Jared Powell:
John Kiely, welcome to the show.
John Kiely:
Jared. Thanks very much. Pleasure to be here.
Jared Powell:
It's a real privilege to talk to you, John. I've been a reader of your work for a long, long time. I was just telling you how much I enjoy reading your prose. It's, it's eclectic, it's esoteric, it's, it borrows from many different fields. And I, before we even get started talking, I'm gonna urge everybody listening to go on Google, John, Kiely, I'll put some of your references in, in the show notes because it, it is really fun writing. You can actually read it and be almost entertained. So shout out John, Kiely,
John Kiely:
Almost entertained . This might be one of the most sideways but best compliments by writing has got I guess the good thing with writing is you can go back over it and edit it, not like a conversation. So just, I would say manage your expectations, if you don't mind.
Jared Powell:
Yeah. You've gotta be humble. But, but it is really good. So, so John, I want you to introduce me and our listeners to who you are. What do you do? What does a normal week look like for you? What are you interested in? John, you said you're a boring guy off the air a moment ago. I'm sure you're into something interesting. So tell us what you got.
John Kiely:
Oh. I gonna have to make something up now, but yeah, basically what I am is yeah, I've been invested in kind of sports and sports training since I was a kid. Had a kind of a long mixed, varied sporting career. Made all the training mistakes, all the injuries, et cetera, et cetera. I learned a lot from that kind of struggle. But yeah, I was just totally obsessed with that all, you know, the, the first half of my life I was coaching young, maybe, you know, 21, 22 mostly combat sports. And then when I was about only six, you know, wasn't really going anywhere professionally. I didn't have a profession, you know, I was just working and, and training and coaching. So sports science degree started in the, a university. The University of Limerick said I'd have a go with that, did that luckily enough went straight into a job within the Irish sports system.
John Kiely:
Spent a couple of years there, decided I don't really know what I'm doing. I need to learn more. There was a well known professor Mike Stone from the US who was working in the University of Burg in Scotland. So, you know, saved up some money, decided I'd go do the to do that. Did that, came back, worked in the Irish system worked with some good people, you know, through Sydney Olympics. Moving into Athens, was at a Athens with the Paralympic. Got a nudge about a job coming up in UK athletics, which is, you know, obviously one of the, the big track and field organizations in the world. So they were looking for a lead. S and c interviewed for that. Got that moved over there, and then all of a sudden it was a different scale of challenge working with a specified number of podium hopes for the Beijing Olympics.
John Kiely:
And then trying to quality control and manage service to, you know, people who were expected to make finals, people who were expected to qualify. And so it was really multi-dimensional, challenging, interesting. Long story short, stayed, stayed with back and field until 2012 through Beijing. Then kind of old story partner back here. Us traveling over and back between Ireland and England all the time. UK University were starting this course called professional doctorate. So they said, well, look, we need someone who is maybe a critical thinker, but is a practitioner at heart who knows the industry. If you come work for us, you can do it from your back kitchen in rural Ireland. And that's what I did. And yeah, so I, I did that job for a few years and since then the, I've relocated to an Irish university again, I say relocated virtually re re relocated.
John Kiely:
I'm still in my back kitchen. And I'm, we started a, a new professional doctorate in performance and innovation there, and it is going really well. And it is, I guess, satisfying my itch to push innovation and to push performance and how we think about it. I guess via the medium of not doing it myself now necessarily, but working with people who are out in the field all the time. So these are, you know, the in, in sport context market, people in the league, E P L N F L, all kinds of everything. So it's, you know, I, I am harvesting the benefits of the technology, you know, that we can have, like, we're having a conversation now. You're sitting in Australia at one end of the day, I'm here on the other end of the day, later on, I'll talk to people in the US in Europe. So, so yeah. So it is great. I'm, I'm like a child in the sweet shop, basically
Jared Powell:
All from, all from your kitchen in, in, in Ireland, John, it's a, it's a fairly surreal thought, really. If you were to, to take this conversation back 50 years ago, 25 years ago, and imagine that your primary occupation was, was doing this with, with athletes and coaches and, and what have you all around the world, it, it wouldn't really make much sense, would it?
John Kiely:
No, and it's amazing. The the kind of density of the experience and interactions you can have now. It's just unbelievable. I mean, you know, when I kind of come out from my primary degree, and I was working in the field, it was pre Sidney, it was 98, and this was like a, I, I don't even know if Skype was a thing then. And now its, it's, yeah, it's, it really is good. And it's just talking to interesting people every day in all kind of far flu corners of the world. And yeah, I love it.
Jared Powell:
It's, it, I, I have an anecdote about Sydney Olympics in 2000, John, I, I won a competition. I, I'm, I've got an athletics background myself, and I won a competition to go to the Sydney Olympics in 2000 and watch a couple of obscure events. It might have been like handball and something else obscure for, for, for people down under. And so ba there was no Skype, because I remember having to go to a payphone, and I didn't know how to use a payphone. I was like 12 years old or something. And to ring my parents to tell 'em that I was okay, I don't know why there wasn't a landline, they should have provided that for us. But, but there you go. There was certainly no Skype, and I had to set up an email address specifically for that trip. So there you go, mate. So there was definitely no Skype back then.
John Kiely:
Well, what I'd say is to, you know, to any kind of young practitioners coming through now, the opportunities there just to interact and learn with people. Yeah, it is unbelievable. And when I, I really didn't want to work in the university. I wanted to stay in professional sport. That was my meet and drink, but it was just circumstances. And I wanted to definitely keep a foot in the, in the larger sporting pool that, that is the uk. So it was it was a best fit rather than something I thought. No, I, I really like this. But yeah. But, but it's worked out well now. And every now and again, I do, you know, I, I get to go to professional out output or output outfits and, you know, do a talk or ru run a workshop, and that keeps me happy. And every now and again, I get a decent contract that might be, you know, four weeks away or six weeks away for some tournament. And and that kinda satisfies that it as well,
Jared Powell:
There is, there is an, an inexorable pool towards academia that I'm starting to see as once you get to a certain level. So it's good that you are enjoying that. And also you get to get your feet wet every now and then with some field work. So that's, that's good to see.
