Common sense makes a comeback
Surprising findings at the Silicon Valley Health and Performance Summit
|Henry Abbott||Dec 10, 2019|| 7||1|
BY HENRY ABBOTT
The cutting edge of health and wellness has always been home to kooky ideas and unstudied claims. More than from snakes, snake oil comes from slimy salespeople in this exact business sector. So maybe there’s reason to raise an eyebrow at something called the Silicon Valley Health and Performance Summit, which was put on by Sparta Science last Friday.
But it had promise: Sparta’s founder Phil Wagner, M.D. has impeccable credentials and talks with purpose about bringing real science to sports, as did many no-nonsense guest speakers, like science writer Christie Aschwanden; CrossFit trainer, author, and physical therapist Kelly Starrett; and—pay attention, NBA fans!—R.C. Buford, who has run the Spurs through one of the most successful periods of any team in sports history.
The summit was held in a cavernous warehouse where, on most days, elite athletes get high-tech Sparta Science assessments. On this day, the turf was filled with super-fit conference goers. A guy in the third row was a major league baseball pitcher. One of the Sparta Science staffers played professional baseball, too. Posture was generally excellent. Many a business-casual sweater was tested by pecs and biceps.
Uncomfortable in infrared pajamas
Aschwanden, an athlete and science writer, fit right in: she ran cross-country at UC Boulder, where she was also part of a national championship cycling team. Later, in a third sport, she raced on skis in Europe and North America for Team Rossignol’s Nordic team. She writes for FiveThirtyEight and, recently, wrote the book Good to Go, which assesses the science of athletic recovery, using the findings from 1,000 scholarly articles and interviews of 250 people.
Aschwanden took the stage in the morning, to the audience’s left. To the right: Sponsor’s booths hawked Silicon Valley’s widgets and gizmos, many promising exciting-sounding recovery claims. There’s a fancy kind of bed that pumps magnetic charges through your body—they tell me it’s guaranteed to stop your hotel room key from working, and it might also charge you up like a cell-phone battery. If you want a device to track your steps, sleep, temperature, movement, and the like, the Oura ring goes on your finger, the Whoop goes on your wrist, and the PowerDot goes wherever you stick it.
Just 30 miles north of here, the Warriors recently opened a $1.6 billion cutting-edge stadium, which is home to electric NormaTec recovery devices, foam rollers, and a giant cryotherapy area. Aschwanden doesn’t mention all those gadgets by name, but she does use a mocking tone regarding many of the tricks and tools NBA players hold dear. She shows photos of various devices on a slide with Amar’e Stoudemire bathing in wine (which is so absurd that Aschwanden doesn’t even bother to debunk it).
In general, she says, of every device she has studied that purports to aid recovery, “the quality of the evidence is low.” Everyone is polite, but there’s a little tension in the room. Later in the day I heard an attendee use the phrase “the Theranos of sports.” Theranos was Silicon Valley’s revolution in blood testing—the key executives are now facing fraud charges.
This conference is about good science that improves sports performance. The reality is that there isn’t much good science to support almost any of the products that are targeted to athletes. (Except, of course, banned performance enhancing drugs. Hold that thought.) In a way, Aschwanden points out, that is nobody’s fault—it’s a search for small effects in small populations.
Derek Belch, founder and CEO of Strivr, which uses virtual reality to improve training in sports and many other things, notes that most venture capitalists won’t even invest in sports technology for elite athletes. The market is too tiny—there are about 30 big-league teams in each major sport, and they all want the best products for free. Making a difference for cutting-edge athletes could sound like a great way to impress the giant market of weekend warriors, but in reality they have different tastes. Research might show some obscure recovery drink works better than Gatorade, but general consumers just like drinking the sugary brand they know. That kind of stuff happens across the industry. The thing that works is seldom the thing that makes money.
The secret is there is no secret
To be clear: In all of human health, very few things are truly effective when held up to the scrutiny of science. Aschwanden points out many times that “the secret is there is no secret.” But how’s an entrepreneur supposed to profit from old fashioned hard work, vegetables, and a good night’s sleep?
Magic potions might not exist, but the appearance of them leads to profits. Sports science products need to say something to close the sale. I spent a little time on that magnetic bed as I got the pitch about how much energy was in my cells, and how this would make them sing. It sounded like science.
