Healthy, Wealthy, & Smart with Karen Litzy | Episode 320: Nick Tumminello – Exercise Prescription
On Episode 320 Karen brings on Nick Tumminello, author and 20-year esteemed physical trainer, to the podcast. They hit a range of topics including how to apply the four principles of strength and conditioning to a training program, progressive and regressive loading, using the Socratic Method in training philosophies, and more. Listen to the full conversation and hear what insights Nick brings to the table from 20 years of experience.
Listen to Podcast View Podcast Transcript
Welcome to the Healthy, Wealthy and Smart podcast. Each week, we interview the best and brightest in physical therapy, wellness and entrepreneurship. We give you cutting edge information you need to live your best life healthy, wealthy and smart. The information in this podcast is for entertainment purposes only and should not be used as personalized medical advice. And now, here’s your host, Dr. Karen Litzy.
Hey, everybody. Welcome back to the podcast. Today’s episode is brought to you by Net Health. Representatives were just at Graham Sessions, so I met them a couple of weeks ago. They are so nice. Such a great company. So what do they do? They have ReDoc, powered by xfit. It’s a cloud based fully integrated EMR and billing solution, plus opt in to completely outsource billing services. That’s the best way to optimize revenue and managing PT billing, coding and compliance experts, taking the back office work off your hands reporting to you. So to learn more about ReDoc and complete revenue cycle management services, check them out at nethealth.com/healthy.
Okay, so today’s episode, I am so excited to have Nick Tumminello on today. Full disclosure, he has given me my strength training program over the last year or so and it has been amazing, but that’s just a side note. So Nick Tumminello is a 2016 NSCA Personal Trainer of the Year and the editor in chief of the NSCA Personal Training Quarterly Journal. He is the author of three books, Building Muscle and Performance, Strength Training for Fat Loss, and Your Workout Perfected. His new book’s coming out soon. He’s been a trainer for over 20 years, is the former strength coach for Team Ground Control MMA and has trained professional athletes in field, court, combat and physique sports. You can find out more about him at nicktumminello.com. And like I said, his new book’s coming out soon, so I think you can preorder it now.
So what do we talk about in today’s episode? Obviously exercise prescription but we talked about how to apply the four principles of strength and conditioning to program design. Once you get these principles down, that’s all you need. Progressive and regressive load management, why the Socratic method should be used when discussing training philosophies, Nick’s approach to new fitness fads and much, much more. So I’m sure a lot of you in my audience are already familiar with Nick. He has a wealth of knowledge. And we had such a great conversation. I’m so proud to call him a friend and it was super great to have him on so I hope you all enjoy this episode with Nick Tumminello. Hey, Nick. Welcome to the podcast. I’m happy to have you on.
I appreciate you having me on. Thank you for all you’re doing to the field to provide myself and people like me like a platform.
Oh, anytime and, and you and I met last year, no earlier this year actually at the San Diego Pain Summit. You were part of a great panel that I moderated with, it was you and Jason Silvernail and Ben Cormack and Jonathan Fass. And a lot of great info there. And I think people can still get that recording if they’re interested, right?
As far as I know, yeah. I think all the San Diego Pain Summits have been recorded and are available online for purchase.
Today, we’re going to talk about… we got well, first we got a lot of questions from people on Facebook, one of which, Jason Silvernail who we’re joking beforehand, I feel like he should do the interview, which maybe one day he will interview you and we’ll we’ll put it on the podcast anyway. But one thing that I hear often from people in the physical therapy world is that physical therapists are not good with prescribing exercise or we’re not good with learning strength and conditioning principles. So if we can, I would love for you to take us through some of the basic principles of strength and conditioning that you use everyday with your clients.
Sure, well actually, this is something that I wrote an article for the Personal Trainer Quarterly NSCA journal about, and I titled it A Principle-based Approach to Programming or Program Design. That’s a title that I came up with. And it was playing off of the evidence based approach, right? So I’ll just give you the verbal version of that article without getting into any specific references and making it as easy as possible. There are and we’ll circle back to this based on our little talk before we kind of went live here, circle back to the importance of taking a principle based approach.
So there’s four basic principles that most people in the health and fitness and other allied health professions, physical therapists, personal trainers, strength coaches are familiar with. And they’re as follows: principle of specificity, principle of individuality, principle of variation. And what’s the other one? Principle of overload, progressive overload. So those are the four. Now what I talked about in this article, and this is something that comes from me now is that normally, we hear those principles provided in kind of their own ways. But what I propose in this article was that if you are to take a principle based approach, which is the approach I talked about taking, that they actually work best if you utilize them in a decision making manner, almost like people say what is your clinical decision making process?
Well my strength conditioning programming decision making process predicates on using those principles in a sequential manner, because one provides you information that is important to the other and that you really can’t properly utilize one until you understand the other one. So here is the kind of hierarchy of principles if you look at it that way that I utilize. First is principle of specificity. Second is principle of individuality. Third is principle of progressive overload. And fourth is principle of variation or variety. Right now, I would say the last two, you could probably flip those two, but it’s the first two that I think are the biggest.
Now, let’s bracket that for a second and what those come out in questions. First is, what’s the individual’s goal? Because you can’t apply the principle of specificity until you understand the goal. So that really is the first determinant. That’s what it looks like in practical terms. What is the goal? Not about me, not about my chosen methods. What does their goal determine I need to use in regards to programming approach because not every approach is best for all goals?
