Darin Deaton: Barbells in the Clinic

[Mark Rippetoe]

Barbell Use in the Clinic | Darin Deaton

[spacediver]

really good stuff, love the case studies. I was surprised to hear that squats are easier on the back compared to deadlifts.

I imagine that the key variables are:

1: The moment arm between load and the intervertebral joints (longer moment arm = more counter torque that the spinal erectors have to produce, less compression due to the load, and more compression due to the action of the erectors. Also more shear force).

2: Degree of hip flexion. More hip flexion => more hamstring tension => spinal erectors have to work harder to overcome hamstring tension.

I would think that the squat taxes the back more than the deadlift on the first count (more hip flexion). And I think (but not certain), that the moment arm is, on average, greater with the deadlift, due to the more horizontal back angle. Maybe it's my own anthropometry (short torso, long legs & arms), but I've always found squats tougher on my lower back than deadlifts, given the same weight on bar. Perhaps this is because the long arms allow me to establish a more vertical back angle in the deadlift compared to the average, thus reducing the moment arm and the amount of hip flexion.

[Jr_Geezer]

Over the six months or so I've posted this to the Coaches, the Elderly and the Recovery forums. The posts have gotten plenty of views but only one response (from Tom C, saying 'Let's see what people have say'), as apparently what my friend is going through is not a very common experience. I thought I would try one more time under what seems to be a relevant topic. Thanks for your indulgence.

A friend of mine, who I've known all my life as we were next-door neighbors as kids, just turned 57 (less than a year older than me) and appears to be kind of falling apart. He tells me he has myelin sheath degeneration due to stenosis in C3-C4 and lower. He has problems with his hands going numb and (in his words) 'the "bar-fusions" and degenerative crap going on feels like burning pokers on my spine when I do repetitive motions for ANY length of time, with any weight.'

This is a guy who was a star athlete in high school (catcher on the baseball team) and is retired Air Force (flew KC-135 tankers) and currently on medical leave from his career as a commercial airline pilot (kidney stone issues). It pains me to read his emails where he says he is like 'a flare, burning brightly early but now burned out' and, worst of all, he says he is not bothered by it. Fifty-seven is way too early to be burned out.

Now I know I can do very little about his mental attitude, but I have told him about my lifting progress and how it has made me feel so much stronger. Funny how growing up he was always the bigger and stronger one of us two. However, it does seem to me like lifting wouldn't do anything to alleviate the sheath degeneration issue or if any lifting is even possible. My question is if any one has had any experience with these types of physical problems and if there is anything I can recommend to my friend.

Thanks.

-RJP

[Mark Rippetoe]

Stenosis is operable. Is he not interested?

[JHG]

Are you sure it is due to stenosis? Or might you be mistaken with multiple sclerosis, which is a neurodegenerative disease as a result of demyelination of neurons. If it is MS, there is good evidence to encourage strength training: High Intensity Exercise in Multiple Sclerosis: Effects on Muscle Contractile Characteristics and Exercise Capacity, a Randomised Controlled Trial

[David Kirkham]

I have C4-5 and C5-6 stenosis. I hate bench days because my arm is on fire. I love press days because it calms the fire down.

I hate bench so much I'm seriously considering asking Matt to only program me 1/week. The only reason I bench is because I just gotta get that 300 goal.

Pressing is almost as good as Advil for calming my nerve down. I certainly recommend it.

[Jr_Geezer]

Stenosis is operable. Is he not interested?

Not sure, I'll try to find out. What kind of procedure is typically involved? He's familiar with going under the knife as he had both knees worked on in 2013, to repair the meniscus and clear out floating cartilage. He was in rehab for 8 weeks after that, with a lot of time using a CPMM (Continuous Passive Motion Machine). I think his main concern now is with the myelin sheath erosion, and I don't know if that is caused by stenosis or is a separate issue.

Thanks.

-RJP

[Bekah Cygan]

JHG

That is not MS. This type of myelin degeneration is localized and not systemic- it is due to mechanical stress. We can tell this because it is a predicable nerve pattern. MS presents differently.

I am with Rip- if he is experiencing nerve pain constantly- I would consider finding a good surgeon. If the nerve is impinged when it is unloaded...it is pretty impinged...and hell to live with I am sure. Loading the nerve more with training stress may not resolve it very quickly.

In David's case- the press is obviously helping to resolve his issues- and bench pain is only temporary. If my arms were burning all the time- I would look to a surgical intervention.

[JHG]

JHG

That is not MS. This type of myelin degeneration is localized and not systemic- it is due to mechanical stress. We can tell this because it is a predicable nerve pattern. MS presents differently.

With all due respect, we don’t know what the condition is at this juncture. RJP indicated that his friend has “myelin sheath degeneration due to stenosis”. If spinal stenosis causes demyelination of neurons, this is news to me. Stenosis also sounds similar to sclerosis, which is an honest mistake for someone who is unfamiliar with the terms.

It very well could be stenosis of the cervical spine causing nerve compression or it could be MS as the pathogenesis of MS is not clear and symptoms of MS vary considerably. There are several differential diagnoses for demyelination, but to my knowledge, stenosis is not one of them.

[Will Morris]

He was in rehab for 8 weeks after that, with a lot of time using a CPMM (Continuous Passive Motion Machine).

A complete waste of 8 weeks.