John Kiely:
Yeah. Well, I, I still feel that that's my home turf, you know, but as regards to that inexorable pull towards academia, I guess it, it's probably not towards academia. And, and, and I know that's not necessarily what you meant, but it's, it's towards higher level critical thinking. And I guess in, in, certainly in professional sport, it didn't really evolve. It just kind of happened. And it was driven by a load of what I think of now as kind of archaic beliefs, beliefs and ideas. And I think the more people spend think about it, the more they're seeing these big gaping holes in our philosophies, and the more they're thinking, I could do something about that, I could change that I could, I could move this forward in some way. I could innovate in, in this space in some form. So the people that that, that I'm kinda lucky enough to work with now, yeah, they're, they're all trying to, they're fill gaps, drive innovations, and, and it's just amazing to see how many, there are really lots of things that I've never thought about.
John Kiely:
So for example, I'd work with people who are interested in communications, Brett Baru who many your, your list listeners will know folks who are in maybe e p l contexts who are interested in decision making. So sciences that exist in other domains. But, you know, even though, for example, we swim in the water communications as physios or sport scientists or coaches, but no one ever educates us in communication decision making, the same thing. There is ways to make better decisions. There is ways to design meeting processes, data collection processes to optimize informed decision making. But again, it's not stuff we ever learn our conventional professional courses or c p d opportunities. So yeah, basically, as you can tell, I'm a, I'm a pig. I'm a pig and, basically,
Jared Powell:
the best type of pig. Alright, John. So
John Kiely:
Cool.
Jared Powell:
You mentioned gaping holes before. So let's explore some of these gaping holes. That's, that's a horrible turn of phrase. I apologize for that. So let's explore,
John Kiely:
Sorry, I'm trying to, I'm trying to scrub it from my Yeah. Brain at the moment. So
Jared Powell:
Knowledge gaps, that's a little bit more politically correct. So I first came across your work probably a few years ago now reading this, this paper, one of your landmark papers in sports medicine, probably where you, you'd challenge, maybe attempt to refute, maybe that's too strong a word, but certainly challenge periodization and the theory of periodization. That was a really interesting read. And this is, this is this concept about general adaptation syndrome, or you, in the paper you talk about general adapta adaptation syndrome, which was proposed by Han Celler. And then you sort of talk through about how this general adaptation syndrome has now evolved into this concept, which we call allostasis. And it just hasn't been a natural evolution. That's sort of where we are today. So physios are becoming much, much more aware of general adaptation syndrome, allostasis, all of these kinds of terms. Do you mind just giving us a little bit of historical background to what these terms actually mean?
John Kiely:
Perfect. so I guess like most practitioners, I bumped into these terms through the periodization literature, and I guess I've come to view the periodization literature a little skeptically as times gone by. And I've, I've been thinking about this since at least 2000. I mean, I started writing about this in 2000. I, now, it, nothing happened with that writing. It was just me, you know, scribbling. But it eventually turned into a, a, a paper I wrote in 2012 when I was, I was still a practitioner that did get published. But long story short, if, if you read a periodization paper, periodization is essentially, if you boil it down to its kind of bare bones, it's about prediction as coaches as rehabers, as physios, we, we want we want to know how we can give people best advice. We want to know how we can plan for somebody.
John Kiely:
Periodization is essentially the science of saying, well, this is what we know. This is the theoretical background. So we can predict what will happen. So, you know, we will plan what you're gonna do for the next four weeks, then we're gonna change. We're going to do something else for another four weeks, and so on. And obviously, that's where the word comes from. You're breaking everything down into periods. Now, the justification for that like the big, I guess I, I don't wanna say lie, that's probably too strong, but the first missing step there is, it's pretty clear. It is blatantly clear at the moment that you cannot predict raining outcomes or intervention outcomes. You, you can't, it's been, you know, demonstrated multiple times empirically how still to this day. And there was a paper in 2018 in sports medicine, which is, you know, top tier sports journal.
John Kiely:
And the title was, you know, general adaptation syndrome. And yeah, it was all about how the general adaptation syndrome is the foundational bedrock upon which we build our, our, certainly our periodization. So what is general adaptation syndrome? So this was cell experimenting with rats in the twenties and thirties. I'm using the very coarse metric of, you know, sacrificed the rats. First of all, he was stressed. The rats in some way put them on the roof in Canada, when it's really cold, put them into boiler room, chased them around. All these type of, what we would think of now was stresses, sacrifice, rats ground up their adrenal glands and weighed them. You know, that was, it was, it was pretty basic stuff. But he came up with this concept of the general adaptation syndrome, which basically says, when you get a stress and, and a key characteristic of a stress, so some stressor is applied to you, there is a sequence of steps that happen.
John Kiely:
There is an alarm step, a resistance step. And then if you keep stressing yourself, there's an exhaustion step. And he graphed this. Now, Celia, late in life in, you know, maybe 82 or so, w was interviewed by maybe he wasn't interviewed, but certainly he did a presentation in relation to sport, I think maybe in Australia. And he had is quoted as saying he's, he never thought of his, his he only thought of things in the medical context. He never taught, he never taught to apply them to sport. But within sport, we've taken those ideas and, and really ran with them to the extent that they're still ingrained in sporting culture. But if you go and look at other scientific disciplines, g a s is, is a, it's a dead notion. It is, it is not a thing. There is no general adaptation syndrome.
