science

Science, Belief, Psychology and Nonsense

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“The good thing about science is that it’s true whether or not you believe in it.” ― Neil deGrasse Tyson

I want very much to be on the side of science. The scientific method is perhaps the most powerful and influential tool in all of human existence. A long line of dedicated scientists have blessed us with electric light, the eradication of smallpox and polio, a steady food supply, clean water, air conditioning, and every bit of computer technology ever known just to name a very few things. That said, I will admit my own confusion and I will admit adherence to various practices and ideas that don’t hold up to vigorous scrutiny. (I’m trying to do better.)

Mention the word “science” to some people and they’ll take it as a dirty word. Some don’t like the pointy-headed image of scientists telling us certain unfortunate truths (climate change is man-made for instance.) Others among us have been scared by genetically modified food (GMOs) and vaccines. This is unfortunate for a lot of reasons. Many of us walk around in needless fear for instance. More specifically, fear of vaccines has led to needless outbreaks of disease. Famously, Steve Jobs delayed rejected science-based cancer treatment for complimentary/alternative medicine (CAM.) According to his biographer, Jobs regretted this decision.

Some people think that “science” equates to “Western medicine,” or “pharmaceuticals.” Not true. There’s plenty of non-scientific practices and methods employed by modern medicine and the pill companies. In fact, good, thorough, rigorous science can expose the ineffective or dangerous aspects of medicine and drugs. In Bad Science and Bad Pharma, Ben Goldacre has done a great job discussing the misuse and abuse of science by both complimentary/alternative medicine and the pharmaceutical industry.

Skepticism

Skepticism is useful. This is a questioning point of view. A skeptic requires solid evidence before he or she believes something. Being skeptical means you’ve set a high bar for your beliefs. You don’t accept information at face value. Nor do you accept anecdotal evidence or information gained from an “experiment of one.” Healthy skepticism can save us money and may save our health. Here are some things that I understand about skepticism: When we hear about a “miracle cure,” “secret trick to whatever-it-is-you’re-dreaming-about,” “startling breakthrough” or “what the doctors don’t want you to know,” the skeptic in us should come to life and pay close attention to what we’re being told. It’s probably nonsense!

(BTW, skepticism doesn’t equal cynicism. Skepticism is not a negative thing. A skeptic simply asks for valid evidence to be shown.)

Correlation and Causation

Today I wore green shorts. I didn’t throw up. Green shorts prevent nausea! They protect against throwing up! I know it to be true because I was there and I witnessed it. That’s proof enough for me. “I know what works for me.”  

Does this sound familiar? Does this line of thinking make sense?

Here’s another example: Someone gets acupuncture for seasonal allergies (or any other ailment you care to think of) and some time soon after they feel better. Someone could see this as “proof” that acupuncture “works” to cure allergies. So every time this person feels their allergies come on, he or she gets acupuncture and soon the symptoms are gone. This could be fairly convincing to a lot of people that acupuncture works very well at curing an illness.

Acupuncture correlates to the resolution of the illness. But did acupuncture cause the illness to go away? Here are some things to think about: Why do we seek treatment for an illness? Typically people seek help because the symptoms are too tough to deal with. Guess what usually comes on the heels of our bad symptoms whether or not we seek treatment or not: We feel better! There’s a normal course that most illnesses take and it doesn’t usually end with us in the grave. Rather, our immune system fights off the illness and we feel fine, acupuncture or no acupuncture. Chiropractic adjustment or no adjustment. Homeopathy or no homeopathy. So what would we say if someone got acupuncture and they felt worse? What if someone did not receive acupuncture and he or she felt better soon anyway? All of these are possible outcomes. We might think that acupuncture doesn’t have much relationship to illness at all.

Fitness

“I consider corrective exercise to be the alternative medicine of the fitness field.”
– Coach Nick Tumminello 

That statement has given me a lot to chew on, and I am coming around to agree with him. The fitness universe abounds in various systems and methods that promise better movement and less pain. All of them are sold by people with impressive credentials who use technical and scientific-sounding terminology. I have absolutely fell under the spell of some of these systems.

Now I look back and realize that either a) I should’ve been more skeptical towards some of the claims I’ve heard or b) because I was searching desperately for a solution to my 10-year-long chronic back pain, I was ready to believe many things told to me by those who spoke with certainty–even though I tiny voice in the back of my head may have been questioning those claims.

Tumminello has written a series of posts on his blog that discusses the psychological factors that make us susceptible to faulty thinking. He’s aimed this series at the fitness community but he really discusses psychological tendencies that all humans seem to share–no matter how smart or well-informed we are. Why Smart Trainers Believe Stupid Things: Part 1 discusses bias toward positive evidence.  In Part 2 we learn how “authorities” can use jargon and inflated language to sway us. Part 3 goes into regression to the mean (discussed previously) and why it’s easy to believe a given treatment may “work” when in fact the thing the treatment was meant to fix has simply run its natural course. Psychological reasons why coaches will never stop arguing; training debates are a waste of time; and the fitness industry will never be united (long title) is very similar in tone and content to the previous articles.

These articles were very illuminating to me. If you’re a critically thinking fitness professional, they may help sharpen your thinking quite a bit.

New Thinking

As I’ve said, I’ve swallowed some nonsense and falsely ascribed amazing results to methods that simply didn’t do what I believed. The health & fitness field is perhaps more awash in phony gurus and foolish hocus pocus than almost any discipline on earth.  (Religion may take 1st place.) From medicine to food to exercise–especially corrective exercise–there are numerous minefields out there. Misinformation and half-baked nonsense is widespread on the Internet so I must be careful what to believe.

