Biofeedback: A Misapplied and Misunderstood Term in Strength Training

Posted on 12 Sep 2012 16:37

By Eric Troy

Have you heard the one about the guy who walks into the gym, bends over and tries to touch his toes, does a deadlift, touches his toes again, scratches his head, does a squat, touches his toes again, does a barbell curl, touches his toes one more time, and decides, due to the biofeedback he got from trying to touch his toes, that the barbell curl is indeed the best exercise to perform that day?

Good one, right? Okay, maybe not such a great joke, but that's because I didn't make it up as a joke, it's real. I exaggerated a little, sure, about the barbell curls, but this method of biofeedback is out there.

Biofeedback has become one of those overused and misappropriated terms in strength training. People who are "using" it in these ways seem to think that biofeedback is a sort of magical thing whereby your body gives you 'feedback' about internal processes and you can immediately act on this report in order to make better choices. Think of it as a memo your body sends out.

Except that is not what biofeedback is. I've been hearing about these biofeedback techniques for strength training for years now but recently someone sent me a link to a video demonstrating how to find the best sort of pullup to do by using a toe touching range of motion test between different pullup attempts, such as regular, chin up, wide grip, and rope pullups. You bend over to touch your toes but you just let your arms sort of naturally hang so that you reach your range of motion without forcing it. Then you do one of the pullup attempts. Then you do the toe touching thing again and see if your range of motion has improved, stayed the same, or worsened. Presumably, when it gets better your body has told you what the BEST type of pullup to do that day will be.

Quite amazing! Almost magical. Now, people are applying this kind of thing to what strength training exercise they should do on a certain day, much like the tongue-in-cheek scenario I laid out above.

Now, biofeedback is a real term. It is used by psychologists and there is ongoing research on using different types of biofeedback as a therapeutic tool, for all sorts of people with all sorts of problems.

Before this gets too confusing, then, let's define biofeedback. First, biofeedback is a tool. A technique that is used by professional psychiatrists, and the like. In a biofeedback technique, information about a normally unconscious physiologic process is presented to a patient (and/or the therapist) as a visual, auditory, or tactile signal.

I'm going to put those last three terms in bold, to drive them home: visual, auditory, or tactile signal.

Okay, let's compare two very simple scenarios, and then decide whether one or the other fits the definition of biofeedback.

1. A Zen kind of Yoga master dude sits in a meditative position and carefully slows down his heartbeat by calming his breathing and doing some other mysterious stuff.

2. A patient is hooked to a heart rate monitor and his heart-rate is presented to him in real time via an auditory bleep. He then tries to slow down the rate of the bleep, by using different mental processes, breathing exercises, etc. When the bleep slows down, he knows whether what he is doing is working or not, and if it speeds up, or stays the same, he knows he is not being effective.

I don't have to tell you that example one is not biofeedback, although you've probably heard, on TV or something, that it is. The reason it is NOT biofeedback is because the monk guy is receiving no ongoing direct signal, in a simple form, about the state of his heart beat. He is not reacting to anything. He is simply relaxing and slowing his heart rate through some technique that he has learned through years of practice. Sure, he may claim to be reacting to some signal that only he can detect, but well…you can believe that if you'd like to. I do not. The fact that it is not biofeedback does not mean it is not very cool that he can do this, and very useful, as well. However, actual biofeedback therapy probably would have been much quicker to learn. Why? Information. Biofeedback is a bit like learning to ride a bike. You are just doing it until it becomes natural. You don't think about it, it just happens. Your brain uses the information to find the quickest path to the desired outcome. It's a lot like playing a video game.

It is true that sometimes the word biofeedback is used in regards to physiological processes in the body but these are automated processes that we have no control over. This is not the sense of the term we are concerned with here.

