Today we’re going to talk about the philosophy of evidence-based practice.

What does it mean?

Why is it so important?

And what are the issues that we tend to come across as coaches and clinicians when we hear this?

What is steadily becoming a buzz word within the world of physical health and physical fitness – we first need to define evidence-based practice.

The notion is that we would/should utilize empirical data and/or utilize the latest scientific literature to govern our practice – Govern the exercises that we give to our patients, our clients, govern the nutritional protocols that we rely on to action results within the people that we work with.

And why is it so important? Why is it becoming more and more common and why is it becoming something that is, nowadays an essential part of practice?

Well, ultimately, it’s more important within the clinical setting, but as we’re starting to see now within coaches and personal trainers, because people are presenting with so many comorbidities and contraindications just as part of the general population, these two professions are starting to become gradually intertwined. And we can take a lot of information from either end.

The standard that we need to set as an industry increasingly relies on scientific literature.

Ultimately, when we’re dealing with this kind of population group, whether it be Gen Pop, whether it be people that have actually come into a rehabilitative setting, we need to make sure that exercise is safe.

Any time people present with contraindications, you need to know as a coach or clinician, what you can safely administer to action results. And that’s the first priority.

On top of that, nowadays, it’s becoming more common to try and stand out within the world of this ‘entrepreneurial mindset’.

A lot of people tend to rely on their fixed narrative or a biased view because ultimately that’s what sells. But within the world, of action and results, we need to make sure that we’re relying on an evidence base that is reliable and that isn’t subject to bias. And obviously, bias is present in any industry. You’ll always be subject to some form of confirmation narrative. But again, the evidence base, the scientific literature seeks to correct that.

And then finally, one of the key points that I’ve seen when I’ve spoken to different coaches and different clinicians is, ultimately, when we’re trying to deal with as many people as possible – we need to know that there is a system in place and there’s predictability between the individuals.

Now, that doesn’t necessarily mean that it isn’t tailored to that person, but it’s becoming common to have a vast quantity of clients or a vast audience that relies on one singular individual – and that person needs to be able to provide information that will, as a rule, apply to the majority of people.

And this is, again, where the evidence base tends to fall into place.

So what is it that we’re going to talk about today? And why is the evidence based fitness buzz word becoming a problem?

A line that I heard from a very close mentor of mine that “security wise in obscurity” and this is increasingly present with new individuals, people that are new to the industry are new to a topic in general that you can often get caught up in the details to the point where you feel like it has to be more complicated than it is. And no one is a bigger victim of this as I am, because I am someone that has always been obsessed with the theoretical stuff that we’ll talk about in a moment. But ultimately, the problem lies in this overreliance on scientific literature to the point where there is no versatility.

And that’s basically what the purpose of today is. We’re going to talk about that, how we correct it, what we look to implement from a coaches and clinician standpoint to try and accelerate the rate at which we can learn these different pillars of evidence that we can draw information from.

So what I’d recommend grab a drink, make sure that you’re comfortable, because I’ll be going through a lot of information now over the course of the next five or ten minutes. And hopefully I’ll be able to draw a little bit of value from it.

So the first thing is science will always prevail as the underlying authority or the underlying way of thinking without going off into too much of a global, political, Sociological viewpoint. The scientific revolution is the thing that’s led us to where we are now in terms of technological innovation, in terms of our systems way of thinking etc. If you’ve noticed, whenever a politician presents with a new kind of policy that they have in place, we want to know the evidence. We want to know the numbers and the data that supports it. And it’s great because it’s led to this kind of pragmatic scepticism. That means the kind of three points that I mentioned earlier that we aren’t subject to bias and that everything is safe and it’s predictable.

The problem is it leads to frustration, particularly with the new newer practitioners, because what happens when you get put in a situation where there are 10 research articles saying the ketogenic diet is the most ideal nutritional protocol for people with Type two diabetes, yet the individual doesn’t want to do that.

And you can often get caught up in this notion of as a practitioner thinking, well, no, that’s what the data say. So you have to conform to that. You’ve got to remember that we’re working with individuals; working with people with agendas, people with behaviours, people with their own unique biases and your job is to educate but it isn’t to force a square peg into a round hole. Your job is to deliver results and solutions to that individual.

