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Shit Doctors Say | Starting Strength Radio # 28

Mark Rippetoe | November 01, 2019

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Mark Rippetoe:
"Lifting weights will not bring your muscle back. You need to do cardio. Tell me, are you jogging?" [Laughter]

Mark Wulfe:
From The Aasgaard Company studios in beautiful Wichita Falls Texas... From the finest mind in the modern fitness industry... The One True Voice in the strength and conditioning profession... The most important podcast on the internet... Ladies and Gentlemen! Starting Strength Radio.

Mark Rippetoe:
Welcome back to Starting Strength Radio. We're happy to have you with us this Friday afternoon...Friday morning depending on where you're looking at this or listening to it. I think we... don't we do audio release of this podcast.

[off-camera]:
Yeah.

Mark Rippetoe:
I'm just a complete dumb ass. I don't actually know what's going on. Nobody tells me anything. But I think we released this on Twitter on Audible?

[off-camera]:
Audible, I think. And iTunes.

Mark Rippetoe:
itunes. And where else? Some other place where it's only the audio. And then YouTube. YouTube is the video where you want to watch if you if you, in fact want to watch.

[off-camera]:
Which is way more interesting.

Mark Rippetoe:
It's more interesting to watch, I think. You get to watch my hand twitch, you know.

[off-camera]:
Your lobster claw.

Mark Rippetoe:
My lobster claw twitch like it is right now for... I can't even stop that. Isn't that amazi... it's involuntary. I can't stop it. Sometimes this hand tries to... choke me. Oh shit!

Mark Rippetoe:
It's a problem sometimes. All this involuntary shit going on. All right. Now, let's begin with our normal beginning segment that we always begin with. And it's...

Mark Rippetoe:
Comments from the Haters!

Mark Rippetoe:
And this week we only have one. "Rip, are you really a cannibal?"

Mark Rippetoe:
I mentioned something about cannibalism a couple of weeks ago in terms of how to solve the homeless problem in San Francisco and Los Angeles. Let's just use them as protein.

Mark Rippetoe:
So this guy wants to know if I'm really a cannibal. Well, yeah. Aren't you? You may be a cannibal and and not know it, right? I think if you've eaten at Taco Bell. Hey, you're a cannibal one way or another.

Mark Rippetoe:
And that's...Comments from the Haters!

Mark Rippetoe:
Now, now that that silly bullshit is over with. We're going to talk this week about a favorite topic of ours. Something we have to deal with professionally, essentially every day. All effective strength and conditioning coaches must deal with shit doctors say.

Mark Rippetoe:
All right, now we're going to talk about a whole bunch of shit doctors say today. But I want to go ahead and and disclaim this thing first by saying that not all doctors say this stupid shit because not all doctors are stupid, but lots and lots of them are. And you know this from personal experience, don't you? You know, the doctors say stupid shit and we're just gonna talk about the stupid shit they say today. We're going to talk about the misconceptions that doctors have laid on very, very heavily in the mind of the general population. And we're going to talk about why they say these things. But first, we're going to we're going to talk about some of the more common things that doctors say.

Mark Rippetoe:
See my new shirt? Boys at Fenix ammunition gave me this shirt. I thought I'd wear it today. Nice guys. Follow the show. Follow the program. Load excellent ammunition. Give them a give them a look on the internet. Fenix ammunition.

Mark Rippetoe:
That was free, by the way.

Mark Rippetoe:
Okay. There are a few things the doctors say that you've all heard. You've either been told them yourself after an injury or you've got somebody you know closely who's been told this after an injury. And we're just going to go down the list here and talk about the problems with each one of these things.

Mark Rippetoe:
All right. And what all of these things have in common is the fact that when doctors tell you these things, they have no idea what they're talking about. But that doesn't stop them from saying them anyway. And this is kind of a problem. Like the tried and true "Don't lift more than 10 pounds." Right. You go in with any kind of any kind of pain in your body, a doctor will tell you don't lift more than 10 pounds.