Aschwanden warns against “science washing.” By this point she’s going to town on Patriots quarterback Tom Brady’s lucrative empire of sports products. She holds a special place in her heart for his infrared pajamas. “This, just nonsense,” she says, “to try to make these pajamas seem like they’re worth $200.”
She has tried all the toys—a sensory deprivation chamber where you brine yourself in the pitch black, and the pulsing high-end NormaTec pants that are ubiquitous in NBA locker rooms.
She was surprised by how much she loved those last two. “Here I am in a pair of squeezy pants,” she says, narrating a photo of her NormaTec experience. “I love them,” she says. “I wish I could afford them.”
Those pants allegedly improve circulation, but, she notes, “athletes don’t need that. The reason they work is they make you sit down for half an hour and relax! That works.” Infrared pajamas have similar effect, because of the second word in the name. Put on your pajamas and get in bed. The floating chamber too. At home in Colorado, Aschwanden says she achieves similar results by sitting on the porch and sipping a glass of wine while chatting with her husband, or walking her dog up a beautiful hill.
I bet this Aschwanden statement would start some fights with the obsessive types who dominate a lot of sports training conversations: “You want to do the minimum amount of training that works for the adaptation you want.”
It turns out a big recurring theme of the day is stress. Stress is a vague term that captures both what a hard workout does to your body and, say, the anxiety that Adam Silver says is rife among NBA superstars. It all affects health and performance, though. Another Aschwanden catchphrase: “stress is stress.” That’s why chilling out for a half hour is helpful to athletic performance. We imagine that the demanding part of an athlete’s day is sprinting up hills or weighted lunges. But Aschwanden points out there’s excellent research showing that collegiate athlete injuries spike during finals week. Think about that. You’re worried about a test--so you pull a muscle.
“We are witnessing the devolution of the human body.”
The next speaker, Starrett, makes the profound and wild claim above. Darwin, natural selection, everything we learned in eighth-grade biology … our bodies aren’t doing that anymore?
It’s mind blowing, but inarguable. A room-full of people sitting in chairs checking their phones needs no reminders that we’re not using our hunter-gatherer bodies as designed. We can’t really count on future generations being healthier than we are. When you see children today, do you expect that they are generally more fit than humans of the past?
He asks who in the audience is pain-free. Very few hands go up. What in the hell is happening? He casually drops phrases like “Gordian knot of pain.” (I had to google it.)
I could listen to Starrett talk all day. He has encyclopedic knowledge—doctor stuff, mobility stuff—with a touch of Robin Williams’ manic brilliance. Mostly, he stays dialed into the big mission for a room packed with coaches and trainers: “let’s create stable, robust people.” We are all offending the lessons of the day merely by sitting inside all day; Starrett, to his credit, spent a chunk of the day against the side wall, in the same healthy squat he recommends to his clients.
He has stories galore. One is about major league baseball pitchers who, he says, take 30 milligrams of Adderall in the World Series. It’s a giant dose. After that, they can’t sleep, so they need an Ambien. Of course, over time, they’re far from their best. What a bunch of idiots, right?
Not so fast, says Starrett. “You all do the same thing,” he points out, “with caffeine and alcohol.” I put down my coffee cup.
Starrett has the kind of brain that would love to, in his words, “untangle the complexity of sleep trouble” that inhibits so many of us, including the world’s best athletes. In his experience, the solution hinges on moving more—all the time. Your workout is great. Relaxation is nice. The trouble is that the rest of the time we are too still. “Non-exercise activity,” he says is what we need. Walk the dog. Take the stairs. If you must measure them, try 12-15,000 steps a day, to start.
The research now reinforces a lot of what was once common sense. Eat whole foods. (Or, as he also put it, don’t “eat like a millionaire crybaby teenager.”) And make sure you feel safe and loved. Starrett wasn’t the only presenter to say something like this, but his phrase was that all the things that could be considered “mothering stuff” works.
Stress and inflammation
Jim LaValle—an expert on metabolism—didn’t talk long before he got pretty excited about cupcakes and gummy bears. A few decades ago, just about everyone could eat them. Now a piece of bread or a sip of milk sends people running for the bathroom. Doesn’t it seem like everyone you know is allergic to something these days? What is the story?
“A healthy immune system,” he says, “should be able to tolerate more variety of foods without inflammation.”
There were some aha moments for me around this point. Maybe Aschwanden, Starrett, and LaValle are all describing the same thing. “We have a lot of modern stressors, and we have a paleolithic nervous system,” LaValle explains.
