Accounting for the Variables – The Imperative of Individualization in Performance and Physical Therapy

When clients ask me, "Why is my body like this?" I often find myself in a challenging position. As humans, we crave definitive answers and logical explanations for what we experience. However, the reality is far more complex. The answer I provide is rooted in the multitude of variables that shape each individual's physical condition …

When clients ask me, “Why is my body like this?” I often find myself in a challenging position. As humans, we crave definitive answers and logical explanations for what we experience. However, the reality is far more complex. The answer I provide is rooted in the multitude of variables that shape each individual’s physical condition and performance capabilities. We need to think of individualization as the primary mode of prescription.

The Complexity of Humans

Consider the genetic makeup of an individual, the environment they were born into, and every exposure they’ve experienced throughout their lives. These factors collectively contribute to who they are at this very moment. This complexity is why individualizing programming for performance improvement and physical therapy is not just beneficial – it’s essential.

In the world of human performance, we’re constantly navigating a sea of variables. Our decision-making process is, at its core, an educated guess based on the best available information. We focus on monitoring and influencing the variables that we and the individual can control, always keeping in mind the specific context of our goals.

The Team Setting Challenge

Let’s consider a collegiate sports team as an example. At first glance, these athletes might seem alike:

  • Similar age range
  • Comparable exposure to practice and game volume
  • Shared drills and sport-specific demands
  • Common meal times and options
  • Relatively similar schedules

However, beneath this surface-level similarity lies vast individual variability. As a performance coach responsible for each athlete’s development, it’s crucial to recognize and account for these variations.

A mentor once told me, “We don’t know what these kids are going through. Did they just fail a test, get dumped, or anything along those lines?” This advice underscores the importance of considering factors beyond the physical realm. Mental and emotional states and other outside factors significantly impact performance and recovery, yet they’re often overlooked in standardized training programs.

The Pitfall of Cookie-Cutter Programs

In both team sports and traditional physical therapy settings, there’s a temptation to rely on pre-set, generalized programs. A therapist might have a standard “shoulder program” that they prescribe to everyone with shoulder issues. However, this approach ignores the unique aspects of each individual’s condition, lifestyle, and goals.

I have been taught the “Rule of Thirds,” which illustrates the problem with this approach:

  1. One-third of the group will respond well to the program.
  2. One-third will see no significant change.
  3. One-third may experience negative effects.
 

This distribution highlights why individualization is crucial. A program that works wonders for one person could be ineffective or even harmful to another.

The Science Behind Individualization

Recent advancements in sports science and rehabilitation have provided substantial evidence supporting the need for individualized approaches:

  1. Genetic Variability: Studies in exercise genomics have shown that individuals respond differently to the same training stimuli based on their genetic makeup. Some people are “high responders” to certain types of exercise, while others may see minimal gains from the same routine.
  2. Biomechanical Differences: Each person’s body moves uniquely. Factors like limb length, muscle fiber composition, and joint structure can significantly affect how an individual should train or rehabilitate.
  3. Recovery Capacity: The ability to recover from exercise or injury varies greatly between individuals. Factors such as sleep quality, nutrition, stress levels, and hormonal balance all play a role in determining optimal training frequency and intensity.
  4. Psychological Factors: Motivation, adherence to programs, and response to different coaching styles can greatly influence outcomes. What works for one athlete might be demotivating for another.
 

Implementing Individualization in Practice

As noted prior, perfect is not necessarily “real.” With total treatment freedom, a few limitations remain. One of those is resources, so working within the logistics offered by the space you are in is essential. Another, more important restraint is the inherent bias as a practitioner. We will all always be blind to what we cannot see, yet it is on us to attempt to fight off biases and the comfort of “our style” to the best of our abilities.

At the forefront of individualization strategies are the goals of the individual in question. What is it that they want to accomplish, why is it important to them, and how much time do we have to get there? From there, the plan can begin to develop. Starting with our best guess, we build from safe-to-fail experimentation, learn what influence the genetic makeup and body structure have, what the recovery capacity might be, and so forth. Remain adaptable and open to evolve. Transparency of this process with the client is essential to the progression towards their goals.

Conclusion

The human body is complex, shaped by countless variables throughout a lifetime. In the pursuit of peak performance or effective rehabilitation, acknowledging and accounting for this individuality is not just beneficial – it’s essential. While perfect individualization may be an ideal rather than a fully achievable reality, striving towards this goal can significantly enhance outcomes.

As practitioners, our challenge is to balance the practical constraints of our settings with the imperative of individualization. By leveraging scientific knowledge, technological tools, and our expertise in performance physical therapy, we can create more effective, personalized approaches. In doing so, we not only improve physical outcomes but also empower individuals with a deeper understanding of their unique bodies and capabilities.

At Sustain Physical Therapy and Performance, we strive to implement individualized strategies in both our performance coaching and physical therapy sessions to help each person achieve their optimal potential. Want to learn how we do this? Check out our page on our Physical Therapy Services!

Sustain Physical Therapy and Performance
Dr. Adam Babcock PT, DPT

“We Help Active Adults Quickly Recover From Pain Or Injury So They Can Stay Active, Get Back To What They Love To Do, and Do It For Decades”