Mark Rippetoe:
You know, I don't know where the figure came from. Do you know what a bag of groceries weighs? What's a bag of groceries? 12, 15 pounds? What are you supposed to do? Hire it done? Just hire done your fifteen pound bag of groceries. Hire your shopping done?

Mark Rippetoe:
"Don't lift more than 10 pounds" is an incredibly non-specific recommendation that really doesn't bear any resemblance to good advice about anything. Lifting it can be done lots and lots of different ways. If you pick ten pounds up off of the counter there at the checkout stand in the grocery department and set it back in your basket and then walk it out to the car. And pick that basket of... that bag of groceries - 12, 15 pound bag of groceries up - and put it in the trunk of your car or in the front seat or wherever you're going to put it, it would take a seriously frail individual to risk injury from picking that up. And an individual that frail is not go into the store anyway. You know why? Because she's in a rest home.

Mark Rippetoe:
So 10 pounds. I don't know what they think ten pounds is going to do to you. That's going to disrupt your physical existence? I'm not sure it's just one of these things they say that doesn't make any sense.

[off-camera]:
I wonder how they came up with that number.

Mark Rippetoe:
I don't know. That's that's the problem with it.

[off-camera]:
It's a round number.

Mark Rippetoe:
"Don't lift more than 10 pounds." Nine pounds is OK, 11 pounds will kill you. This is obviously the first thing that occurred to anybody when they heard this ridiculous nonsense come out of the mouth of this this medical professional.

Mark Rippetoe:
"Nine pounds is OK, but 11 pounds is not?".

Mark Rippetoe:
"Yeah, just ten pounds. Don't lift more than ten pounds. You don't need to lift more than 10 pounds."

Mark Rippetoe:
What's your kid weigh? If you've got kids, you can't pick your kid up, you know. What do you... what are you talking about?

Mark Rippetoe:
This is typical of the kinds of things they say. It indicates a complete absence of having considered the ramifications of that advice. And every time - here's the interesting thing - every time they say something stupid like this, they undermine their own credibility and it hasn't occurred to them that that's the case.

Mark Rippetoe:
And what they'll encourage you to do if you go into the doctor's office and you're engaged in any kind of an exercise program - young guy goes in, you know, in his 20s and his foot hurts or something like that - the doctor will say, "You know, you're you're just lifting too much weight. Why don't you just lift lighter weight and do more repetitions? And that'll do... that does the same thing." Lighter weight and higher reps does the same thing is heavier weight and lower reps.

Mark Rippetoe:
See, now this would be the same thing. As somebody coming into my gym and me giving them advice about brain surgery. "You know, Rip, I've got this... I've got these headaches, you know, I I just can't... I can't I can't make them go away. I've tried everything, I've tried ibuprofen, tried Tylenol, you know."

Mark Rippetoe:
And I say, well, you know, the answer is obvious, what you need to do is get your wife to go out in the garage and get your cordless electric drill and then you put a 3/8 inch drill bit in this electric drill motor and her drill a hole in your skull in in the approximate position that you feel the pain, because obviously it's pressure. You just need to let that pressure out.

Mark Rippetoe:
Same thing. Right? Lower weights and higher reps is the same as heavy weight and lower reps.

Mark Rippetoe:
Or when they tell athletes, "You know, lifting weights just slows you down. Lifting weights slows you down, makes you all muscle bound."

Mark Rippetoe:
Muscle binding is such a problem. It was a bigger problem back in 1955 than it is now though. I mean, you don't ever hear "muscle bound" anymore, but that's what he's saying.

Mark Rippetoe:
He's saying that a stronger muscle doesn't contract as fast as a as a weaker muscle. That's what he's saying. And he may actually believe that. It's amazing.

Mark Rippetoe:
And then they get real specific. They don't want you to squat below parallel because that's bad for the knees, right? They don't want you to press overhead because that's bad for the shoulders, causes shoulder impingement, you know.

Mark Rippetoe:
Oh yeah, everybody knows that. Causes shoulder impingement every time you pick your hand up over your head, why it impinges your shoulder, right? Because your shoulders, after all, are that badly designed. Right? Why everybody that's ever pushed anything up over their head has impinged their shoulders. And, you know, it's just I don't know. I don't know why you need to push anything up over your head in any anyway.

