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Thread: Archives: Back Rehab Case Study with Mac Ward

  1. #1
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    Default Archives: Back Rehab Case Study with Mac Ward

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  2. #2
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    This is quite amazing. Both because the author continued business as usual despite clear warning signs that something bad was going to happen, and for the shear determination to make it better with barbells. I have to admit that back pain is easily one of my most dreaded type of patients. Usually they don't have anything like the level of pathology in the above article, but are willing to do virtually nothing to improve their pain. I was recently fired by such a patient who refused to get out of bed because of pain but had very minor structural problems. I attempted to explain to this patient that this decision would assuredly lead to a bad outcome. I wish I could just say, "if you lay in bed all day, you are fucked." I tried to get as close to saying this as possible. Obviously that's not what the patient wanted to hear.

    This also underscores the deplorable state of current PT. Obviously, you can't just tell someone to do this, no matter how beneficial it would be. They either need the knowledge to perform the lifts themselves, or they need a coach. The best we can currently do is to send people to some milquetoast PT and hope for the best, maybe suggesting that they start a strength program once they are released.

  3. #3
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    I agree with Pluripotent in that this is an amazing case study. I think it is very important to highlight Mac’s rehabilitation through barbell training, especially given the paucity of research studying the effectiveness of the barbell lifts in a rehabilitation setting.

    I was able to locate one paper, likely the only study of its kind to date (The effects of a free-weight-based resistance training intervention on pain, squat biomechanics and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back) demonstrating the benefits of employing squats, deadlifts/rack pulls for people with chronic low back pain. The study participants experienced significant reductions in pain and disability following a 16-week course of resistance training with barbells.

    Hopefully, the results of this study will prompt further research in this regard, alerting the medical community to prescribe barbell training as the intervention of choice for physical rehabilitation.

  4. #4
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    This seems to be close to my own experience. I never had a severe back problem, I just had a weak back, leading to pain when standing for too long, sleeping oddly, whatever. Similarly, I had a baseball-related shoulder injury when I was in high school, around 15 or 16. Strangely enough, when I started pressing and deadlifting, my shoulder pain disappeared. I suffered a shoulder impingement last September by being an idiot and trying to reset my upper back while bench pressing (the barbell was in my hands). Again, as soon as I started pressing and deadlifting, the impingement markedly improved.

  5. #5
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    Quote Originally Posted by Pluripotent View Post
    This also underscores the deplorable state of current PT. Obviously, you can't just tell someone to do this, no matter how beneficial it would be. They either need the knowledge to perform the lifts themselves, or they need a coach. The best we can currently do is to send people to some milquetoast PT and hope for the best, maybe suggesting that they start a strength program once they are released.
    Would any of our SS Coaches be willing to train a client with neurological symptoms like Mac's?

  6. #6
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    I also had back pain for years - maybe over a decade - sometimes severe, sometimes tolerable, but always there. No structural problems. Tried a ton of stuff. Nothing worked until I got serious about Starting Strength.

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    Quote Originally Posted by Cinic View Post
    Would any of our SS Coaches be willing to train a client with neurological symptoms like Mac's?
    Of course. We do it all the time.

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    Quote Originally Posted by Mark Rippetoe View Post
    Of course. We do it all the time.
    Good to hear. I got the opposite impression from something Will wrote or said a while back. Could have sworn that he indicated neurologically symptomatic patients were bounced out of his office to surgical consults. I must have misunderstood something.

  9. #9
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    I can't speak for Will, because he is his own person. But it would depend on what you consider to be "neurological symptoms." Sciatica is a "neurological symptom," and we deal with it all the time. I think this is your misunderstanding.

  10. #10
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    starting strength coach development program
    That's fair. I was thinking more along the lines of foot drop or numbness of lower extremities.

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