Populations who should not train?

[Diddyin94]

Sully wrote up a solid list of pathologies prohibiting training a few years back.

Doctors are trained with a "risk minimization" mindset, and emergency physicians in particular will always fear the worst case scenario (as they should). However, as discussed at length on these boards in the past, we receive no education in physical training of any sort. This makes it impossible for physicians to perform accurate risk / benefit estimations in these sorts of situations, and they default to focusing on the "risk" side since "heavy barbell training" sounds scary.

Although I obviously cannot give specific advice pertaining to your mother, there is nothing inherently "dangerous" about training with osteoarthritis or rheumatoid arthritis. There is even data to support this for those who insist on seeing published literature for everything.

There is a weight at which the exercises can be performed safely and correctly.

I absolutely understand that Doctors are paid to accurately asses risk/reward of certain situations, what would be the downside in her/any doctor saying "I don't know what the risk is"? In your experience, are there situations in which you need to tell a patient "I don't know" is this an acceptable answer to them?

[Pluripotent]

I absolutely understand that Doctors are paid to accurately asses risk/reward of certain situations, what would be the downside in her/any doctor saying "I don't know what the risk is"? In your experience, are there situations in which you need to tell a patient "I don't know" is this an acceptable answer to them?

I don't know is an acceptable answer and there are plenty of situations where it is the correct answer. Sometime it's not an acceptable answer to the patient, who thinks you should know everything, since you're the doctor.

[BMueller]

I don't know is an acceptable answer and there are plenty of situations where it is the correct answer. Sometime it's not an acceptable answer to the patient, who thinks you should know everything, since you're the doctor.

To be fair, in my experience, it is much more often unacceptable to the doctor than it is to the patient.

[Mark Rippetoe]

Given the General Population's normal tendencies, this is obviously quite true.

[Pluripotent]

To be fair, in my experience, it is much more often unacceptable to the doctor than it is to the patient.

I suppose the IDK needs to be defined. If you don't know something that you should know, that's a problem. You need to be knowledgeable about your scope of practice. But people have a tendency to not fit neatly into the defined population groups in RCTs, so to some extent we are virtually always extrapolating trial data to our unique patient, which may or may not be accurate, but until that start doing trials on the types of patients we generally see, it's necessary. So to some extent, no one knows.

And sometimes I just say IDK because it's more polite than saying, "that is totally irrelevant to what is going on now."