Through a DoD grant, Dr. Carmen Russoniello of East Carolina University is working toward a portable biofeedback training program that could prevent or reduce post-traumatic stress symptoms. (Photo by Dr. Carmen Russoniello)
Image from ArmyMedicine via flickr

Through a DoD grant, Dr. Carmen Russoniello of East Carolina University is working toward a portable biofeedback training program that could prevent or reduce post-traumatic stress symptoms. (Photo by Dr. Carmen Russoniello)
Image from ArmyMedicine via flickr

You may have heard that when you get cravings for certain foods, this is biofeedback. Your body is giving you feedback about what it needs. No. This is not biofeedback and there is absolutely no evidence that our brains will reliably signal cravings for foods that we need at a certain time. In fact, our brains are much better at craving things that are exactly what we do not need, and from time to time, people crave all manner of weird things. Cravings are much more centered on taste and texture than nutrient content. People have theorized that weird cravings are also some signal that you need some certain thing. For instance, if you crave dirt (yes, it happens to people) you must need minerals! Now, you think about that one for yourself.

For more on the kind of claims made about cravings see the forum thread Food Cravings? Here is What Your Body Really wants. Pay attention to the comment I quoted by a Dr. Clark, as his comment pretty much sums it up.

The point is that cravings are seen as a way that your body signals you about its biological needs. Similarly, this toe touching range of motion thing is seen as your body signalling you about its exercise needs, or preferences, or something like that. This simply shows a misunderstanding of the meaning of the word. The bio part of the word does not mean that your body is signalling you, it means you are receiving a signal about a biological process.

Everyday Biofeedback Devices

This is not to say that we do not have devices in our everyday lives that are examples of biofeedback devices. A bathroom scale, for instance, is one. It measures your weight and displays the results back to you. Your weight is a function of your biology but you would not really know it without the scale display. This does not mean that the scale is a great training tool, as far as biofeedback goes, but it is an example.

Another example is a heart rate watch, like you use for jogging. This may not be a great way for you to learn to control your heart rate, but it is a form of biofeedback and it allows you to reach a target heart rate, for instance, hold it for a certain period, and then decrease the intensity to allow your heart rate to go down. You wouldn't need this device if you did not think that a certain target heart rate was necessary, and that is open to critique, but nonetheless, it is a kind of biofeedback device.

Here is one you may not have considered: A mirror. A mirror displays your appearance to you. If you have bags under your eyes from lack of sleep, then there you go: biofeedback. If you look a little green because you've been drinking too much and you're hung over: biofeedback. Not a great tool because of the subjective nature of your reaction to what the mirror tells you, but it could be called a biofeedback device, as well.

Putting your hand on your chest or feeling for your pulse, while trying to control your heartbeat is biofeedback. Not a very effective way to do it, of course. We are stretching things a bit and supposing that your hand is the device and it provides a direct tactile link to your heart rate. Which it does, although not very well. The problem is that the device itself does not display accurate, unambiguous results. You have to interpret what you are feeling. Is it a little faster? A little slower? To be more accurate you'd have to also use a stopwatch to time the beats within a certain period. By the time you do all that, the whole point of biofeedback is lost. So, we see that biofeedback uses simple and unambiguous ways of displaying the information, so there is no "processing" involved for the trainee.

Biofeedback Training

Real biofeedback relies on an ongoing signal to the patient that translates the biological process into an easy to understand and easy to react to stimulus, not one to be judged by subjective measures. For instance, either the pitch of a sound goes up, or it goes down. It is straightforward. Just saying "My heart is beating fast, I must be nervous," is not biofeedback. It is simply an inference. Biofeedback is not diagnostic, it is a tool used to teach certain people to control certain things. Biofeedback research was never meant to test how one should progress on a pullup or which exercise out of several choices a trainee should perform. The whole concept is absurd.

Toe touching is used in biofeedback research, but not to evaluate someone's readiness to do an exercise. An example of how the toe touch has been used is to demonstrate a lack of muscle tension awareness, which applies to most all of us, but people with musculoskeletal pain could benefit from being aware of this. Muscle tension could also be a good measure of autonomic arousal.