And ultimately, because the human body is an open system, we know that there are an endless number of solutions to a problem. As the saying goes, you know, ‘there’s a thousand ways to skin a cat’. There are several different ways to get to the destination that we’re after. And just because there is a slightly higher number of research articles that support one narrative doesn’t necessarily mean it’s the most ideal situation for every single client that you work with.

We’ve spoken about before as part of the Consulting Strength curriculum, about the Law of 33%: you should be spending 33% of your time with people that are ahead of you in the career path that you’re after, 33% of your time with your peers and 33% of the time with people that are slightly behind and that you want to help pass on the information to.

And within that, you’ll notice that the 33% of the people that are in front of you tend to have what’s known as ‘skin in the game’. They tend to have more experience. And part of that experience tends to be crafted in the form of anecdotal evidence, in the form of knowing that certain protocols won’t work with people because logistically that is not feasible. And as a young student, I was really frustrated when this came into play. I recall quoting specifically to strengthen conditioning coach that was employing me at the time, that I didn’t want to work in a situation where I had to compromise what was optimal for logistics, when in reality that was my own naivete.

It’s something that is a key fact of life, because not a lot of people, in fact I would go out on a limb and say that there are less people that you’ll work with that will see training as a key priority in their life. If you work with people that are in pain, if you’re working with people that have reached the point of hindsight, where they know they should have done something earlier, then chances are, yes, you’ll have a little bit more motivation from the client.

But again, that doesn’t always tie into adherence. And I do think that it’s your job to kind of find the balance between the two. I’m not a believer of ‘you should do what you enjoy’ – We’ll talk about that in a later episode – I do believe that there needs to be an element of discipline in the process.

However, like I said, you’ve always got to keep in mind the element of trying to force a square peg into a round hole.

So the solution to developing skin in the game is to ultimately build an experience. The problem is people confuse experience with time.

They think that they have to spend more time, accrue the same number of years, accrue the same number of hours coaching on the ground floor, so to speak, or in your practice to be able to achieve the same kind of results that you see with these high level coaches.

And that’s just simply not the case. And if it was, it would be a kind of painful existence to know that you can only learn from your own mistakes.

There’s a famous quote from probably arguably the world’s greatest investor, Warren Buffett, saying “That you should learn from mistakes, but those mistakes don’t have to be your own”. And he said, you know, we could talk about vicarious reinforcement and everything in the world of psychology.

Ultimately, you don’t have to go through the same gauntlet of failures and everything that every other coach does. You can learn from these experiences.

So if you’re a new student and most of the people that were looking at this content will be new students to the world of strength and higher level strength application. Whether you’re a physiotherapist, whether or not your personal trainer doesn’t really matter when you were a new student. The key thing is to draw lessons from all three pillars of evidence.

So the three pillars of evidence are theoretical, empirical and anecdotal. And in order to define these and help separate them into individual categories, what I like to use is the world of physics.And for those of you that are familiar with a very famous TV show, The Big Bang Theory, you’ll see that there’s different personality groups with obviously different areas of the study of physics.

In Physics, there are several different branches, but primarily there is theoretical, there is practical physics and then there is experimental. And basically the theoretical is obviously the theorist. The empirical would be the experimental within physics and then the practical would be the anecdotal side of things.

The theorists, let’s start with them. So the theorist is essentially what I like to call a ‘professional cynic’, their a skeptic who seeks to challenge what we know in order to achieve a higher level of understanding. For those individuals, how do you develop knowledge? You can come up with new ideas, but that tends to come from challenging previous ones. There’s a really famous book that I’ve read recently by Thomas Kuhn, The “Structure of Scientific Revolutions”, and that’s the underlying narrative within that book is the notion of challenging pre-existing thoughts to be able to develop new theories.

That is the concept of science is to disprove what we thought we knew in order to achieve a higher level of understanding. But the job of the theorist is to draw from the data that is there, draw from what we would deem is logical and what we’ve observed and cultivate these new theories but don’t necessarily have any scientific, “experimental” backing.

Then the empirical people would be the ‘Lab Rat’. So that’s the “tests for the sake of tests”, the people tend to be the intermediary between the theorists and the actual “ground level workers” and they basically seek to validate the theories that have gone before them or validate the practices of the people that have been doing it for the past twenty years – which you’ll see in a moment when we talk about it within the world of training.

