Throughout my career as a sports medicine practitioner and coach, I have used VO2max testing for three main reasons:
To establish potential
To establish baseline
To assist with motivation
Establishing Potential
As a coach, I have used VO2max testing to help establish an athlete's potential. This assessment is useful, particularly if they have ambitions to become professional or elite.
VO2max is part of a package of assessments that include:
Body Composition
Time Trials (including heart rate and power output responses)
Actual Race Results
Technique
Health, and
Personality/Psychological testing.
VO2 max measures the maximum amount of oxygen the working muscles can process. It is either expressed as litres per minute or, when bodyweight is taken into account, millilitres per kilogram bodyweight per minute. A good VO2 max reading is directly correlated with improved endurance and stamina.
Gas exchange analysis is the best way to measure VO2 max in a serious athlete. Usually, this is done in a laboratory on a treadmill or exercycle. It requires sophisticated equipment, a skilled technician/scientist, and a determined athlete. Wearing a mask when going full-out is not for the faint of heart.
Average values for the sedentary population for males are 35-40 ml/kg/min, and for females, 25-30 ml/kg/min. Elite male endurance athletes score between 65 and 80 ml/kg/min, and females 55-70 ml/kg/min. The highest score ever reported in a male athlete is 97.5, in a relatively unknown 18-year-old Norwegian cyclist in 2012. Meanwhile, 1984 Olympic marathon champion Joan Benoit is credited with the highest VO2max ever measured in a female at 78.6 ml/kg/min. (ref: Wikipedia)
VO2max is largely genetically determined and can only be improved by 5-15% over the short term (weeks/months) and up to 10-25% in the long term (years).
The range in improvement in VO2 max through training is because training response is also genetically determined. There are strong responders and weak responders to training. This is one of the reasons why when you give two similar athletes the same training, the outcomes over time are different.
A male athlete with a VO2 max below 65 is unlikely to make it as an elite; for females, this arbitrary cut-off point is around 55. A male elite endurance athlete with a VO2 max of 72 can beat an athlete with a VO2 max of 78 if he is more efficient in processing oxygen, but in general, it can be said that the higher the VO2 max, the more likely the athlete will achieve elite/professional status.
Establishing Baseline & Providing Motivation
I have done hundreds of indirect VO2max tests in sports medicine when assessing patients for exercise rehabilitation and fitness programmes. A commonly used indirect VO2max test is the Astrand submaximal bike test. The correlation between heart rate and a predetermined 6-minute load gives a relatively accurate estimation of VO2max.
I have found this helpful for two reasons
1/. To establish baseline fitness and give the patient a fitness score:
Very Low
Low
Average
High
Very High
This gives both me and the patient a starting point. I will start them more conservatively when they score (very) low, and the patient can have a goal to move up one or more categories over time. In my experience, they always improve if they are compliant with the program, even if the rate of improvement is unpredictable
2/. It is a great motivating tool for the patient when they see the progress they have made and have gone up one or more fitness levels.
Summary
In my opinion, we don’t do enough VO2 max testing on potential elite athletes, probably because it is technically tricky, time-consuming, and expensive. It can help the coach and more serious athletes establish potential.
In contrast, indirect testing is much more accessible and a useful monitoring tool for beginners, patients, and interested age-groupers. It can be self-administered, as all you need is a bike or treadmill, a heart rate monitor, and a recommended protocol, which can be easily found online.1
Back to Table of Contents
For more information on VO2max, and indirect testing, please refer to VO2 Max Essentials by Brady Holmer. Brady is the author of Physiologically Speaking here on Substack.