Do You Know? Or Do You Understand?

Examining the difference between knowledge and understanding in the world of health and performance

Perhaps the best explanation for the essence of this article is the picture - learning to ride a bike requires no reading, and conversely reading about it probably doesn’t help much. It’s neither necessary, nor sufficient. This is because knowing how it is done per se, is not the same as being able to do it. Now this isn’t to suggest knowledge never plays a role as much as it is to say that practical experience and experiential learning can really aid in truly understanding something (rather than just knowing it). This phenomenon certainly applies in the realms of health and performance. Explained differently, and for an audience aged 20-50ish:

“There’s a difference between knowing the path and walking the path” - Morpheus (The Matrix, 1999)

If anyone is at all unsure about how this looks in reality, go watch a new graduate in STEM fields work in their first job (believe me, this has been me three times). Well equipped with the ‘what to do’, the ‘how to do it’ is very much missing in many cases. This is in part an art vs science conversation - that is; the art is using the knowledge and implementing it vs just having that knowledge.

But this applies much more broadly. Specifically when it comes to behaviour change and optimising (or even just improving) factors in your life from a health and performance standpoint.

Decision Making

I find decision making itself particularly interesting as an undertaking. Ultimately making better decisions will mean you have a better life in all aspects, but this is almost too broad and crude of a statement to have real meaning.

There are infinite numbers of decision making frameworks and rules of thumb, I even wrote about some lenses I use for this in the health and performance realm here. That said, there is nothing like experience and ‘skin in the game’ when it comes to decision making. This is probably the reason that STEM graduates often struggle in the early phases of working in their professions to varying degrees. The gravity of the outcome and the skin in the game can paralyse decision makers or even cloud their decision making in certain cases.

The Test vs The Patient

There is a very clear transition for many students in the health realms, but particularly medical students, when they start seeing patients. Specifically, they go from the knowledge used in exams (often memorised facts) to having to apply said knowledge and create connections. I won’t go into the semantics of this, and what it’s called in the world of education (where I spent some time) but suffice to say it’s a bell curve situation with most doing fine, a couple excelling and a similar amount really battling through. A very concrete and relatively simple example is something like names of diseases and pathophysiology where an understanding of basic latin pretty much answers the question for you rather than having to memorise the words (understanding vs knowledge).

My podcast cohost has taken to scouring the internet for medical questions in a tongue in cheek way of teasing me to prove I am a real doctor. He’s found it a challenge asking questions when you don’t have the topic specific knowledge, but has ended up asking many questions that are physiology related. Some of which have fallen into a trivia type of category, many of which have fallen into tidbits that are unlikely to be something anyone has learned for whatever reason unless it is their niche in their PhD. But the basic grounding in physiology that I have from my studies means I can often answer these, much to his amazement, regardless of whether this is something I learned specifically. (Here is a link to the podcast on various platforms if you would like to listen).

Emotional vs Intellectual

Another way to frame this piece up may have been intellectually knowing vs emotionally understanding. This certainly fits a good proportion of the time, though at times you could split the know/understand from the intellectual/emotional paradigm. Perhaps this latter paradigm has a portion of belief - which can, of course, be founded in experience or in faith. The latter of which is often the realm of coaches (instilling belief via faith in the coach and their advice - which they may have learned via experience).

Another way to frame this is more around emotions themselves. For instance, in matters of the heart - when there is loss (in a relationship or in the family) there is a clear intellectual understanding that things will get better and be ok in the long term but emotionally getting to this point is often a long way away. Again, we could frame this as a knowing vs understanding situation.

Where Have I seen This Play Out?

There are an absurd number of examples I could cite here, but some that I see more often and better illustrate the point are below.

Race and pacing plans in races for athletes - this includes the breadth of the field from elite to beginners. I have seen many a race ruined because, despite having a pacing plan (either self or professionally developed), athletes cannot or will not execute it (no judgement here).

Body composition change - this could be gaining muscle, losing fat or both. The information required to do this isn’t particularly advanced (there is even some research suggesting Chat GPT is pretty close). But like many changes in lifestyle (all of these goals require aspects of both nutrition and exercise, I’d also argue sleep and stress management but let’s not get tangential) it’s rarely a knowledge issue - there’s a knowledge-action gap that needs crossing.

Coaching - I use the term in its broadest possible sense, applied to the workplace, sport, health and any other facet. As someone who started coaching formally at 17 years old (informally much earlier) I can categorically tell you, that experience is invaluable. I covered many learnings from elite sport here, almost all of them were things I learned many years after starting my coaching practice (and after gaining qualifications which, if anything, reinforced the opposite of most of these learnings). This may be best summarised by the fact that earlier on in coaching you are concerned with the ‘what’ and the 'best way’ to do things - later on you realise that coaching is a practice and a relationship which is much less about your ideas of good, optimal or anything else and much more about helping someone unlock their own learnings. *For those interested in more on this line of thinking I’d recommend looking into motivational interviewing and behaviour change.