Prime example, are you primarily trying to look at fat loss? Are you trying primarily looking at maximal force production, which is training more for strength. There are different programming approaches to maximize those, to create an environment to maximize those types of adaptions, which is all programming is. It’s about creating adaptions. So obviously, yes, some of them, they’re not mutually exclusive. Can you work to strength and also lose some fat at the same time? Of course you can. But we’re looking at how to maximize one or the other, because we have to have primary and secondary goals.
So first is principle of specificity. What is the goal? Then the next question is, well, what is the person’s abilities/limitations? So that’s the principle of individuality. Basically, okay, there’s lots of ways to work on strength, force production. But maybe this person is not built based on their hip structure, based on their medical profile. Maybe they just don’t like certain things, preferences. Maybe they’re not built to do heavy deadlifts from the floor with the arbitrary height of the Olympic plates, the 45 pound plates. So that is the principle of individuality.
Individuality is goal specific or sorry, it’s not only about their goal, but it’s also about their training environment. What kind of areas are they working out in? Well, let’s say they go to a big box gym twice a week, but they work out at home twice a week because they have very busy schedule on certain days. It’s not realistic based on times they’re coming in and out of work with traffic that they can’t necessarily get, with kids, whatever it is. And maybe at home, they only have dumbbells up to 50 pounds and a few resistance bands and a stability ball. So that’s where the principle of individuality applies.
So then the next question is, how do I provide progressive overload within the methods that I have determined, which are the exercises work well for them based on their individuality, individual movement patterns, ability, medical history and training environments? Then from there, we’re starting to narrow things down.
The last question is how do I vary the things that I’m giving them to keep things interesting? Now then here’s where people sometimes lose it. It depends on the individual’s goals. Some people are just looking for general fitness. With general fitness, normally they’re looking for more of an experience. They like a little more variety. If someone is a little bit more, I say this in quotation marks “serious”, more of like a gym rat type where they’re chasing certain numbers like they want to boost their deadlifts up or they want to boost their chin ups up, whatever it is, maybe it’s the amount of push ups they do. Whatever it is, then they’re going to look for a little more consistency that reflects whatever direct metrics they’re looking to have. And those are metrics that you decide again, back to principle of specificity, how do you know you’re getting stronger? How do you know you’re getting fitter? Whatever it is, goals are different. Some people, it’s chasing a bigger back, other people’s chasing bigger lifts, other people, it’s just simply working out three times a week more than they were before or maybe it’s four times a week. Maybe it’s twice a week because they weren’t getting to the gym more than once a week.
That is an individual thing, again taking us back to the first one. So that is my hierarchy. And that is basically my approach to programming. It’s those questions. What’s the goal? What’s the ability? And then what exercises can we use based off those previous two? And then how do we vary those concepts based off of the third one?
And so when you’re designing a program, so let’s take a case study. We’ll use me as the case study. So I came to you earlier this year, and I’m fine talking about this. So I give permission. I came to you earlier this year. And after we met in San Diego, and I think my goals were I wanted to be able to do a push up. I wanted to be able to feel like my arm’s not going to come out of the socket. I was really looking for stability in my shoulder. I wasn’t necessarily looking to lose weight and I’d wanted something that was going to be fun, that would fit into 30 to 40 minutes, and then I can go to the gym three times a week. So those were my goals. And I think that they were pretty specific, right?
I think you were looking for more muscle building.
Muscle building, yeah.
Yeah, basically look better in the mirror kind of.
Right, right. Yeah. And so the program that you gave to me had a lot of variation to it. A lot, which was awesome, because I’m still using it and I don’t get bored. But how do you decide when you’re doing these programs on let’s say on what kind of weights are you going to use? How are you going to progressively overload? Because I think that’s where people kind of get caught up. You always hear that oftentimes people are under loaded. And then they end up perhaps with an injury because they weren’t ready to do X, Y and Z because they were under loaded to begin with. So how do you work through progression, regressions and proper load management?
All right, so there’s two answers to that same question, because one is individual and the other one has to do with kind of a general programming approach. So let me answer the individual one first. If the question is what weights do I start with, which is what a lot of clients and patients will ask their trainers or physical therapists, obviously client or patient depends on the context of who they’re working with. You basically say, “Well, that’s determined by your ability, your strength.”
So what that does is you provide them a rep range. So let’s say I say, “Karen, I want you to do four sets of six to eight repetitions of trap bar squat or deadlift.” I call it a trap bar squat, because it looks more like a squat as your torso is more upright, but I understand some people call it a trap bar deadlift because you’re picking it up off the floor, and it’s dead weight, whatever you name it. What I’m telling you there is that I want you to use a weight that’s heavy enough that you can’t do any more than eight reps before your form breaks down.
Now yeah, you might be able to cheat out a few more reps, but I’m looking for no more than eight in the technique that we have deemed we’d like to see you’re doing in. So I’m determining the weight based on the rep range. But in regards to what weight that exactly translates into when you are on the gym floor doing it is going to be have to be determined by you. So that’s the way I put some metrics on it. And the reason why that’s important is because that’s going to change from set to set. So for example, if I give you and this is important to keep in mind for people who are training in a big box gym, especially at 5:30 at night when everybody and their dog is there.
So let’s say I give you dumbbell presses, and I say, “Give me four sets of six to eight reps.” Well even if you’re resting three minutes between sets, and let’s forget about whether we’re giving you paired sets or tri sets and keeping you busy, let’s just keep it simple and just talk about the dumbbell presses, for example. You’re going to have subsequent fatigue at each subsequent set. You’re going to have fatigue at each subsequent set. But if I’m giving you the same rep range, it’s more likely you’re not going to use the same weight each time, because you’re going to lose about five to 10% of strength in each set. Now, obviously, it’s going to be a little bit individual, depending on your muscular endurance and recovery.
