Thoughts on Motivation

How do we get motivated and stay motivated to change?

The main reason why people seek chiropractic care is that they want change. Most people want to change their symptoms. For example, they want to reduce their pain. People want decreased symptoms and they want their joints to move freely without restriction. People want a return to the activities they value both for basic daily tasks and for enjoyment. Many people also want to change their health. They are looking for guidance, and assistance, and empathy.

One reason why some people are apprehensive about seeking chiropractic care is that they are worried about being told that they will need routine chiropractic adjustments for the rest of their lives. Stereotypically, chiropractors lead people to believe that in order to obtain what they want, they must lie still on a chiropractic table and get their backs cracked over and over again. To be fair, some other healthcare professions that provide treatment for muscle and joint conditions also may have the tendency to lead people to believe that effective treatment requires special passive therapies. When I reference “passive therapies” I am referring to treatments that are done to a patient, generally while the person is not actively participating. Good examples of passive therapies are chiropractic adjustments, massage, laser, and e-Stim. Many healthcare providers who rely on passive therapies claim to have special skills or equipment and unique clinical settings, without which, change cannot occur. This may or may not be true. But, if you want significant change, you probably won’t receive it by lying motionless on a table for a few minutes once a month. That may not be realistic. So, if you want significant change, you will most likely need more. You may need to actively participate in your treatment plan. Examples of active treatment are rehab, exercise, and lifestyle changes. People who want to live active lifestyles, need active solutions.

Chiropractic adjustments and other common passive therapies are relatively safe and they can be effective for short-term pain relief for some people, sometimes. There is no denying that. I do not want to diminish the potential value of safe therapies that may help people temporarily decrease their pain. I think it’s wonderful that we have these options. But a dilemma presents itself when I ask my patients what they are hoping that I can do for them. You may assume that chiropractic patients just want to get their backs cracked, but almost all of my patients want more. Unfortunately, many people are led to believe that routine chiropractic adjustments or other passive therapies can offer more. Which is not necessarily accurate.

My patients want less pain, less frequently.

They want to understand their symptoms.
They want someone to listen to their story empathetically and respond inquisitively.
They want a unique plan that works for them.
They want control over the way their bodies feel.
They want to increase or maintain physical activity.
They want to be physically fit.
They want to enjoy the activities they value, not modify and substitute because fun stuff hurts.
They want to be less stressed.
They want to sleep well.
They want to eat nutritious food.
They want to invest in a lifestyle that builds longevity and health.
They want change.

For those who want more than short-term symptom relief and lifelong clinical visits, we must discuss additional options. During these discussions, the initial question that I receive from an overwhelming number of people is: How do I get motivated to change and stay motivated long enough to achieve the changes I want?

Most people know what they need to do in order to change their life, or improve their health, or reduce their pain. People are not dumb, and they know their bodies better than I do. When I ask, most people can quickly formulate an effective plan to get what they want. But an effective plan does not always seem doable. That’s the problem. There appear to be way too many barriers in everyday life that block the efforts to make the changes that are obviously needed. And, lack of motivation over time is one of these huge barriers.

Big changes take small consistent efforts over a long period. We are talking about the power of small interventions performed consistently and routinely over decades (not unlike a financial retirement plan). How does someone stay motivated to play the long game? This is the million dollar question.

Research on Behavioral Change Strategies

A recent study tested the effects of different behavioral change strategies in older adults. The research team compared self-focused behavioral change strategies with group behavioral change strategies on their effectiveness for helping older adults stick with a strength training and walking program.

In a randomized clinical trial, participants who talked with peers about their exercise program were able to increase exercise and sustain higher physical activity levels for up to 12 months after the experiment was done. Participants who used self-motivation and individual goal setting produced no significant changes in physical activity. The self-focused participants utilized problem solving, goal setting, and individual action planning. These are very commonly used in research and by people trying to make changes on their own. The participants who incorporated group goal setting strategies benefited from peer-to-peer sharing and learning, such as social comparison and social support. These social processes included networking and engagement. The group who participated in the shared goal setting accomplished noteworthy increases in physical activity compared with the participants who utilized self-focused goal setting. This paper replicated the results of previous research.

