The Minimum Effective Dose of Training by Mark Rippetoe | January 08, 2020 "For real people, if something works in theory, but not in practice, it doesn't work.For academics, if something works in practice, but not in theory, it doesn't exist." — Nassim Nicholas Taleb @nntaleb In his famous 2011 essay, Jonathon Sullivan MD PhD observed quite correctly that Barbell Training is Big Medicine. Other people have taken the concept and run with it, because it's an excellent concept. But “medicine” means a couple of different things, and if we look closely at them we find that his analogy is even better than we thought it was. “Medicine” can mean the practice of the healing arts and sciences – the diagnosis, treatment, and prevention of disease. Barbell training can certainly be used very successfully in the treatment and prevention of disease, as Dr. Sullivan and Andy Baker describe in their important work The Barbell Prescription: Strength Training for Life After 40. The use of strength training to treat and prevent the diseases that plague affluent western societies may be the most important yet underutilized tool in the little black bag – read the book and find out why. “Medicine” can also mean the stuff you take to treat and prevent disease. In this sense, the proper term would be medication, although conversational English regards the terms “medication” and “medicine” as synonyms. A medication is a substance used to produce a (hopefully beneficial) change in an organism's physiology upon administration. We commonly understand that “drugs” are medications. In this usage, barbell training is the treatment itself, the thing we “administer” to change our organism's physiology, hopefully for the better. It's the medication, as well as the practice of treating and preventing the diseases which accrue from sitting on your ass while your body decays into uselessness. It's a far more powerful way to change your physiology for the better than any chemical medication, although nothing beats cyanide for powerfully changing your physiology for the worse. Like any medication that has the power to alter physiology, barbell training must be administered with attention paid to dosing – the amount and the schedule. It's damned hard to kill yourself with barbell training, and you'd have to be ignoring a lot of things if you ever even got close, but it's easy to get carried away and do too much, too often, with too much weight. The price paid is not death, but wasted time and potential. The Dose In medicine, there is an important concept known as “therapeutic range” – the variation in the amount of a therapeutic agent administered and that amount's effectiveness on the condition being treated. The range is bounded by the minimum effective dose (MED) and the maximum tolerated dose (MTD). The MED is the lowest dose level that provides a beneficial response, measurably greater than that provided by a placebo. In strength training, squats would have a MED, whereas riding a bicycle would be a placebo (riding the bicycle can improve strength in an untrained person for a very limited time, but the psychological effects of doing so may make it look like an effective intervention has taken place if not compared to squats). The MTD is the maximum possible dose level that produces the therapeutic effect, or a version thereof, that is not actually toxic, i.e. that doesn't cause actual damage to the organism. Doses in excess of the MTD are immediately harmful, doses in the vicinity of the MTD may be harmful over time, and doses lower than the MED are ineffective. Obviously, we need to find the sweet spot. Training and Practice First, some background. Remember our Two-Factor Model of Sports Performance Preparation – the training/practice paradigm, holds that an Accumulated Physiological Adaptation for the performance must be trained through the directed process of stress/recovery/adaptation, and skill must be developed through practice, the repetitive execution of movement patterns that are dependent on accuracy and precision, with the highest possible degree of fidelity to that which is executed in a performance. Barbell training makes use of repetitions of the exercises grouped in sets. Sets and reps multiplied by the weight on the bar – the tonnage – are the currency of barbell training and its dosing. Intensity refers to the percentage of 1RM the load is – how heavy the set is compared to limit strength. Taken separately, the sets and reps together are sometimes referred to as “volume,” although it doesn't tell us anything if we don't know how much tonnage the volume constitutes. For example, the volume of 10 sets of 3 is 30 reps, whether loaded to 40% of 1RM or 80% of 1RM, and these two different workouts would have very different dosing effects because of the difference in intensity, despite having the same volume. Tonnage and intensity are the two variables that comprise the dose of training. For novices, 3 sets of 5 at a 5-pound PR over the last workout are sufficient in both tonnage and intensity to drive stress up just enough that recovery and adaptation can proceed. For an intermediate lifter, tonnage and intensity get divided into separate workouts over the week, with each variable contributing to the dose. Advanced lifters require more tonnage and intensity – and consequently the ability to recover from the increased dose over the period of its administration – and the way the variables are divided between the workouts will require time periods longer than the week which worked for intermediates. Thankfully, most of the people we deal with are not advanced competitive lifters, and the level of complexity they require is fairly low. Why Are We Here? There has arisen a school of thought, that holds volume itself as a critical variable in barbell training. Lots of sets and reps are said to create the “hypertrophy” that is necessary