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Thread: Training Barrier Construction | Will Morris

  1. #1
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    Default Training Barrier Construction | Will Morris

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    Starting Strength Coach and Doctor of Physical Therapy Will Morris presents his concept of Training Barrier Construction during the Starting Strength Nutrition and Rehab Camp held at Wichita Falls Athletic Club in October 2019.


  2. #2
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    Very interesting. I have become aware of the advice given by some of my physician peers surrounding exercise and it is woefully inaccurate. Besides me wondering why someone would ever ask me or another doctor about exercise, especially the specifics of what is safe or not, I’ve realised it’s much easier to tell people just to use the cross trainer or resistance machines because injury is very difficult on these, and even if you did get injured it’s unlikely you would be blamed for giving that advice as these things are considered “safe” by the general medical/fitness community. Their actual effectiveness is a secondary concern. However if I recommended starting strength to a 55 year old overweight woman, despite it having the potential to reverse or prevent a huge amount of the diseases she is at risk of (osteoporosis, type 2 diabetes, OA), any injuries would be assumed to be because I suggested a crazy program of squats and deadlifts!
    In essence risk aversion rules in medicine because no one wants to recommend anything where a bad outcome can be directly traced to them, even if that risk aversion leads to a huge loss of potential in improving the health of a population. Hopefully as people take charge of their health more they will be happy to start a program like starting strength without a clinicians approval. I’m not saying it’s terrible to seek a well qualified professionals advice before starting on a fitness regime but that can be like trying to offset any risk on to their shoulders and they might prefer to recommend a less effective program that is considered “safe” in the eyes of their peers.
    Happy training everyone!

  3. #3
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    Quote Originally Posted by Jdcuth View Post
    Very interesting. I have become aware of the advice given by some of my physician peers surrounding exercise and it is woefully inaccurate. Besides me wondering why someone would ever ask me or another doctor about exercise, especially the specifics of what is safe or not, I’ve realised it’s much easier to tell people just to use the cross trainer or resistance machines because injury is very difficult on these, and even if you did get injured it’s unlikely you would be blamed for giving that advice as these things are considered “safe” by the general medical/fitness community. Their actual effectiveness is a secondary concern. However if I recommended starting strength to a 55 year old overweight woman, despite it having the potential to reverse or prevent a huge amount of the diseases she is at risk of (osteoporosis, type 2 diabetes, OA), any injuries would be assumed to be because I suggested a crazy program of squats and deadlifts!
    In essence risk aversion rules in medicine because no one wants to recommend anything where a bad outcome can be directly traced to them, even if that risk aversion leads to a huge loss of potential in improving the health of a population. Hopefully as people take charge of their health more they will be happy to start a program like starting strength without a clinicians approval. I’m not saying it’s terrible to seek a well qualified professionals advice before starting on a fitness regime but that can be like trying to offset any risk on to their shoulders and they might prefer to recommend a less effective program that is considered “safe” in the eyes of their peers.
    Happy training everyone!
    Jdcuth, as luck would have it, after this presentation was given, a question was asked regarding the very topic of why physicians, allied healthcare providers, etc do things like this. My response was eerily similar to yours here. As a physical therapist, I have perhaps a lot more leeway with making the case that a specific intervention (squats, deadlifts, etc) was safe for the patient, but I would be judged by my peers if I were to ever end up in court over a patient harm scenario. If I were to argue that the deadlifts were prescribed to strengthen the lower back, and I can show that the individual progressed appropriately, etc. it might be very tough for an expert witness who is a PT to argue with that line of reasoning. There is plenty of data to show that weightlifting injuries is no more prevalent than injuries in any non-contact sport.

    I certainly agree that a physician has a lot to potentially lose for giving this same exercise prescription....if something goes wrong. I don’t think that a physician’s peers would be able to make the same judgment call. I think a physician who told a patient to start a resistance training program that consisted of anything but nautilus machines would potentially be in danger of having an “expert witness” state this physician was negligent.

    There was another part of the seminar where we had a discussion about self-efficacy and the need for a physician’s clearance to start a training program is likely not needed for the vast majority of the population.

  4. #4
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    Hi Will thanks for the reply,
    I guess I need to hope starting strength spreads further in terms of more qualified coaches and gyms worldwide so I have the opportunity to direct people towards them!
    BW
    James

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    As someone who once thought his left knee and hip were hopelessly destroyed, I can say for certain that low bar squats, done below parallel, actually un-destroyed those joints. I used to get lots of pain in both those areas, haven't gotten any at all since I started with The Squat.

  6. #6
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    Docs:

    Enjoyed the video and this discussion between two physicians who obviously give a shit!

    Now let me add the perspective of a retired attorney. Although I confess to having handled a few (very few) personal injury (and NO medical malpractice cases) in my early life, I will simply say this and hope the judgment is not taken too harshly:

    The legal practice, insofar as medical malpractice is concerned, is a virtual cancer on the American judicial system. Surely, there are some bad doctors, but the ill effects caused by parasitic lawyers, in my opinion, far outweigh any deterrence they provide against truly bad medical advice and procedure.

    We have completely abandoned the principle of personal responsibility—in what is nothing more not less than another scheme to transfer wealth from one sector to another, and to enrich another powerful lobbying group.

    I am 74, with bone-on-bone arthritis in my right knee. My good, well-meaning,reputable and (possibly ass-covering) orthopedist told me NOT to squat below parallel. To the extent that he was covering his ass, I can’t blame him. And like a good patient, I took him seriously, but as a responsible adult who ain’t got that long in this mortal coil, I turned immediately to this website—and the (hopefully) sound advice of doctors (as well as normal people&#128512. And I am by-God going to squat below parallel! Hopefully, the advice of my well-meaning orthopedist will not turn out to be prophetic—but if it does—fuck it—it was my responsibility.

    How is this for lawyer talk:

    “I hereby take full responsibility for any injury I receive while training, and absolve any physician or other advisor, of any and all liability from the beginning of time until the end of the Earth and I do hereby bind my heirs and assigns forever—whether in Heaven or more likely, Hell.”

    Thanks again to both of you!

    Russ

  7. #7
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    @CommanderFun me too. Patella tendon rupture doing CrossFit 2012 (btw it was totally my fault not the instructor). Lots of rehab focused on strengthening different parts of the quad (I needed to activate my vastus medialis more apparently) led to so much pain and frustration. Read starting strength, which explained how the low bar squat allows progressive loading of a movement where the hamstrings balance the forces of the quad and haven’t looked back.
    @Comancheria lol great post lots of bad docs and lawyers on this side of the pond too only people worse are the politicians

  8. #8
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    starting strength coach development program
    Very nice rebuttal to the aggravating issue of “well my doctor said...” thanks Will!

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