Working in groups or teams with people who are striving to achieve similar goals enhances positive results. The secret sauce for success may be creating or joining a community.

CrossFit Example

Let’s look at CrossFit as an example. In a 2004 CrossFit Journal Article, CrossFit was defined as a strength and conditioning system built on constantly varied, if not randomized, functional movements executed at high intensity.

Fast forward to 2024. Here is the most current definition: CrossFit is a fitness program that produces measurable outcomes through lifestyle changes, centered on training and nutrition. Workouts consist of constantly varied, high-intensity, functional movements, and are most fun and effective among friends at a local CrossFit gym.

The concept of “constantly varied, high-intensity, functional movements” has not changed. But did you notice the differences between both definitions? I love what they added:

“Produces measurable outcomes through lifestyle changes.” (not through magic exercises or rep schemes)
“Most fun and effective among friends at a local CrossFit gym.” (100% about community)

Let’s consider a completely hypothetical experiment. What would happen if I created two groups and assigned each group to one year of CrossFit training with seven sessions per week (including recovery sessions) for 365 consecutive days? One group would train at a local CrossFit gym and one group would train as individuals in their own homes. All participants would complete the exact same workouts with equal volumes and prescribed intensities.

Let’s assume that these hypothetical participants are not competitive athletes and their main goals center around health. If I could guarantee 100% participation and equivalent intensities from all participants, in both groups, which group would have the best outcomes at the end of the year?

In this highly unlikely hypothetical experiment, my hypothesis would be that we would see no significant differences if I could guarantee 100% participation and equivalent intensities. The problem is, in the real world, we would never get 100% participation, so there definitely would not be equal volumes. Also, the intensities would probably not be equal. I would predict that participation and intensity would be significantly higher in the group training at a CrossFit gym. Therefore, the participants training at the CrossFit gym would probably outperform those training individually at home.

The main factors influencing the different outcomes would be volume and intensity. But I would predict that volume and intensity would be strongly correlated with the environment (i.e., having OR lacking a coach and a community).

Let me summarize… We need volume and intensity to produce results. Based on human nature, it is more likely that we would achieve higher volume and intensity within a community sharing physical struggles and common goals. Once again, community would be the secret sauce for people in this hypothetical experiment. That would be my prediction.

Fit Club Example

Allow me to share some anecdotal evidence from my own experience. In 2023, I led an experimental physical fitness program for faculty and staff members at a local college. The program lasted six months and required strength and conditioning sessions five days per week. The training program was structured as a mixture of in-person group sessions with a coach present and individual, self-led sessions without a coach present. All training sessions were pre-programmed (sets, reps, time, intensities, etc.) and delivered to the participants via an app that provided video and written instructions. The app also allowed participants to log the specifics for each training session (loads, RPE, notes, etc.). All session data were monitored virtually using the app.

Over the six month experimental period, group sessions with a coach physically present produced about a 70% participation rate. Individual sessions without a coach physically present produced about a 55% participation rate. The group dynamic and having a coach physically present appeared to be strong factors influencing participation.

During the later half of the program, participants were formally organized into small teams to help improve participation both during supervised large group sessions and on days when a coach was not present. With this restructuring, one team of four men collectively achieved a 91.9% participation rate for aerobic sessions and a 98.9% participation rate for strength training sessions. These stats included both supervised and unsupervised training. For these four participants, a formal team dynamic resulted in exceptional participation over a three month period. Remember that these men were training 5 days per week. Those stats are impressive!

Imagine what you could accomplish if you formed a group that helped you exercise 3-5 days per week for the next few decades.

Here are some interesting stats that MAY help motivate those who are listening but don’t think they could stick to a similar program. We surveyed our participants before we began training: 80% of the people did not strength train prior to the program; 60% reported that they performed 0 to 30 minutes of cardio each week. As you can see, we did not recruit fit, active people for this experimental cohort. If this sounds like you, I hope you feel encouraged about the possibilities. After six months of training five days per week, the program achieved a 78% graduation rate. That’s not bad. And, as I mentioned, some of those graduates achieved participation stats in the 90th percentile. Again, the secret to their success was probably related to community and coaching.

