Common Themes and Differentiation

The manner in which I treated patients early in my medical career was based upon recommendations by my professors. As I progressed, I began reviewing reams of scientific evidence and choosing best treatment methods based upon clearly superior results and my intepretation of those results. As time has passed, my medical practice is still based upon respected colleagues recommendations and my interpretation of the available science, but my experience is allowing me latitude in choosing treatment methods for individuals, even when it may not particularly follow “what the books say” to the detail. The variances today are based in recognizing subtleties in specific patients and my own collective experience, which may not yet achieved statistical significance or undergone peer review. I believe many of my treatment successes with difficult cases are based upon this growth in detecting individual patient differences and applying personal experience to the scientific evidence available.

For me, I have found my coaching/advising development has followed much the same path as my medical practice. I initially learned by rote fashion, then slowly adapted my training based upon scientific evidence and now tend to use a combination of personal bias mixed with scientific evidence and respected colleagues experience.

Training protocols, like best treatment medicine, are a wonderful place to structure basic outlines of athletic improvement. But similarly, strict adherence to an algorthim generated as a collective mean lacks the crucial element necessary for a successful outcome: attention to individual variation.
**************
What does all this mean? Let me give you a couple of real world examples.

In medicine, it is accepted that vancomycin is the drug of choice for MRSA infection . Though resistance is emerging, this antibiotic is life saving for millions of people with this infection It is the drug of choice and routinely given…if you aren’t allergic to the drug. If you are allergic to vancomycin, administration of the drug can result in anaphlaxis and death.

This outcome is rare. If you looked at the success of vancomycin treatment versus the incidence of anaphylaxis/death, overwhelmingly most would agree with its use MRSA infection. UNLESS, you are allergic…it’s use in this patient could result in death.

**************
How does this relate to training protocols? I find it interesting reading opinions on what endurance sport training regimens should be or which particular coach has the correct recipe/method/plan. I constantly hear the debate of quantity vs. quality…intensity vs. volume debate. But generally speaking, I don’t know anyone who trains all sessions easy nor all sessions hard. Yet, random debates continually arise depicting one method as exclusively one way or the other or people depicting a certain coach/athletes approach as exclusively one way or the other.

Instead, I’ve found speaking to different coaches (who are labeled as one type or another) reveal general agreement to most training principles. And I tend to look at the principles that the different coaches and plans agree upon. For me, this is reasonably solid evidence that despite sometimes diabolically different philosophies, the common ground likely works most of the time for most of the people.

These common principles are based upon the population in general. And it is safe to assume most principles hold true for nearly everyone. From time to time, there are individual traits that cause that athlete to stray from the population as a whole. And this must be identified…similar to the patient who has a vancomycin allergy. It would be pointless to send two novice triathletes the same workout without knowledge of unique traits.

For instance, consider two 30 year-old individuals who are training for their first triathlon. They are both cardiovascularly healthy individuals who are near their ideal body weight. Neither has any recent swim/bike/run training. However one was a “swimmer kid” growing up, competing in high school on the swim team. The other was a high school pitcher whose career was ended by shoulder pain and a current exam of his shoulder reveals pain and weakness with internal rotation and resisted forward flexion. It would be suicide to send the latter athlete the same workout as the former. It is likely he would need some time to rehab his impingement syndrome and strengthen his “swim muscles”.

***********

It is rare that you find a “quality, intense session” based coach who advises novice athletes to go hard from their very session nor “quantity based, LSD” coaches who never recommend intensity. What differs in their approach is applying “best treatment” protocols in consideration of the individual athlete AND the ability to elicit/diagnose limiters/unique traits that make variations to the basic protocol critical to the success for that athlete.

That is the tricky part. Can you identify a particular athletes position on the fitness continuum or specific strengths or weaknesses? Can you help deliver what the athletes need in a way that is positive and encourages the athlete? And ultimately, can you help the athlete identify what their ultimate goal is and guide them along the path to achieve that goal?

********
So, who is the best coach for any particular individual? I’ve fielded that question a lot recently and I believe it has more to do with whom an athlete can develop the one trait that nearly every coach believes in: consistency. I can speak from experience on the methods of Gordo Byrn, Kevin Purcell, Scott Molina, John Newsome, Alan Couzens, Tim Luchinske from whom I have personal contact as their athlete, camper at their camps, or training by their side. I’ve read musings from Joe Friel, Brett Sutton, Paulo Sousa who are popular on the many blogs and forums. And countless others as I write this seem to fit that bill as well…Mitch Gold, Rich Strauss (I know everyone can fill in their coach here as well).

Developing an environment that is conducive to consistent training over long periods of time is the key. Some coaches & plans do that well within certain athlete populations, others within a certain geographic location. But the ability to communicate effectively, create trust, and have fun go a long way in supporting the consistent training needed to succeed in athletics, and life.

*********
The little success I’ve had athletically is certainly in part attributed to one of two groups I’ve been fortunate to train over the past 5 years or so. The pic above is a part of the Winston-Salem, NC triathlon community (Go TriCoWS) that I raced with at Lake Placid. (My wife digs those sock, by the way, so I wear them as much as possible)

Here’s to finding what keeps you consistent,
Dr. J