for the development of strength at some point in the future, but right now PR-level weights for 3s and 5s are just not as important for training as getting in enough sets and reps at whatever intensity you feel like working with. Squat and pull several times a week, mix up the exercises, lots of sets across, lots of warm-up reps for the volume, bench 4 times a week, etc. In effect, titrate up to your MTD. This apparently comes from exercise science studies with which I am not impressed. It doesn't comport with my 42 years of experience in this field. It does not come from the experience of satisfied clients who are setting regular PRs. It also does not come from kids squatting 70% of 315 for 5 sets of 7 with gigantic legs, arms, and traps, because none of them have gigantic legs, arms, and traps. If you have been training for 6 years, and for some reason feel like exploring your MTD of junk reps, it's fine with me. Have fun with your training, and pay your gym dues on time. But if you are a professional barbell coach or personal trainer, it's important to retain your perspective: who do we train, and why are they training with us? 1. They want to get stronger. You know this because you advertised your services as a strength coach, and they hired you. 2. They don't have 15 hours a week to spend in the gym. They're working – that's how they pay your exorbitant fees. They probably have families that want to see them. They need to sleep sometime. They may even want to get a beer occasionally. But you have them doing 7 sets of 4 squats today, and 7 sets of 4 deadlifts tomorrow. And some more benches. 3. They want to feel better. This precludes being sore all the goddamn time, with creaky knees and elbows and a dull headache, and tired all the goddamn time, like they will probably feel when they're 75, but should not feel at 45, or 35. The Minimum Effective Dose will be the least amount of work you can do and still set PRs on a regular basis, as frequently as possible – not once a year or once every 6 months, but as often as possible, depending entirely on your level of training advancement. This approach contrasts with the most work you can do and still set regular PRs, and is in diametric opposition to doing so much work that you cannot set regular PRs. So, let me tell you what you should do: find the Minimum Effective Dose of squats, benches, presses, and pulls, and do that. As a coach, you get to prove your value by helping the client find it. You, the client, should insist that this be the case. What's Wrong With MTD If you train by yourself and you haven't set a PR in a long time, you're no longer training, you're just exercising – maybe very hard but still just exercising. Maybe you paid for a training template provided by an expert, and you think you're actually being coached – just not for strength, because you aren't lifting heavier weights that you previously were. Maybe you think that all this volume burns calories so you'll have slabs of abs – except that you don't have slabs of anything. You're not growing, you're not getting stronger, you're just spending a lot of time in the gym, getting sore and doing lots of volume that, even though it's not heavy enough to make you stronger, is still a stress that must be recovered from anyway. Junk reps that don't make you stronger can still make you overtrained, because even though they are not heavy enough to drive a strength increase, they can produce inflammation if they are of sufficient quantity that their fatigue keeps more productive work from being done and recovered from. Like running 10 miles or jumping off roof of the building, it's hard, but it's not useful. If you are an advanced competitor, you may think you don't have the luxury of this more practical MED approach. You've got to fight for 10kg of new total every year, you know, to keep your endorsement income up over seven figures. But honestly, are you really an advanced competitor? And if you are, have you ever tried it the other way – just training up to one properly-programmed heavy set as infrequently as possible to still make progress, in contrast to always staying just one set away from overtrained? Overtrained is not good. It doesn't make you stronger, or better, or more pious and atoned and holy and forgiven. Overtraining destroys long-term progress, and prevents short-term progress. And chances are that if you're doing a bunch of junk reps for the sake of “volume,” you're either overtrained or headed in that direction. This is especially true if you are trying to do this on “a cut” – a caloric deficit, and even more especially true if you're “cutting” from 175 down to 165. Tired all the time isn't good either. Just plain old tired, the way you get when you can't sleep because you're sore and your knees hurt, is what makes people feel old. It kills your sense of humor, your libido, and your girlish laughter. Older clients don't sleep well anyway, and near-MTD programming is an excellent way to make things worse. And if you are an athlete training for an actual competitive sport, this is very important: the training component of your preparation cannot be allowed to interfere with the practice component. If you are training at MTD-levels – if you are sore and tired all the time, overtrained from being a dumbass in the weight room – you are contributing to the misunderstanding sports coaches seem to universally possess about barbells and sports. You are confirming their bias by turning your practice, the only thing they really know anything about, into shit. Stop doing that. So, let me tell you again what you should do: find the MED – the Minimum Effective Dose – of squats, benches, presses, and pulls, and do that. For most people, this is a much more practical, productive, satisfying, and effective approach to training. You already know if I'm talking to you. Discuss in Forums