So at that point, I’m actually making you use maybe three different sets of dumbbells at that point, or I just give you a rep range when I say six to eight, but if I just say eight reps every time, you’re going to have to use lighter weights to get eight reps on the fourth set than on the first set.
That’s why I give you a rep range and I might say, “Okay, on the first set, I want you to give me eight reps. The second set, give me seven to eight. The next set, give me six to seven. The next set, give me at least six, maybe even five.” And that way, I’ve allowed you to only use one set of dumbbells. That actually makes more sense in a big box gym scenario because once you grab one piece of equipment, keep that equipment versus having to keep trading them in back and forth because okay, you were using the 25s, now you got to drop 20s. And they’ve only got two sets of 20s. And somebody’s already using them because they’re like the hottest dumbbells to use in the gym, basically the 15s to 35s, they’re the toughest ones to grab at six o’clock at night or 5:30 at night.
So these are all things to consider. Now, that’s a more specific scenario in regards to individual strength and also individual training environment. If you’re training at home and it’s just you and your cats, they’re watching you, then no problem. All right now, more of a general approach. Progressive overload depends how I’m going to progress you gradually is going to depend on your main primary goal, and I actually did a Facebook post about this a few weeks ago. It becomes very simple. If your main goal is strength, force output, force production, I’m going to progress you by gradually making the weights heavier.
Now we’re going to bracket that, we’re going to come back in a second, because there’s some nuance there. If your main goal is more hypertrophy, which is basically muscle building, it’s what we all know as bodybuilding. Just because you’re trying to build muscle in certain areas doesn’t make you a bodybuilder, by the way. In that case, I’m more going to progress you in volume. Yes, I understand that you can lift heavier and also gain muscle but most people that are looking for muscle building are not as comfortable with going in really heavy loads. And sometimes they get bored with doing six sets of four and things like that. I’m one of them right now. So I would much rather do four sets of 12 in however many reps it is, then you do an equivalent of if you reverse that, 12 sets of four. I would get bored. All right, I have the same exercise. So it’s all about volume. So I’m going to look at increasing, gradually increasing your volume over time if muscle building is the goal.
If conditioning is the goal, which is basically how to become more fatigue resistant, which can help you, if you can resist fatigue, what else can you help prevent? That’s a strategy to minimize fatigue related injury. Well, in that case, I’m going to actually gradually reduce your rest periods. Now, there’s a point at which in all of these, that you kind of can reach a cap where it’s just unrealistic to progress any further. Now circling back to strength, if it was the case that I could give you a heavier weight every time, I’m 38, I’ve been lifting weights since I’ve been 13 years old, I will be squatting 2,000 pounds by now.
That’s not really realistic.
Exactly right. So what that would look like in practical terms would be as follows. Provided if someone’s goal is strength, obviously we’re going to give them a baseline, a training foundation first of using lighter weights and building up their form and tissue tolerance, whatnot. But let’s say you’ve been through that. It would look something like this. I might start you with four sets of six reps. Next week, I give you five sets of five reps. And obviously, there’s a window there. Next week, I give you six sets of four reps.
So notice I’ve given you more sets. But as the sets went up, as the sets increase, the weight went up, because you’re doing less and less reps. So I’ve forced you to use heavier and heavier weights. But there’s going to be a point at which in that program within that same exercise, trap bar, dumbbell press, whatever it is, that because of the principle of adaption, the body’s adaptive, you’re going to kind of reach your limits where you’re not going to be able to do any consistently heavier and heavier weights, even if we’re starting, I mean yeah, we could throw in like quarter pounds and whatnot.
But at that point, you might go, “I’m just ready to try something new.” So what I say is you should be getting stronger every week on a strength based program for about four to six weeks. And at that point, what we do is we just switch the movement pattern but it still could be something similar. So a lunge turns into a Bulgarian split squat, a barbell squat turns into a trap bar squat, or something like that. So it’s a similar movement pattern, but it just varies enough to where we’re not just hammering the same movement.
Last point here. The reason why is because I’m not training a powerlifter. I’m training somebody who is an athlete or a fitness enthusiast or a weekend warrior, who’s trying to get stronger in the weight room. They don’t need to be a master of specific lifts. They need to do all kinds of lifts in a competent way. So we don’t need to say, focus on like three big lifts or two big lifts because nothing is a big lift to you. They’re all just lifts to you at that point.
Right, and that goes back to that individuality and what are the goals. So if someone came to you and said, “I want to be an Olympic lifter.”, obviously that program is going to look much different because you’re going to be concentrating on what is the lift they have to do if they want to literally get to the Olympics.
Yes, it’s about the lift now. It’s not about them. And I will first say right off the bat that I don’t train powerlifters and I don’t train Olympic lifters. I know you understand that. You’re not saying I do. But I know people will be like, “Well, you shouldn’t be talking about that. It’s just not what he does.” Well, you’re right. But from a global standpoint of what you’re talking about, goal’s 100%. What the point you’re making is not about Olympic lifts is saying that the approach is determined by the goal, going back to my first point about specificity. It’s not determined about my bias as a trainer for my favorite pet applications of exercises just because I like to do powerlifting, which I don’t. It bores the crap out of me. It doesn’t mean that everybody else who trains with me therefore gets powerlifting programs and unfortunately, that’s what we’ve been seeing for a while. And it’s actually getting worse because things have become more about the trainer and less about the individual client as we’ve been seeing in the current climate of things.
