ABSTRACT
Elite aerobic athletes have extraordinary characteristics that allow them to perform at levels not achievable by normal individuals. This chapter briefly addresses the spectrum of factors that contribute to exceptional performance, with focus on the aerobic aspect evaluated in an exercise laboratory. The measurement of VO2 max and the anaerobic threshold (AT) with CPET are the critical variables that provide insight into the state of conditioning that will help athletes in training. The VO2 max in these athletes is usually 65–85 cc/kg/min, and the AT arises at a higher percentage of VO2 max than normal. Training can move the AT to an even higher percentage of VO2 max. The main component of the high aerobic capacity is the high cardiac output with large stroke volumes. The high percentage of Type I muscle fibers in sprint and power athletes will produce very high maximal exercise lactate levels, but muscle fiber type is not related to maximal oxygen uptake. The high maximal oxygen consumption observed in trained aerobic athletes is secondary to both a high cardiac output and, to a lesser extent, more efficient extraction of oxygen within the trained exercising muscle groups. From a pulmonary standpoint, lung volumes are modestly increased relative to height-matched normal subjects. As a group, elite aerobic athletes demonstrate relatively low ventilatory equivalent (VE/VCO2) values during submaximal exercise. Some of the exercise characteristics described in these elite athletes are necessarily inherited but can be improved with training.