Interestingly, many of the small groups still meet weekly at the gym to train together without any coaching. I see them working out every week. A few people joined a local CrossFit Affiliate (CrossFit Timoro) and they train multiple times per week with a new community, further demonstrating the power of community when it comes to long term motivation.

But is it really THAT surprising that forming groups helps motivate people?

Anthropology

My undergraduate degree was a Bachelor of Science in Anthropology. I am, by no means, an expert on anthropology; however, I did learn a few things. I recall a relatively well accepted idea that a major contributing factor to the development of our large brains was our ancestors’ ability and willingness to share. Sharing provided more consistent resources and safety. Sharing fostered community and allowed early humans to accomplish things that would not be possible as individuals. Sharing may be ingrained in us so deeply that it may be an essential part of being human. What I am saying should not be shocking. Even Aristotle acknowledged that, “Man is by nature a social animal.”

So, if you have not been successful with individual efforts to make large changes in your life, your shortcomings may be related to your failure to share your burden with other people attempting to achieve the same goals. Now, if you have not been successful with group efforts to make large changes in your life, perhaps you chose the wrong people. Perhaps you didn’t create or join the optimal community to achieve your goals. It’s food for thought.

Focusing

At this point, let’s assume that you are ready to make changes. Perhaps you have suffered from failed attempts in the past, but you are now ready to play the long game. You have assembled a community of people who are willing to walk with you and support you on your journey. How do you begin?

I love this quote by Yogi Berra: “If you don't know where you're going you might end up somewhere else.”

You and your crew need to focus. Focusing means clarifying what changes you can make to achieve your goals. Focusing may be simple or it may be more complex. You need to identify the specific results that you want. Ideally, you will create at least one quantifiable and measurable goal. Then you need to identify the changes that you believe will help you achieve your goals. Ask this question: What would I like to do for myself?

Once you have identified the destination (which is your goal) and the desired path to that destination (which includes the changes you are willing to make), then you need to discuss your motivations. Why do you want to achieve this goal? Why do you think the changes you are willing to make will lead you to your destination and why are you motivated to walk that path?

Understanding why you want to achieve a goal and why you think it is important to walk a specific path is vital for long-term motivation. Without understanding why, many people get lost along their journey and become discouraged. Change begins to seem unattainable and people tend to abandon their goals due to lack of motivation and lack of belief.

The planning process is important.

How might you go about making this change?
What would be a good first step?
Based on your own experience, how could you make this change successfully?
What obstacles do you foresee, and how could you deal with them?
What gives you confidence that you can do this?

Keep in mind that goals can change. Your priorities may shift over time. This is natural. Even the best plan may require refocusing and adjusting.

Final Thoughts

The process of change can be intimidating and demoralizing; therefore, at times, it may seem hopeless and pointless. The changes we desire often appear to be a million miles away over terrain that seems insurmountable. If you feel this way, you are not alone.

Some people can make big changes on their own. It is possible. Others need the support of friends to make the journey. Many people need even more help.

This is where someone like me can be of service. Typically, I help people find the motivation to stick with a rehab program long enough to get what they want. While rehabbing, it is valuable to improve things like sleep, nutrition, and stress management. So, I help people find the motivation to make those changes as well. When my patients are done with a successful rehab program and they are happy with their results, I help them find the motivation to stay active and keep training so they need me less in the future.

In a way, I act as a mentor. Mentorship is not when someone walks ahead of you and then tells you how they did it. Mentorship is when someone walks alongside you, to guide you. Because sometimes you need a guide to walk with you. There is no shame in that. You may need someone who, not only has been to the destination before, but has successfully guided others to the destination. You may need someone to help you plan the route and to be there when obstacles and setbacks present themselves. Mountain climbers need a Sherpa to make it to the summit of Everest. And there would be no Batman without Alfred. Sticking to a rehab plan and making lifestyle changes to augment your rehab plan often require the same level of support.

Remember, the secret sauce for success may be a community, or a coach, or a guide, or a mentor. You need a plan and you need a strong sense of why. You must have patience if you want to successfully play the long game.

Some goals may take months or years... not days or weeks.

I hope this helps.

References

PMID: 38421648

PMID: 28188585

CrossFit Journal, Issue 19, March 2004

Where to find Chris Netley:

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