Starting Strength Weekly Report

July 10, 2017

  • In Rehabilitation, Rip explains why "the concept of 'letting' an injury heal beyond an initial few days reflects a lack of understanding of the actual processes that cause the return to function" and why an active, holistic approach is far more effective.
  • From the Archives: Marty Gallagher introduces readers to Lee Moran, lifter and Hell's Angel.
  • From the Archives: Rip explains some key points about lower back position control when lifting weights and how to coach lifters to develop this critical skill.
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In the Trenches

craig campbell in highland games competition
Fivex3 Training intern, Craig Campbell, competing in the Highland Games at Kernstown Battlefield, Winchester VA this past weekend. After the throwing events, the competitors also took part in Strongman events. [photo courtesy of FiveX3 Training]

Best of the Week

Lifting and hypercholesterolemia

I have a brother a year older than me. We looked like twins when we were growing up. Both of us developed hypercholesterolemia and hypertension as adults. He decided to control his medical issues by following his doctor's advice and taking pills. I decided to get stronger before I die.

Three years later he is still on the pills and the quality of his life has diminished. I ended up gaining ~50 lb and a bit more strength. I went to my doctor for a physical. He commented favorably on the increase in muscle mass. The blood analysis no longer shows any hypercholesterolemia and for the first time in forever my LDL and HDL numbers are good. Furthermore, I have become pre-hypertensive instead of hypertensive.

Size wise, I am 70-in in height and 210-lb.

Coach Rip, I have always been active. I have run marathons, half-marathons, triathlons and my numbers didn't look so good. My father, God rest his soul, had the same issues my brother and I have and those issues led him to a relatively early death.

Could lifting and getting stronger be the difference?

Mark Rippetoe

Barbell training is Big Medicine. And I doubt you're actually even pre-hypertensive.


The things that seem to me to be contrary to conventional medical wisdom are the following:

  1. an increase in weight (50 lb) led to a decrease in blood pressure
  2. an increase in weight led to a better lipid profile in the blood test
  3. an increase in weight led to a reduction in cholesterol reading
  4. an increase in weight led to a dramatic increase in HDL
  5. an increase in weight led to a dramatic decrease in LDL
  6. my cholesterol reading dropped in spite of my increasing age

I am still marveling over the changes in my body chemistry due to getting stronger and gaining weight. My genetic disposition seemed to want to cause me to end up as my father and brother but it's like once I went over 300-lb on squats and deadlifts my body changed. My diet hasn't changed. It has always been a relatively clean diet. I did increase my protein level based on a comment from Dr. Feigenbaum.

Currently I am following programming from Coach Andy Baker as my gym training protocol.

Coach Rip, you have talked about gene expression and I have read about genes being turned on or off due to environmental factors. Could the environmental factor of a heavy load being moved by my body caused the appropriate genes to be expressed, which then caused my body chemistry to change?

Mark Rippetoe

I don't know. To the extent that gene expression runs the show, maybe that's one way to explain it.


You are talking about a weight gain that involves a change in body composition, something that BMI does not capture. BMI only works in a sick society. It doesn't work for healthier people with proportionally more muscle. And now Medicare is enforcing their new MIPS, which docs the pay of physicians who don't badger their patients about these things.

Muscle is a very metabolically active tissue. Fat is as well. But if you have a high BMI because of muscle, you see the beneficial effects you listed. A high BMI because of fat has negative effects on metabolism. Also, fat is an endocrine system, emitting mostly estrogen-like compounds that feminize you. While muscles are full of insulin receptors, which help prevent the problems associated with insulin resistance. Fat also emits a lot of inflammatory compounds that cause endothelial damage, among other things. So maybe gene expression is part of it, but the very different metabolic and endocrine activity between muscle and fat means you want more muscle and less fat. And BMI doesn't work for muscular people.

Best of the Forum

Using prowler to alleviate low back injury
Simma Park

The story for those of you who were not there is that I tweaked my low back right when I was warming up on Friday night with overhead squats using a broomstick, because my left hamstring and calf suddenly developed a deep ache, and the bottom of my left foot started to "zap." Even though I intellectually know how it presents, I'm personally unfamiliar with how sciatic pain feels, and I'm as prone to magical thinking when it comes to my own self as anyone else, so I chalked it up to layoff woes (it was my first time under the bar since my brain surgery earlier this year). I did that because I wanted to chalk it up to layoff woes. Woe is me for being a hard-head.

Saturday, Tom C. gently helped me accept that it was probably a disc/nerve problem, so I talked to Rip about it. He immediately recognized it as a sciatic thing. He adjusted me on Saturday night, dug around in my low back and hip a bit, and I felt much, much better. Slept Saturday night without pain.

Sunday morning, I was feeling good so decided to warm up for squats and see how it felt. I stood up from the first warmup with the empty bar and realized I had fucked something up big time. Severe, deep, aching pain down the hamstring and calf through the heel/Achilles area, and tingling in the heel and bottom of the foot. It was bad enough that it was difficult to pick my foot up properly while walking.

Rip adjusted me again, but it didn't help much this time. Then he put me on the treadmill and instructed me to do it at a speed at which I could take really long strides. I tried it for a while but it made me really unhappy. It hurt a lot to do it.

So I reported back to Rip, who then declared he was going to put me on the prowler.

Yes, my first thought was "WTF?!" But it was Rip, who knows way more about this than I do, and whom I trust to care about my back. And after I thought about it a bit, I realized it didn't seem that nuts after all. He had me hold the posts at the top, brace my elbows into my lats, and take very long strides.

After the first two 50-yard pushes, even with no weight on the thing, I walked back into WFAC to get some water, and I felt a dramatic difference. One of the other coaches noticed immediately and said, "Your gait is totally different now." Rip then put a very modest amount of weight on the prowler, since the point wasn't to condition me but to help me get the structures in the hip moving naturally. After 8 more 50 yard pushes, I stopped and felt like I might actually make it home through a day of air travel without killing someone or myself.

I actually feel better than anyone who could barely walk two days ago has a right to feel. There's still pain, but I can function around it for daily tasks, and walking and sleeping are completely normal and pain-free (granted, I have a talented feline masseur and I live on a concrete and asphalt block that poses few challenges once I'm out on the street).

Note that the solution is not magic. Sitting still sucks big time, particularly the part where I stop sitting and have to get up, and when I go up or down stairs, people give me a wide berth because I turn into a gimp with Tourette’s. But it's very effective for delivering a much larger dose of relief than one would expect, and I have no doubt it provided a significant shortcut on the path to recovering from this very annoyingly timed injury.

So I wanted to post about this, Rip, because I think it's an important thing for coaches and lifters to know and something that probably wouldn't occur to most of them, and because I wanted to discuss a bit more what the mechanism was for delivering such dramatic relief because I don't quite understand what it might be.

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