Programming & Intervening with clarity: Is the tail wagging the dog?

Exercise, sets, reps, tempo, intensity and load – some of the common ingredients of a training plan. All are parameters that we understand and program in seemingly overlapping scenarios, but not always with an appreciation of the complexity or individuality of the case at hand. Two people or problems may share some similarities but their multi-variant individuality means their response to a stimulus will not be identical. People need tailored interventions or solutions but the trade off is increased time & consideration. Training systems can emerge with pattern recognition, consistent outcomes or logistical constraints that encourage typing or bucketing of similar individuals. Furthermore, a narrative you may have witnessed occurs – “We’ve seen ‘x’ presentation or problem before and we used ‘y’ as our method and it’s worked consistently”. Perhaps through our experiences, our bias, or by efficient mental association we can start to skip steps and jump from the evaluation of a person or problem to the method itself. The middle step that should influence or inform the last decision, in this case the method is the desired outcome or in a physiological sense the adaptation. The “tail wagging the dog” in this context is synonymous to the method controlling the decision because the critical reasoning is missing. 

Adaptation / Outcome Led Programming – (Alex Wolf Episode 32: Inform Performance Podcast)

Adaptation led programming was eloquently described during a podcast discussion between myself and Performance Consultant Alex Wolf. Alex has presented on this topic before and framed a question; Why do we strength train? The common answer being “to get stronger”. Yet however seemingly agreeable this response is, Alex with clarity offers a more pragmatic alternative “To optimise the biological systems capability to produce a specific force or velocity, strength training is a methodology not an outcome. Getting stronger or lifting more weight is a nice side effect. This conversation stood out to me as a clinician and coach as we may habitually select an exercise or intervention (the method) with reasoning that is vague. Prescription of a method has the potential to yield physical or athletic benefit, but without scientific clarity or reasoning we risk programming athletes with guess work or even worse applying kitchen sink approach – a battery of ideas that lack confidence or precision in any one of them individually. We need technical understanding to identify or understand the problem or objective and we need technical clarity to select the most appropriate method at the right time and delivered in the most effective way possible.  

“As a physio, treatment is never an answer, treatment is always a question and should be looked at in this way”. (Gordon Bosworth) 

Experientially as a Strength Coach or Physiotherapist, the more detail and understanding I have understood, collected been able to draw upon for a problem or objective – often the simpler my intervention, approach or program has been. This experience has been reinforced by the conversation with Alex Wolf, mentorship from Gordon Bosworth and more recently in conversation with Scott Epsley the Sixers Medical Director, who emphasised the importance of better understanding basic sciences to be effective clinically. 

Personal professional experience accompanied by fortunate conversations with the experts mentioned, has pragmatically encouraged or reinforced me to become increasingly focussed on the complexity in understanding the problem. To then paradoxically take a more refined approach tackling it clinically or practically. 

Andy McDonald BSc MCSP CSCS

Andy McDonald BSc MCSP CSCS

Physiotherapist,
Strength & Conditioning Coach,
Inform Performance Podcast Host