Personalized exercise, recovery, and the stubbornly unfit

I’ve written before about exercise non-responders. or as I called them, rational coach potatoes. They’re people who exercise but who don’t get any more fit as a result. For some people the decision not to invest a lot of time and energy in exercise makes sense. It’s rational to sit on the sofa.

But it turns out that for some people regular exercise can be worse than that. Some people even get less fit and less strong, through exercise! It wears them out without building them back up. See this Gretchen Reynolds’ column in the New York Times.

She writes about a study published in March in which 95 older, overweight men and women began five months of endurance or weight training. “By the end of that time, the volunteers were, on average, 8 percent stronger or more aerobically fit (depending on which program they had followed). But 13 percent of those in the endurance group had lost aerobic capacity, and 30 percent of those in the strength-training group were weaker.”

That’s kind of wild.

One possibility concerns rest and recovery and the different amounts of it we need. We all know that the gains in fitness and strength that we make actually happen after, while we’re resting and our bodies are adjusting to the new demands we’ve put on them. But how much rest we need varies a lot. Without enough rest your muscles can’t rebuild and your tough workouts could be doing more harm than good.

And for some people, sad to say, there is no amount of rest that’s enough. All exercise did is wear them out. That’s not good.

I notice the variation in response to exercise each year when I go on cycling holidays, and this year at bike training camp. Some people get fitter and faster pretty much everyday. That’s me! Phew. We take one rest day in the middle and that’s enough. Other people seem to get worn out. They start out strong, perhaps, but then slow down as the week goes on. It might be there’s not enough rest for them.

There’s a big move in medicine to personalized treatment. What’s that? The American FDA defines it this way, “The term “personalized medicine” is often described as providing “the right patient with the right drug at the right dose at the right time.”   More broadly, personalized medicine (also known as precision medicine) may be thought of as the tailoring of medical treatment to the individual characteristics, needs, and preferences of a patient during all stages of care, including prevention, diagnosis, treatment, and follow-up.”

Our bodies are all different. We respond to drugs differently and we heal differently.

That’s relevant for medicine, but for fitness too. When it comes to fitness programs, whether its cycling, lifting, or running, it’s an argument for personal coaching. Or at the very least listening and learning from your own body. One size definitely doesn’t fit all.