“No Excuses”? Baloney.

by Jonathon Sullivan MD, PhD, SSC | February 01, 2023

elderly lifter locking out a deadlift at greysteel

We’ve made the case for a Barbell Prescription in healthy aging. We’ve made it with our book, our articles, and our videos. We’ve made it by pointing to a mountain of biomedical evidence that heavy strength training is a fountain of youth for older adults, improving their strength, power, mobility, conditioning, balance, body composition, and resistance to illness and injury. Above all, we’ve made the case with our clients – many thousands of them now, the world over, coached by trained professionals who witness the fantastic power of the bar to transform lives on a regular basis.

We’re winning: Adults over 50 and even those beyond their 70s are more willing than ever to get under the bar. The absolute necessity for strength training in this demographic, once at loggerheads with conventional wisdom, has become the conventional wisdom. It is uncommon now for me to have to argue with a prospective client’s physician about it, and even more uncommon for me to have to play the “you’re-not-only-doctor-in-this-conversation” card. I’ve even had people come into my gym with prescriptions for barbell training. That’s winning.

In fact, there’s So Much Winning that you’ll often hear people say “No Excuses,” explicitly in the context of older adults training. Hell, I’ve said it myself.

But that’s bullshit. There are always excuses.

I have in hand a paper from the most recent issue of Circulation. It was brought to my attention by a client who isn’t looking for any excuses, but thought others might seize on it for one. The paper is an implicit review (that is, not an actual experiment) in which the authors state: “Our review of the medical literature demonstrates that the prevalence of coronary artery calcification and atherosclerotic plaques, which are strong predictors for future cardiovascular morbidity and mortality, was higher in athletes compared with controls, and was higher in the most active athletes compared with less active athletes.”

You don’t need to be an Interwebs genius to write the clickbait headline for that one, especially if you ignore or don’t even read the rest of the study, which finds no patient-oriented outcomes (heart attack, hospitalization, stroke, death) consequent to this surrogate marker of disease in the context of athletic behavior, and which relied in part on data sets in which the volume and intensity variables were determined by questionnaires. (Have you ever noticed that physicists, engineers, and chemists never use questionnaires?)

But that’s not the point: This paper is a perfect excuse not to train.

Because if you want an excuse not to train, you’re damn well going to find one. You’re going to find a paper somewhere that says you shouldn’t train, because you can find a paper saying anything you want to believe. (Hint: when you find it, make sure you don’t read it. Just quote it, confidently and often. It is, after all, Science, and the last word on the matter.)

If you want an excuse not to train, you will find somebody you love, or somebody you know, or somebody on YouTube, holding the strong opinion that you shouldn’t do all this hard and heavy lifting. They may even be able to cite papers, which will save you the trouble of looking them up and not reading them yourself.

If you want an excuse not to train, your body will be there to help you out, because, as a wise one once said on the SS board, you can be old and beat up and strong, or old and beat up and weak. Both populations have built-in-excuses: They’re old and beat up. So your body will definitely write you light duty chit any time you want. Your shoulder will mysteriously hurt when you wake up on press day, your back will hurt on deadlift day, your knee will hurt on squat day. You’ll be dizzy, as you often are (it’s a part of old-itis), but maybe a bit worse today. You’ll feel extra tired. You’ll be anxious. You’ll have gas. You’d better abort.

Excuses abound!

Look at the comments. Right now the trolls are like pigs at a trough, calling me out for my irresponsible conduct. You’re a doctor, and you’re telling people to lift when they hurt! Oh, the humanity!

I have resolved this year (again!) not to argue with Pigs in Poop, but let’s make sure the non-porcine among you are clear: We always want to be judicious. There are in fact contraindications, both acute and chronic, to heavy training.

Now, you know that’s not what I’m talking about, but Trolls Happen, so let’s belabor the point. We wrote a list of contraindications to lifting for The Barbell Prescription, which we had to leave out for reasons of length. It included stuff like active osteomyelitis, intractable seizures, refractory malignant arrhythmias, aortic aneurysms and dissections, cancerous bony metastases, fulminant stupidity, and acute presentations suggesting significant injury, neurological compromise, or end-organ damage.

The vast majority of you will notice something about this list of conditions: you don’t have any of them. These are the real excuses not to train, but they’re uncommon. And the people I’ve met who do have them don’t think of them as excuses at all, but rather as the more-or-less impassable obstacles to the training they desperately need and desire.

Context. It’s a bitch, isn’t it?

So, yeah, be smart. I’ve talked about this sort of thing elsewhere, and a little common sense and experience go a long way. A swollen unstable knee, an acute exacerbation of severe radicular pain, an acute febrile or gastrointestinal illness, a body part that suddenly won’t work, an acute deformity or discoloration, acute physiological distress of any kind, a sick family member, or an impassable blizzard are among the many reasons why it might be imprudent or impossible for you to get under the bar.

And none of them obtain right now, when you could really use a good excuse, do they? But have no fear. If you don’t want to train, you’ll find a justification somewhere.

But “no excuses?” That’s bullshit. The real question is why you need one. If you don’t want to train, just admit it to yourself and stay home, and live with the decision and its consequences. It’s more honest and less fuss for you, and those of us who do show up would really appreciate it. We didn’t want to hear your excuses anyway.

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