Mark Rippetoe:
I mean, if your house is correctly designed, all your cabinets are at eye level. Right? Everything in the house is at eye level. Everything at work you do is not above the level of your your eyes. So why do you you know, I mean, if you've designed your life correctly around the obvious anatomical limitations of your shoulders, you're not pushing anything up over your head anyway so why do it in the gym? Don't be stupid. Don't be stupid. Just lift light weights for high reps. You know, because heavy weights slow you down. Right?

Mark Rippetoe:
Oh, these these things get so, so repetitive and boring. But but once again, they're evidence of a man or a woman who is perfectly confident in saying things that they have just recently jerked out of their asses and presented to you as though they're true and with absolute conviction in the analytical processes that resulted in this is wonderful advice they're giving.

Mark Rippetoe:
Or the classic "You'll Never Walk Again." Right. Oh, God, how many times have you heard that? You know, the doctor said, I'll never walk again. He said I'll never walk again. So it would be wrong for me to try.

Mark Rippetoe:
And that's the net effect. That's so aggravating. God damn. Our friend Brian Jones falls off of a house, falls off a two story house. He's an insurance adjuster. He's up on a ladder. He's up on the roof. Something happens. Dumb ass falls off the house and lands in a standing, upright position with his knees locked and shatters both of his ankles, pilon fractures both ankles just, you know, little chips of bone and flesh ground up in these... in his lower legs.

Mark Rippetoe:
And I mean, he's a he's a big man. And, you know, he's got wife, kids, and he's proud of his self-reliance. And this is several years ago. In fact, it's on our website videos called Recovery via Barbell Training with Brian Jones. And you need to look at this. You need to look at this video. Here is a guy who was told literally he would never walk again. He.. they had him in a wheelchair. They had fixation devices on both ankles.

Mark Rippetoe:
This is a bad injury. This is a terribly bad injury. And he just didn't feel like playing this ridiculous game. And he was intelligent enough to understand the thing that doctors seem not to understand. Which is: Stress, recovery, adaptation. Wherever you are right now. Wherever you are, you can apply a stress to the system that will result in adaptation. If the stress is recoverable. And if you do what's necessary to recover from the stress, this is the basis of training.

Mark Rippetoe:
And Brian applied this obvious process to his own situation. and he started off not being able to walk, of course. It's a terrible des... terribly destructive, invasive injury that he suffered. And slowly, you know, the process would be described as sitting and crawling and then walking, then standing and then walking and then deadlifting and squatting.

Mark Rippetoe:
And, you know, three or four years ago, Brian deadlifted 600 at a meet having been told that he would never walk again.

Mark Rippetoe:
I understand that a lot of that is covering your ass on the part of the doctor. If he tells you you never you will never walk again. And you never walk again. Then he was right. Right? And everything that happens better than that is no skin off his nose.

Mark Rippetoe:
So that's the that's the that's the reason for these pessimistic predictions. You'll never walk again. You'll never throw a baseball again. You'll never blah blah again. Right. And then if you do, it's great.

[off-camera]:
It's a miracle.

Mark Rippetoe:
It's it's an absolute miracle. We have no medical explanation for this.

Mark Rippetoe:
Well, of course you don't because it's not medical. It is biological. And you guys didn't have enough biology in school to have absorbed the stress, recovery, adaptation thing. Right?

Mark Rippetoe:
So, if there's no downside to being pessimistic. Then that's what we need to be, is pessimistic. Shoot for a low.

Mark Rippetoe:
But there is a downside to it. There's a terrible downside to this. If you with your silly-ass advice and prediction, prognostication that this guy's never going to walk again. If he is stupid enough to believe you, then you have discouraged him from trying and he never enters the stress, recovery, adaptation process. And he never gets any better because you've imposed a limitation on a person with a less than concrete constitution. All right.