The best snake-oil salesmen blend truth with bull$hit.  (Dr. Oz comes to mind.) I need to examine each statement and claim from the person making it. I shouldn’t give the benefit of the doubt to anyone based on their credentials, popularity or status.

Rather than seek out information that confirms my beliefs, I need to look for evidence that actually disproves what I believe. (That’s a tough one!)  I should be prepared to set aside my beliefs when solid evidence contradicts those beliefs.

There are a lot of cases where making leaps in thinking leads to inaccuracies.  Nutrition is rife with this type of thing. The fat-causes-heart-disease idea seems to be in this category. A researcher may expect that A causes B–animal fat consumption causes heart disease for example–but this conclusion may be based on animal studies or educated guesses. What should happen isn’t necessarily what actually happens, yet many of our Federal dietary guidelines have been based on assumptions, not evidence.

I need to be (more) aware of my biases and my emotions. I should be aware of my herd mentality and I shouldn’t be afraid to ask questions. If a proponent of something wonderful can’t or won’t answer my questions, or uses excessively big and complex language in their explanation, I should beware.

Other non-BS resources

I’ve found some useful resources for evidence-based information. There must be many more out there. Here are a few:

  • Genetic Literacy Project: Lots of good information on GMOs.
  • Science Based Medicine: A wide range of medical information. From vaccines to chiropractic to acupuncture, nutrition, evolution, veterinary medicine and a lot more.
  • Soma Simple: This for manual therapists, physical therapists, pain management people and coaches. It’s a very high bar to cross if you want to put out your ideas. The group here demands evidence. I’ve learned a ton about pain science here and I’ve been made aware of a lot of the exercise baloney that’s out there.
  • Evidence Based Fitness: Bryan Chung does a great job of discussing and laying out the research facts on the latest fitness research.
  • Exercise Biology: Similar to Evidence Based Fitness. Anoop T. Balachandran discusses the evidence pertaining to strength training, pain, nutrition, supplements and more. His post on pain should be required reading by all trainers and coaches.
  • How to Detect Bullshit: My article wouldn’t be complete without a link to this fine piece of writing from Scott Berkun. I might need to read it several times.
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The Benefits of Supervised Strength Training

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Supervised Strength Training is More Effective, Swedish Study Finds, is an article from  Science Daily.  What does it tell us?   It turns out that supervision and personalization is an important component of an injury-prevention (prehabilition) workout–at least when it’s performed by Swedish volleyball players.  This information probably isn’t a huge shock but the implications are worth considering not only for injury-related issues but also for any fitness or sports performance goals.

The study surveyed 158 elite-level volleyball players by way of a questionnaire.  The answers indicated that almost all the players performed some kind of injury-prevention program yet almost half of the players had been injured.  Most of the players exercised without supervision.  Further, two groups of players were given exercise programs.  One group was given a personalized program and was supervised by a physiotherapist.  The other group was given a non-personalized program and they were not supervised during workouts.  The supervised group both improved their performance more than and had a lower injury rate than the unsupervised group.

Now, from the description of the study, there are several weak points that we could discuss: small sample size, physiological differences in the groups that might predispose or protect the players from injury, effect of the supervision vs. the effect of the personalized workout in the results, validity of the questionnaire.  What’s more important though is that even elite-level athletes might benefit from a personalized, supervised conditioning program.

“I have a feeling that more athletes really stick to the program and focus on the task if there is a coach present. Many players may feel that the strength and conditioning training is the boring part of their sport, which makes it tempting to ‘cheat’ when nobody is watching,” says Sofia Augustsson, author of the study.

These are people for whom their sport is a major focus of their lives to the point that they may be earning a living from volleyball, so we might expect very strict adherence to any exercise program given to them.  However, the behavior of these athletes and the results of their exercise programs confirms something I learned in graduate school: personalized programs and close interaction with individuals has impact.  The more a fitness instructor or coach can work with one person or a small group the more likely that person or group will adhere to a program and succeed.

Does this sound like an argument for hiring a personal trainer?  Well, yes, absolutely it does!  Obviously I’m biased here but at the same time, there seems to be just a little bit of science to back up the idea.

To take it a little further, what I often see in the gym are people exercising but putting forth little effort.  They’re often doing the same workout over and over.  They may be neglecting their needs in favor of their “wants.”  (“I want bigger pecs,” or  “I want washboard abs” for example but what he or she may need is more hip or spine mobility, better shoulder stability or better nutrition.)  So often these folks are putting in the time but they’re not getting the most value for their time–but at least they’re doing something in the way of exercise.   Many more gym goers will give up altogether.  They’ll spend some time exercising but never knowing the important whys and hows of getting to their goal.  They’d stand as good a chance of getting a college degree without a degree plan.  (BTW, here are some interesting stats on Americans’ exercise habits…  Had to throw that in somewhere.)

It’s entirely likely that some time (and yes money) spent with a trainer could improve things dramatically.  Just about anyone will benefit from a different set of eyes to look over their goals and their methods to achieving those goals.  Even the most dedicated gym rat works harder when someone else is pushing him or her.  Getting in shape and staying healthy is more than just reading an article or doing the workout you did in high school.  So if you want to get the very most out of your time in the gym, or on the road, or on the track, the pool, the basketball court–wherever it is you exercise, seek out professional advice and you may achieve more than you ever imagined.

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