wal

You need to do that RMO rehab shoulder thing sometime, because I have had cortisone in both rotator cuffs years back and numerous physio sessions with the rubber band thing, however the left shoulder never really recovered until I started pressing and so on.

Is it possible that the actual strength training program is in itself its own rehab? Rehabilitation then is best handled in house if this is the case.

The whole Physiotherapy industry appears then to be based on the premise that any physical injury must have the intervention of a Physiotherapist. Mandatory over here for any work injury.

There is a lot of money involved in injury management and the outcomes are not always a full recovery.

Aryah

Great talk there. I'm a little way along into the process of applying Starting Strength (as far as is possible) to my wife who has severe scoliosis. We were at a second orthopedic specialist on Monday this week for another opinion on her situation. Surgery isn't an option, although my wife has in the past had spinal fusion (it was 30:16 in the video which made me think of this) and two Harrington rods. This second orthopedic professor warned against loading weight on or above my wife's shoulders as it will compress the spine. In that moment I saw your face with a sarcastic expression talking about sheer (and inadvertently compression) in an interview and saying that the back gets stronger to compensate for increased weight. She has also gone from an underweight 49kgs to a good 53kgs (so far), but the orthopedic professor warned against the weight gain given that it will load the skeleton further. On our way out my wife and I discussed how we had both in the that moment resolved to carry on with her strength training anyway, because we both knew its benefits from having done it. Her pain has decreased and she has suffered no injury from her training. As a whole she is doing much better in terms of quality of life.

Rip you helped me previously recover from my lat insertion injury simply by training it. It recovered amazingly quickly by the way, from having severe pain for months to having no pain after about two or three weeks. Using the same principle, I rehabbed a hip muscle injury (didn't push my damn knees out enough in a squat) with the same protocols and it was good to go in no time at all.

With the above in mind, it blows my mind that the common physical therapy practice has reached this state of stagnation and uselessness when the solution is so simple.

Mark Rippetoe

And the reason you think that the external rotators are slow in coming back is because you are being told that they function in isolation as external rotators of the humerus. They do not. The only time they actually do this in in the PT office. Think for a second: have you ever performed this motion outside of the therapy appointment? Ever? Even once? Their actual anatomical function is as humeral stabilizers -- they maintain tension on the humeral head, keeping it seated in the glenoid. They also happen to externally rotate the humerus if you construct an artificial situation in which this can be done with a tiny weight -- that cannot make anything stronger.

Presses and chins require that the humeral head remain stable in the glenoid, and all the muscles that perform this function are involved in these movements. ALL OF THEM. So, if you press and chin/lat pull, you are working all these muscles, including the injured ones, and doing so in a more normal anatomical context than in isolation with a 3-pound dumbbell or an elastic band. In the systemic context, the injured muscles work while (whilst?) being protected by the healthy muscles adjacent to the injury. As they heal, they assume a greater share of their normal anatomically-assigned role. And this is the basis of correct rehab. Typical isolation-based PT is not.

LowCarbDude

For at least Bench and Press should I be trying to do the rep from contracted as fast as possible, and ease down from expanded. Slow to average down, quickly up?

Does this really help build strength faster?

Kevin Pavon

In Starting Strength:Basic Barbell Training 3rd Edition, p. 163, Rip says,

"For both the bench press and the squat, optimum bar speed occurs when the bar moves fast enough to efficiently elicit a stretch reflex and thus permit an efficient drive up. Bar speed is too slow when the descent produces fatigue, as it will if you deliberately lift submaximal loads very slowly. Bar speed is too fast when it actually adds momentum to the load on the bar on the way down, so that you must decelerate against both the weight on the bar and the effect of its excessive velocity on that load -where the effective load on the bar is actually heavier than the weight."

Also on that page,

"Don't think about lowering the bar; just think about driving it up."

Read up.

Mark Rippetoe

The muscles in which the stretch reflex occurs will obviously be the muscles which lift the weight. Eccentric/stretch reflex/concentric. So, triceps, pecs, delts, et al. I believe the book mentions that you have to tighten things up voluntarily to create the stretch reflex.