What Does This Mean for Your Health and Performance Goals?

Firstly, this notion liberated me (at least a little) from the frustration I felt towards a younger, more stupid, self in many ways (the quote “to be old and wise you need to be young and stupid” helps too). I could cite examples ad nauseam, but overtraining myself thinking I could tolerate more load in the gym and not understanding it was happening comes to mind immediately. In the example cited, the understanding gained from the situation gave me insight into the experience of overtraining rather than the knowledge of it - so the two paired allowed me to better be able to see it in others. Ironically the person who helped me see it in myself hadn’t been through it (more on this later).

What this means for you, though, is that on some level you need to start the process. There are unforeseeable learnings you will take from mistakes made along the path that will help inform success. Don’t worry about not being ready, get going and course correct - in many cases the ‘perfect course of action’ is more of a procrastination tool than helpful.

Does This Mean You Should Only Engage Professionals Who Have Been Through it Themselves?

The short answer is “no”. The longer answer is “no with a but”.

This is one of ‘the hills I will die on’. I do think that having experienced something is helpful, but it is neither necessary nor sufficient to have been through something to help someone else to get through it - there are many “straw mans” to this argument (take your pick of medical pathologies as a starting point). Yes, the empathy is helpful, but it isn’t enough. To really help you need the knowledge, the empathy and, to be honest, experience helping others (not just yourself) to truly make impact. One of the most common errors in thinking is to think your journey is the same as someone else’s.

There are many professionals who help people lose weight who haven’t themselves ever needed to do so. Of course, the true empathy may not be there (here’s a film I remember quite vividly that documents a personal trainer looking to gain and then lose weight for this reason - it’s unbelievable to see the inertia of habits). Likewise, however, those who have lost weight may not have the same barriers and enablers as someone else, so whilst their own experience is helpful and creates belief and buy-in from clients (and this shouldn’t be understated in its potency) it may not be representative of the client this person is working with.

On a similar note, previous top athletes don’t always make good coaches. They do succeed but in my experience not at a higher rate than others (in my experience those who were not quite good enough probably make better coaches as they had to develop strategies to outperform their ‘talent’ deficits). Again, in the world of coaching, one needs tactical and technical knowledge (which ex-elites often have in spades), physiological knowledge, psychological ability, teaching ability and empathy (this can often be the deficit of ex-elites; they often don’t understand how someone can’t see or do what they can/could). More on coaching and these concepts here.

How Do You Start Walking the Path?

The efficacy and potency of feedback is undeniable here. You will absolutely need feedback, and as such may need to engage a professional (feedback and accountability may be the two most impactful parts of working with a professional).

One means to get feedback, with or without a coach, is to collect data and seek patterns in it that may be informative. This is not about outsourcing intuition and subjective experience as much as a it is adding other sources of data to it. To this end, wearable sensors may provide some helpful means of data collection. In my experience, there are groups of people who see great benefit from the use of wearables to track a behaviour they wish to optimise. For more on choosing wearables see this piece.

Wearables or not, and with feedback sources, the simplest answer remains - START (I said simple, not easy). Full books have been written about what effectively boils down to “you don’t need more information, you need to get started!”
This is particularly pertinent for my fellow Type A personalities in the readership. More broadly I will say, I was liberated from the propensity to avoid starting in my coaching career by the thought of a more senior coach (I cannot remember who, my apologies), effectively saying “if you don’t look back and cringe at your old work you aren’t developing.” So perhaps this thought also disabuses you of the notion that you shouldn’t get going.

Ideally this piece has helped readers better frame up their own health and performance journey. Bringing into focus aspects of whether or not (and when) to engage professionals, how best to work with them and how to use data in these cases. Ultimately, it hopefully serves in part as the nudge needed to get started, rather than to continue to plot your course - removing the illusion of the perfect plan being able to be created in a vacuum.

To close this piece I figured I would try to squeeze another movie quote into this piece, from another all time great philosophically inclined movie character, but with an older age demographic.

“Do, or do not, there is no try” - Yoda (The Empire Strikes Back 1980)

References

1. Washif JA, Pagaduan J, James C, Dergaa I, Beaven CM. Artificial intelligence in sport: Exploring the potential of using ChatGPT in resistance training prescription. Biol Sport. 2024 Mar;41(2):209-220. doi: 10.5114/biolsport.2024.132987. Epub 2023 Nov 20. PMID: 38524820; PMCID: PMC10955742.