But to use a toe touch to demonstrate muscle tension, or lack thereof, a researcher would not just have someone bend over and then say how he felt about it! Why? Because didn't we just say that most people are unaware of their muscle tension? Most will report that they are relaxed and felt fine about the whole thing. And just having them touch their toes over and over would not be biofeedback, it would be stretching. If they are able to bend over further after performing this several times, is it because they have been able to relax after evaluating the results of their toe touching efforts? Or, is it because they have increased their range of motion, as would be expected after repeated toe touching? And, is range of motion on toe touching really a measure of general muscle tension?

graphic respiration display for biofeedback training

Graphic respiration display for Biofeedback
Thanks to Fredric Shaffer, PhD, BCB

graphic respiration display for biofeedback training

Graphic respiration display for Biofeedback
Thanks to Fredric Shaffer, PhD, BCB

So, while the patient would certainly be reporting his subjective experience, what the practitioner needs is a way to give the patient direct feedback as to his muscular tension. Surface electromyographic recordings (SEMG) of the patients back and neck would be used.

After initially trying the toe touch, the patient could receive this SEMG feedback while they bend forward and touch their toes again. This feedback would give them immediate information as to how successful they are at relaxing their muscles. The signal could be auditory, or tactile, or both. If the SEMG increased, the pitch of the auditory signal goes higher. The practitioner could use verbal coaching to help the process along, etc. The goal would be to achieve mastery of the skill of hanging forward totally relaxed, both back and neck, using the SEMG feeback. Then, to be able to repeat this skill without the benefit of the feedback.

Now, of course I didn't just make all that up about toe-touching, that was based on a report given by Thorne, et al. at the 42st Annual Meeting of the Association for Applied Psychophysiology and Biofeedback, as related in the book Case Studies in Applied Psychophysiology: Neurofeedback and Biofeedback Treatments for Advances in Human Performance, edited by W. Alex Edmonds and Gershon Tenenbaum.1

According to the book, the biofeedback movement began in the late 1960's and early 1970's amidst lots of excitement over its perceived potential to turn human beings into virtual super-humans. Early researches thought that biofeedback would allow humans to gain "enhanced awareness and control over visceral physiology, musculature, and states of consciousness." A founder and first president of the Biofeedback Research Society, Barbara Brown, boasted that biofeedback would give to human beings a new mind and a new body, which she later imagined as a supermind with "expanded consciousness and unlimited potential."

As you are well aware, these superminds haven't quite happened yet and there is no longer such a lofty goal for biofeedback research. What biofeedback is used for is to give people tools to have better awareness of their mind-body "linkage," increased control over their physiology, and better self-regulation strategies, to borrow liberally from the book's language. That is a good thing, but a far cry from unlimited potential.

Now that we have a firm grasp on biofeedback (we do, don't we?) let's evaluate this toe-touching to choose which exercise technique to see if it meets the criteria of what we've learned biofeedback to be.

When I described the toe touching study above, what was actually being reported by the patient, as far as his/her subjective experience? Was it how close they came to touching their toes? NO. It was there impression of how relaxed their backs and necks was simply a report of their subjective experience of their state of relaxation. Yet, the toe-touching exercise technique correlates range of motion directly with the appropriateness of an exercise. Furthermore, in an actual research setting, the person would be instructed to basically just flop over and hang there, but not to attempt to pull themselves down further, as if stretching, in any way. A person who was trying to figure out what exercise to do, even if a toe touch could be relied on as a good test, could NOT be relied on not to cheat, albeit unconsciously.

But what is really being looked at? It is not range of motion, it is relaxation. Your state of relaxation, as in your state of muscle tension, is associated with your autonomic arousal. So, why would one exercise change this state, making it "lower," presumably, while another exercise increased it? Is it because, there is some process in your body that evaluates the best exercise out of a group of exercises and then reports this to you via an increase or decrease in muscular tension?

heart rate monitor watch

Heart Rate Monitor Watch
A Cheap Biofeedback Device
Image by D100a via wikimedia

heart rate monitor watch

Heart Rate Monitor Watch
A Cheap Biofeedback Device
Image by D100a via wikimedia

No, of course not. There is only one reason why performing one exercise would increase your arousal level, and so muscular tension, and another decrease it. And this has everything to do your your mind and how you feel about that particular exercise! It is simply this: We all feel more comfortable with certain exercises. This has to do with many factors, such as your level of advancement, familiarity, previous injury history, the overall perceived challenge and skill level needed, etc. Little things about even a minor variation could subtly increase tension level, which might, presumably, show up in your range of motion when you tried to touch your toes. But we are presuming too much! Because there is no reason to think that just touching your toes and looking for changes in range of motion is really telling you anything at all.