Yeah, I see that quite a bit with patients like I have women who are training with someone at the gym who he himself is a powerlifter, and that’s what he likes to do. And so he has women who that is not their goal. Their goal is to be able to get through their day, to not have aches and pains and to feel strong. It’s not to be able to deadlift 200 pounds, 300 pounds, whatever it may be. But I definitely see that quite a bit. And it gets a little frustrating from my standpoint.
So here’s a question, leads me to an interesting question is-
Actually, can you pause for a second because I want to make a strong point here. The way a lot of those trainers if you ask them, well, so I’ll say two things. One, something I’ve always said is that a lot of personal trainers and I understand we’re doing group training these days, right, but personal training, a lot of times trainers don’t give personal training. What they give is private lessons in whatever that trainer’s bias is. So if you’re a powerlifter as a trainer, interestingly, all your clients somehow need to get better at the three big lifts. If you’re really into yoga and pilates, somehow all your clients seem to need to be better at doing the pulsing movements and lack of mobility and flexibility, right? So it’s kind of a lens we look at. That’s normal human nature.
But that’s not personal training for their goals. It’s private lessons in whatever the trainer’s bias is. Now, if you ask those trainers, they’re all very well intentioned people and they’re only doing the best way they see fit, they’ll justify what they’re doing by telling you this, which is the famous line, “Well, I’m not there to give people what they want. I’m there to give people what they need.” Well, give people what they need is not being a facilitator. That’s being a dictator. So what I say is a facilitator gives people what they need to achieve what they want, so I give people what they need too. The problem is, is the trainer is determining what their end goal should be. What I’m doing is I’m saying why are you Here, what is your end goal? And then I’m giving you what you need to get to that goal. I’m not diverting you to say, “Well, you really don’t want that. You want this up here.” That’s the fundamental difference.
And that’s a huge difference. And from, let’s say I’m a physical therapist, and I want to approach someone’s personal trainer to maybe talk about the program that they’re doing, because let’s say it’s running counter to what the patient’s diagnosis or physiology needs at the moment. How do you suggest a therapist or even just another professional approaching or a trainer approaching another trainer? What do you suggest would be the best way to approach that without being like snarky or bitchy or being a jerk or being thought of as a jerk by the other person?
Well, you can’t really control that. You can only control how you handle a situation. You can’t handle, you can’t control scenarios you’re in. You can only control how you handle yourself in this scenario. I would just say the answer is simple, Socratic method. Ask questions, ask questions, and genuinely listen and genuinely be interested. Don’t ask a question because you’re going through some sort of trope that you’ve memorized, but the whole time you’re looking around, you’re looking at your phone and got your arms crossed, you’re showing that you’re not really listening.
No, listen and now okay, what questions do you ask? Well, the starting point is you don’t come at come at it from an approach of you thinking they’re wrong, and you want them to justify to you. That’s already putting them on the defensive. You ask inquiring questions that you’re trying to learn and you genuinely should be because that person may know some things that you don’t know.
So for example, I’m really curious, this would be a sample question. I’m really curious to know so and so, imaginary patient client has been telling me a lot about your sessions. And I really love to learn so I have a better appreciation for what you’re doing and what your understanding of training is, why you’re deciding to take that approach with insert name of patient or client here. And let them shake that out a little bit. And as they start shaking it out, you start asking other questions. And you have to genuinely, it’s okay, you might be able to catch them in contradicting themselves, which is kind of what the Socratic method is about.
Now, what happens from there, and if they still think that you’re not the type of person they want to talk to, it’s on them. But you tried your best at that point. So that’s my method and that goes across the board to any sort of debate. We can talk a little bit more about a few other tactics and things but that’s the big one is ask them questions, genuinely be interested. And then also ask them, don’t ask them what is your evidence for that? Because that obviously has a bad connotation these days. It triggers something.
So the way around that is you ask well, I’m really curious why it is that you believe that. Can you give me some background on that? It’s the new framing for what’s your evidence for that? But it doesn’t spark that same defensive, because then also people say, “Oh, well, I’ve been doing this for 10 years, and whatever.” And so then, of course, you can start bringing up other things. Okay well, I’ve been working with another trainer who had been training for 20 years. So does that mean that somebody would be better off going to the training with the most experience? Because if that’s what you’re using as your foundation of knowledge, then what about someone who’s been 20 years who disagrees with you?
Well, I mean, you catch them in these, and that’s all of us, that’s helpful for all of us to start reevaluating ourselves. Now some people may just act really defensive because once you start catching them in these contradictions, but at least you get an idea and you’re not positioning yourself as just the person who’s just trying to ding this, just the gotcha person and just trying to be well I’m smarter than you. You’re not trying to play that game.
Yeah, yeah. And I think that’s great advice. Okay, so before we move on to some of the questions from different listeners, is there anything that we missed in talking about these basic principles of strengthening and conditioning or anything else more that you’d like to add?
Sure, well, I would just say, since you told me the question you were going to ask me at the end, which you ask everybody is what advice would I give to myself, can I just, and this has to do with the… so can we throw you off and answer it now?
All right, because obviously Karen and I talked before this interview. She gave me an idea of what we’re going to talk about. So the question that Karen said she likes to finish her interviews with is basically what advice would I give my younger self? Do I have that right?
All right. So it really actually goes back to, since we’re talking about principles is, I would say, to focus more on a principle based approach, and less on a methods based approach. Now everybody says they’re basing things on principles and not methods. But when you really get down to it, they’re not. Strength and conditioning coaches will look at programs and determine whether it’s bad or good because it does or does not include certain exercises or methods that they are biased to.