John Kiely:
We're still redeploying it in sporting context. And again, from my perspective, it's a setup. It's a way of justifying, well, no, this is predictable. And every periodization paper you'll see, go and have a look. There'll be this a mention of cell. They'll probably mention Walter Cannon who came before him, who coined the phrase homeostasis. It'll probably mention Charles Bernard who came before them. 80, no, the late 19th century, early 20th century. They'll show the graph, and then it will be a quick slide of hand that goes from this all about prediction to and now. So here's how we lay out training. Mm. And there's a veneer of what I would think of as really archaic citations that go underneath that, something to justify timescale. And it's normally some archaic Russian or Soviet reference that you can't find. Or when you look it up, it's about, you know, something that is completely not re directly relevant to sport. So there's something around timing. There's something around order, where order is, we do this type of training first, and then we do this type of training again, built on these shifting sands of, well, first we'll have the general science justification, then we'll have this very light touch of selected evidence to substantiate aiming or to substantiate order.
John Kiely:
And, and I guess this is what I was seeing. I I don't know if this is built on anything and then become more and more clear that this is a, this is a magic trick. Essentially, we're going back into the past, we're picking up some evidence that really suits our purpose, and then we're we're building a story on top of that. Mm-Hmm. . Now, just to clarify, I I, I'm not pointing my finger at anyone. What I'm saying is we, culturally, that's what we've done. And that's been our way of, I guess, coping with the uncertainty of, oh, I do not know what to do with this person in front of me. How am I going to manage this uncertainty? So that was a long round about answer. Just one thing to go back to gas it's pretty clear now from the science, the only time there is anything like a gas response is in extreme stressors. Like, you know, major burns, septic shock, you know, this, this type of thing. There isn't any gas for,
Jared Powell:
So gas meaning general adapt adaptation syndrome for everyone. Yep.
John Kiely:
E yes, I'm sorry. Yeah. Again, and this is celia's formulation of this is what happens. This is the graph, this is the chart, this is the way, you know, if you get a stress, this is what happens. And then the slide of hand was fitting a time period to that. And the next slide of hand was, okay, well first you do this and then you do this, and here's some justification. Albeit very vague. It's a very handy justification. And something that a coach facing all this uncertainty, fumbling around the dark, can grab onto and go, okay, now I know what to do. And in, in a way, it's, you can't blame coaches because it was, here's something to grasp onto in the wilderness mm-hmm. where there was no other messages really. There was no other theory of how you should construct physical exercise in a coherent, intelligent way to get you the, the optimal results that you wanted.
John Kiely:
One other point, I'm, I think I briefly mentioned water cannon and homeostasis. Homeostasis is the notion that every process in our body is kind of tightly bound within constrained limits. And once there's some form of perturbation, whatever that may be, there's some form of perturbation that knocks that homeostatic homeostasis outside of those limits, then that's what instigates the gas response. And the gas response is there to restore that homeostatic balance. So to bring it back into bandwidth. Now this is my long drawn way of kind of pivoting into allostasis. So the way to think of homeostasis is there is a specified bandwidth for all these different processes in your body. Once they go outside that bandwidth, there's an alarm response activates a gas response, the gas response restores homeostasis to within those tightly bound limits.
John Kiely:
So, and, and that was, I guess, common belief. I dunno, maybe sixties, definitely getting challenged in the sixties, definitely being overturned in the seventies. But certainly since, you know, two thousands, it's clear that yes, homeostasis is a thing, but it's only a thing in some very critical processes, brain pH, things like that. It's not a, it's not a a way, it's not an efficient way of regulating all neurobiological processes. It's just those really critical ones. So a way to think of it is, there are some critical processes that if they go, if they de, if they're deviated through perturbation outside of their tightly bound limits, they're gonna cause a negative cascade of consequences that can be fatal. But they're very much in a minority. So the literature at the moment would suggest that homeostatic processes are in the minority. Instead, what we have is a much more flexible system that, and that you mentioned as allostasis.
John Kiely:
Now terminology can be ny here cause there's, is it allostasis? This other group over here says, no, it's adaptive homeostasis. You know, so, so there's some terminology, te terminological thing going on. But what I would say is eventually our belief was homeostasis is disrupted from gas response predictable. Now it is, okay, yeah. There is a homeo ho homeostatic processes, but they're very much in the minor, the minority, and they're, they're critical life threatening issues under that are the other processes. Ultimately they're allostatic processes, meaning that they're very widely in tandem with each other in concert, in collaboration. They're not tightly bound within limits. So maybe I should pause there and take a breath and, and just see if, if yeah, if I've gone too far off track.
Jared Powell:
No, it's a fabulous, fabulous start. So general adaptation syndrome is this linear, predictable, repeatable kind of process when there's a perturbation to homeostasis to, to bring us back to, to homeostasis effectively. And this was this, and this was proposed by, so yeah, a long time ago, originally with rodents. And then we've extrapolated this in, in a very creative way judging on, on the history there. And it's ended up being a real bedrock and foundational principle in sports science and training, which is interesting. So much of what I agree I what you said there, I can really relate to John. And what I'll do in this episode is I'm gonna relate a lot of what you say in coaching and sports science to physiotherapy and, and pain and injury, because that's my area of expertise. And you mentioned uncertainty, cuz coaches have to latch onto a principle.
Jared Powell:
Otherwise, what are you doing? Right? It's all haphazard. Same thing in physiotherapy. We have to latch on to certain principles, and those principles may not be the most accurate, but hey, it's a working hypothesis and let's just run with it and see what happens. And, and to be honest, some of these principles kind of work, right? They're not, they're not abject failures by, by any respect. Someone might get a good response with a periodized training program, but the mechanisms underpinning that might be different for each person. And we can talk about that a little bit later on. So this concept of uncertainty and we latch onto it, it's a coherent hypothesis. It's a, it's a coherent principle that we can understand. Makes sense. So we latch onto it. There's so much parallels with physiotherapy there that, you know, we're sort of breaking out of the biomedical model, which I know you've got interest in too, particularly the biopsy psychosocial model, John, which we, we can maybe even go next.
