Warning: this post contains liberal amounts of ad homonyms, strawman arguments, and pure cow manure; but hopefully will inspire some mutual eating of crow and perhaps some critical thinking.

I Have a Joke For You, And It’s Not Your Ugly Squat

It’s truly amazing that amongst all the peasantry and squabbling in the fitness and rehab industries, coaches and practitioners actually work with clients and patients while also eliciting some results.
Yes, there are professionals out there making a difference in their client’s lives, not just bitching and moaning over biased outlooks on trivial topics related to pain, movement and trainingAfter decades in this industry co-existing with a host of experts of every specialty, I like to explain the biased and highly subjective outlooks from many different pockets of specialists in our industry as something like a trip to the local watering hole.

Maybe you’ve heard this joke before…

A bunch of exercise and rehabilitation professionals walk into a bar. They all want to order the best drink in the house. The bar keep says, “What can I get you?” Here’s what they say:

Home Health Physical Therapist

“I have a low tolerance, so I’d better take it easy. An O’Doul’s, please.”

Starting Strength Coach

“Screw your non-alcoholic beer and all the other types of alcohol for that matter; my experience and the goddamn laws of nature dictate that the only real alcohol is gin.”

Personal Trainer

“Every person has their own tastes, so you can’t tell me which alcohol is best!”

Collegiate Strength and Conditioning Coach

“Well, if I was having gin, it would have to be 1 ounce, but at this time in my cycle, I’m having rum and it has to be 2.4 ounces.”

Pain Science Therapist

“The amount, taste, and texture of your rum are not at all important; it’s how you describe the alcohol that matters.”

Manual Therapist

“Actually, the description doesn’t matter, nor does the type of alcohol, but give me any alcohol and I can tell you the exact way it was made just by tasting it.”

Hybrid Therapist/Strength Coach

“Give me the strongest alcohol content and just fill it to the top.”

Functional Specialist

“I like an alcohol that is subtle and has hints of fruit, but it needs to be stirred clockwise four times and blown on with minty breath before drinking.”

Movement Guru

“There is no one best type of alcohol; it’s important to like them all.”

CrossFit Trainer

“Give me FIVE random shots, but I want them hard and fast!”

Evidence-Based Practitioner

“Show me the data on alcohol content, and then I’ll decide.”

At that point, of course, they all start a brutal fight that would rival the carnage of a Quentin Tarantino movie. Sound familiar?

The Biased Guru-ism of The Fitness Industry

science vs gym

Yeah, that’s basically what happens on a daily basis on forums and social media when the topic of exercise technique or prescription comes up. And before anyone gets their undies all knotted up, obviously, these one-liners are intentionally jam packed with ad hominems and strawman arguments among other logical fallacies, so no offense is intended. Having said that, can you detect some truth in there somewhere within the humor?

For the record, I greatly respect all of the above approaches for what they are – biased and dogmatic approaches. I know full well that the people behind all of these approaches have good intentions and believe in what they do. When it comes to exercise prescription, you can go dizzy trying to sort out the various opinions to know what to do. So, who’s right? Well, they all are and they all aren’t. How’s that for more confusion?

I truly believe we all have something to learn from, no matter who you are. So, on that note, what can we learn from each of these approaches? Let me break down these specialists approaches in a more complementary way, and the take aways we can learn from each camp in the industry.

Home Health Physical Therapist

The fallacy: Home care therapists, and many other physical therapists, are too lenient on their clients and thrive on under-loading them.

The reality: Many individuals simply do not have access to, nor have any motivation to spend time in the gym. Also, many clients that they see have had lifelong sedentary lifestyles. While I do believe we shouldn’t underestimate any of our clients and their potential, we should be cognizant that many people don’t fit our ‘ideal prescription;’ at least at the outset of treatment/training. Remember that the best form of training is the one they will consistently do. Once they are consistently active and more motivated, your options open up.

Starting Strength Coach

The fallacy: It’s a cookie cutter approach with no wiggle room for individual differences.

The reality: Most people can progressively lift heavy with a barbell using some fundamental principles. There is a reason the Starting Strength method is as popular as it is – it works. Reading the text Starting Strength and applying to my training has done more for me over the years than any other method I’ve read. The importance and generalizability of strength and the basics of linear progression, bar positioning/path, lift set up and breath, whole body tension, and patience with the process are staples in my teaching, research, and training.

This is what I learned from Starting Strength:

Personal Trainer

The fallacy: As long as the client is happy, you’re doing your job; even if it means completely varied programming.

The reality: Individualizing programming can make a lot of sense. Not everyone wants to use a barbell with the same exercises over the long term. As well, not everyone ‘fits’ a barbell to the same degree as the other guy. Finding the right variation of the lifts to fit an individual’s anatomy and mobility can go a long way to maintaining trainee longevity.

Collegiate Strength and Conditioning Coach

The fallacy: Periodize your prescription for everything and each type of adaptation has its own variables.

The reality: While the research clearly does not support a defined rep/set/loading scheme that results in purely hypertrophy, strength, or power adaptations, training programs for advanced trainees will need to have some variability in order to continue to make gains. Once a linear progression phase is over, some creativity in loading schemes is needed. In addition, the concept of task practice is an important carry over from this mostly athletic approach. Integrating the practice of important skills for the individual can help refine the application of the strength they’ve gained.

Pain Science Therapist

The fallacy: Biomechanics and technique do not matter.

