Meet Results: 2018 WFAC Strengthlifting Challenge
Having listened to your back pain video this morning, I was wondering what your experience is with people coming in with chronic knee pain. Specifically, I have a friend who wants to get into the program after seeing my results, but she has a long-standing "injury" from the military. If memory serves, there is pain, but there was no evidence of injury anymore, which is at least in part consistent with your video on back pain. There was at one point a "leaking bursa" but honestly I don't even know if it is real, if it can resolve itself, or if it is a training contraindicator. I've had her squat a few times and with empty bar she can mostly assume the position at the bottom, but there was weight gain after the injury that might cause some issues with assuming a below parallel position, but I think she stops short of her full range of motion because of perceived pain in the knee. I'm sure this is a strength issue, but in your experience is there any reason to not train due to problems of this sort? I tried to have her start on an unloaded leg press and I don't know if it was an especially bad pain day or the movement itself, but it hurt so bad she shut down that training session herself. Does this pain jive with your experience on the leg press?
The leg press, having fixed the position of the hips, is less forgiving of the knees than the squat. She needs to squat, and the squat fixes non-specific chronic knee pain, but this may be irrelevant in her case. Not everybody will do what they should do, as has been your previous experience.
I trained an individual who was shot in the leg and abdomen 7 times with an AK-47 while in Afghanistan. She was missing 13+cm of bone from her tibia and had a Taylor-Spatial Frame on her leg for over 2 years before there was some semblance of union. There was significant volumetric soft tissue loss to her calf, a round went through her femoral triangle and injured her femoral nerve but miraculously spared her femoral artery. She had to have an ankle sparing procedure that caused her to have a pronounced plantarflexion contracture. She leg pressed 3 sets of 5 with 600# within 3 months of working with me. Once she started training with progressing resistances, she began to wean herself off of opioid medications and ion-channel blockers. I received picture in a text message from her some months after I left that duty station and she had redeployed to Afghanistan and only sparingly used a cane.
One cannot overstate the value of self-efficacy, as that is almost certainly the #1 prognostic factor in any patient or trainee.
I can't agree more. Unfortunately we also all know you can't force someone to do something everyone knows they should. Squatting hurts it in the moment, but walking three miles makes it hurt for a week. What's the disconnect? I don't know. There's an odd aversion to pain and difficulty in this society that pretty much everyone I've ever met that participates in strength training has gotten over and it makes them much better people and more useful in general.
This has been my experience. In addition to back pain (mentioned in the other thread) I've had chronic, non-specific knee pain since I was 12. My mom took me to a PT, who took some scary X-rays and told me my patella was grinding through my meniscus and to do step aerobics to strengthen my quads. I think I did that for 6 months before deciding it was stupid and that I'd just live with it.
Three months into LP, I noticed I didn't need to brace myself for a little shock of pain when I used stairs any more. I had braced myself and... nothing. My knees neither click nor grind any more. The PT got one thing right: I needed to be stronger. Everything else she said or had me do was worthless.
Do you know where I can find a barbell that's less than standard weights (< 20 lb) but can still be loaded somewhat (up to a few hundred pounds)? I’m looking for my 60-year-old parents.
The light bars I've found claim to not be able to handle weights in excess of 45 lb, and a standard barbell is too heavy to start with.
I have an idea. Get your elderly parents a light bar, and then when they get strong enough to use a 45-pound bar, let them use a 45-pound bar. That way, they can load the heavier weights on the 45-pound bar.
I see a handful a women do this all the time: use a shorter, lighter bar on the first few warmups of a bench or press and take out the big guns instead of loading the short bar to weigh 95 lbs. Some guy somewhere said that "there's a weight that you can start at" and I think that applies here. Even if it's only to get you started, it's worth the small investment if it means squatting 135 a few months down the road where otherwise the person wouldn't be squatting at all. We all start somewhere.
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