New muscle-tracking software provides real-time data on professional and Olympic athletes and is used to improve their competitive advantage. In the near future it could be a game changer for patients recovering from knee, hip or other surgeries that impact their ability to get back in the game of life.
The muscle “fuel” or glycogen level is an important indicator of muscle health and a measurement of the energy that’s available for the body to perform. New technology makes it easier to gather this data and use it to improve athletes’ performance and recovery times. Through a combination of portable ultrasound technology and proprietary software, doctors are perfecting the diagnostic tests for muscle health.
“Until recently, the only way to measure muscle health and energy levels was through muscle biopsies that took weeks for results, ” said John Ireland, director of Performance at MuscleSound. “Now we can take an ultrasound image of a muscle or muscle groups and view data on a monitor within 30 seconds.”
Patented Software Correlates With Muscle Biopsy Indicators
The non-invasive technology was discovered by Iñigo San Millán M.D., and John Hill, M.D. San Millán is a world-renowned applied physiologist, director of the Exercise Physiology and Human Performance Lab at the Anschutz Health and Wellness Center in Denver, a faculty member of family and sports medicine at the University of Colorado School of Medicine and a former professional cyclist. Hill is director of the Primary Care Sports Medicine Fellowship at the University of Colorado, which he formed in 1998. He was one of the first sports medicine doctors in the U.S. to use musculoskeletal ultrasound in his practice and speaks frequently on this topic. He also is a team physician at the University of Denver.
“They [San Millán and Hill] started to use ultrasound to look at muscle tissue during pre- and post-testing of athletes, and believed they were seeing the movement of glycogen, ” said Ireland. “They approached Stephen Kurtz, now chairman of MuscleSound, and the company was founded in 2013.”
In 2014 independent validation studies directly comparing MuscleSound ultrasounds to muscle biopsies to measure glycogen levels were completed at Appalachian State University and the University of Colorado Medical Center. “The correlation came out at 92%, which is extremely high, ” Ireland said. The results garnered the attention of several professional athletic teams, including the Colorado Rockies baseball team and the U.S. Women’s Track Cycling team.
MuscleSound secured three patents from the U.S. Patent and Trademark Office covering the use of ultrasound to measure muscle glycogen and related proprietary software. Company leaders also applied for a patent for technology that uses ultrasound to measure body composition.
All major sports leagues use MuscleSound software, and the company is expanding its use to top fitness and health gyms, as well as European sports teams. The software and portable ultrasound technology is useful for managing soft tissue injuries, ensuring proper fuel for athletic competitions and increasing the speed of recovery, Ireland said.
Measuring Muscle Fuel, Size and Composition
MuscleSound allows users to track glycogen (fuel) and muscle composition so that athletes can perform at their optimum levels. Using a portable ultrasound machine, MuscleSound is able to scan major muscle groups. The images are then uploaded to the cloud. The software is able to focus on isolated muscle tissue, calculate relative glycogen concentration and prepare results, Ireland said.
“The whole test takes about 30 seconds, it’s repeatable and non-invasive, ” Ireland said. “You can see the results on your phone, tablet or computer, download and track them over time.”
MuscleSound protocols are used for eight to 10 muscles, and two muscle groups, in particular—the rectus femoris, gastroc nemius and soleus—which are strong indicators of glycogen movement, Ireland said. MuscleSound will test additional muscles and conduct research as product use becomes more widespread among athletes.
“For example, in baseball we may look at a pitcher and get readings on his flexor muscle group, pitching arm, as well as leg, to get an overall reading on how he is doing, ” Ireland said. Additional types of readings include muscle size and composition. Ultrasound images are captured, uploaded and analyzed to detect fat-muscle boundary and to calculate thickness for each site, body fat percent and lean mass.
Perfecting Performance
Ireland joined MuscleSound in 2013 to do field testing with the Colorado Rockies baseball team. “We’ve learned that glycogen levels are affected by performance, regeneration, travel time, time zone, lack of sleep and physical stress, ” said Ireland.