Jared Powell:
We've had to break out of it in physiotherapy where we've got this reductionist look at the world, your pain is due to this structure. Your pain is due to this muscle imbalance. Your, your, your dysfunction is due to an underactive middle, lower T trapezius, whatever it might be. We're trying to break away from that really granular and overly analytical kind of clinical reasoning. Can you, can you relate that d does that sort of, is that a, is that a decent analogy to draw from a physiotherapy perspective back to your coaching and sports science pers perspective?
John Kiely:
No, absolutely. And I think in coaching and sport science, we're, we're behind you folks in terms of overtrained biomedical model. We are very much biomedically driven. Just to pick up in a couple of other things you said there. I, I totally agree. I mean, this is, it's, this isn't about periodization is wrong. It's about sometimes periodization templates can really help you, but it depends on context. If you're working with, I don't know, 150 university level athletes and you are one person with limited brain space and time, yeah, you're, you're gonna have to take some shortcuts. It's, when I say shortcuts, cognitive shortcuts in terms of how am I gonna organize this? Well, I can't organize, I can't individualize for everyone, so I'll need to organize it like this. And something like ization provides a template, so it can be useful for sure, but we shouldn't conflate that utility with being accurate, are being based on scientific principles because it's neither.
John Kiely:
But once we acknowledge, okay, I'm gonna make some big bold assumptions here and it's not gonna be perfect, then that's fine. I guess where I get a little bit irritated is when we try to smuggle those convenient principles in under the kind of banner of, oh, well this is scientific. Or if you don't agree, then you're disrespecting the work of these great scientists who went before. Well, you're not, you're, you're trying to build them on top of what they've done, aren't you? You're trying to improve. One thing that I I will also mention is that if you were to boil it down to, you know, and you could go down the rapid holes of homeostasis and allostasis, and both are essential, you know, in, in effect they're different words for different ways the body reacts. If it's a homeostatic reaction, then it's a severe challenge. If it's an allostatic reaction, then it's probably just mundane everyday training challenges, for example. But both of those work together, you know, if anastasis goes wrong, homeostasis has to kick in and correct it.
John Kiely:
A, a good way of thinking about this is homeostasis is reactive. Homeostasis kicks in. If allostatic, all allostatic processes have continually got it wrong, and now you have a drama on your hands. Now what a critical process is after going outta whack or something happens that was totally unpredictable. So with Anas allostatic process, the way allostasis works is it is anticipatory, it predicts your brain, predicts what's going to happen and starts to adapt in advance to meet that future challenge. And I guess that's probably the biggest step change. It is the idea that in professional sports I think in in rehab r t RTP as well, we have this still embedded belief that if I want someone to adapt something to adapt, the stimulus I need is some physical stimulus. An allostatic perspective would say, well, this is all anticipatory. If I am stressed, for example, you mentioned the word stress earlier.
John Kiely:
If I am stressed, what is that doing to my adaptive processes? Well, in effect, stress is some sense of threat, some sense of upcoming uncertainty. What does your brain and body do in those circumstances? Well, it starts to more tightly regulate resources where resources are cognitive attention kind of big expensive molecules you use in the brain, energy, all those things. It conserves. What does that do for adaptation? Well, it limits it. You use an extreme example just to kind of prove the point, or not prove the point, but drive the point home. You put a, a growing kid in a high stress environment and their growth will often slow. Why is that? Well, it doesn't make sense to keep adding on spending resources on these building projects if you're not sure about whether you're gonna survive tomorrow. So everything goes into maintaining, when I say everything, cognitive resources chemical neurobiological resources, energetic resources, everything goes into conserving a current state of high alert.
John Kiely:
It does not, it is not dedicated to building projects. So with things like psychogenic dwarfism, which is, you know, extremely rare, but it's where there's extreme stress and your body just stops linear growth, stops neural development. That's an extreme case of I think what happens with stress. If your stress illness takes longer, pain in most contexts will go up or will be higher neural development goes down, learning goes down. So all these negative things that are really just reflected facets of the fact that your brain and body are carefully regulating expenditure in case they need resources right now to save your life. So can I just check if, if that made sense or if I went off and a little bit of a journey there
Jared Powell:
Really good, i I want to take that in and now apply it to sport or to athletic training or to coaching or, or whatever you wanna do. So how do these principles, or how should these principles underpin our approach to exercise prescription? If you're a strength and conditioning coach or a PT or whatever you are, if you want to, let's say, obtain some form of outcome, now everyone's gonna have different goals. So let's, let's just start really, really broad. So how do we apply these principles of more of an allostatic type of thinking, a a non-linear a chaos theory, a complexity theory kind of thinking, and apply that to exercise prescription, for example.
John Kiely:
Brilliant, thank you. That's a really kind of focusing question that, let me clarify some things. So what we normally do is the coach or the therapist or whoever goes away and in their brain comes up with the best set of exercises are the best program. But what the fact that so much of our regulation is anticipatory, it is your brain making a prediction on what's gonna happen next, what the challenges you are facing. And off the back of that prediction, mixed with prior learning, is deciding how much resources can be afforded to be allocated to responding to that exercise, let's say. So there is, we've always believed driven by the biomedical model that the stimulus for adaptation is the direction and magnitude of the physical stimulus. But contemporary theory suggests allostatic theory, you know, predictive processing theory which is the premier replacement of the biomedical model in, in current sciences.
John Kiely:
What that suggests is it's not just the stimulus, it's your set of beliefs, assumptions, biases, aversions preferences, anxieties that are wrapped around that stimulus. So it's not a case of you apply a physical stimulus and maybe you're stressed and that takes the edge off your adaptation. It is the initial stimulus is a combination of what you do physically and your set of beliefs and assumptions around the implications of that stimulus to you. So the implications would be, can I handle this? Is this something that I'm nervous about? Am I anxious about this? Is this an injury risk? Does this make me feel uncomfortable? I really like this type of training. I really believe that this type of training benefits me. It's all of those things. Now, if you were to drill down and I, I like, this is a, a wormhole, but my reading of the, the kind of clarence best science in this is that fundamentally what drives stress, anxiety or dampens, it is uncertainty.