That’s putting methods before principles without ever knowing what the person’s goals are. Physical therapists do the same thing. And you’re always going to have these new schools of thought. You can never get ahead of all the methods and you can’t be an expert in every method and any school of thought that’s out there. But those things come and go like clothing styles, and we have our own trends in the field. We just don’t look at them as trends because they’re packaged in more scientifically sounding, more anatomically framed terminologies but this happened with the TBA drawing crowd. It continues to move forward. Everybody who was shirtless was retracting the scapula is back in the 80s and 90s. And then it went to packing your shoulders and packing your neck. Well, that’s the new version of retracting your scapula. And now, we don’t hear that anymore. It’s other things.
So these are methods. They sound good, but somehow they’re the new thing. And then somehow people just forget about them. You don’t hear about them anymore. Because they appeal from a certain, they made sense logically, but they didn’t really have any sort of… they didn’t really fit with principles of what we understand. So what I would tell my younger self is what I tell trainers right now, is if you focus your training or your rehabilitation approaches on principles, and you’d go from principles up, methods down, your training or your rehab approach will never go out of date. You never have to look back 10 years ago and go, “Oh, man, I’m so much different now than I was before.”
No, you’ll get better at communicating it, you’ll get better at expressing those principles. You’ll refine it. But you won’t look back 10 years from now and go, “Man, that was so 2017. Oh, that was so 1997 because I was so caught up in the TBA this. I was so caught up in the enter your three or four letter certification. That’s the hot thing.” That’s where you go wrong. You can pluck things from it. But if you focus on principles, and you use that decision making process that I’ve provided right from the jump, there is nothing that you will do that you’ll look back and go that was less effective rather date. You’ll tweak, you’ll refine your turn dials, but you won’t have to go to a different station if I can use the radio analogy.
Yeah, yeah, that makes a lot of sense. And on that note, we’re going to take a quick 30 second break to hear from our sponsors, Net Health.
PTs, what do you hope to accomplish in 2018? I bet providing even better patient care and increasing revenue are top on the list. First, expand your visit capacity, then get paid for your services, ramp up patient engagement and eliminate worries about documentation and compliance. The good news is, there’s one solution that brings it all to the table. ReDoc powered by xfit is a cloud based fully integrated EMR and billing solution. Imagine PT billing, coding compliance experts taking the back office work off your hands and reporting to you. Learn more about ReDoc and complete revenue cycle management services at nethealth.com/healthy.
And it all comes down to critical thinking.
It all comes down to critical thinking, which is a great segue for my next question from Jason Silvernail.
Principles provide that platform, that standard for critical evaluation of certain methods.
Exactly. So Jason’s question is Nick has read and shared a great deal to fitness audiences about critical thinking. How has this shaped his online presence and communication with others?
That’s a great question, man. Well, I mean, how it shaped my online presence is not really for me to determine. It’s kind of like giving yourself a nickname. It doesn’t work unless other people give it to you and it sticks. So what the free market of ideas has determined is my online presence. I would say that I’m lucky that people have come to me and said that they appreciate that approach, the critical thinking that helped me think more clearly kind of approach.
That’s about all I can really speak to that. How it’s shaped how I communicate? Well, I would just say that understanding that there is a gap between what people who value skepticism and scientific evidence, which are normally people who fancy themselves as critical thinkers. They have a premise they’re starting with, that obviously doesn’t value, that knows a lot of the problems with anecdotes, that has a basic understanding or at least an awareness of three things, logical fallacies, heuristics and cognitive biases.
Now it’s beyond the scope of this interview to get in all those but there’s lots of books that can be read about that kind of stuff. These are the reasons why science and statistics, the scientific method came up to work against because basically, and the short of it is because of how our brains are wired or hardwired, it’s very human, normal and natural to misinterpret, misremember and misjudge the evidence of your own experience. We all don’t realize we’re doing that. We say we know what we saw. But the question there is why have you ever seen a magic show? You know what you saw, but you don’t know why, you don’t know that conclusion and your conclusion about how it happened is probably wrong, which is why we all want to know how would you do that?
All right, we just jumped to conclusions. We see an outcome, nobody’s arguing the outcome. We’re arguing the conclusion you drew from why A is connected to B is we might, that’s where the debates are. And that’s where science and statistics came up. So, framing my interactions is realizing that I have to see what this person that I’m discussing with or debating with or whatever, what do they value? Because a point to them is maybe not a point to me.
So for example, someone who values scientific evidence may say, may use a RCT, a randomized control trial or maybe a systematic review meta analysis, and they look at that as, if I can use American football analogy, that’s a touchdown. That’s seven points. But there’s another person who doesn’t understand why they should value those things, which that other person would be me 12 years ago. I value people who are under the bar, to use a strength analogy. I value people who’ve been in the field for a long time. So to them, using an expert’s anecdotes in a website that has 100 anecdotes or 100 testimonials and 25 of them are from professional athletes, to them, that’s the touchdown.
So right now, we are playing on two courts. We’re playing on two different courts. We’re saying yeah, I scored a touchdown or use a different field sorry, I’m using a tennis and football analogy at the same time. So yeah, you scored but you scored on the field that I’m not playing on and I scored in the field that you’re not playing on. So what I’ve learned is first again, going back to Socratic method is and this goes back to basically I would say debates or discussions, argumentation, however you want to frame that.
