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I work in medical research and in medicine one important source of knowledge for good clinical practice are guidelines. Usually guidelines are made by some experts committee including and they usually say what treatment in what constellation one should do and what the evidence for this recommendation is. This is super helpful. Is there something similar in sport science for the execution of certain exercises?


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For example, some years ago I heard at the bouldering gym that hanging with completely straight arms leads to shoulder injuries. I did not question this information and always tried to keep my arms bent while bouldering. Some month ago I started to do the dead hang and I saw so many articles and videos stating that hanging with completely loose muscles and completely straight arms would be beneficial for shoulder health. So I started to do a completely passive dead hang with straight arms. But some days ago I read an article that this would be "the fastest way to kill your joints". There is a question about this issue here on PF but the answer refers to an article that contains no sources. So the question remains: Who is right? And how to find out?

There seems to be a wide range of contradicting information and it is often unclear what it is based on. There are Fitfluencer, Defluencer, Professionals (physiotherapy...) and so on, i. e. many different opinions and no certainty - but I can't find any widely accepted guidelines.

So what I am looking for is a source, maybe a database, that embraces recommended execution of certain exercises as it was formulated by an expert committee. I expect such guidelines to include scientific sources, an evaluation about the level of evidence for the recommendation and also that the guidelines are updated each few years. Is there something like this?

I understand that there are different kinds of sports. Actually I would await such guidelines for each kind of sport (in medicine each field has its own guidelines too). But personally I am most interested in bodyweight training and the proper form of execution.

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    I suspect the closest thing to that would be to look at a certification authority like the NSCA, NCSF, CSCCa, or ISSA. Unfortunately their information is notoriously tight-lipped because they want you to spend hundreds of dollars taking their courses, or hire a coach that was trained by their guidelines.
    – DeeV
    Commented Feb 12 at 21:39
  • @DeeV Thank you for that hint!
    – LulY
    Commented Feb 13 at 15:12

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No. Guidelines for individual medical interventions exist for reasons which do not apply to individual exercises:

  • Pharmaceuticals have owners who are required to formulate dosing and contraindication guidelines as part of the approval process.
  • Medical interventions of all kinds tend to carry substantial costs, risks, and side-effects, and their application needs to be managed in order to limit these harms.
  • Placebo medical interventions are possible.
  • Blinding of medical interventions is possible.
  • Government bodies have financial incentives in order to develop guidelines in order to reduce unjustified prescription of subsidised interventions, and reduce costs associated with iatrogenic harms and illnesses that could be avoided through either preventative medicine.

In contrast, exercise:

  • has no owner responsible for its implementation,
  • is almost always health promoting,
  • has minimal potential to cause harm, with injuries typically being both infrequent and very low in severity,
  • cannot be replaced by a placebo for study, and
  • cannot be blinded for study.

In particular, the extremely low rates of exercise-related harms make it near impossible to study, except in the higher risk population of professional athletes, where findings would not apply to the general population who are not exercising at similar levels of volume and intensity.

Furthermore, guidelines on exercise technique would largely serve as a barrier to exercise, which would be immensely harmful to overall population health. (Consider the effect on exercise participation is exercises had to be prescribed by a doctor or other professional who was trained in administering the guidelines.)

This is why the existing exercise guidelines (e.g. The World Health Organization's Adult Physical Activity Guidelines) are no more specific than just saying that absolutely everyone should exercise, including both cardiovascular and resistance training, for minimum durations of time per week.

For example, some years ago I heard at the bouldering gym that hanging with completely straight arms leads to shoulder injuries. I did not question this information and always tried to keep my arms bent while bouldering. Some month ago I started to do the dead hang and I saw so many articles and videos stating that hanging with completely loose muscles and completely straight arms would be beneficial for shoulder health. So I started to do a completely passive dead hang with straight arms. But some days ago I read an article that this would be "the fastest way to kill your joints".

None of those claims have any evidence behind them, or even any plausible mechanism by which they could cause harm. They remain popular though, because pandering to people's anxieties is an effective way of hooking them in to listening to you.

A reasonable way of handling such claims would be to look for the evidence of an actual incidence of injury, and dismiss the claim if one does not exist. E.g. It is commonly claimed that sit-ups carry a risk of back injury, yet it is unheard of for injuries to actually occur while performing sit-ups. Given that sit-ups are an extremely common exercise, the absence of frequent injuries strongly suggests that the claims of their danger are false. But taking such claims without skepticism is truly maladaptive.

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  • I disagree with many points. To name some: Rare events are common and it is not "near impossible" to study such events, one can use case-control studies for example. "Pharmaceuticals have owners..." You mix up the clinical phases of drug development and approval with guidelines. See here for an example...
    – LulY
    Commented Feb 13 at 17:58
  • ... @Placebo. What your write about medicine is wrong. Not treating people is considered unethical, thus studies with placebo control are usually not feasible (exception: There is no existing treatment at all; obviously this is seldom). Usually a new drug/ medical device/ procedure/ nutrition/ other intervention is tested against the existing ones (not against placebo). What you write about fitness: Absence of placebo is no problem at all. One can simply use another control group. Using the example of my question: One can test injuries in passive vs. active hang.
    – LulY
    Commented Feb 13 at 17:59
  • I don't think you're grasping how impractical that study would be, in terms of volume of participant-hours needed to produce a number of injuries large enough to expect a statistically significant difference in injury rates between groups, or how useless the results of that study would be. Commented Feb 14 at 2:45
  • I am a statistician in medical science, so I think I do grasp the importance of balanced groups and statistical power. However, you seem to neglect that rare events is a common thing, for example many diseases are rare but nonetheless have been investigated. This is because there are statistical methods that can be applied in case of rare events and because there are study designs that are efficient even in rare events (compare a prospective cohort study vs. case control study, to name a widely used example). Read this for example.
    – LulY
    Commented Feb 14 at 5:54
  • Your link states "No studies describing unique methods for conducting observational studies in patients with rare diseases were identified." Even if they had found methods for studying treatment of rare diseases, that still wouldn't be applicable, because you're asking about studies assessing prevention of extremely rare outcomes, not treatments. In the latter case you can find study participants who already have the illness of interest, but in the former you would need huge groups to observe any instance of the event of interest. Commented Feb 14 at 6:20

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