And then finally, you’ve got the anecdotal people and these are the ones with the skin in the game. So these are the coaches that are delivering the results. A lot of them will understand the scientific literature. But to them, that’s not what matters. What matters to them exclusively is delivering results. And it’s not uncommon to see these coaches with actually zero “formal”, qualifications. They’re just good at what they do.

And ultimately, it’s not about saying one is better than the other. The goal is to be well versed in all three areas because ultimately the job of any good coach is, like I said earlier, to be versatile, to be able to adapt to the situation, utilize the evidence base that we have present from an empirical standpoint, and be able to implement it with the individual.

If you lack the understanding of the other two pillars. So the empirical would be at the forefront. But if you lack the understanding of the theoretical evidence, what’s coming up in the new “discussions” with all of these theorists and you lack the anecdotal experience of other coaches, then you will struggle with the 3rd Law of Training, which is something else that we talk about within the Consulting Strength Curriculum – within the 4 Laws of Training – The 3rd being “Individuality”.

You have to remember, “Individuality is the crux of implementation”. Individuality is the thing that determines ultimately what you can implement with the individual.

So you can read the extensive archives of empirical data that’s out there. But if you don’t understand how that will apply to the individual, the practical elements that you can draw from it – knowledge is only as useful as its ability to be implemented with any individual that walks into your practice, any individual that you meet in the gym.

And again, this comes from drawing from the other two pillars of evidence.

So as a final take-home from today’s discussion, a little bit of homework…What I would recommend that you do in order to build on the “The evidence base” that you have – understanding how all this information applies to individuals.

Let’s start with the theoretical work. And I won’t go into too much of a tangent with this, but with any theoretical model, you’ve got to understand, it’s something known as the Lindy Effect. Again, I won’t go into too much detail, but it’s essentially “how long something has lasted is directly correlated, how long it’s going to last”.

So if there are theories within the world of physical training that have been around for 40, 50 years and they’re yet to be disproven within science, then chances are it’s going to be around for the same length of time.

And this is where we start to see a lot of the topics, a lot of the methods within the world of training resurface every few years.

Cluster sets are a classic example.

They’re something that’s gaining a lot of attention within the world of training at the moment and within the world of research – they were being done back in the 40s and 50s by the Soviets.

They were something that was implemented, discovered, proven. As a really valid method of developing strength and power. And again, it’s resurfacing because as we talked about earlier,in the social media age nowadays, we like to have things that are “fresh and new”, whereas in reality, all we’re doing is recycling theories that we know, work.

So from a stand point of view, as a coach or clinician, what I would recommend to do is to seek out those theories. Seek out the talking points, the theoretical evidence that we have about how training actually influences the body and what is proven to work in the past – not just the newest training method.

And then the other pillar of evidence being anecdotal. How would you build your anecdotal evidence base?

This is where networking comes into play. This is where you need to talk to other coaches, people that are ahead of you, people that are getting results regardless of their formal qualifications.

Ask them.

As an industry, we want to help other people. We like to spread information to one another. That’s the purpose of this article.

Ultimately, being able to speak to these people, create a network and just ask them how and why they would implement certain methods, nine times out of ten, you’re going to get a good outcome. And even if you don’t, then that’s absolutely fine.

There are thousands of other coaches in the world that will get you the information that you need.

And you can ask them, “why is it that you’re doing the sumo deadlift as opposed to the conventional deadlift?”

OK, “why is it that you’re getting an individual to squat with a front loaded position rather than having the bar on the back? Because I’ve seen in the research that the back squats the best exercise, So why are you doing that?”

And again, this will allow you to start to form links between those three pillars of evidence to make you wholeheartedly a more versatile practitioner and more adaptable practitioner with the implementation of strength.

So I hope it all makes sense. If you’ve got any comments, please leave them below. If you have any questions about topics that you want to discuss further down the line then just get in touch.

I’m aiming to keep these episodes a little bit shorter than usual. This was just quite an expansive topic that I wanted to talk about today and hopefully get you guys thinking the way that you need to be in terms of developing yourself as a well-rounded practitioner.