“As you can imagine, baseball as well as other North American sports teams travel all the time. You are looking at 30, 000 to 50, 000 miles during the course of a season. Travel takes more out of the athlete than we realize, ” Ireland continued.
A glycogen baseline is developed for each athlete, and then athletes are typically tested before a game, a training session, a race, or some other athletic event that requires their peak performance. “Over time, our software is so clever that it will begin to recommend starting levels of glycogen volume for different muscles within an individual. At pre-event, you can have them at their optimum level ready to go. If they are not, and if there is enough time, you can try to influence their levels by giving them a high glycemic product. If it’s two hours or more, they can eat something that can be digested to fill their fuel tank and help with their readiness to perform.”
Going for the Gold
During their work with the U.S. Women’s Track Cycling team, Ireland and staff tracked fuel levels for each racer. The team had three World Cup races prior to the Rio Olympics.
“They were in Columbia in November, New Zealand in December, Hong Kong in January, London in March, and then the Rio Olympics in August, ” said Ireland. “The trip to Hong Kong was 16-17 hours. On our technology we have a symbol like a traffic light that is easy to see, with green meaning ready to go, yellow caution and red warning. We scanned the cyclists close to departure, and they had just come off of a hard training. Just under half of the team’s reading was under red, the rest were yellow and green. On arrival to Hong Kong, they were all red. This was telling. They had to back off of their training schedules, take it easy, and boost their fuel levels to get ready for the World Cup race at the end of the week.”
MuscleSound was one of nine organizations in a technology ecosystem designed to make the 2016 World Champion women’s pursuit team the fastest in Rio. Because of all of the information and training, the women’s team was able to win the World Championship Pursuit in March and became world champions for the first time in U.S. history. “From where they were two years ago, to world champions, to Olympic silver medalists, it’s been a fantastic journey to be a part of that, to be a piece of that jigsaw puzzle, ” said Ireland.
“Over the two years, the team’s race time improved from 4:39 minutes to 4:12 minutes, ” Ireland said. “This is a phenomenal drop in time, due to all of the trials, the abilities to get the right caliber of athlete, the coaching from Team Director Andrew Sparks, and the team chemistry they had coming in to this year. We were able to help them with readiness for camps for training, for racing, helping one or two riders improve their nutrition, their outlook. It’s been a real joy to watch them.”
Tracking Injury Recovery
The combination ultrasound and software technology was instrumental in managing the recovery of two U.S. Women’s Track Cycling Team members who crashed while cycling around the track at 60 Km per hour. “This happened in December, and the world championships were in March, ” Ireland said. “Thankfully, nothing was broken, which was incredible in itself. When I got there, the athletes were all warming up, ready to go into training, and I’m scanning them pre-training to see if they are ready, and one of the athletes scored the worst I’d ever seen on the glycogen fuel test.”
“She got a red warning, down 20-plus points, ” Ireland said. “The head coach pulled two riders out of training that day based on those numbers. It was three days later before they got back in to do a light training session. So, though the athletes each thought they were ready and nothing was broken, I could see from the impact of that crash the trauma and stress their bodies were under, because their glycogen scores had dropped dramatically. They wouldn’t have known that they couldn’t perform.”
Long-term Applications for Surgical Care
Ireland says Musclesound’s software and ultrasound technology has broader application in the field of orthopedics, especially during pre- and post-operative care. For example, a baseline report can be generated from a patient who is embarking on knee surgery. Muscle size, composition and fuel levels can be recorded.
“If a patient was having left knee surgery, you’d want a baseline on that knee, as well as the healthy side, so both right and left quadriceps muscle groups, ” Ireland said. After surgery, additional testing will determine whether muscle health indicators are returning to pre-surgery levels.
“We will be able to do that very soon, by taking circumference measurements off of the ultrasound image and using our software to track this, ” Ireland said. “Better muscle health going into surgery will mean better recovery after surgery. Overtime, if I am not seeing a change in muscle size, shape or score, in terms of glycogen level, then I know that I am not activating that muscle in the way that I want and I have to look at that closer.”
Ireland said the company will undertake a series of case studies on baseball athletes recovering from Tommy John surgery.