It comes down to this. You have to ask before you start arguing, I don’t mean yelling arguing. I mean, just start your putting up your propositions. Ask what would it take for you to change your mind, first. You first have to ask all this about yourself. So that I’m saying the biggest thing is in half and understand how they’ve considered it. And then I know how to speak to you where you’re at. Now obviously, sometimes you realize based on those answers that some people you just go, “Well man, we’re just not able to communicate here.” Okay, fine. But at least you’re not going to talk past one another. The real debate is not about the conclusion that you may hold about a given premise. It’s about why you hold that conclusion. Everybody has reasons for what they believe. And everybody thinks they have good reasons for what they believe. The discussion needs to be what are good reasons and that is where the disagreement is. Something that you think is not a good reason, they think is a good reason. And that is where the discussion needs to happen.
Sometimes you can find a middle ground, sometimes you can’t. Sometimes you can change people’s mind or at least get them to be a little more open to maybe something outside of what they believe. But I think if you can start planting little seeds of well, maybe they did have a point here or maybe I will look at this paper that they told me to read, and then people can kind of take it from there.
Sure. Well, I think there’s room for all voices. And I know what you’re saying. And so again, I agree with you. It’s not my approach. But I understand why people are doing that. And that’s fine. I would say it’s a little tougher to change minds. But maybe that’s not their goal. Maybe they’re really speaking to the people who are already in their camp, and that’s fine. We all need people that represent us, too. So again, there’s room for all voices. But I agree with you. We’re originally trying to change minds, you also have to realize that most people are not going to do a complete flip right there unless someone like you or me really value scientific evidence, and we’re already on the same page. And if I just say this, and you just wham. hit me with a systematic review, and say, “Well, Nick, the evidence says this.”, and I’ll go, “Okay. You’re right. I was wrong.” And that’s happened.
That happens to me, absolutely.
Yes, so but again, because you have to value that type of evidence in the beginning, and then it goes back to the point I was making before.
Yeah, yeah. No, that makes a lot of sense. Let’s go to another question here from Matt Danziger, who’s such a nice guy. Do you know Matt?
We’ve interacted on-
On Facebook, but I’ve never met him in person as far as I know, I don’t remember.
Yeah. Nice guy. So his question is, what if anything, has Nick changed his mind about in the past year or two? And what has that changed? And how has that changed his practice?
Well, perfect segue from what we were just talking about. I would say the two biggest ones, one I’m not a nutrition specialist. I’m not a dietitian, but certainly nutritional based. All the things about carbs are not the thing that makes you fat, I would say certainly that also when I was coming up, it was really the really big push on the organic foods. Whole Foods was getting bigger and looking a little bit more into everything was going to kill you, microwave, everything is a big conspiracy. And I think I was buying a little bit into that stuff.
I’ve always been a little bit kind of, I grew up with kind of a punk rock, be yourself type person so I’ve never really jumped on anybody’s bandwagon because I never liked being there. I’ve never liked the authority, authority from expert authority, not like first responder authority. But yeah, I definitely was leaning in that direction and kind of I would say like the naturalistic fallacy, so I’ve definitely changed on those types of things and look at those in each instance. And not just general approach. And again, I would say getting off the carbs are bad mentality. I grew up with my mom as a bodybuilder. I grew up with all that sort of dogma, all you eat, you got to minimize your fruit intake as fructose, you know what I mean? That’s going to kill your body’s ability to burn fat and all these things.
So I’m guilty of saying all that stuff. And then as a trainer, I would say certainly guilty of getting too caught up in the standing on wobbly stuff, which was big in the late 90s, early 2000s.
You mean, “functional training?”
Yeah, I mean, I still think that’s a legitimate terminology, but like everything else, it gets bastardized. That’s a discussion for another time. But yeah, I certainly got too caught up in that. And then with that, got way too caught up in what we would call corrective exercise in the training term, which is basically trying to use some sort of formalized evaluation procedure. Corrective exercise is really about the evaluation procedure.
My heart was in the right place because I wanted to pay attention to detail. I wanted to create a more individualized experience. So I understand why trainers do that. But the premise, what I’ve changed is looking at the evidence of the premise of what all those things are based on, what all those standards of what is normal or what should be normal. This is ideal posture, this is ideal way to squat, all these sort of things, which is what these formalized evaluation procedures are based on. I use evaluation procedure, not to use the word assessment because as soon as you say assessment, people who do screen say I don’t do assessment, I do a screen and if you do a screen, they say well it’s an assessment. So I’m not going to allow you to get away from it.
So formalized evaluation procedure, that covers all of it. So I’ve certainly gotten away from getting caught up in what I would say as we did the article, the corrective exercise trap, getting out of that and not making the training direction, not making it more about the evaluation procedure, making it more about the client and creating a training effect and not trying to fit somebody to some arbitrary standards of whatever is being dictated by whatever evaluation procedure that I’ve been taught.
Yeah, that makes a lot of sense. Now, another question from Jason Silvernail, and he says, “I’ve heard him use the expression PE teacher for adults. What does that mean to him? And why is it important?”
Well, I would say in simple terms, it really comes down to the fact that a lot of us trainers and strength coaches, we have an identity crisis, in that we’re constantly trying it seems as if and I’ve been around, I can think I can speak with some level of experience on this from how many trainers and strength coaches I interact with, the hundreds of conferences I go to in all over the world. We’re desperate to show that we’re not just people who guide people through exercise, that we do these other more technical things, which is why I would say fringe practices are so common within our field because we’re constantly trying to justify ourselves.
Oh, we’re not just that person who shows you how to do bicep curls the right way, and shows you how to set the Cybex machine. No, no, no, no, we were more than that. And that’s why we want to buy into things. But the reason why I think it’s important to embrace that is to understand that most people who are training with most trainers in most settings, and that’s private, semi private group or just going into gyms that you’re on the fitness floor and helping, are not people who are in the physique training realm or in the powerlifting training realm or CrossFit.
