomarkers #Healthspan #PrecisionMedicine #AIinHealth #CorporateWellness

I’ve enjoyed developing this pilot project—designed to test how medical and historical data, when structured and visualized effectively, can inform decision-making for Sports Medicine and Performance teams. Thanks to AI for some randomized data to use in the pilot. Live Video's in the links in comments The attached screenshots are from two dashboards: - Player Specific Heat Map: Looking at individual player trends over time and their injury tendencies, comparing them to the average of the team. Responsive with Tooltips (Tableau) providing deeper insights into individual instances - Team Overview: Looking at the entire team over the course of selected timeframes. Ability to select specific phases of season (Preseason, In-Season) with a date filter and select playing groups (Goalkeepers/Defenders/Midfielders/Attackers) to gain insight into trends at a position-level. This is about more than just injury logs or time-loss metrics. It’s about uncovering patterns, identifying trends, and leveraging context to better support athletes through prevention, rehab, and performance planning. Excited to see where this can go as the profession continues refining how data shapes care, communication, and competitive readiness.

🏆 Maximizing Performance with InsideTracker: A Case Study 🏆 In the high-stakes world of pro sports, every edge counts. That's why one team turned to InsideTracker to optimize their athletes' performance through personalized blood testing. What They Did: Before the season, the team's athletes underwent blood testing to identify key biomarkers. With this data, they implemented personalized recovery and performance strategies. By understanding each athlete's unique biological response to training and recovery, coaches can tailor programs to prevent injury and performance drops. For those athletes out of range, adjustments were made to their training to prevent overtraining and enhance recovery. Who Is This For? This approach isn't just for individual athletes but is invaluable for team staff in Performance, Sport Science, and Nutrition. It allows for informed, data-driven decisions that benefit the entire team's health and performance. InsideTracker's science-backed approach is transforming how teams manage athlete health, proving that personalized data can lead to peak performance on the field, while helping to manage athlete care at scale.

Can Strain Gage Sensors Help Reduce the Risk of Concussion in Contact Sports? Traumatic brain injuries, from mild concussion to long-term degenerative diseases like CTE, are a growing concern in sports, the military, and beyond. Often, the most dangerous impacts go unnoticed: athletes under-report symptoms, signs are missed on the sidelines, and sub-concussive blows accumulate silently over time. That’s why engineers and researchers are turning to smart sensing systems—including those based on foil strain gage sensors—to better understand and manage head impact exposure. Foil strain gage sensors, when embedded in helmets or worn on the body (such as flexible patches on the neck), can measure the forces generated during impact with high precision. While these systems do not diagnose concussion, they can: 🔹 Flag impacts above predefined thresholds to trigger sideline evaluation 🔹 Provide real-time data for screening—not just observation 🔹 Offer feedback that supports coaching, behavior change, and technique improvement 🔹 Help reduce cumulative exposure to sub-concussive impacts across a season Recent studies have validated strain-based sensing systems—particularly flexible wearable patches—as tools for estimating head kinematics and identifying high-risk events. The goal isn’t diagnosis but awareness and early intervention. As researchers refine these systems, and calibration and filtering improve, the path becomes clearer: precision sensors like strain gages can support a smarter approach to athlete safety, where data—not guesswork—guides decisions. Because protecting the brain starts with understanding the forces it endures.