When I was a sophomore in high school, I handed in my musical instrument (I played the violin in junior high school and switched to cello my freshman year of high school), quit the orchestra, and signed up for weight training 101 (much to my orchestra teacher's displeasure). It ended up being a really great class for me, as it started my interest in sports science and sports medicine, which had a significant influence on my desire to become a physician (as I have posted many times, my lifelong dream all through college was to be the team physician for the Chicago Cubs!). One of the first things that I learned in weight training 101 was the "principle of progressive overload." Simply stated, if you want to get stronger or faster, you have to push yourself just a little harder every time you work out. For example, if you want to build up your muscle strength so that you can increase your maximum bench press, add 5-10 pounds to your bench press work-out every few days. Alternatively, if your goal is to run a marathon, start out with running one long run every Saturday and add 1 mile every week. Slowly but surely, over time, you will build up your muscle strength (so you can bench press a couple of hundred pounds) or increase your stamina to the point where you can run that marathon.
Later, in one of my exercise science classes in college, I learned about Milo of Croton. Milo was a great wrestler from ancient Greece (Croton was a city at the base of the toe on the Italian peninsula) - basically he was the LeBron James of his day. Milo won just about every sports competition that was held in his day. He was a six-time wrestling champion at the Olympic Games, a seven-time champion at the Pythian Games, ten-time champion at the Isthmian Games, and nine-time champion at the Nemean Games - you get the picture, he was really good. In fact, Milo won Ancient Greece's version of the Grand Slam (winning the Olympic, Pythian, Isthmian, and Nemean Games during the same year) five times (the Grand Slam title was called the Periodonikes). Legend has it that Milo was walking to the gym one day when he saw a newborn calf at a farm near his home. He convinced the farmer to let him carry the calf from the farm to the gym. Milo repeated the feat every day for the next four years. Of course, the calf grew larger (and heavier) every day, and eventually Milo was carrying a four-year-old bull all the way to the gym - in other words, the principle of progressive overload!
As it turns out, the science of improvement has its own version of the principle of progressive overload. Whenever you are trying to improve a process, you should start out with small, incremental improvements. Plan-Do-Study-Act (PDSA) cycles start with so-called "small tests of change." After you carefully study a process, you will probably come up with a number of possible interventions that will make the process more efficient or better in some way. Rather than implementing all of the process changes all at once, start with only one. Test your hypothesis by implementing the process change and studying whether the change results in an improvement. Then move on to the next process change. As each successful change is adopted, the overall process becomes more efficient - continuous improvement through the principle of progressive overload!
And just imagine, I learned all of this by giving up playing the violin so that I could take a weight training class!
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