John Kiely:
Uncertainty about what your future, your immediate future holds for you. If you can provide certainty, then you dampen down stress. For example, you know, anxiety if there's a lot of uncertainty, then it does not make sense. Your brain is going to budget resources accordingly. And there's gonna be, look, I'm not sure if this is safe, I'm gonna hold back here now, I'm, I'm using the term hold back. Holdback is chemical resources, energetic resources. It is likely all kinds of bioelectrical resources as well that we're, you know, we don't really have a good handle on. But if we just take that as a general principle and it kind of, it's nearly common sense. There's a budgeting problem our brain faces all the time, is this safe? Is it not safe? How can I make it safer? If I'm anxious about it, how do I resolve anxiety? And based on those tradeoffs and negotiations your brain is allocating, are not allocating resources. And that is what fuels performance movement adaptation to physical stimuli. How did that go? Did that, did that land or was it very unclear
Jared Powell:
Sound. Sound very good. I I will, I will attempt to add a couple of things if you don't mind John, and again, relate to, to physiotherapy or musculoskeletal healthcare. So couple of things that you said really hit home. Again, there is not a one-to-one or an isomorphic response between stimulus and outcome or result. Basically, we, we, we see that with training, which you are alluding to, and we see the exact same thing in in pain with, with no csection or a one centimeter cut is not half as painful as a two centimeter cut Pain. Pain goes beyond the size and the magnitude of, of the injury that you may have. You know, there's this, there's something emergent there. There's not a one-to-one relationship between tissue damage and the experience of pain. And you're kind of saying a similar thing with, with responses to, to training stimuli as well, I think. Is that, is that correct, John, before I before I go any further there,
John Kiely:
Yes. I'm saying the exact same thing. It is not, it, it is not, obviously it's not a nociceptive signal. Yeah. Wrapped around that are all type of Yeah. It's, as you know, as pain is a perception, it is not a direct translation
Jared Powell:
Of that. It depends who you talking to, John? There's, there's a conver there's a, there is a conversation out there between sensation versus perception, which I'm trying to get off the ground in terms of a debate, but I'm with you. I believe pain is a perception.
John Kiely:
Well, yeah. Well, okay, sorry, this is warm hold. What am I do? If you think you and your listeners would be interested, I'll send you on what I think of as the kind of major paper in, in, in this area for theoretical background. And just really briefly, it's by three kind of really heavy hitters. Akin Peters, who back in the late nineties, came up with the selfish brain hypothesis. Bruce McCune, who is one of the key academic drivers of allostatic theory and Carol Friton. And for any other kind of nerds out there, Carol Friton is like this ity.
Jared Powell:
Oh
John Kiely:
Yeah, yeah. Especially when you're come into, you know predictive processing, predictive coding, active inference and so on.
Jared Powell:
I don't interrupt you too long, John. I just wanna say Carl Friton, I looked up his H index the other day, 280, his H index, he has like, yeah, he gets like 500,000 citations per year. It's yeah, I, he's he'll win a Nobel Prize one day.
John Kiely:
No, for sure. I think. But very, very, it is, I think unless you're totally invested in that field, it is impenetrable to us, if you like, but there still is messages coming from that. And maybe there's maybe two things, if it's okay to have a slight pivot just to kind of bring us maybe back into the practical world. If I was to kind of think of what was the big difference between older perceptions of homeostasis and current perceptions of, yeah, okay. Of course there's some home homeostasis in emergencies, but it works hand in hand with anastasis and allostasis function is to prevent homeostatic reactions effectively, to preempt challenges and adapt in advance to meet those challenges. Homeostasis as perceived in the exercise literature is an archaic s interpretation of what cell described. And that was a brainless phenomenon. It didn't care what you thought it was, you know, it, it happened like from the head down if you, you know, it was a glandular automated reflexive reaction.
John Kiely:
Yeah. But it was automated. And reflexive allostasis and contemporary theories are firmly putting the, you know, the origin of the stimulus that drives adaptation to exercise and or injury and or pain. It's a brain centered phenomenon. They are brain centered phenomenon, and it is, they influence emotions, perceptions, cognition and actions. And through those kind of four avenues, that's a response. It's not like, well, there's a physical response. It's not to do with the brain. That is not the case. Now, quickly translate that to kind of, to to, to more view of the world of pain injury adaptation. What you feel, what you believe is, is a fundamental part of that adaptive stimulus. It is not just a physical signal. It is the physical signal in conjunction with your set of beliefs of what this physical cha challenge means and your perceptions of the resources you have or the capacity you have to safely handle that challenge.
Jared Powell:
Love it. Love it. So let's apply it now. So how, how would we apply this? Say, say, John, you're handling a group of athletes, they are college level athletes. Let's say they're in the USA for whatever reason, because that's neutral between you and I, and they are basketball players and they've got dreams of going to the N B A and they've got, they've been given this, they've all been given this, three athletes have been given the same program by their athletic trainer or whatever they are over there. And it's meant to, to achieve similar outcomes for all. They're meant to make them strong and it's meant to make them powerful. It's meant to make them jump high and it's meant to do something else. So how, how, why is that wrong, first and foremost, and why, if indeed it is wrong from your perspective and why, why might we want to, to, to take an alternative approach in instead of assuming a one size fits all approach is adequate?
John Kiely:
Okay. so first of all, I wouldn't say it's wrong. I think ultimately we need to put things down on paper. D you know, we need to communicate with athletes. This is what you need to do or this is what we're going to do. And I think, I think that how we do that should depend in context. If I'm working with 150 athletes, I'm gonna have to make generalizations. I'm not gonna be able to go around and talk to everyone and educate everyone. You know, why this is go, this intervention is really going to help you. I can't do that. So I have to make generalizations. And in a sense, that is what the base of periodization is. It is, let's make these generalizations ba based on science available at the time, what the next step was. Let's scale this out to everybody. Then, you know, it's like whether you're an elite triple jumper or you are part of a squad, or you're in a kind of some aerobic group that need to lose some weight. It's the same type of principles, whereas it's not, it depends on resources. If I have time with you, then we're gonna go into things in more depth. We're going to be more sensitive in terms of how we retune and recalibrate training.
