“Sorry, My Wearable Called and Said I Can’t Work Out Today.”
I’m being a little bit sarcastic, but after a late night out following a Chris Stapleton concert, my wearable told me the next day that I should take the day off from working out. I found this to be a rather interesting suggestion given that it was poor lifestyle choices and Tennessee Whiskey that put me into recovery mode. I felt like it was rewarding me for making poor decisions. My wearable seemed to say “you’ve run a marathon” while I was really just got over-served and hadn’t slept well enough.
Nowadays, a lot of people decide when to work out based upon whether they receive a positive or negative recovery score from their wearable, ring, or band.
But, before we get too far into how a recovery score of a wearable device can negatively affect your decision to exercise, you need to know the history and why a marketing slogan got us to where we are today.
Manpokei (which means “the ten thousand steps meter”) was a pedometer developed by a group of Japanese researchers in the early 1970s. A key point to note here is that there were no physiological data to support the claim of 10,000 steps per day and therefore no clinical trials to back up the claim of 10,000 steps per day. The reason that the 10,000-step-a-day goal became so popular was its easy to remember goal that looked great in advertisements.
Since then, research has shown that the 10,000-steps-per-day goal is not needed for cardiovascular benefit and benefits usually land between 6,000 and 8,000 depending on age. Also shorter bursts of steps, such as several 15-20 minute walks at a time spread throughout he day, rather than long periods of low level activity improve cardiovascular health
It has now been 50 years since the original Manpokei and the same marketing strategy is still alive and well today with Whoop’s Stress and Strain Score, Oura’s Readiness Score, and Garmin’s Body Battery Score.
Wearable companies intend to do good (to simplify and gamify), and although each score will represent some degree of physiological fact, each will also reduce a very complex physiological occurrence to a simple proprietary number.
For years, we’ve allowed ourselves to let marketing make our clothing decisions. Now, we’re letting marketing make our health decisions.
Although I recognize that the wearable companies did not originally design the above mentioned scores to predict clinical health events, I suspect that many users have accepted the numbers generated by these devices as scientifically accurate.
Research regarding the effectiveness of wearable device recovery scores (WHOOP, Oura) is mixed and this article was not meant to be a deep dive. Research indicates that WHOOP’s Recovery score is effective in preventing runner injuries and overtraining, however, other independent research challenges the validity of WHOOP’s Recovery score. Research indicates that Oura’s Readiness score is useful for determining if someone needs rest, however, no independent research exists validating the ability of Oura’s Readiness score.
As a doctor, I am excited about the possibility of using digital biomarkers to assess my patients. And I can only hope that the significant valuations of the major wearable companies will result in significant funding to pursue R&D that will transform tools intended for wellness into Validated FDA approved tools capable of improving the health of users.
In the end that Sunday morning after the concert I didn’t take the day off. I didn’t deserve the reward. That’s the point. These scores can’t tell the difference between a race and a concert. We have to use common sense. Sometimes the real recovery plan when you land on a red number isn’t rest.
It’s exercising and drinking less Tennessee Whiskey and Strawberry Wine.
References
For those who want to have a deep dive, I would point you to an article on Smortsmith. Whoop vs Oura Ring: Real-life data, analysis and comparisons by Sports Scientist, Dr Peter Tierney and Dr Sian Allen. And Readiness, recovery, and strain: an evaluation of composite health scores in consumer wearables.