The reality: The context of what we say and how we say it does matter. The impact of our approach to the perceptions and fears of the client can be huge. This is the foundation of the biopsychosocial method of pain science. Telling someone they can’t ever flex their lumbar spine can have debilitating consequences. Having said that, you can’t neglect the ‘bio’ arm of this. I think you have to consider the context and purpose of your training. There is a place for developing client confidence with painful or previously painful movements and there is a place for looking at good practices for exercise technique that allow for optimal performance of the exercise. These don’t have to be mutually exclusive concepts and I believe some of the best approaches include both.

Manual Therapist

The fallacy: Exercise is an afterthought, but what’s important is to mobilize the specific joint that is limited or segmentally stabilize one that is hyper mobile.

The reality: Manual therapy works – maybe not the way that we think it does – but it works. Manual treatment has come under fire of late given emerging research suggesting that our skills in palpation and segmental movement may not be as specific as we’ve been taught. There is a huge effect of the act of touch, of passive movement, of the confidence a skilled practitioner can give a client. Some of the best therapists I’ve known use manual therapy to assist in movement development through increased client awareness of the area in question, the reduction in pain, and increased mobility after treatment.

Hybrid Therapist/Strength Coach

The fallacy: Just load it, bro!

The reality: This is my realm, so I’m pot shooting myself here. Optimal loading is one of the most important factors in physical and physiological adaptation – ok, psychological too. Having said that, if loading is the goal, the movement has to be of sufficient quality to achieve what you’re trying to achieve. Is there a place for round back deadlifting? Of course (see comments under pain science). Will I promote this when developing whole body strength in most people? Not a chance. Movement matters and technique matters. If we want to keep our clients healthy and resilient the loading needs to be appropriately progressed with a technique that supports longevity.

Functional Specialist

The fallacy: Our bodies are dysfunctional! We can’t load that dysfunction before I can fix it with my 128 point screening and corrective exercise approach!

The reality: As therapists, we are taught to develop an eye for finite deviations in movement or posture. In my experience, for the vast majority of clients, we tend to take this too far. Our bodies are naturally designed to have some asymmetries and anatomical differences. Just because something is slightly asymmetrical or limited in ROM doesn’t mean that we need to harp on this before we can get someone training. If your limited hip ROM is due to the anatomy of your hip socket, all the mobility work in the world won’t change that. Also, if a slight asymmetry is not painful and doesn’t cause major deviations in lifting technique, don’t create a problem where there is none. Having said that, I do like the screen and corrective approach for assisting with determining individualized technique modifications and to help with grooving motor patterns. I would do this concurrently with lifting, though, rather than a prerequisite. I call this a top down-bottom up approach which you can learn more about below:

Movement Guru

The fallacy: Just move, baby!

The reality: Motion is lotion, so there really is no wrong way to move. Unless, that is, you’re in acute pain with the movement or you’re lifting heavy with that movement (see above). Sample movements, find what works for you, but keep technique in mind when lifting heavy.

CrossFit Trainer

The fallacy: It’s all random BS that’s too intense for most people. And you’re guaranteed to get injured.

The reality: CrossFit has a well-designed system of controlled randomness that elicits multiple adaptations across many physiological and physical parameters. When trainers are following the method well, it is scalable for any person and results in pretty impressive gains in fitness. Athletes who are stronger tend to perform better, but CrossFit results in pretty strong people as well. A common criticism is that CrossFit training may not train you to make the optimal adaptions in a single aspect of fitness, although CrossFit’s Russ Greene shared some pretty compelling evidence to the contrary HERE.

For the vast majority of clients, though, they don’t need or want to be the strongest or fittest, but want to be well rounded, which is what CrossFit does. They’ve also done the community aspect well which helps with adherence.

Evidence-Based Practitioner

The fallacy: If it’s not in a meta-analysis, it doesn’t count.

The reality: Exercise itself, regardless of type, is a pretty impressive, evidence-based method of obtaining health and fitness (and rehab) goals. There doesn’t need to be a controlled trial for every type of exercise that someone ever wants to do. Get them exercising with something they will continue with, and you’ve done more good than if they were sitting on the couch. The trick in navigating the research is in determining which studies apply to your client in front of you, at the current time. This is too huge a topic to be covered here, but just be open to considering the evidence if it directly refutes what you’re doing.

Now That I’ve Offended Every Type of Fit Pro…

Maybe we don’t have to fight about all this after all? We can waste our time arguing over social media on the merits of each approach, or maybe it’s enough to say, “hey, I do it differently than you and that’s ok. What can I learn from you?”

Maybe the answer is nothing. Or maybe we can expand our thinking a bit and avoid being ass hats behind our keyboards. Or, and that little important thing about doing the best for our clients. An open, but analytical mind can’t hurt that at all.

About The Author

Scotty Butcher

Dr. Scotty Butcher, BScPT, PhD, ACSM-RCEP is an Associate Professor in Physical Therapy at the University of Saskatchewan, co-founder of Strength Rebels, and consultant at Synergy Strength and Conditioning in Saskatoon, SK, Canada. Formerly certified as a CSCS and currently training as a powerlifter and part time CrossFitter, he has a passion for strength training and translates this to promoting quality exercise training and rehabilitation practices for clinicians and students. His focus in research, teaching, and clinical work is on the hybrid rehabilitation/strength training approach, and shares his views through blogging and vlogging. Connect with Scotty on Twitter, Facebook, and YouTube.