VO2 Max Testing in Athletes

Measuring Cardio Fitness and Endurance Capacity

Measuring VO2 Max in an athlete
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VO2 max, also known as maximal oxygen uptake, is the measurement of the maximum amount of oxygen a person can utilize during intense exercise. It is a common measurement used to establish the aerobic endurance of an athlete prior to or during the course of training. It is one of several tests used to determine an athlete's cardiovascular fitness and performance capacity.

VO2 max is measured in milliliters of oxygen used in one minute per kilogram of body weight (mL/kg/min). It is based on the premise that the more oxygen an athlete consumes during high-level exercise, the more the body will generate adenosine triphosphate (ATP) energy in cells. ATP is often referred to as the "molecular unit of currency" of intracellular energy,

VO2 max should not be confused with the lactate threshold (LT) testing, which refers to the point during high-intensity exercise where lactate builds up in the muscles faster than it can be removed.

How the Test Is Performed

VO2 max is typically conducted in a sports performance lab. It is most often graded, meaning that the intensity is carefully calibrated and increased over time.

Either a treadmill or stationary bicycle may be used. Prior to the test, you would be outfitted with a face mask that is connected to a machine which can analyze your respiratory rate and volume alongside the concentration of oxygen and carbon dioxide in inhaled and exhaled air.

A heart strap would be worn around your chest to measure your heart rate.

The test usually takes between 10 and 20 minutes. To prepare for the test, you would need to:

  • Dress in comfortable workout clothes.
  • Refrain from exercise or training 24 hours prior to the test.
  • Avoid food, alcohol, tobacco, and caffeine for at least three hours prior to testing.

    VO2 max is reached when your oxygen consumption remains at a steady state despite an increase in the workload. It is at this plateau that the athlete moves from aerobic metabolism to anaerobic metabolism. From there, it is usually not long before muscle fatigue sets in and forces the athlete to stop exercising.

    What the Scores Mean

    The VO2 max values can be used to establish your baseline fitness level before the start of a training program and used thereafter to track your progress.

    The algorithm used to calculate your score can vary, although the one widely used for commercial applications is called the FirstBeat method. Introduced in 2012, the FirstBeat method measures your VO2 max value based on a linear relationship between oxygen consumption and running (or cycling) speed.

    Other methods of calculation include the Cooper test, designed for the U.S. Air Force in the 1960s, and the Uth-Sørensen-Overgaard-Pedersen estimation, which factors in your resting heart rate (RHR) and maximum heart rate (MHR).

    Broadly speaking, VO2 max values are characterized in men and women as follows:

    VO2 Max Norms for Men
    AgeVery PoorPoorFairGoodExcellentSuperior
    13-19Under 35.035.0-38.338.4-45.145.2-50.951.0-55.9Over 55.9
    20-29Under 33.033.0-36.436.5-42.442.5-46.446.5-52.4Over 52.4
    30-39Under 31.531.5-35.435.5-40.941.0-44.945.0-49.4Over 49.4
    40-49Under 30.230.2-33.533.6-38.939.0-43.743.8-48.0Over 48.0
    50-59Under 26.126.1-30.931.0-35.735.8-40.941.0-45.3Over 45.3
    60+Under 20.520.5-26.026.1-32.232.3-36.436.5-44.2Over 44.2
    VO2 Max Norms for Women
    AgeVery PoorPoorFairGoodExcellentSuperior
    13-19Under 25.025.0-30.931.0-34.935.0-38.939.0-41.9Over 41.9
    20-29Under 23.623.6-28.929.0-32.933.0-36.937.0-41.0Over 41.0
    30-39Under 22.822.8-26.927.0-31.431.5-35.635.7-40.0Over 40.0
    40-49Under 21.021.0-24.424.5-28.929.0-32.832.9-36.9Over 36.9
    50-59Under 20.220.2-22.722.8-26.927.0-31.431.5-35.7Over 35.7
    60+Under 17.517.5-20.120.2-24.424.5-30.230.3-31.4

    Over 31.4

    Factors That Influence VO2 Max Values

    The average sedentary male will achieve a VO2 max of approximately 35 to 40 mL/kg/min. The average sedentary female will score a VO2 max of between 27 an 30 mL/kg/min.

    These scores can improve with training but may be limited by certain factors. Among them:

    • Age plays a central role with VO2 max scores typically peaking by age 20 and declining by nearly 30 percent by age 65.
    • Gender also contributes with elite female athletes typically having higher VO2 max values than their male counterparts. However, when values are adjusted based on body size, blood volume, and hemoglobin content, a man's VO2 max will generally be 20 percent higher than a woman's.
    • Altitude contributes simply because there is less air to consume at higher altitudes. As such, an athlete will generally have a five percent decrease in VO2 max results for every 5,000 feet gained in altitude.

    Higher VO2 max scores are associated with certain endurance sports, most specifically cycling, rowing, distance running, and cross-country skiing. Tour de France winner Miguel Indurain's VO2 max was reported at 88 mL/kg/min during the peak of his conditioning, while cross-country skier Bjørn Dæhlie reportedly achieved a VO2 max of 96 mL/kg/min.

    It is important to note, however, that VO2 max values are not inherently linked to sports excellence. While they can certainly contribute to one's success, particularly with endurance sports, there are other factors that arguably play a larger role, including skills training, psychological preparation, lactate threshold training, and nutrition.

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