John Kiely:
But just to go back to your question, it's large scale. Okay, how can I take these principles? Well, first thing we need to do is, is there any way, and these are just examples, is there any way I can kind of survey the beliefs of these people? So maybe there is, maybe there's a time efficient way, and maybe it's three questions that everyone gets on the squad to get an email. And you get that information. You think, okay, well look, maybe there's some education needed. How can I educate 150 people at the same time? Okay, well maybe I can, I'm, I'm not gonna sit them down in class, but maybe at the start of every session, I'll give 'em a two minute brief and every two minute brief, I'll reinforce some messages. I'll reiterate, here's why we're doing what we're doing today. And maybe there'll be a sentence or two kind of nudged there, understanding forward.
John Kiely:
And in a very simple way, like that you can start to foster understanding deeper understanding of training processes, deeper understanding of what they need to do or the life that they need to lead. And maybe, so I guess the other step I would always have then is some feedback mechanism. And again, that feedback mechanism would need to be scaled to actual context. You know, I'm, I'm not gonna have 150 sit downs with people, but maybe I'm gonna give them a 92nd debrief at the end of a session, and I'm gonna ask, okay, I want three suggestions of you know, things that aren't working for you or you feel are getting in the way, or something like that. So I, I guess I'm kind of tying myself in a knott here, but there's always some way within your context, regardless of what that context is, that you can gradually start to move, understanding belief, buy-in further down the line.
John Kiely:
There's always some way that you can get feedback. There's always some way that you can impress upon the people you are working with, that you have their best interests in heart, and that you were taking a professional and taught through and considered approach to their care. And if you were getting those messages across, that is, that is powerful, because that is, that is it, it's not just a noise to do. But in terms of, if I go back to what's the fundamental stimulus, the fundamental stimulus is not the physical exertion. It's not your, just your belief around that exertion. It's a mix of those two that will regulate the magnitude and direction of the adaptive response launched in response to the, the exercise challenge. And just maybe to clarify a little bit, I, I came across lots of this through looking at the placebo literature and within medical context, there is that move now towards, well, rather than just driving an intervention, let's maybe survey whether patients believe this intervention will be helpful or not.
John Kiely:
And if they're suggest, if, if the feedback comes back that, well, no, they don't really think it's helpful, then we have a problem. But I think that that penny is dropping, that these beliefs are really important. So we need to adapt our processes around that. And I know in the physio world, you know, there's some kind of standout folks that are pushing this message certainly down your neck of the woods, LAR, Mosley Peter, Peter Sullivan, you know, d different people like that. So it's becoming much more common and noticeable in your pers domain in professional sports. Not really there so much, very, very erratic. And again, it's, it just seems where I'm that transition point between all that old biomedical reasoning and a more, and again, it, there's a terminology thinking it's here, here, here. Is it biopsy psychosocial or is it more of a predictive processing driven phenomenon?
John Kiely:
But we have that conflict and I guess we need to think about it in terms of exercise prescription as well. Exercise prescription can't just be numbers on a page that the coach pulls from their brain. It has to be something that is, it comes to life. It is it through communication, through designing processes where athletes feel that their opinion is valued, where they become more invested in the program. They buy into the program, they buy into you as a coach. They understand you have their best interest in heart. You take care of your communication. Last thing, and I know this is a really big grant, so sorry. One of the issues that's come out of the placebo research the past few years is the disproportionately damaging effects of no Sibos. So it's not a one-to-one, you know, here's a unit of placebo and here's its minus one noce effect.
John Kiely:
As human beings, we're kind of evolutionary wired to be sensitive to risk, to be risk averse. So a little dollop of can undo a lot of positive placebo. And and again, I'm sorry if this is again, confusing to me, placebo, it's not a, it's not a thing. It, it's a reflective facet of predictive processing. Placebo is just, I get a positive message or I get some hint that the future is b going to be brighter, and that changes my resource allocation determination. So now, hey, things aren't gonna be so bad. I can free up resources. I don't have to stay on this highly alert, highly sensitive state that costs a lot of energy. [inaudible] The opposite. Okay, whoa. Okay, I need to dial back here. I need to husband or carefully manage resources because I need to maintain a highly alert state that's really, really expensive. So we need to be careful in placebos, placebo signals, we need to promote placebo signals. And the final layer then is we need to do all that in an et in an ethical non deceptive way. , so got way over time. I'm sure you've dropped off there.
Jared Powell:
No no, I'm, I'm hanging off every word, John. Really good. I I've got a lot to say. I mean, I, I wanted to interject 25,000 times and, and say something, but I had to, had to utilize some self-control, so really, really good. But where do I go here? So placebo, noce, fortunately, fairly well researched and people are, are aware of it in physiotherapy. So well done for you, for to you for bringing this to the coaching realm because I mean, still, still in physio I say, I say we're aware of it. I mean that we we're in an echo chamber, I guess. So, so I think everybody's aware, but you go out into the, into the, to the messy reality. And, and, and, and most people aren't unfortunately. And, and throw away no CIC comments are being thrown around all the time, which undo all the good you've just done in the 29 minutes prior, unfortunately.