Mark Rippetoe:
Brian didn't want hear any of that shit. And he knew that he could push himself and he could tolerate some pain in the process. And that in the process of pushing himself, he got better. So he's better than lots and lots and lots and lots of people. Right.

But when a doctor tells you, you'll never fill in the blank again. That is so seldom true that it should be immediately disregarded.

Mark Rippetoe:
Now, once again, not all doctors are this fucking stupid. All right. They're not this dense. Not all of them are this way, but lots and lots and lots and lots of them are. Ok.

Mark Rippetoe:
And it is your job as a functioning human being to disregard the dumb things they're telling you, especially if they run counter to your own experience, and lots of these things do, right?

Mark Rippetoe:
The "ever walk again" thing that's... you all know that that's not true. All of you know people who've been told... who've been handed these limitations by doctors and disregarded them and we're better for it.

Mark Rippetoe:
How about the "my doctor recently released me to full activity"? This is a offshoot of this never walk again thing. Right.

Mark Rippetoe:
The doctor has released you to do what you want to do. All right. He's released you. But up until that release who did you belong to? You or him?

Mark Rippetoe:
Right, now I understand that foolishness in the aftermath of reconstructive surgery is not a good idea, but it's not much worse an idea than immediately beginning to use the structure that was repaired.

Mark Rippetoe:
I've had a lot of personal experience with this. Lots and lots more personal experience with it than I really want, but I have learned from personal experience over decades that what happens after an injury is you have to get back to the use of that structure as quickly as possible. And this may or may not coincide with your doctor's experience. Or his wishes.

Mark Rippetoe:
Now, I will go so far as to say that if a doctor has never had a shoulder reconstruction, has never had a rotator cuff repair himself personally, he doesn't know. Really. He doesn't really know what you can and can't do with a shoulder that has been repaired.

Mark Rippetoe:
Now he understands his repair better than you do, right? But you understand the way your shoulder feels and responds on a daily basis to the things you do to it than he does. And that is what is important. OK.

Mark Rippetoe:
It is very seldom correct to completely immobilize a repaired structure. Very, very seldom correct. There are some examples of such things, but the vast majority of structures that were damaged are immediately better after the repair, aren't they?

Mark Rippetoe:
If you'll remember our conversation with Dr. Mangi and his discussion of cardiac rehab. This is this is terribly germane to this situation. Your heart, after it is fixed by him, is way, way better than it was before the surgery, all right. And it is a mistake to not use it and further force a healthy adaptation to the stress.

Mark Rippetoe:
He's sawed your chest open. He's retracted your sternum. He's taken your heart out in his hands. He's sewn on it and slapped it around and drained it of blood and frozen it and warmed it back up and done all kind of unspeakable horrors to your heart. Yet you want to sit around on your ass after this repair and listen to these people in cardiac rehab who want you to go up to a heart rate of about 100 beats per minute during their little silly-ass rehab program that they by the way get paid for...

Mark Rippetoe:
And look at that episode. It it visits the situation in detail and you take those principles and apply them everywhere else. If my knee is deranged, then when it's repaired, it's better than it was before. And I understand we have to let the repair heal. I understand that. Understand that way better than you do. OK. Because I've had both my knees worked on. I understand about letting repairs heal.

Mark Rippetoe:
But what I do understand is that you force things to heal. You don't let them heal. Things don't heal if they don't have to. Any repair must be loaded whether it's a fracture or a suture or anything else. There has to be some stress applied to the repair to tell the structure that it's damaged and that it needs to go ahead and remodel itself. And that remodeling is the result of the forces that you apply to the repair. This goes much faster.

Mark Rippetoe:
If you take a shattered femur and immobilize somebody in a bed for six weeks guess what happens? Nothing. If it heals at all, it's accidental. And the way you know this. Is the obvious example of fractured ribs, fractured ribs are the quickest healing fractures in the human body.

Mark Rippetoe:
I'm familiar with the case of a woman that was in an extremely bad car accident who had a flail chest on one side of her body, a complete flail chest. Which means that all of the ribs are broken to the point where they lack the rigidity necessary to hold negative pressure against the lungs during respiration. It's a flail chest. It's a disaster. It's a fucking mass. All right. Or any broken rib. If you've ever had a broken rib, you remember very clearly how bad the damn thing hurt. You also remember that three weeks later it was OK. Three weeks later, it was OK.

