Strength Training, Pain, and the Regressive Fallacy

Posted on 29 Jun 2010 05:32

You're going to wonder why there is a psychology lecture on a strength training blog, I'm sure. Well bear with me because I'm not even going to talk about psychology, even though that is an interest of mine. Listen to the lecture by Dr. Paul Bloom of Yale University and get with me on this because it relates to some of the points I've been making in my posts here and many comments and articles throughout the site.

Dr. Bloom starts out talking about depression and therapy for depression. He says most people who get depressed don't go to therapy. Even most people who suffer from chronic depression probably don't go for therapy. Yet, as Professor Paul Bloom explains in this Yale lecture, those who do tend to go report that therapy made them feel better.

But does therapy really work? As Prof. Bloom explains the answer is very difficult to pin down. You ask someone if therapy made them feel better and many of them may say yes but this doesn't "prove" that therapy works.

Dr Paul Bloom on The Good Life: Happiness

As Dr. Bloom explains, people's self-report on whether therapy made them feel better could be a statistical byproduct of what's called "regression to the mean.":

"So, the idea looks like this. This line plots how you feel from great through okay to awful and it goes up and down and in fact in everyday life you're going to-some days are going to be average, some days will be better than average, some days worse than average. You could plot your semester. You could do a plot every morning when you wake up or every night before you go to bed. You could put yourself on a graph and it'll come out to some sort of wiggly thing. Statistically, if something is above average or below average it's going to trend towards average just because that's a statistical inevitability. When do people go to therapy? Well, they go to therapy when they're feeling really crappy. They go to therapy when they're feeling unusually bad. Even if therapy then has no effect at all, if it's true that people's moods tend to go up and down after you feel really bad you'll probably improve rather than get worse. And so this could happen-the normal flow could happen just even if therapy has no effect at all."

Now we would never really plot out our moods and we certainly wouldn't plot out our strength training progression, or pain, or anything like that. But maybe we should. In fact, I have used plots before. I use them to make points. My comments on the Single, Double, and Triple Progression page made great use of charts to bust the myth of "linear progression". The thing about plotting any 'organic' thing (best word I could think of) out is that the longer you plot it the less wiggly it gets. That was the main point I was making in those comments anyway.

But when it comes to any parameter of "fitness", in the short term, most people are going to have very wiggly plots. Same thing with musculoskeletal pain. You get good days and bad days. Always. Dr. Bloom asks, "When do people go to therapy?"

"Well, they go to therapy when they're feeling really crappy. They go to therapy when they're feeling unusually bad. Even if therapy then has no effect at all, if it's true that people's moods tend to go up and down after you feel really bad you'll probably improve rather than get worse."

I mentioned bodybuilding and strength traning "programs" and I mentioned pain. Think about all the alternative "medicine" out there claiming to stop pain. Stop that low back pain!

Let's ask our own questions.

When do people start strength training programs or bodybuilding programs? Mainly, I mean.

1. When they are really out of shape.

2. When they aren't getting results because their training is not organized.

Now think of Dr. Bloom's comments. When you are really really out of shape you can only improve by doing something! When your training is disorganized anything that organizes it will seem like a miracle by comparison. And if you 'feel' out of shape to boot, well, you probably WILL feel better. But you probably would have felt better some days anyway.

Most of the programs people are selling are only a little bit better than Dr. Bloom's suggestion of doing naked jumping jacks on the roof.

When it comes to pain it's even easier. When do people go "get an adjustment", or buy some miracle herb product?

When their pain is really bad.

And they feel better after getting an adjustment or after taking a pill. But if you plotted out their pain you'd find that it was up and down regardless if they took the pill or got the adjustment. This is what is known as a "regressive fallacy". What happens is that we do not take the "long view" and see the big picture. And in the big picture, you have good days and bad days. Pain peaks and it ebbs.

Do programs work? Do herbal formulas work? Do alternative treatments work? People say they do, that's for sure, but that does not really show us that they work. Especially since people keep switching programs, or keep taking new pills, or keep going back for adjustments over and over and over again.

Dr. Bloom says that we CAN say that therapy works, by and large. I take it that's assuming that people start and end therapy, then. Seems part of the definition of 'working' doesn't it? That it ends at some point. Why is it then that people will keep doing the same magic program even though they keep hitting walls in their training? And why will people keep going back for adjustments, for the SAME pain, for YEARS? Or keep taking herbs, sometimes 20 or 30 different ones?

I picked on chiros because of an incident that happened a while back. But I need to back up.

Many chiropractors have branched out and started to view the body as a whole, especially regarding the undeniable importance of soft tissue physiology. They understand that if a joint is out of whack it's probably a soft tissue problem that PUT it out of whack so man-handling the joint may not be the answer. So I'm picking on the stodgy old stuck in the mud types that only do adjustments.

A while ago a friend of mine was talking about her neck pain (from a car accident) and someone nearby said "go get an adjustment". I almost bounced out of my seat. I was pretty brutal and maybe even somewhat rude in my response to that. But hey this was my friend who had been in a car accident, injured her cervical spine, and someone was suggesting she have a guy MESS with it.

But this person obviously believed wholeheartedly in "getting adjustments" and had probably been going to the same chiro for years to have her neck jerked around. After my vehement reaction I was informed that chiros do "lots of research on the spine".

"I do lots of research on the spine as well," I said. Want me to fix yours?" I think I pissed them off and I really didn't want to but my reaction was "from the heart" so to speak. Yes, I do like some people with chiropractic backgrounds. I never dismiss anyone out of hand. But even to those people I will say I think adjustments are whacked. Get it? I said "out of whack" and then I said "whacked".


Paul Bloom, Introduction to Psychology (Yale University: Open Yale Courses), License: Open Yale Courses Terms of Use

This page created 29 Jun 2010 05:32
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