Rheumatoid Arthritis preventing Press/Bench on NLP Rheumatoid Arthritis preventing Press/Bench on NLP

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Thread: Rheumatoid Arthritis preventing Press/Bench on NLP

  1. #1
    Join Date
    Jul 2018
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    390

    Default Rheumatoid Arthritis preventing Press/Bench on NLP

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    Hi,

    My girlfriend will start going to the gym with me again, and is very interested in strength training via SSNLP. She's got a good pair of lifters and a new dominion belt coming in the mail, and had asked me to post here for some guidance.
    She's in her late 20's and had RA for 10+ years which makes barbell pressing movements difficult. Dual fused wrists and mobility issues in the elbow. In the press this prevents proper grip, and the floating rack position is always too far forward. It's also painful in the wrists, even with wraps. Bench has the same issue with grip and pain.
    The only pressing movement that is manageable is dumbell OHP with neutral grip, and wraps (this is great, but dumbbells obviously can't be LP'd)
    Otherwise, Squats and DLs work just fine. Pull-ups work fine (unassisted can't be done yet), but chins are a no-go. Cleans/Snatches are also out. I'm also aware of replacing the Press with Barbell Curls in older populations as a way to get some upper body work done, but curls can't be done either.

    Given this situation, I'm wondering what your thoughts are on a modified NLP where the Press and Bench are replaced with Pull Up-type exercises and dumbbell OHPs as a way to get upper body work in an LP when bench and press aren't possible.
    I'm trying to draw up a plan here:

    A
    Squat 5x3
    Dumbbell OHP 8x3
    Deadlift 5x1

    B
    Squat 5x3
    Pull Up assistance, alternating band days and negatives/pulldowns: Training the Chin-Up | Niki Sims
    Deadlift 5x1

    We've also read some arthritis threads and watched a few of Inna's videos. From there we would assume that NLP is totally doable, just with smaller jumps and a submaximal start. Eventually progressing from 3 sets of five, to five sets of 3 on squat.

    Strength Training With Arthritis
    Rheumatoid Arthritis and Strength Training | Inna Koppel
    Training with Arthritis | Starting Strength Stories

    Thanks,

    KK

  2. #2
    Join Date
    Dec 2014
    Location
    New York, NY
    Posts
    353

    Default

    Certainly you can NLP other variations of the lifts. Note they now make loadable dumbbells, so you can NLP those as well. I find it interesting that pull-ups are ok, but OHP and BP are no good. The grips are similar. Any idea what that is? How many variations of grip (narrower to wider) and style (incline BP, close grip PR, landmine PR, Floor Press, etc.) have you tried?
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  3. #3
    Join Date
    Jul 2018
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    390

    Default

    I've got some responses from her. To answer your questions:
    -We're stuck with the gym dumbbells unfortunately. Past 20 lbs per dumbbell, the smallest jump is 5 lbs each.
    -It's compression on the wrists that causes the pain, not pulling. Sharp pain in the wrist during the lift, present the next day too.
    -We haven't tried any of the variations you listed.

    Updates:
    We were in the gym today and tried pressing again. Cleaned up the form and grip a bit (Phil Megger's video was timely) and she says her wrists are fine right now. Of course this was only the first pressing workout since March. She knows that when things get heavier, there's pain. She's just not sure if that's something that needs to just be fought through.

    And here's some Xray notes of the fingers and wrist, if this is helpful in any way:"Mildly increased joint space narrowing of the second MCP and similar severe joint space narrowing of the third MCP and fifth MCP with periarticular erosions and periarticular osteopenia with periarticular soft tissue swelling
    of the MCP joint. Joint spaces are preserved of the DIP and PIP joints.
    Continued progression of carpal fusion with complete joint space loss of the
    radiocarpal joints and osseous erosions involving the distal radius and distal
    ulna. No acute fracture."

  4. #4
    Join Date
    Dec 2014
    Location
    New York, NY
    Posts
    353

    Default

    By varying grip and trying some different exercises, and using very small weight jumps you should be able to have her progress in a program. However, if you are limited to fixed dumbbells the grip and weight jump restrictions will likely hold her back. So, I would look into getting more equipment.
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  5. #5
    Join Date
    Jan 2017
    Location
    Alameda, CA
    Posts
    63

    Default

    I used a set of magnetic weights when I was in a similar situation. If I recall correctly, each magnet is a half pound. This is the brand I've got: Pace Weights magnetic lb fine-tuning weights for barbells, dumbbells & weight machines

  6. #6
    Join Date
    Jul 2018
    Posts
    390

    Default

    starting strength coach development program
    Thanks for the feedback!

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