I was reflecting this week on the way that we wield evidence and thus make decisions in the health and fitness space. There seem to be quite a few blindspots that extend a bit outside the scope of a trainer (which is fair enough) and, as a result, we tend to see a lot more claims made that aren’t supported by the evidence.
Let me give you some examples...
✅Lab Testing / Screening — Many trainers, particularly those who consider themselves to be more advanced, will refer their clients for a whole host of blood tests, despite the client not being in a population for whom such tests would be recommended. This is not just unnecessary, but has the potential to be harmful, particularly in cases where a client may then undertake further testing and/or intervention for an incidental finding. Overtesting,
overdiagnosis.
✅Rehab — It’s hard enough to get physiotherapists to pull back from the nonsensical diagnoses and treatments, so it’s completely understandable why trainers would fall into this trap. We obsess over posture. We tell our clients they have muscle imbalances. We tell them they have structural issues. We pathologise their movements. We make up fairytales about how their fascial slings are affecting their cognition
(okay, only some people...). And, from there, we create solutions for problems that never existed.
✅Nutrition — Nutrition is a funny one, as this can clearly go in one of many directions. Some of us say things like “epidemiology is useless”, without trying to understand how nutritional epidemiology works. We might say “food quality doesn’t matter”, without actually reading any evidence on post-prandial responses to meals, the longevity effects of different food components, atherogenic properties of others, etc.
Despite all of that, we may turn around and talk about how we are evidence-based.
Why waste time pointing this out?
In all examples provided above, there are plenty of research papers that could easily point out your errors should you wish to learn more. Read about the harms of excess screening, overdiagnosis, etc. Read
about the holes in a kinesiopathological approach to pain and injury. Read about the overwhelming concordance between nutritional epidemiology and randomised controlled trials (and the merit, or lack thereof, of an RCT in the context of nutrition).
The information is there. However, as trainers, we often think that we have learned all there is to learn once we know that calories and progressive overload matter, and maybe we will follow a few leaders in the industry to confirm what we know. I get it, I’ve been there, I’ve held a lot of the thought processes mentioned above. Get stuck in...