We developed over millennia to cope with very stressful things now and again. Our bodies developed to carry a child over a mountain range, or plunge into the melee of a hunt. We would have a big curve of stress hormones like cortisol. It goes up—stress! But then, if you’re healthy, it comes down. Those big emotional events would be followed by a period of relaxed unplugging. (Steve Magness and Brad Stulberg’s book Peak Performance notes that the elite in almost every field work in an alternating pattern of hard work and real rest.) People spent a lot of time looking at the stars and around campfires. Those are quaint scenes from history now.
In sports, we are amazing at coaching more stress (a dad on the sidelines of our local Thanksgiving 5k to his young daughter, about four seconds into the race: “PICK UP THE PACE!!”). But only the occasional Phil Jackson really coaches the other side of the slope. Find some time to unwind! Meditate! We are suspicious that wanting less stress might be a sign of weakness or loafing. Witness the commentary around load management.
The science of it all was a little intense, but essentially, LaValle said cortisol does important healthy work when it is on the scene for a short time—like a guitar solo. As cortisol goes down, though, other things happen. The chorus of the song resumes. DHEA is part of it. LaValle says DHEA protects our memory, fights inflammation, and fends off colds and the flu. DHEA seems lacking in modernity.
The problem is that stress nowadays comes in many ways, including little bursts all day long. However, we are struggling to get to the second part of the cycle, where chilling the hell out lets the DHEA and its friends do their important work.
The morning after the conference, I noted when I felt amped or had little low-grade fight or flight moments: on the steep part of my morning run, navigating travel logistics on the phone, when the Lyft driver did some exciting driving, when I saw the security line at SFO’s Terminal 3, when I opened the laptop and thought of all the work I had to do, and for sure as the plane bounced in crosswinds on takeoff. Little drips of cortisol, one after the next. All before noon on a weekend day.
Every day is like that for most of us. Without a lovely beach stroll, laughing with friends, that glass of wine on the porch, LaValle says the healthy cortisol curve flattens. That leads to metabolic disorders, chronic inflammation, and maybe cancer. It also makes the best athletes in the world more prone to injury.
Silicon Valley is looking terrible here, to be honest: Ineffective high-performance sports products. “Science-washing.” And on top of that, thanks for the phone in our pocket, Silicon Valley—our cortisol IV drip. Giannis Antetokounmpo says a secret of his performance is that he ditches his phone basically all the time. A few years ago, LeBron stopped all social media and the like for the playoffs. They’re amazing players.
I wonder if, in essence, the iPhone—arguably Silicon Valley’s biggest success—is why sports injuries are up, despite modern advances. And if that’s the case, is this where we should be looking to solve sport injury problems?
The elephant in the room
The whole room was thirsty as hell for a product that—in studies—makes a real difference to running fast and jumping high. There is a proven way to do exactly that: performance enhancing drugs (PEDs). Supplementing testosterone, anabolic steroids, and human growth hormone might not be safe, healthy, or fair—but if the goal is short-term athletic performance, we know it works. And this room full of military and MLB people knew it too. Yet, nobody mentioned these things all day. Which seemed weird.
LaValle has NBA clients he didn’t name. He examines their blood profiles and makes recommendations to improve performance. But he mentioned in an aside that he is “not allowed to test testosterone in NBA players anymore.” That set off alarm bells. If you’re trying to improve a player’s performance, this is an insane limitation. Who would tell a doctor not to test for it? Don’t we have to consider the possibility that the reason you’d ask a doctor not to test elite athletes’ testosterone is that you’re worried about what you might find?
Around then, we notice that Lance Armstrong is here. The elephant in the room is literally in the room. He didn’t talk to many people, but there he was, the disgraced king of all PEDs, sapping the day’s earnest goodwill in his leisurewear-wrapped confidence. It’s not easy to attend a conference with that guy and come away really believing the secret to success is a good night’s sleep and leafy greens. His whole career suggests otherwise—I would argue Armstrong’s still successful because of his doping.
When Starrett says the goal is to create stable, robust humans, I take it that he is subtly taking sides. In elite sports, there are tradeoffs between health and elite performance. In some cases, Armstrong’s teammates had perfectly stable and robust careers as pro cyclists. Then, as told in their confessions to the U.S Anti-Doping Administration and reported in dozens of books and articles, they joined Armstrong and encountered immense pressure to inject EPO or take testosterone pills. One cried before succumbing to the pressure to inject banned drugs. He got faster that day, but not more stable and robust.