Jared Powell:
And, but I just thought, so something else I wanna talk about while I've just, I'm just gonna switch gears just randomly right now because I just had some weird thought pop into my head. I dunno how that happens. I dunno, the process of thinking, but something's just come into my head. And when you are saying that you, you basically alluded to a moment ago that in, in not so many, or not the exact words, but I'm gonna paraphrase you a little bit, that an individual will probably have a different response to a stimulus based on that, the entirety of what being that individual means from a genetic perspective, from an epigenetic perspective, from a sociocultural perspective, from a physiologic, so on and so forth. Right? There's probably gonna be some spectrum of response to the same program. And I'm reminded of, of these twin studies which have been done here in Australia where I identical and non-identical twins were exposed to a str a strength training program and a and a and I think a, an aerobic program. And even identical and non-identical twins have a different response to the stimulus. And I'm sure you're aware of this, John, and it makes me think if identical twins who are theoretically genetically the same, have a different response to the same stimulus, of course there's going to be a different response between you and I or, or me and someone who's living in South Africa or, or somewhere else in the world. Do you have any comments or commentary on that?
John Kiely:
So, so yes, I guess one of the big debates obviously is nature versus nurture. And that that study, that Australian 2021 study showed that identical twins were having as much difference between responses as non-identical fraternal twins and, and randomers. And it's really interesting that like, one of the reasons for that is potentially, well, okay, well what were your beliefs around that? Or what were your perceptions? What were your, the set of cognition's emotions wrapped around that particular training? Because that's, that's a regulator of resource allocation. And so, yeah, so that mar study was powerful because it kind of pulled the rug out from under the, you know, any remaining thoughts that it's dictated by genetics. Mm. It's not obviously. So, but it, I think that there's some things we don't know. You know, there's a lot of, there's a lot of kind of biological neurobiological adaptation we have written, figured out, but at the same time, we know enough to know that the way we've done it in the past isn't the right way, and we need to adapt accordingly until more evidence comes up to, you know, nudge just even in a, in a more well-directed direction.
John Kiely:
Sorry, I'm getting mixed up my words. I did see something that I, and I'm sorry I don't have the reference to hand, but I'll find it via you and send it to you. But just yesterday I was reading another recent study that come out, can't remember who the first authors were, and it was relating response and non-response, I think to medical inter in some, in medical intervention and pain. And what they were coming back was the differentiate, the differentiator, or key differentiator was perception, or sorry, I'm saying perception, set of beliefs. Whether you ex your expectations, did you expect relief? Did you not expect relief? And that was pretty much dictating response. Now that's very rough and I'll need to refresh my memory, but again, that logic maybe speaks to my biases in terms of, okay, well that would make sense to me.
Jared Powell:
We have some work here that, that I know, I know the author very well, Rachel Chester, she's published a paper that suggests expectations of physiotherapy. So whether you expect a good result or a bad result. And there's a, there's five points in between. If you expected positive results with physiotherapy, you got better. If you expected poor results or were agnostic about your outcomes with physiotherapy, then you had a statistically worse result. And the, and the other one was self-efficacy. So your, which is effectively your, your belief in your ability to, to manage your shoulder pain. And so expectations and self-efficacy were the biggest predictors or what mediated outcomes more than any other variable. And they included like, I think baseline pain and disability and, and various other sort of biomechanical or biomedical kind of measures. It was expectation and self-efficacy, which is fascinating.
John Kiely:
Well, that I, I guess that chimes with what, what we've talked about. I guess we're just extending it to adaptation, how you regulate the resources necessary to productively adapt to an exercise stimulus that's pretty much budgeted by how you feel about the value of that stimulus and it's potential contribution to achieving your long-term objectives. Mm-Hmm.
Jared Powell:
.
John Kiely:
So, so yeah, that may, that might well be the study I'm actually talking about. I'm, I'm not sure
Jared Powell:
We've got a ton of them. We, we know in pain that the, the, the biggest predictors of outcomes are non-physical. Basically. It's, it's all what's going on. It's the, it's the inner movie, which is driving the outcomes in our mind and more than anything else. And we're, we're, we're pretty onto that. Some of us are pretty onto that in physiotherapy, and I'm, I'm so stoked that you are flying the flag when it comes to, to coaching as well, because I believe it has, it has the potential to have such a great effect on outcomes for everyday coaches, in my opinion. Do, do you, do you see that this would have a positive effect for the, the day-to-day handling of, of clients in a gym if you're a personal trainer? Or do you feel like this is too metaphysical? Do you feel like this is too philosophical and it won't, it it won't impact their day-to-day exercise prescription?
John Kiely:
No, I definitely don't feel that. I feel this is a necessary evolutionary step. It's like, good exercise prescription isn't writing down sets and reps and exercises and then given technical instruction. That's not it.
Jared Powell:
It's John, are you saying that exercise prescription goes beyond sets and reps?
John Kiely:
Yes, I definitely am. And, and, and, you know, tech technical considerations, and that's the way I was educated. That's the way a lot of coaches operate. It's like that's what gets the brain space. That's what the coaching conference is, and workshops are about exercise design. And don't get me wrong, I'm the biggest offender in the world. I've, you know, nerded out that for donkey's years, but it's more than that. It is. And, and you kind of summarized it well in the, in the last bit you talked about, and I, I was thinking that's just the whole podcast in 30 seconds. It is exercise adaptation or, you know, or any experience, any perception we have. It's not, it's not mechanically driven. It is a product of your expectations married with reality, and then your interpretation of that reality and how it relates to you, your long-term goals, whether it's a risk, whether it's something positive and and productive.
John Kiely:
Now there was something else I was gonna say. So yes, so co that's what coaching is, that's what physio is. I think it is in the large part, in a sense, you are the placebo or the placebo, the way you carry yourself, the way you present, the way you communicate, the kind of vibes that you give off in terms of how you care or how you don't care, right? And I think it opens up the extent of the challenge as well. If, if we are carrying that in our backs, that if, if I make a mistake in driving a SIBO response, that's a big no-no, it, it's a pressure. But at the same time, for me, that's the job. You just need to be carefully considered, just in the exact same sense that you'd expect an athlete to warm up and get their head in the game as practitioners, then we need to do that too.
