Substitute exercises for medical reasons

[metaloid]

Hi Mark.
A friend of mine, not over or underweight had a serious surgery years ago. In it he lost some of his abdominal muscles and has to use a kind of girdle. The surgeon said that when he recovered he could go back to the gym, but of course that he should be careful with the weights and the exercises that he chose. He also recommended him to go to a sports physician.
So, I'm not asking for a medical advice, just an opinion from your years of experience and knowledge.

I want to coach him on the SS program. The bench press is not a problem, we can overload it progressively as needed.
But of course, the problem remains for the other exercises - squat, deadlift & overhead press, given that they use the whole body and the abs to stabilize. The power clean is not an option, unfortunately.
What exercises should he perform to replace them? I want to avoid machines as much as possible, given that they don't provide nowhere near the benefits of compound free weight exercises, and based on all the things you explained in your books. And the leg press seems to put some pressure on the abs when done at heavy weights.

Thanks for your time and work.

[Mark Rippetoe]

We need a lot more information about the surgery, and what is missing.

[metaloid]

from the center of the left side of the abs to approximately the pubis is missing muscle, instead there's some kind of special mesh to hold things together as "if" they were the abs.
I dont know what else to add, but I'll ask him anything else that's needed.
a1.jpg

[Mark Rippetoe]

I can't recommend anything on this forum without having actually seen you. Obviously a belt will be very important, and using it properly. What was the reason the muscle was removed?

[metaloid]

a tumor in that area had to be removed.

[metaloid]

hey Mark.
I follow up the last entry I left in this post.
I decided that he should do 8-12 reps for the ohp, squat and deadlift, which rely heavily on the abs. Before you kill me, consider my reasons.
I noticed that when he did 5 reps he would start tilting the bar exactly in a way that would compensate his lack of muscles. So, in order to prevent not just bad form, but also possible problems from so much pressure I went for the 8-12 reps, which I know, its the "bodybuilding" range. Not surprisingly his form is perfect, and he still has to exert a lot of force. And I agree with what you said on your podcast about that range, that basically its not enough weight to promote strength, but given that he is a beginner he should still see strength benefits. Sure, not as much as 5 reps would, but considering this particular situation, I dont see other option. We also bought a belt, according to how you described it in your book.
Weight progression is slower, meaning that we don't add 5 lbs every workout, but rather every third session or so.
I would like to know your opinion on this decision if possible.
Thanks

[Mark Rippetoe]

What happens to his form when he gets fatigued at the 10th rep?

[metaloid]

I run the test between 5 and 10 reps in the Squat and OHP. The form breaks down just a little bit at the last rep, whereas in the 5 rep range his form starts breaking down more significantly quite soon, around the 2nd rep, maybe 3rd.
I haven't compared the ranges for the deadlift though because of what I noticed to be the root of the problem (the abs), so we jumped straight to the 8-12 range. Besides, I wanted to be extra cautious given the high intra-abdominal pressure of the exercise.

This stays consistent throughout all the sets.

[smokeyjones]

I run the test between 5 and 10 reps in the Squat and OHP. The form breaks down just a little bit at the last rep, whereas in the 5 rep range his form starts breaking down more significantly quite soon, around the 2nd rep, maybe 3rd.
I haven't compared the ranges for the deadlift though because of what I noticed to be the root of the problem (the abs), so we jumped straight to the 8-12 range. Besides, I wanted to be extra cautious given the high intra-abdominal pressure of the exercise.

This stays consistent throughout all the sets.

I ain't no medical professional but just curious. You see form breaking down in a set of 5 and instead of thinking the weight is too high. You believe the rep range is wrong?

The 3-5 range is generally pretty good for enforcing form. Going heavier without sufficient experience can invite form breakdown. On the flipside - too many reps is always gonna turn into an endurance exercise. Not conducive to rigid form.

Not the expert. So maybe 10s are perfect. Just a thought.

[Alexander Dargatz]

I went for the 8-12 reps, which I know, its the "bodybuilding" range. Not surprisingly his form is perfect

I run the test between 5 and 10 reps in the Squat and OHP. The form breaks down just a little bit at the last rep, whereas in the 5 rep range his form starts breaking down more significantly quite soon, around the 2nd rep, maybe 3rd.

That doesn't make much sense. If the form breaks down on the 2nd rep, it's not the "5 rep range", it's too heavy.
And if there's a weight he can do 9 perfect reps with, add a little bit to that and have him do 5 reps. Or just have him do 3x5 at that same weight instead and add the little bit next training.