Populations who should not train? Populations who should not train?

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Thread: Populations who should not train?

  1. #1
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    Default Populations who should not train?

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    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)?

  2. #2
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    Patients with Abdominal Aortic Aneurysm should not train. People with the flu should stay home. Likewise, people with ebola. Patients with osteoarthritis and RA must train, if they want some of their lives back.

  3. #3
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    We have trained clients with arthritis, loss of joint cartilage, multiple post chemo patients, auto immune conditions, PTSD, etc. All of them derived strength, health and psychological benefits from training. There are few conditions (aside from acute illness or injury) that completely rule out barbell training. And those may have more to do with the coach's willingness to take on the liability than anything else.

  4. #4
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    Everyone who is physically capable of moving should perform strength training in some fashion. The method of training may vary depending on n=1 deficiencies and physical defects.

    Anyone who tells you otherwise has no idea what they're on about.

  5. #5
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    Quote Originally Posted by Diddyin94 View Post
    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".
    Docsplaining.

  6. #6
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    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.

  7. #7
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    Quote Originally Posted by Mark Rippetoe View Post
    Docsplaining.
    Wonder if she made the OP strip down, put on a hospital gown, and sit and wait in a little room on a bench covered with paper, before delivering her docsplanation .

  8. #8
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    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.

  9. #9
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    Quote Originally Posted by dfclark68 View Post
    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 haven't had any luck with people with any form of muscular dystrophy.

  10. #10
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    Quote Originally Posted by Mark Rippetoe View Post
    Patients with Abdominal Aortic Aneurysm should not train. People with the flu should stay home. Likewise, people with ebola. Patients with osteoarthritis and RA must train, if they want some of their lives back.
    This.

    Unfortunately, the general response is, "I already tried that." To which I usually reply...




    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.

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