Jared Powell:
I, I've, I've just finished some research and submitted a paper where it's basically a qualitative study where, where interviewing people about their experience with exercise. And you could have given the best exercise program under the sun perfectly prescribed based on what have you. But if you, if that person hates you, doesn't trust you, doesn't care about anything that you're saying, then that exercise program is going to fail. So this exercise program has a causal power only if it's manifest in the right way. So it's disposition only if it's met with a patient who can actually manifest that positive result. So there's this, there's no one best exercise program that you can just parachute into some sort of physio office and it's gonna help everyone. It's always complicated and interdependent on the particular patient in front of you, your relationship with them and the, and the specifics of the exercise program. Any commentary with that?
John Kiely:
No, I totally agree. Absolutely. And I think it does put more of a challenge on the practitioner, but again, that, that's the game. If you're in the game, you gotta, you know, you, you, you gotta acknowledge that and adapt to, to kind of meet those demands. So did the last thing maybe, or one of the last things I say is that I think really good coaches, certainly in my world, if you go back far enough in any of the major sports, the really legendary coaches had this, they mightn't have been able to describe it using, you know, the terms that we use, but they were good at managing the person on front of them. They were good at communicating. Now, I don't think it means that, you know, good coaches and good managers, good communicators coming all shapes and sizes. It's not about, you know, for me, you know, normal, average, boring white male.
John Kiely:
It's not like me trying to be a comedian and get everyone on board with me. It's, it's not that at all. It's just me communicating in a way that is authentic for me, essentially. And so the athlete who is motivated, or the person in pain who is re desperate to get outta that pain, they, they invest, they, they, they believe, they see that I'm on board and I'm behind them and I'm on their team and I'm guiding them as best I possibly can. That's what's important. It's not so much you are kind of all singing, all dancing, trying to get a personality transplant, you know, w we are who we are. I guess it's just being the, and I don't like using this term, but like, being the best possible version. It's a performance, you see a client, you're, you are, you're, you're on stage essentially.
Jared Powell:
Absolutely. Yep. You gotta be, I say a clinical chameleon, you've gotta, you gotta, you've gotta perform, you've gotta adapt, you gotta, you've gotta, you've gotta be this person and the next person. It's fatiguing. It is hard. And I, I burn out a fair bit actually when I'm seeing a lot of patients, but I just, but it's the way it's gonna be. John, I'm conscious of your time. We got to question two out of the eight questions that I had written down, . But we covered a lot of ground, so I don't think we've missed anything. Is there anything else that you want to teach me or the audience or at least converse about?
John Kiely:
Oh, I, I'm, I'm definitely not a teacher. I'm more having a conversation with people person. Let me see. No, I, I think the concept of, I mean, conventional perspective, historical perspectives, biomedical model, it's brainless, contemporary, pers scientific perspectives and how we manage. It's all about it's, it's brain centered. It is the brain is the organ of stress. The, you know, the, the, it is the brain that runs the budget and that budget is very, very influential. So if we want someone to allocate resources, valuable, precious, limited resources to things like adaptation or managing pain, then we need to give them good reasons to do so. You know, so yeah, I guess that's a, a kind of a, I pivoted into a little bit of a summary there.
Jared Powell:
Good, good. We've been from, from Soer and, and rodents and Gas to Alice Stasis to, to everywhere in between. It's been a, it's been a really good conversation. I wanna ask you though, John I, this is a customary finishing question or a traditional finishing question. I know you're a reader, so what, what book are you reading if, or what books are you reading? Cause I know you're an avid reader and, and I wanna know what TV show you're watching and it, and I don't care what it is. You've gotta be honest. You've gotta, you've gotta be upfront about what TV show you're watching as well.
John Kiely:
Oh, okay. I guess. Books fiction. I'm reading Frederick Backman, if people have heard of him. A man called dok, I think might have been his first one. So his latest one is called The Winners. It's set in Scandinavia, ice Hockey Town. As somebody who struggles to write a lot, he's just a fantastic writer for me. You know, a sparse clean, really succinct. So I, I really like him. And that's a really good series of books I'm enjoying. So, so that's fiction, non-fiction. I've kind of two undergo at the moment. One is called Active Inference, which is the densest worst nighttime reading you could possibly imagine. And characters in who we mentioned is a co-author on that. And it's his first venture into I guess non-peer review writing. But yeah, it's, it's, it Ain't Easy . And then I'm reading a book called Immune, which is basically about the immune system which I, I know it sounds very dry and very boring, but I'm enjoying it. Love it. So, yeah.
Jared Powell:
Can, do you recommend the Active Inference book by Friston and colleagues?
John Kiely:
I think you, you'd have to know some of that, like ha have read around it first. What I'll do if it's okay, is I'll send you the Peter's McCune and Friton paper. I think that's a much better introduction and that boils it down much more succinctly within a paper that this book, I, I can't judge in it because there's so much stuff that you have to go away and research. And it's probably gonna take me seven years or 10 years to read. So, yeah. It's not riveting. It's not a page turner.
Jared Powell:
Yeah. Cool. And what, what about TV show? Let's go there.
John Kiely:
Okay. I'm going to be very dry and boring here and every now and again, my, my partner forces me to sit down and not go to the shed and do a bit of exercise and watch something. So the last thing we were watching. Succession. Succession maybe. Yeah. So, so cool. Yeah.
Jared Powell:
Cool. That's an alright show. That's good. That's good. Seems to be critically acclaimed, so it's not too bad, John.
John Kiely:
No, no, no, it's good. She, yeah, I'm, I'm not a great TV person. Yeah,
Jared Powell:
Good.
John Kiely:
But I, I, but, but I'm trying, I'm trying , I, I realize I'm, I'm not just boring, but antisocial and boring, so,
Jared Powell:
Well, I disagree. I've had a, I've had a really great time talking to you and I'm sure listeners are gonna get a lot of out of it. A lot out of it. John, I want to thank you for your time,
John Kiely:
Jared. It's been a pleasure. I'm sure we ran over time. Sorry about that. And yeah, I was, I enjoyed the conversation, so thank you,
Jared Powell:
John. Thank you very much.
