Take 12 Weeks Off And Come Back Stronger?

Consider the following scenario. You have trained well and have just taken part in the Swimrun World Championships. You then take 12 weeks off from training. You resume training again for 12 weeks and tests show your VO2 max levels exceeded those just before you took 12 weeks off. 

Too good to be true? Can a long break be that good for you? 

A French exercise physiologist and triathlete Romuald Lepers agreed to take 12 weeks off deliberately (for the sake of science) and allowed himself to be tested. With his colleagues' help, he underwent a whole bunch of tests straight after he competed in the World Swimrun Championships in 2022. After that he rested for 12 weeks and the tests were repeated. He then resumed training for 12 weeks and repeated the same tests. 

The results were published in 2 different journals last year showing what happened when you lose and then regain fitness, raising a possiblity that perhaps a long training break is actually good for you.

The first published article documents Leper's changing fitness. After 12 weeks of rest, his VO2 max measured in a treadmill running test dropped by 10.9 percent. In a similar test on an exercise bike, it dropped by 9.1 percent. That's a big drop equivalent to about 15 years of normal aging. For reference, Edward Coyle's famous paper from 1984 saw a 16 percent drop in VO2 max after 12 weeks of laying off training.

Here's the surprising good news. He gained 5.5 pounds of fat and lost 4.6 pounds of muscle during the 12 weeks rest. After retraining, he lost 9 pounds of fat and regained 2.4 pounds of muscle. His body fat levels  went from 10.1 percent to 13.3 percent then to 8.4 percent. A net loss of 5.7 percent at the end of the experiment. 

Cycling VO2 max levels

After 12 weeks of training again, his VO2 max did not just recover, it was better than before he stopped training (5 percent higher). The running test was 4 percent higher than before. In the cycling test it was 6 percent higher (pictured above). 

The fat loss will explain some of the improvement in his VO2 max as it is calculated relative to body weight, so losing weight can create the 'illusion' that you get fitter without changing your oxygen processing abilities. However, his overall oxygen processing capacity did improve, independent of his weight.

Another possibility documented in the second published journal is that something changed in his muscles making them more responsive to training. Lepers had muscle biopsies (ouch - they are very painful!) at each stage to measure the chemical changes occuring. Fast twitch muscle activity was ramped up during detraining while aerobic capacity and mitochondria function decreased. Retraining mostly reversed those changes and in his case resulted in better than baseline muscle properties.

Now, Lepers is an accomplished triathlete. In his younger days he placed in the top 150 at The Hawaii Ironman World Championships. At the time of the study, he was 53, training 10-12 hours a week and consistently placing near the front in his age category in Ironman 70.3 races. Lepers has trained consistently for more than 3 decades, and never missed more than 2 weeks of training at a time previously. 

Sounds good so far? Leper's results also seem to line up, declining with detraining and impoving to be even better with retraining.  If you're in your 20's, you can take 12 weeks off, train hard again and definitely regain your fitness and more. This case study suggest the same can be true in your 50's.

Note that this is just a case study, where n=1 where we may not get the same results as Lepers. This is different as missing 12 weeks through injury since you may not be able to start training full on especially if surgery was needed.

So here are the not so good bits if you read both articles in detail. Leper's cycling efficiency went down and his running economy worsened. He did not recover the muscle mass he lost and that is worrying (note to self : need to maintain strength training). Fortunately for him, his race results in the following season with similar with the previous season. Actually I thought that was remarkable given the fact that he took 12 weeks off.

I really liked Leper's experiment since I am in the same age group as him. Many of my older patients and friends take shorter and less frequent breaks from training because they are afraid they will lose their fitness from too long a break. I am definitely in the same boat. Now we can all be less paranoid about taking long breaks from training. Even if I do not get better than before, just the fact that one can get back to your previous level is reassuring enough.