Who knows if Starrett spied Armstrong from the stage, but at one point he joked: “Either it’s about creating a circus—let’s enjoy making mutants!—or it’s about making people happier and healthier.”
Safe and loved
Robert Paylor takes the stage in a wheelchair, talking about the Cal rugby game that changed his life a couple of years ago. He was crushed under the scrum. From my notes:
“My face slammed against my chest and I immediately can’t feel anything below my neck.”
“I can’t move. It’s like I’m totally detached from my body.”
“It is happening. It’s the most real thing I’ve ever lived.”
“Am I going to be able to feed myself again?”
His doctors, at one point, told him he might not make it. Now his goal is to walk across the stage at graduation in a few months—he’s getting closer. It was beyond moving. Everything else we have talked about can’t compare. He told a story that made clear this accident made him into a superhero of grit and perspective. He shows a photo of himself covered in wires and tubes. There’s a lot to notice, but Paylor notes “there’s a smile on my face. There’s a decision being made.” Yes it is. Choosing to see the good possibilities is a choice, and is very similar or identical to toughness.
How did he do this? Remember when Starrett mentioned the importance of feeling safe and loved? Paylor mentions a spreadsheet his rugby teammates made so they could take turns walking with him all over the steep, wheelchair-challenging Berkeley campus at all hours of the day. Paylor rehabs in the high-performance gym alongside his rugby teammates. His coach said he will always be on the team.
Of course it’s easier for Paylor to keep fighting when he has all that love around.
Spurs CEO RC Buford talked about how the Spurs pursue things similarly. Only a few minutes in, he discussed the team’s legendary dinners, and how the team dealt with the toughest loss in franchise history. He talked about players connecting in ways that have nothing to do with basketball, about building relationships, about the “growth of a family and support system.” He went on a little detour about the city of San Antonio itself, and mentioned that he loved that people there “allow our players to lead normal lives.”
This is a different value system from most teams. It’s long-term thinking. Just as this conference was taking place, the Knicks fired another coach.
Which makes me think back, over 100 years of science. Why, again, don’t we have the healthier habits of walking everywhere, spending time outside, laughing with friends, building lasting relationships? Why are we devolving?
In no small part because of science. Or, one small scientific innovation after another. The car, the TV, the phone, the instant ramen, the microwave. Untold pharmaceuticals. We are isolated in cages now. Remember those harsh experiments where baby monkeys grew up with no nurturing, and then thrived when people touched them and loved them and cared for them? We’re like those monkeys, and at long last the scientists are saying essentially: get out of your cage, get some fresh air, hug something!
Isn’t it worth pointing out that the only person who ever thought a baby monkey would grow up in a cage is a scientist? Are these leaps forward, or just finally getting back on track after a stupid detour?
My grandmother walked the dogs twice a day, got good sleep, and handled stressful things like raising babies during the rationing and air raids of World War II England. In her old age, she broke her leg walking her dog in the sand dunes. It was some time later that she thought to mention that once she had broken her leg, she crawled miles to the nearest road to flag down a passing car. She could teach many of this conference's lessons.
In the bigger picture, though, we are here now, and we need science. If we’re going to revert to healthier living and restore healthy cortisol curves, we will need data. Should we change the NBA schedule to allow LeBron James more time to walk with his family on the beach? Probably. Will the billionaires who run the league go for that? Not without some freaking evidence.
And, science can claim plenty of important contributions. Retired Major General Spider Marks was the day’s last speaker. He remembered being a high-school athlete during a time before concussions were well understood. “Throwing up on the sidelines, and then going back in.” It was, he recalls, “just stupid.” (He also asked: “What’s the past tense of bullshit? Bullshat?”) That doesn’t happen anymore. Thank you, science.
In a smaller way, I was fascinated to hear the Oura Ring CEO, Harpreet Rai, note that when he attended a conference that involved sleeping outside … all kinds of people had their best sleep measurements ever. Interesting! And, Oura expresses its stats to users in an interesting way that the NBA could really use: A “readiness score.” That’s a great way to look at the world. The right question to ask is, “Is LeBron ready to go today?” Cutting-edge science can help answer that with hard data that modern decision makers respect. But the way to actually get LeBron healthy and robust? My grandma has some wisdom on that.
Coming later this week: A Lonzo Ball mystery.