Even if it does, it is only reporting to you your level of relaxation after a certain attempt. If you are NOT relaxed, and are in a state of high arousal, a much more direct route would be to use relaxation techniques (e.g. breathing exercises), imagery, etc. to self-regulate. But if you find yourself just a bit more keyed up after a certain exercise, does this mean you should NOT do it? Are we looking for a state of total relaxation? No. That is not what we are looking for. Athletic performance and total relaxation does not go hand in hand. Being a bit keyed up does not mean you can't do an exercise and perform quite well at it. Being completely bonked out and stressed may mean you shouldn't do it, OR that you should first do some relaxation in order to bring down your arousal level to an appropriate pitch, but looking for tiny little subtle variations in muscle tension, between one exercise and another, through toe touching? It is the opposite of scientific and reasonable, it smacks of magical thinking.

And there is one more important criteria. Remember what the point of the toe-touching experiment with SEMG was? To achieve mastery of the skill without the benefit of the SEMG feeback. This is the main point that the toe-touch test for exercises is missing…that there is not a point. There is no skill being learned, nothing at all being accomplished.

Quite frankly, that is absolutely pointless and it in no way has anything to do with what exercise you should perform. Most of my trainees would be performing deadlifts every day because they'd cheat their way to the barbell. A better guide to what you should do today might be, I don't know, what you did the day before? What's on your schedule?

No matter what exercise you do, you are going to be affected by it neurologically based on your comfort with it. In other words, different "skills" cause different levels of arousal. This arousal is basically your state of anxiety. Those exercises you are more "anxious" about will cause you to be more tense, pure and simple. And not just anxious. Those exercises you don't like. Those that you are dissatisfied with your ability on. Those which have given you problems in the past. OH! Those you feel you have suffered an injury during? Sure. All of this, and more.

I watched a video demonstrating this pullup technique and, low and behold, chin ups "tested" better. Chin ups are always easier than other pullups! So, is it really a surprise that they "tested" better? Or did they test better? Was it that he just wanted to do chin ups because he liked them and, duh, they are easier, so he "tested" better. How do WE know how well a person is actually testing without a system in place to monitor things? We do not. In fact, this test violates just about every criteria that makes for a good test.

Dyspenesis: Unneeded Work

Okay, a lot of this has to do with something called "dyspenesis". That is something that's been discussed since the 1970's. If you look at a few things:

1. When you perform a task of some kind, or an exercise, you are not really aware of any excess muscular tension you get from it or bring to it.

2. You tense up muscles that you do not need to tense up when you do certain exercises. I.E. you tense your neck during the deadlift, etc., but you are unaware of it.

4. Between repetitions of an exercise, or during some task, you never relax at all, as if your whole body is continually performing the task, even when it is not.

All these things are part of dyspenesis and it refers always to work that is unneeded. Misplaced effort. The best way to become aware of this unneeded muscular tension is to learn to do relaxation exercises. By learning to relax, you learn what it is like to NOT have excess muscular tension. Since you are always having excess muscular tension, you can't be aware of it until it goes away. Think of it like a lumpy bed that you are used to. When you get a new mattress, suddenly you realize how uncomfortable that old one was! I go deep into all this in the Getting in the Zone Series.

Recap on Biofeeback and How it Might Be Used in Athletics

The idea of something like a toe touch is not to "test" how well a certain exercise will work for you. Instead it is simply a movement screen, and a silly one, at that (I won't start on movement screens, or I'll never stop). The idea of biofeedback is for an individual to learn to control physiological reactions and processes! It is for the "user" himself to USE to learn to control these things better. These Yoga master dudes who are supposed to be able to control their heart-rate, as I mentioned above, are not practicing biofeedback. It is just relaxation.