They’re not a gym rat. They’re there to be a mom, a dad, a lawyer, an accountant, whatever, who uses exercise for general health and fitness purposes. They’re not trying to organize their lives around kitchens and gyms. They’re not food prepping. They’re not doing all these things and with that in mind, that exercise in and of itself is about health and fitness, less stress, reducing the risk of all cause mortality, weight management to offset the things that you’re eating.
And those are all very valuable things not just for general health and fitness or those things I talked about. But as we learn about pain and overall health when it comes to achiness and movement capacity, that exercise is more therapeutic from that perspective than it’s given credit for, which is why a lot of trainers turn to this corrective exercise where we think oh yeah, well getting people active will help them manage their weight or even lose weight or get a stronger upper body muscles and lower body. But when it comes to all this function and pain stuff, we got to do this other special stuff, the specific stuff, as if general exercise is not good enough.
Now when I say general exercise, I don’t mean individualized to the individual, to the person. It doesn’t mean everybody squats the same way. It just means getting people to use their legs in some fashion. That’s what I mean by general exercise, versus some magical formula, what I call Shaolin monk techniques, like they have the secret of doing something in a very specific order or breathing in a certain way, whatever that is. So that’s why I think it’s important to embrace. Basically what I’m here to do with most clients are there to do is come in to get their regular activity, and that’s where they’re with most trainers and they just don’t want to get hurt and they want to keep coming back. That’s physical education for populations that are out of school that don’t have it anymore. And it’s time that we embrace that and think, man, I’m actually more valuable than I thought when we look at all the benefits of simply doing that, and that is what’s been under pushed, under promoted in the field that that’s our primary job.
And I also think that’s under promoted in the field of physical therapy as well. I mean, general movement and general exercise is, like you said beyond important for everything from all cause mortality, from diabetes, pain reduction, brain health, cardiovascular health, you name it. And like you said, a lot of people don’t need to get into the minutiae of what’s happening on a cellular level. They just want to go to see you, they want to feel better, move better and live better.
Sure, and some people just sometimes have a hard time with that because it doesn’t sound technical enough. And I get it because they’re saying, “Well, anybody can do that. How am I going to justify myself? What do people need me for?” Well, let me tell you, the technical aspect comes from how to apply those principles, how to organize and prioritize a program based off the individual’s goals and limitations, looking, understanding biomechanics, understand how to put force across joints in a way that’s going to minimize risk of injury, that’s going to progressively overload somebody. Those are the technical things that professionals know better than non professionals. So, it is a very technical job and it has a lot of, you do need to be a technician to understand it to be a good trainer aside from the emotional aspects of your clients liking you and creating culture and all that stuff, but that has been under appreciated for just falling into some sort of method, whether it be corrective exercise or this and that is what has somehow been conflated with being a better trainer.
And it really is the people who are most informed in a variety of topics, whether it be pain science, whether it be biomechanics, techniques, strength and conditioning principles, like we said at the top of the interview. It’s those people who can make those programs in a way that is simple and in a way that is seamless for their clients, those are the people who are successful, because you kind of have to be pretty well versed in something to be able to simplify it for people who aren’t in the biz, so to speak.
Correct, yes. Trying to bring fitness, my way is trying to bring fitness back to fitness professionals because everything seems to be about performance or about physique and they got this idea that if you’re not doing that, well, heck, you’re working out, you’re not training as they say. Well, what’s wrong with working out?
I don’t think anything’s wrong with working out. And I remember I had posted something on social media just about the workouts that I do and how much better I’m feeling. And someone said, “Well, if you’re not lifting very heavy things, then why are you even bothering to do it?”
Well, I would say the same thing about driving. Well, if you’re not going to drive at a NASCAR level, then why even bother? I mean, there are other reasons to drive aside from being an elite driver. Well, I’m going to go grocery shopping. Well, okay. I’m trying not to die. How about that? I’m trying to reduce the risk of all cause mortality. If that’s not a good goal for you, then I don’t know what planet that you’re living in. This is the perception that goes back to, you have a bunch of gym rats who are trainers. And if I can just kind of, I don’t know, go off on a soapbox here for a second. I say there’s two types of trainers in the field. Obviously by trainers, I mean people who are taking other people’s money to give them some sort of exercise direction.
You have fitness professionals and you have fitness hobbyists. Yes, I understand a professional is somebody who does things for money, but roll with me here. A professional’s someone who takes it as a profession and tries to spend most of their time learning how to understand the technical aspects to do better for other people and understand it’s not all about them. A hobbyist is someone who gets really excited about something because it changed their life. And yeah, their heart’s in the right place. But they’re really just trying to get everybody excited about their thing that they got them excited. Going back to what we said before, if you’re really into powerlifting, a lot of times your sessions just seem to be private powerlifting sessions, not personal training.
Now, it’s different if someone’s coming to you for private powerlifting lessons, but most of the time, it’s not, that can be applied to yoga people, pilates people, bodybuilding people, functional people, whatever. So don’t think I’m just picking one brand of trainer here. So that’s what we’re really coming down to.
It’s hard for some people to accept what work is working for you, because perhaps it’s not what they would do. And again, it goes back to those principles of individuality and specificity that we talked about earlier. So because I wouldn’t say well, because this really works for me, you have to do the same thing because your goals are maybe not the same as mine. You don’t have the availability that I have of being in a gym with everything under the sun. So I think we have to be careful when we as certainly health professionals, try and insert our what worked for us bias onto everyone else.
