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Amanda Carlson-Phillips on the Use of DXA Performance Data for Elite Athletes – Part 1

Amanda Carlson-Phillips, MS, RD, CSSD is no stranger to the importance of data for optimizing human performance. She serves as Senior Vice President and Head of Performance Innovation at Exos, an elite performance center that works with clients ranging from business leaders to pro-athletes on various fitness, wellness, and athletic training initiatives. Through her time at Exos, Carlson-Phillips has gained nearly 20 years of experience working with anthropometric data to help clients accomplish their performance goals. 

“I think both practitioners and athletes are [becoming] less scared of data. There used to be this concept of FOFO, ‘Fear of finding out’, and we really want to create a different perspective of getting people into FOMO with data—they’re missing out on all of these data points. I think the DXA data points and anthropometric data points that come out of the ‘gold standard’ of DXA have real power in the integrated story around the utilization of data for athlete performance.”

In her current roles, she’s heavily involved in company development and product innovation, which is why she was at the forefront of Exos’ recent acquisition of Discovery DXA system to further its position as a global leader in human performance. Now, in part one of our two-part blog series with Carlson-Phillips, she shares exclusive details with us about how DXA technology is being used at Exos to integrate data across silos and enhance athlete performance at every stage.

A Holistic Approach

Exos’ team members consist of health fitness specialists, performance coaches, physical therapists, registered dieticians, and psychologists—all of whom rely on large amounts of data to make informed recommendations for clients. But how can these different types of professionals use all of this data efficiently and collaboratively? This question is a key reason why the center invested in Discovery DXA system, according to Carlson-Phillips. 

“Exos has always been about ‘How do we integrate the disciplines of mindset, nutrition, movement, and recovery?’ About 18 months ago we took a step back and said, ‘We really want to lean into advancing our position within data collection for our athletes … and integrate data points across silos for prescription.” 

Given all of the different types of professionals who work with clients at Exos, it’s understandable how that data could become isolated between departments. However, Carlson-Phillips explained it’s crucial this data is brought together, as it allows for a more holistic performance story to be told. 

“Yes, we have our technicians and licensed individuals collecting the data, but as a dietician, I felt that this type of data had lived siloed with the dietician or the nutritionist. And we really wanted to explore how the many data points coming out of DXA, not just the aggregated data points of bone mineral density or body fat percentages, could be utilized in a much more advanced profiling.”

It makes sense the Exos team chose Discovery DXA system for the task of collecting data beyond general aggregate amounts. Whole-body DXA scans provide a more comprehensive way to measure body composition compared to other methods on the market by providing insights into body fat, total lean mass, bone density, visceral fat, and more,1—and these metrics can be crucial to constructing an overall picture of an athlete’s performance state. 

“DXA is the gold standard in terms of anthropometric data collection. I think the DXA data points and anthropometric data points that come from [the system] have real power in the integrated story around the utilization of data for athlete performance. That’s where you get really interesting conversations between dieticians, strength coaches, and athletic trainers, all really coming together to look holistically at the athlete. And the level of specificity that Hologic and DXA data can bring to that conversation is best-in-class,” she added.

Applications of Asymmetries

When asked specifically what types of DXA data her clients and teams get most excited about, Carlson-Phillips immediately referenced the analysis of body asymmetries. “I think what we’re most interested in right now is the differences between left and right. What is the asymmetry? What does that asymmetry mean? How can it help our practitioners ask other questions? How could it be indicative of return to play, or the underlying potential for injury?” 

Based on the above questions, it’s clear the evaluation of an asymmetry using DXA is just the beginning in terms of insights that can be applied to an athlete’s training. As Carlson-Phillips noted, DXA can be used to help evaluate recovery from injury and performance by looking at the differences between left and right limbs.2

However, she also explained that while “having that metric and being able to look right to left is interesting in its own right, it can become incredibly powerful when stacked with other types of performance assessment data. You can have one piece of the puzzle with anthropometric data, and another with a physical therapy evaluation, and another with strength and power training … but when you put all of those things together, that’s when it really becomes interesting, specifically as it relates to asymmetries.” 

The research around asymmetries is already fairly involved as seen through examples Carlson-Phillips gave of how even seemingly-small differences have been shown to impact performance. “That level of research is a bit more advanced. For example, for movement skills specifically, if there’s an 8-15% asymmetrical change, that can be associated with decreased reaction time. The same thing with force-velocity, for example—there seems to be a higher correlation to rates of injury when there’s at least a 12% asymmetry.”

Similarly, across populations, asymmetry in both local and global patterns has been shown to increase the incidence of soft tissue/non-contact injury.3 Clearly, the discovery and evaluation of player asymmetries can be critical to sports performance and player safety, which demonstrates why it’s such a priority to Carlson-Phillips and her team.

While evaluation of these differences can be important to real-time player performance as described above, it also has useful applications when examined over time. “When you look at the anthropometric data alone, sometimes that’s not as compelling. But when you look at it all the way across [a season], you start to have this very broad story of the athlete. So the reason it’s so important to have DXA data at multiple points across the athletic career is so you can really understand how your anthropometrics are changing over time.” While the literature is already fairly advanced when it comes to the evaluation of asymmetries, the research is still only getting started when it comes to long-term applications.

The Future of DXA for Athletics

Throughout our conversation, a recurrent theme from Carlson-Phillips was the importance of using data to tell a comprehensive story. She made it clear that in her eyes, if we want to tell these integrated stories, we must find a way to bring together previously separated data points. “We’re swimming in a sea of data points, and we’re swimming in a sea of siloed data that oftentimes doesn’t connect to a model … we [need to] integrate to create the better understanding of various performance qualities when we’re thinking about an athlete.” 

She also emphasized that even with all of the existing research in the world of anthropometric data, the industry still has a ways to go. “There’s a lot to learn. But I think that’s the fun part of where we are now, developing more collaborations, more understanding, and asking different questions. That’s the most powerful part of having more data that’s integrated into a model. It allows you to ask different, deeper, and broader questions, and pull on a number of different practitioners and experts to answer those questions together.”

Looking to get started on some of those questions? One resource Carlson-Phillips mentioned is the Collegiate and Professional Sports Dietitians Association (CPSDA). She is a member of the board and recently gave a presentation about “Unlocking New Insights with Anthropometric Data” using Discovery DXA system. And stay tuned for part two of our blog series, where Carlson-Phillips dives deeper into the use of the technology for pro-athletes during the NFL Combine. When it comes to DXA, the conversation is just getting started, and we’re excited to be a part of it.