Starting Strength Weekly Report


May 11, 2020


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In the Trenches

extreme bench press ppe
Michael Montfort prepares for Texas “allowing” gyms to reopen by closely following government guidelines to go into effect in a couple weeks. [photo courtesy of CREDIT]


Best of the Week

Knee issues
GiannisKi

I have had a problem almost for one year now. Last summer, during a squat session, I caved my knees in the last rep of the last set. I didn't feel anything at that time. The next day, I started to feel a lot of pain when trying to squat, especially at the start of the ascent. So, after some time, I went to a sports medicine clinic. He examined me and told me I have chondromalacia patellae. He told me to go take an x-ray and come back again. After seeing the x-ray, he told me that my patella has a diamond-like shape, and that irritates my knee. Not sure what to do next, I went to another sports medicine.

He examined me and also told me I had chondromalacia patellae (didn't ask for an x-ray). He prescribed me some NSAIDs, a supplement with chondroitin and glucosamine and some weird exercises like leg raises to strengthen the quadriceps (he found out through measuring that one is weaker and smaller). Nothing got better again.

So, I decided to go to a physical-therapist. He examined me and told me that I didn't have chondromalacia patellae. He told me that the pain was caused by some maltraction of the patella. One reason, he said, was that I had really tight feet. He told me to strengthen my calves, to use a spike ball and some stretching in order to relax my feet. Also, he urged me to continue training, but not squat ATG until my pain goes away.

So, almost one year later, I still feel pain. Should I keep trying to loosen my feet and just suck up the discomfort? I could send you the x-rays also to see.

Nick D’Agostino

I'm sorry to tell you this, but the forum is not going to be the best medium for communication to deal with some of the things you have going on. At the root of your thinking is the idea that you have a problem that needs to be fixed. You think that if you can fix this thing that you will not be in pain. I do not think this is true. In fact, this thinking might likely be perpetuating your experience. If you are open to changing your entire approach and thinking about pain, check out these resources:

I advocate for a mindset of nudging pain rather than avoiding it or pushing through it. This is because I like to attack the expectation that pain-free is best and the goal. Pain-free often does occur, but paradoxically it is usually when people change their mindset to being resilient to it, not when they are seeking its absence. If you have found a health professional you trust, you should listen to them. There are often many routes to the same destination and they probably have a different approach than I do.

If you want my specific advice and for me to help guide you, my webpage is: Emerge Stronger

GiannisKi

I see your point sir. I watched the video also. I'll try my best to change my approach about the perception of pain. It maybe will, if I understand correctly, solve the entire problem. Thanks for your time.


Best of the Forum

Dementia or Alzheimer?
Arlene Dukes

I've got a phobia when a person is having memory lapses. I remember my father-in-law who died without a cure for his Alzheimer. I’m worried that my mom is now developing this type of disease. It might be due to his age or she has a brain disease that causes a slow decline in memory. I hope it's not... What are the things you know about Dementia and Alzheimer? This is to help me sort out if my mom needs consultation already. Please share if you have the same experience with your parents or grandparents.

jfsully

It’s never wrong to get a medical opinion, best would be from a cognitive/behavioral neurologist, if one is available near you.

What kinds of things is she forgetting? Do reminders help? Is she aware of the lapses? Is there any change in the way she is speaking or in her personality? How old is she, and does she have any medical problems or take medications that can affect cognition? These are some of the things they will ask, to help steer you and her toward reassurance and/or further testing.

There are probably message boards designed for this specific question, instead of a sub forum on a strength training site, but you asked it here, so...

Arlene Dukes

My mom keeps on repeating the same things and forgetful of some past events. She can't recognize other relatives close to her. By the way, just to be sure, I asked for some medical opinion and she was diagnosed with an early stage of dementia. So as to help her cope with life easier, we were advised to get. I'm hoping that they will make her life normal as soon as possible.

MashedTaters

Dementia is a collection of symptoms due to other conditions, e.g., Alzheimer's, mini-strokes, Parkinson's, Huntington's, etc. My mom was diagnosed with dementia, probably due to Alzheimer's.

She was diagnosed in 1992 and died in 2003, age 90.