Sure, and not just what worked for us, but also what we value going back to what I was talking about evidence. Well, the same thing about results is different for everybody. And that’s the thing. But all these things, all the answers are right in front of you if you just ask your clients, your patients, or the people, you’re debating with. Or if you notice, every one of these things we’ve talked about, whatever the context, it comes back to the same techniques, ask more questions and genuinely listen, and understand what values them. Now when somebody’s paying you for something, it’s different when you’re just on social media engaging in some sort of discussion, debate, whatever. But if you’re being paid for something as a professional, then it’s your duty to show that person the best direction for them and understand where they are coming from.
That could be a fluid process as they become more knowledgeable, and you debunk some myths that are common among the media sphere, then maybe those things change but you have to guide them through that and not make it about you. Again, dictator versus facilitator.
Yeah. Okay, we have time for one more question here. And since you already answered the question I usually ask as the last question, what we’ll do is I’ll insert a question from Mike Macker. So his question is, what would his best advice be for any young entrepreneur in fitness or rehab early on in their career?
Well, that’s an easy one. And I would say this is also, can I give you a second answer to what you usually close with? I would change what advice I’d give to my younger self. It goes both ways. I would say this. Understand that whether you’re in the rehabilitation, whether you’re a dietician, whether you’re a strength coach, whether you’re a personal trainer, that has its own set of expertise from the relationship side and the technical side. We all realize that there’s a business side to things. But that business side in and of itself has a huge sphere of skills that you need to be really good at, everything from managing social media to any sort of press releases to just managing memberships and getting paid and all these things, branding. You can’t be elite at all of that stuff.
So what I would say is if you’re opening up a business or whether it be online or in person where you have a facility, a location, I would say if you can find somebody, if let’s say you’re a physical therapist or a trainer, find somebody who wants to focus on the business side of that, while you focus on being the face and being the best physical therapist. You create the community. You provide the programming or the clinical decision making and the direction but that person takes care of web stuff, takes care of marketing, takes care of management.
And I would say make sure they have skin in the game. Don’t bring someone in who says they have some degree and whatnot. And you pay them this much because they’re already set now. It doesn’t matter whether you exist or not, they’ll go for another job. But make sure they have skin in the game too where you succeed, they succeed. And everybody’s got some similar amount of risk. It doesn’t necessarily have to be 50-50. It could be 70-30. But basically, hey, you put work in and we grow, then you get 30% of a larger chunk, and I get 70, whatever it is. I would say that’s the smartest approach and there’s plenty of evidence to show that among some of the more successful training centers that are out there and whatnot. That would be the best and I didn’t do a good job of that early on. I was successful with my business partner, who was another trainer despite what we did business wise, not because of it because we were so good and because we had a lot of clients. But let me tell you what, that would not have flown, would not fly in this current climate. I’m talking about opening up a private gym 2000, 2001. It was nearly the same sort of client, we would have just died a much slower death.
I think that’s great advice. And it sounds to me like kind of being self aware of what are your strengths and then trying to find someone who can bring the things that you’re missing into your career, into your business. And it starts with being self aware. And it starts with being able to ask for help. And if you can do those things, then I think you’re more likely to be successful because if you do it all, you’re going to fail. You can’t do it all.
Absolutely. And I understand that’s a big thing to find somebody who’s willing to go in with you and your business, but they’re out there. If you’ve got a good product, if other people who are smart enough, and basically you’re both betting on yourselves, but to me, that’s the way it rolls.
Yeah. Great advice for everyone. And now Nick, where can people find you if they have questions or they want to find your writing because you’ve got a lot going on. So where can people find you?
Appreciate that. Well, easiest place to find me is on my website or social media if you just look up my name Nick Tumminello. Last name is spelled T-U-M-M-I-N-E-L-L-O. Google knows me. That’s my fun little word I like to say. And then I’ve got a little shameless self promotion here. But I’ve got two books you can find on Amazon. Strength Training for Fat Loss came out in 2014. Building Muscle and Performance came out in 2016. And I have a new book that you can pre order right now called Your Workout Perfected. That comes out in the beginning of May 2018. And we actually go in specifically about talking about a training for general health and fitness.
And some of the points we’ve made here are actually brought up in the book and I take a lot of pride in talking about how important, we talked about physique training too. We have programs for that. We have performance type training with fat loss type training, but also general fitness, because it’s always it’s ignored in a lot of these books, which is what helps build this perception that if you’re not training for one or the other, you’re kind of just spinning your wheels. So I take a lot of pride in being the only books that I know that addresses this. And so it’s okay if you’re not training to one end of the spectrum and you’re just training for everyday health and fitness. And we provide workout programs for that and debunk some myths and misconceptions about training for all those sorts of goals.
Awesome. Well, we’ll have links to all of that in the show notes at podcast.healthywealthysmart.com under this episode. So Nick, thank you again for coming on. And this was great. I learned a lot. So thanks so much.
I appreciate what you’re doing. Thank you so much.
And everyone. Thanks so much for tuning in today and listening and downloading and sharing with friends and family. Have a great couple days and stay healthy, wealthy and smart.
And a huge thanks to our sponsor today, Net Health. If you’re looking to expand your visit capacity, get paid for your services, ramp up patient engagement, and eliminate worries about documentation and compliance, then check out ReDoc powered by xfit, a cloud based fully integrated EMR and billing solution. To learn more about ReDoc and complete revenue cycle management services, check them out at nethealth.com/healthy.
Thank you for listening and please subscribe to the podcast at podcast.healthywealthysmart.com and don’t forget to follow us on social media.