Starting with evidence based hypotheses and the refining through hundreds of n = 1 iterations is a powerful method for applying a stimulus to a complex system. Strength and diet are two perfect examples, where you can perform countless mini-experiments in between the rare publication of good studies.
My issue is not as much with the studies per se, as it is with a large number of those in the evidence based community who say that the almost universally low quality studies about strength training in their field, are so dispositive that you should ignore all subsequent real world evidence to the contrary, and all those n=1 iterations you mention aren't even necessary, because we already know the answer. When those n=1 iterations don't match the studies, that could only be because, well, n=1, placebo, bias, etc... According to them, there is no serious possibility that even hundreds or thousands of reports of n=1 contrary to the studies can question the studies. The only thing with standing to question the studies is another study. And this is all with studies that typically have less than 30 participants, for short durations, without any other lifestyle factors controlled for such as sleep, nutrition, genetic potential, psychological motivation and willingness to push to failure, etc...
Nobody who understands how to read a study should think that. For exactly the reasons you list, those studies are limited. They are a fantastic informed starting point, but far from the final word.
I hesitate to name names bc while I dislike their ideas, I have at least generally avoided making it about specific people. But I could show you public posts from prominent evidence based experts and influencers which say or at least heavily imply exactly this. Some even have terminal degrees, MDs and PhDs, and say this under the color of their credentialed expertise.
That is a poor understanding of the tools we have.
Even if they have sone callouses, they likely don’t have the applied science of coaching.
And even then, some are only coaching elites.
I am trying to “coach” post-chemo patients to regain some muscle after a lifetime of being sedentary. The same principles may not apply perfectly in the two groups.
It is a poor understanding, I very much agree. That's why I write/say what I do about "evidence based." Not because I dislike the scientific method, but the opposite, because I think it's being ignored under the guise of 'science' by people under the color of scientific authority - much like we saw with covid. Not coincidentally, most of the same people who do this in the fitness and nutrition sphere, were silent or approved of those covid measures - as far as I've seen.
Some of them do coach, but from what I can tell, their approach is that if something goes differently than the evidenced based studies suggest, that means the person is doing it wrong somehow. There's no real world feedback that could happen, only other studies, that could get them to question anything. The real world is subordinate to the world constructed by low quality studies.
I had an early moment in my oncology career. We were talking about promising results from a phase II study (small, single treatment arm) that looked better than standard of care, and I commented the we should consider using it instead.
My attending politely eviscerated my argument, pointing out the small sample, cherry picked subjects, publication bias and any number of other reasons why what I said did not reflect a careful consideration of the limitations of the paper.
Starting with evidence based hypotheses and the refining through hundreds of n = 1 iterations is a powerful method for applying a stimulus to a complex system. Strength and diet are two perfect examples, where you can perform countless mini-experiments in between the rare publication of good studies.
My issue is not as much with the studies per se, as it is with a large number of those in the evidence based community who say that the almost universally low quality studies about strength training in their field, are so dispositive that you should ignore all subsequent real world evidence to the contrary, and all those n=1 iterations you mention aren't even necessary, because we already know the answer. When those n=1 iterations don't match the studies, that could only be because, well, n=1, placebo, bias, etc... According to them, there is no serious possibility that even hundreds or thousands of reports of n=1 contrary to the studies can question the studies. The only thing with standing to question the studies is another study. And this is all with studies that typically have less than 30 participants, for short durations, without any other lifestyle factors controlled for such as sleep, nutrition, genetic potential, psychological motivation and willingness to push to failure, etc...
Nobody who understands how to read a study should think that. For exactly the reasons you list, those studies are limited. They are a fantastic informed starting point, but far from the final word.
I hesitate to name names bc while I dislike their ideas, I have at least generally avoided making it about specific people. But I could show you public posts from prominent evidence based experts and influencers which say or at least heavily imply exactly this. Some even have terminal degrees, MDs and PhDs, and say this under the color of their credentialed expertise.
That is a poor understanding of the tools we have.
Even if they have sone callouses, they likely don’t have the applied science of coaching.
And even then, some are only coaching elites.
I am trying to “coach” post-chemo patients to regain some muscle after a lifetime of being sedentary. The same principles may not apply perfectly in the two groups.
It is a poor understanding, I very much agree. That's why I write/say what I do about "evidence based." Not because I dislike the scientific method, but the opposite, because I think it's being ignored under the guise of 'science' by people under the color of scientific authority - much like we saw with covid. Not coincidentally, most of the same people who do this in the fitness and nutrition sphere, were silent or approved of those covid measures - as far as I've seen.
Some of them do coach, but from what I can tell, their approach is that if something goes differently than the evidenced based studies suggest, that means the person is doing it wrong somehow. There's no real world feedback that could happen, only other studies, that could get them to question anything. The real world is subordinate to the world constructed by low quality studies.
I had an early moment in my oncology career. We were talking about promising results from a phase II study (small, single treatment arm) that looked better than standard of care, and I commented the we should consider using it instead.
My attending politely eviscerated my argument, pointing out the small sample, cherry picked subjects, publication bias and any number of other reasons why what I said did not reflect a careful consideration of the limitations of the paper.