I think you could add ALS / Upper Motor Neuron Disease to the prohibited list. Vigorous exercise for these patients may speed up the disease process. But, then again, what else are you going to do if you are facing a diagnosis like ALS?
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This is a great illustration of theory versus practice. In theory, people with a whole slew of conditions should never get under a barbell because it will surely kill them.
In practice, we find that nearly all people, at nearly all stages of physical infirmity, derive some benefit from training. This forum is filled with actively training osteopenics, heart attack, stroke, and cancer survivors, and even cancer patients training while going through chemo. Remarkably, training hasn't killed them--in fact, I think all or nearly all would say their lives have improved immensely as a result of training.
Your sister's heart is in the right place, but she's out of her league on this one.
I don't think that possible outcome from not being as resilient and strong a creature can be echoed enough. And truly, if I have a "fatal condition" (for example's sake) stage 4 colon cancer, what's the worst that training can do to me? I'm already on rented time.
I have been on a fairly morbid kick lately. The patient population last week seemed to be all end-of-lifers with some form of horrible end-stage process from which we are supposed to save them by "doing everything." I am probably one of the more aggressive docs I can think of in terms of trying to explain to people why that might be a bad idea. It doesn't always work, but sometimes you can save people from a little extra suffering. In residency, a particularly cantankerous neurologist would make fun of all the heroics we end up seeing at end of life, saying, "we have to save them! ...So that they can die of something even more horrible later. Because clearly, what they're going through now is just not horrible enough!"
Well, I am not a Doctor, but I can tell you this: my 56 year old wife has been battling dermatomyositis for over 15 years. Low dose Prednisone daily, as well as intermittent Methotrexate. She is a fanatic exerciser. P90X and every derivative you can name, jogging, walking, dumbbell nonsense, and even a little fooling around under a barbell (but no real training). She exercises in one form or another at least two hours a day. Pretty healthy eater, but not enough protein. Her commitment to physical activity has saved her thus far. In my opinion, telling someone with this, or any, autoimmune disease to refrain from vigorous exercise of any type is telling them to sit around and die.
Of course, she won't listen to me about barbell training. I have bought The Barbell Prescription. Currently plowing through it. Hopefully, when I return home from my current deployment, I can convince her to read it and agree to give me 60 days of barbell training to see if it makes a difference. I'm sure she can continue walking and even occasionally jogging, because she is already well adapted to it. What she has done so far has certainly staved off physical decline. She is the hardest working person I have ever known. If I could just focus it in what I think is the right direction, I think it would enhance and extend her quality of life.
Refrain from vigorous exercise? No chance. She will probably die by dropping a 25 pound dumbbell on her head while bouncing on a bosu ball.
I have a son with a chronic neuromuscular disease (mitochondrial encephamyopathy with muscle CoQ10 deficiency diagnosed by muscle biopsy) who I have helped train since he was 14, which is the earliest age my gym will allow some one use free weights.
He cannot do the strict Starting Strength lifts at any weight because he has low coordination and he has language difficulties which make it hard for him to use verbal prompts. He uses a leg press machine instead of squatting. I would love to find a way for him to do some sort of modified dead lift -- any ideas out there?
His favorite exercise has been a pseudo press done on a bench like this:
http://allthingsrecreation.com/wp-co...t-Machines.jpg
He began only being able to lift the handles which he would do with the palms of his hands, because his grip was too weak to actually grasp the handles. Now, after 3 years of doing this 3 days a week his personal record is 150 lbs (75 lbs on each side)! His form is not great, so he does sets of 1 and holds them for a few seconds, and I have to slightly push against his abdomen while he does them since he is still learning to brace himself with his abs,
Over 3 years his leg press has also gone from 30 lbs to a personal record of 310 lbs, Most days, he refuses to do any bench press equivalent, so he has made little progress there.
He hated doing thiese lifts at first, but after about six weeks when he started to see his numbers go up, he really got into it and has enthusiastically stuck with it ever since. Now he is the one who wants to set a personal record. Not me.
An added benefit to his training is that while most of his teen age classmates with disabilities are now on meds to control their mood swings (most of which cause huge weight gains) we have so far been able to keep him off of psychoactive drugs,. Thank God.
My advice to those with loved ones with disabilities is find some way, any way, to have them lift with a goal toward lifting serious weight. It greatly improves their quality of life and by extension, yours.
I wrote an appendix of contraindications to barbell training for BBRx, which ultimately could not be included in the book but will probably be an article. While it was in process I was discussing it with a client of mine, a PA with incredible clinical skills who should have been a doctor. He reminded me that I often say, "anybody who can lift weights should lift weights."
Except, he pointed out, anybody who has a longstanding relationship with a vascular surgeon.
Yeah, that's about right.
Right now I've got a wonderful client, 65, a very coachable and affable man, but with profound sarcopenia, deconditioned and weak as hell, who is making slow, careful, steady progress. I really love working with him. I built my coaching practice for people just like him.
But now the interwebZ and sundry orthopods have convinced him that deads and squats will surely cause his artificial hip to disintegrate, and I can't point to any definitive data that says it won't (he's a physician....I'm getting more of them). So in spite of the fact that he can barely squat 110 yet, and really needs this training, I'm probably going to lose him.
We still have so much work to do.