Populations who should not train? Populations who should not train? - Page 2

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Thread: Populations who should not train?

  1. #11
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    Quote Originally Posted by dfclark68 View Post
    People with neurological injuries/disorders like stroke, multiple sclerosis, neuropathy, or parkinson disease can and would benefit from training with attention to safety (poor balance). In these cases training is a prescription for paralysis.

    I advise patients with inflammatory muscle disorders (dermatomyositis, myositis) and other forms of myopathy to refrain from vigorous exercise of any type. They will get rhabdomyolysis. These are very rare conditions, however. Some of these patients may achieve good enough control of the condition to train, at least to some degree.
    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?

  2. #12
    Brodie Butland is offline Starting Strength Coach
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    Quote Originally Posted by Diddyin94 View Post
    Hi Rip & SSCs,

    I was talking to my sister yesterday who is a newly minted emergency medicine doctor. I told her that I got our mom The Barbell Prescription for Christmas and gave her a brief synopsis of the book. She immediately freaked out, explaining that because our mother has both osteoarthritis and rheumatoid arthritis and has undergone Chemo she should never get under a barbell as it would be too "dangerous". I had a slight chuckle at this, but it got me thinking. In your experience are there any actual populations of people who just shouldn't ever train (barring extreme things like paralysis)?
    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.

  3. #13
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    Quote Originally Posted by Pluripotent View Post

    The fact is that if you truly are a person who can't train, you are good and truly fucked. (I think we talked about this on the special snowflake thread). No one gets a pass. Death is probably not that great of an experience for anyone (I don't know for sure, I've never tried it personally, but I have watched a lot of people die). It probably hurts a bit. But if you are not reasonably fit when your time comes, you are almost guaranteed to suffer more and for much longer than people who train. I mean, you could have a heart attack and die in your sleep like everyone seems to wish for. But if you're going to have a heart attack, sudden death only happens about half the time. The other half, you end up crippled and infirm for the next 10-20 years of your life while your sole remaining pleasure is when the home health nurse finally works her way up to your hospital bed to wipe up the feces you've been sitting in for half an hour. Everyone must train.
    Just wanted to say I appreciate you posting this perspective. Posts like these (and most recently The Barbell Prescription) strongly remind me why this shit matters, and they increase my desire to educate myself so that I'm ready to help anyone who asks.

  4. #14
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    Quote Originally Posted by Pluripotent View Post
    ... if you're going to have a heart attack, sudden death only happens about half the time. The other half, you end up crippled and infirm for the next 10-20 years of your life while your sole remaining pleasure is when the home health nurse finally works her way up to your hospital bed to wipe up the feces you've been sitting in for half an hour. Everyone must train.
    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.

  5. #15
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    Quote Originally Posted by Mark Rippetoe View Post
    I haven't had any luck with people with any form of muscular dystrophy.
    I have a trainee with Type II who is doing quite well.

  6. #16
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    Quote Originally Posted by I_iz_a_fatass View Post
    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!"

  7. #17
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    Quote Originally Posted by Austin Baraki View Post
    There is a weight at which the exercises can be performed safely and correctly.
    This.....AND there are remedial versions of the lifts that almost anyone can use.

    If only someone would have the sense to write a book about this?

    Oh, well.

  8. #18
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    Quote Originally Posted by dfclark68 View Post
    People with neurological injuries/disorders like stroke, multiple sclerosis, neuropathy, or parkinson disease can and would benefit from training with attention to safety (poor balance). In these cases training is a prescription for paralysis.

    I advise patients with inflammatory muscle disorders (dermatomyositis, myositis) and other forms of myopathy to refrain from vigorous exercise of any type. They will get rhabdomyolysis. These are very rare conditions, however. Some of these patients may achieve good enough control of the condition to train, at least to some degree.
    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.

  9. #19
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    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.

  10. #20
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    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.

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