Reference

Lepers R, Mater A, Assadi H et al (2024). Effect Of 12 Weeks Of Detraining And Retraining On The Cardiorespiratory Fitness In a Competitive Master Athlete: A Case Study. Front Physiol. DOI: 10.3389/fphys.2024.1508642.

Zanou N, Gremeaux V, Place N and Lepers R (02024). Cardiovascular And Muscular Plasticity In An Endurance-Master Athlete Following 12 Weeks Of Detraining And Retraining: A Case vStudy. JCSM Comm. 7:82-90. DOI: 10.1002/rco2.93.

The Rise Of Padel

Picture from Temple of padel

Recently I have treated many patients who play padel and got injured. I think padel is definitely the latest 'flavour' of the month.

What is padel? It is a sport played with rackets that combines elements of tennis and squash. It takes place in an enclosed court (pictured below) about one third the size of a tennis court. Similar to squash, players can bounce the balls off the walls of the court allowing for rebounds. 

Picture from Demeco et al (2022)

Padel was invented in 1969 by *Enrique Corcuera when he and his wife Viviana were in their new vacation holiday home in Acapulco, Mexico. To pass time, the wealthy couple began throwing a ball at the wall and Viviana quickly fell in love with the easy version of the game. Enrique got builders to build a 20m by 10m cement court against the backdrop of the Pacific ocean. 

The court was closed completely to prevent the balls from falling outside due to the unpleasant memory Enrique had while attending boarding school in England. He said he suffered from being in the cold while looking for balls that fell outside the school court.

Over time glass walls and artificial turf replaced the concrete so spectators could watch the game.

Padel racquet picture from Decathlon

Played mostly in doubles (although singles can be played), with solid stringless racquets(above) and a similar tennis ball but with less pressure. Players serve underarm and the ball must bounce once before being returned. The scoring system is similar to tennis.

From the patients that I have seen, there has been little evidence of play patterns and training regimes. It is a high intensity intermittent sport with less demanding requirements when played in recreational settings, which can hide the risk of injury.

The majority of padel injuries I have seen are mostly in the lower limbs. Padel players usually have to shift their stance and require strong leg power to shift the upper body quickly. Achilles tendon injuries and ankle sprains are common when the patient executes a quick change in direction.

There were also upper limb injuries affecting the shoulder and elbow. This is not surprising due to the nature of overhead strokes (e.g. smashes). Since the court is smaller, this increases the frequency of shots taken. This greater repetition of the abduction-extention movements of the arm would explain the upper limb injuries.

A Swedish study (Thornland et al, 2021) suggested that the smaller size court along with the proximity of the players, the size and speed of the ball and the unpredictability of ball bounces would increase the risk of injuries.They proposed the use of protective eyewear.

Viviana Corcuera believes padel took off quickly because it can be enjoyed by the entire family. Grandparents can play with their children and grandchildren which brings the family together. There are estimated to be over 30 million players worldwide. 

Perhaps padel may even surpass Hyrox in terms of popularity in Singapore. This is my prediction for this year. Let's see ....

References

Demeco A, deSire A, Marotta N et al (2022). Match Analysis, Physical Training, Risk Of Injury, Risk Of Injury And Rehabilitation In Padel: Overview Of The Literature. Int J Environ Res Public Health. 19:413. DOI: 10.3390/ijerph19074153

Thornland C and Jakobsson G (2021).  Eye Injuries Related To Padel. Lakartidningen. 118:21001. PMID:34156668

*In the 1960's and 70's, Acapulco was a major destination for Hollywood's stars and that is probably where padel's popularity with celebrities began. Even the American diplomat Henry Kissinger played when he visited as did many high profile visitors. Prince Alfonso developed a passion for the game in 1974 after holidaying with the Corcueras. He built 2 padel courts in Marbella, that's how the game crossed the Atlantic.

David Beckham, Serena Williams and even French President Emmanuel Macron consider themselves fans of padel. Meanwhile in sunny Singapore, Ronaldo and two of our ministers share a padel moment.

Picture from the Daily Mail