Biofeedback is not just a measurement but it is directly communicating that information to the user. And this information is information that is not usually directly accessible. Most of its research seems to be centered on pain management.

The appropriate use of biofeedback for strength training, would not be to pick an exercise but to help someone control some physiological process that they otherwise could not, had trouble with, etc. Since strength training movements are so complex, it is very difficult to use any of this except globally. That is, to learn to "relax" if relaxation techniques weren't otherwise effective. Other tasks are more discrete so that a person might be able to hone in on ONE thing, and use biofeedback to monitor and control that ONE thing..but this is much harder with strength training movements.

Some strength training things are not "precise" and therefore not amenable to biofeedback training. For instance, a firearms shooter might want to monitor the tension in his forearms, right? Or his breathing right before a trigger pull. You might relate that to a grip device. But a person using heavy grip devices is not performing something so precise…he is simply trying to exert maximal force. He might be able to use biofeedback to monitor unneeded tension but it would be hard to determine if that tension WERE unneeded, or if it actually affected performance.

Biofeeback + Voodoo Science = Comedy!

Unfortunately, while biofeedback research is an actual scientific area and has promising potential as a complementary tool for musculoskeletal pain management, stress management, etc. it has that very scientific sounding name combined with a "new-agey" kinda feel that makes it very attractive to quacks and the perversions of voodoo science. Instead of being content with the slow pace of actual research, they invent all sorts of fantastical properties for biofeedback and combine it with other magical things couched in scientific terms, so they can sell products to a gullible public.

Devices such as the emWave Biofeedback Stress Relief and the StressEraser Portable Biofeedback Device. The latter is a small devices with a cable hooked to a pulse oximeter type thing that uses an infrared sensor to monitor your "heart rate variablility." It displays these results as a wave on a small screen and you are supposed to control the wave to make a "good wave," which is a wave that is not all spikey but nice and rounded.

The emWave does something similar but uses an ear clip sensor and displays rising and falling colored lights displayed in a little window, along with a green light that is supposed to display your "coherence level" at any one time. You can also check your "coherence ratio" for the entire session. Which is something I've been concerned about checking for a while now.

Joking aside, while the StressEraser seems to limit itself to helping you learn to relax by controlling your breathing, the emWave goes over the top with all sorts of fancy made up terms. Before I get into that, let me remind you that you do not need a $150 device to learn to relax through breathing exercises. You can start doing it right now, for free, no equipment necessary.

The emWave is such a great example of pseudoscience, I'm glad I made this particular post just so I can talk about it. First, it was developed by a guy who is CEO of Quantum Intech. Folks, when the word quantum, as in quantum physics, comes up in any kind of self-help or alternative medicine kind of scenario, it's time to hang up the phone and wait for the next infomercial.

According the emWave, stress creates incoherence in our heart rhythms:

However, when we are in a state of high heart rhythm coherence the nervous system, heart, hormonal and immune systems are working efficiently and we feel good emotionally. emWave Personal Stress Reliever helps you reduce your emotional stress by displaying your level of heart rhythm coherence in real time. But emWave does more than just display coherence levels. It guides you toward stress relief by training you to shift into a coherent, high performance state.

I know that not all of you understand all the scientific lingo so let me translate that for you:

Yada yada, gobbledygook. We feel good emotionally hokum gobbeldygook. Completely meaningless nonsense training gobbledygook.

You can get a little further background, skeptically speaking, here.

The take home is that yes, biofeedback is a real thing with real application but you do not need to spend over 150 bucks to do what some simple breathing exercises will do for free. I already have written some beginning ones down for you long ago: Breathing Exercises for Relaxation.

For more reading on this and other aspects of sport and exercise psychology see Foundations of Sport and Exercise Psychology by Robert S. Weinberg and Daniel Gould

1. Edmonds, W. Alex., and Gershon Tenenbaum. Case Studies in Applied Psychophysiology: Neurofeedback and Biofeedback Treatments for Advances in Human Performance. Chichester, West Sussex: John Wiley & Sons, 2012.

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This page created 12 Sep 2012 16:37
Last updated 13 Apr 2018 22:12

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