I'm a 59 yr old female with multiple sclerosis and have been utilizing SS techniques for the last 3 1/2 years. My husband and trainer (evidently you must have an incurable degenerative disease for a spouse to work) has been outstanding for helping me to achieve success for squat, deadlift, press, and bench press. I utilize bent over rows and lat pulls as well. He had always been able to approach a lift from a different perspective to trick my body into performing a lift my brain says I cannot do mostly due to balance. SSC, Phil Meggers in Omaha (60 miles away) has been very helpful as well.
Question - what can I do to help my recent (last 3 months) loss of strength in my upper body? Press is very difficult as much of my strength is lost due to maintaining my balance. Bench press has diminished as well. It took me 6 months to do a body weight squat (mostly due to proprioception issues) and now squat to depth with 115 lb. for 3 sets of 5. I lost strength in the deadlift as well at one time and now I've set a new PR at 155 lbs. for a set of 5 when my husband introduced rows (you would think I would face plant - go figure). I am relatively sure my brain creates new pathways which would explain the ability to achieve success over time. I train seniors and others with disabilities using your tried and true method in our home gym. If you can help me, others will certainly benefit. Any input or criticism concerning regaining my upper body strength is greatly appreciated.
Have you had a flare recently that would account for the loss of strength, or has this just become apparent with training?
I no longer have relapsing remitting MS and now am the proud owner of secondary progressive MS. Loosely translated, this means I have no real exacerbations to speak of it's simply a downhill slide. When I experienced this same decrease in muscle strength in squats my husband had me lift as heavy as I could for three sets of three and deload (80-90%) for volume. A very slow process but I was able to set new PRs. Two days of rows and one deadlift day boosted my deadlift strength. I have implemented this same routine in the bench and am seeing some improvement. This program change is not working for my press.
I believe my struggle with balance is affecting my strength to press and may be partly responsible for strength loss. I press because there is no replacement and even though balance is hard it probably helps me hold on to the balance I have for a longer duration. MS goes everywhere I go but strength allows me to captain the ship even if I don't have control over the weather. So, any suggestions for program or exercise selection to improve or maintain press strength? We are hoping to obtain a taller power rack shortly so I can fence myself in and provide some level of safety to press. This set-up works well for another MSer I train in our gym who is shorter. Thank you so much for your time and consideration.
For what it's worth to anyone else out there with with a degenerative disease, strength training is so worth it. I suspect I have more pain because I lift but the discipline and concentration it takes to lift provides a very decent coping mechanism much better than narcotics. My neurologist is very interested in a study for this type of training. After all, 3 1/2 years ago I couldn't climb a flight of stairs.
This is very important: in your situation, DO NOT DO SETS ACROSS OR BACKOFF SETS FOR VOLUME. Warm up to your workset numbers, do them, err on the side of lower tonnage/heavier weight, and stop. You do not need a lot of tonnage to get stronger, and if you overtrain this condition you will cause problems. Do not get hot/sweaty/tired, just go up to your work weight, do a set or two, and stop.
A data point that would be helpful would be to see how much different your strength is in a "seated, back supported shoulder press" is compared to your press. As Rip just said, I am much more in favor of training MS patients with extremely high weight for repeated singles or doubles with long rest periods. Fatigue is the enemy here.
Mark, how do you explain to physical therapists and strength and conditioning coaches who pontificate on the necessity to build strength in the transverse and frontal planes with, for example, landmines and lateral lunges that the most optimal way to build strength is with basic barbell movements in the sagittal plane, which develops strength that can then be expressed multi-planarly during athletic performance?
I can't stand to see my kids performing ridiculous looking movements under the guise of "functional" fitness.
I have an article that will on T-Nation this Wednesday that will deal with this, among other things. Here is an excerpt:
“An interesting phenomenon, “functional training” is a fairly recent development in S&C. Derived from the practice of Physical Therapy with injured and sick patients, it primarily relies on the use of sub-maximal (light) weights moved through varying ranges of motion in the context of solving a balance problem. The term “functional” is used because it is thought to be more like normal human movement, and therefore more closely mimics the “function” of normal movement patterns than machine-based exercise. Fortunately, it doesn't take much to improve on machine-based exercises. In most cases, the ability to balance the body and the relatively light load is the limiting factor in the amount of weight used in the exercises, not the weight itself.
The theory is apparently that ipsilateral and contralateral movements are so useful in developing “the core” – the muscles that stabilize the spine – that they are therefore sufficient for the production of useable athletic strength, to the extent that heavy barbell exercises are not necessary. Apparently spinal stability is unimportant in a 600 deadlift. The athlete is instead placed in positions of inherent instability and expected to perform stably, damn the force production, damn the increase in force production, and damn the heavy deadlifts.
If it seems obvious that light weights cannot improve strength, and that practices of even dubious effectiveness when used with injured populations have no bearing on healthy young athletes, that's because it really is. Despite this obvious silliness, many S&C programs around the country have devolved into programs that produce neither strength nor conditioning, under the guise of being “functional.”
It's important to remember that you can fall down while squatting, pressing, and deadlifting heavy weights, and you learn not to the first day of training. But the balance problem remains as a factor to be dealt with every time you train, even as strength increases rapidly under the bar. The fact that you don't fall down means that you've solved the balance problem while keeping the focus on lifting heavier weights, and therefore getting stronger while remaining balanced.”
Tune in Wednesday morning for a long, hate-filled screed about the current state of Strength and Conditioning coaching at the D1 and Pro levels.
You're bang on! It really has infiltrated us from the world of clinical physical therapy. I can see the utility in progressing pathological patients from unilateral work and lighter externally loaded movements made difficult through inefficient movement patterns, but surely this needs to progress to truly "functional" training (i.e. that which increases strength) to mitigate risk of future injury by increasing the resilience of the system. And this is BEST achieved through basic barbell movements. Nevertheless, I see this same logic applied to not only perfectly healthy but athletic populations!
Looking forward to the article, Mark. Really struggling with some of the asininity on proud display by so-called "professionals."
I find being stronger more "functional" than being weaker, sooo.... If I can lift 500 pounds off the ground, I'm functioning more functionally than when I can lift only 200 pounds. Right?
I have also noticed that a lot of the exercise recommendations health care professionals give their patients are appropriate for the very weak, sick and frail, but there is no plan to progress from that point and the implication, whether implied or implicit, is that you really don't need to do more than that, and so we end up telling the 35 year old with back pain to do a series of stretches and isometric exercises with some light walking thrown in (which may be appropriate after the acute event) but provide no plan for advancement so the patient can eventually gain the strength so that the back pain never comes back, essentially condemning the patient to a repeat experience.
This is no less true for the whole range of patient frailty...
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