FIND A LOCAL SUPPORT GROUP. While a support group can be talk-about-your-feelings, etc., it is more important as a source of information, where to go for help, and ideas about dealing with your situation. Others' experiences can be valuable information.

YOU WILL NEED HELP. If the primary care-giver burns out, then no one is cared for. This is why you need to join a support group.

Your memory is like an onion where the outer layers are your most recent memories. As the dementia progresses, most recent memories are lost; that is, the outer layer of the onion peels away and the patient is left with memories from long ago. In other words, the patient is in another world now. DO NOT try to bring him/her back to your world; you will only upset them. If the patient thinks JFK is President, well then, by God, JFK is President.

This sounds crass, but use the dementia to your advantage. Around year 3 or 4, my mom's memory was pretty bad. We moved her to a new facility. She was disoriented and upset. We told her that she was there temporarily while a room was being prepared in our home for her. It calmed her a little. Every time I went to see her, I gave her the same story about moving in with us when her new room was ready. She never knew the difference and eventually stopped asking.

It helps a LOT if all siblings are on the same page. That is, you don't have a sibling saying, "Mom's just fine."

If you move the patient to a facility, try, if you can, to get their jewelry away from them for safe-keeping. I didn't and my mom's wedding ring was stolen.

We had to take away the car keys. Not fun. I know some states will do this for you so you're not the bad guy. I'm not sure what is required for this to happen. I know; it's tough, but think of the liability exposure. What if, God forbid, the patient is involved in an auto accident and injures or kills someone else. It has happened.

I wish you the best with this. It's not easy, but with help, you will be ok.

Mark D

I've experienced these types of things twice, so I'll relate both stories.

My father-in-law died last November of Alzheimer's related causes at age 89. He'd always been active and very intelligent, but a few years ago he started doing things like repeating himself, re-telling stories he'd told just a few minutes before, forgetting how to do things he'd always done (like bowling or playing poker), getting confused, etc. The real wake-up call was when he took a solo trip to Atlantic City (he usually went with a neighbor) and didn't come home that night, he apparently spent HOURS wandering around the parking garage looking for his car which had been stolen. My mother-in-law got a call from Security the next day. That's when they took his car keys away.

He was diagnosed with dementia/Alzheimer's. There are drugs which can slow the process, and there are things to avoid if at all possible because they can speed the decline (a big one here is general anesthesia, he was in considerable pain from his hip and needed a replacement, but couldn't have it because dementia patients often have a severe decline after anesthesia, so they treated him with pain management, his last few months he was pretty much confined to a wheelchair).

Second story: In 1989 my mother showed signs of confusion, forgot how to operate her washing machine. We thought it might be Alzheimer's but he happened very suddenly and quickly. Tests showed she had metastatic brain cancer (never found the primary), she died seven months after diagnosis.

So make sure you rule out other possible causes too.

Best of everything to you. I know from experience it's not easy, and as time goes on the definition of "normal" changes.

Bestafter60

At 84, my mom called together our family of 8 grown children and our spouses and announced she had early Alzheimer's. To a one we protested, reminding her she had always been forgetful about little things, and would often pause waiting for a word to come to her in conversation.

She exercised a lot, so beyond genetics I blame her fasting and lack of sleep for the decline. She was deeply religious.

We were taking turns having her for a year each. The others would relieve the primary caregiver by taking her in alternation to their homes each weekend. It dawned on us later just how disruptive this must have been on her!

After a bad first home I found her a gem of a place called Settlers Ridge, where she lived until 93. She initially suffered sundowners syndrome, where she and others in mid-decline sense sundown and try to escape. As others already said, she lost recent memory and often confused her children with her brothers and sisters. Visits were always painful as she continued to slip away. We wondered if we were visiting for her or for us. She didn't know us, and we of course were racked with guilt for not doing enough.

Her death was a reprieve, for her no doubt, and for us. After her sad funeral we got together at my house, about 20 of us, and let our Irish heritage come out. We did shots. We drew numbers. Then one by one my 7 brothers and sisters and I stood in front of the crowd, downed a shot, and expounded at length just why mom loved us the best. Mom was finally at peace, we were together, and remembered her well.

Arlene Dukes

Hello, everyone. I appreciate all your views and help with my mother's situation. By the way, we have considered counseling and I'm happy that we are seeing some improvements in her condition.





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