Mark Rippetoe:
And why is this? Think very carefully. Why does a broken rib heal so quickly? Because it cannot be immobilized. It's moving. The fracture line in the rib is moving the entire time. And the motion is the cell signaling mechanism that causes the osteoblasts around the fracture line to start laying down bone mineral. The movement is the signal for the healing.

Mark Rippetoe:
This is true everywhere. This is why total immobilization does not work. Because in a normal situation, stress that can be recovered from produces an adaptation. And in the case of a weight bearing structure like a bone, stress is load.

Mark Rippetoe:
And this is... This doesn't just apply to ribs. It applies to everything. And I don't understand why doctors are so reluctant to come to grips with this. If they've done a good repair, immobilization for six weeks is... it's not only impossible, frankly, nobody does that.

Mark Rippetoe:
You know, you're going to take a shower, right? You're gonna move your arm around in the shower. You're going to scratch your nose, you know. You're gonna you're gonna move it around, and it may be that they know that. But they don't act like they know it.

Mark Rippetoe:
Movement is necessary. And "you'll never walk again." "And six weeks from the surgery, I'm going to release you to movement to some limited rehab." That kind of thing is just, you know. It's it's it's jerked out of his ass.

Mark Rippetoe:
But it's, you know, it's at some point it no longer becomes just suddenly jerked out of his ass. It did get written down someplace and it's office procedure and it's in that little bad photocopy they give you when you leave the office.

Mark Rippetoe:
Absolute immobility for six weeks. And then we're going to release you to move. Like they own you. That's kind of offensive, you know. It's just kind of offensive to me. May be fine with you.

Mark Rippetoe:
Oh, how about the. "Can't get stronger after the age of 50." You guys heard that? You can't get any stronger. If you're 50 years old, you're as strong as you're ever gonna be because you can't get stronger. No, no, you can't get stronger. No.

Mark Rippetoe:
Because the stress, recovery,adaptation cycle shuts down on your 50th birthday. Yeah. Biology stops functioning. Physiology's no longer in operation after the age of 50, right?

Mark Rippetoe:
So in other words, if you're sixty five years old and you come to the gym and and you say to me, "You know, I noticed that I'm not as strong as he used to be, and I think I'd like to get stronger." I have to say to you, "I'm sorry. You're 65. You can't get any stronger."

Mark Rippetoe:
In other words, I can't find out how strong you are right now on, say, the bench, press, leg press, deadlift. I can't, I can't determine how strong you are right now and then go up five pounds next time. I can't do that because you're sixty-five and it won't work.

[off-camera]:
It'll hurt them, actually.

Mark Rippetoe:
It bends them over. Why you'll break something, you know, and you don't want to let some guy in a gym, you know break you. You know, it's your fault because you ought to have enough sense to know that you're over the age of 50 and you can't get any stronger. The processes that make everybody else stronger a little bit at a time, the processes that accumulate into a strength adaptation don't apply to you because you're 51.

[off-camera]:
49's good though.

Mark Rippetoe:
49...hey! You're fine. Get after it. You know, because you only got a year. You only got a year to get anything done, right? [Laughter] Oh, shit.

Mark Rippetoe:
How about "everybody ought to take statins." There are actually doctors who think statins should be in the water supply along with fluoride. You know, it's it's amazing how good a job the pharmaceutical companies have done on these guys who have vome to the conclusion that everyone benefits from statins.

Mark Rippetoe:
We talked about this lot, stef and I have talked about this a lot. She's real familiar with literature being in the business she has been in for a long time and is familiar with the literature.

There is one group of people, one demographic, one, for whom statins have been proven to be beneficial, and that is men over the age of 50 who have already had a heart attack. That's it. There is no female demographic for which statins have proven to be beneficial and there's no other male demographic for which statins have proven to be beneficial. Yet Pfizer has made, what, several hundred trillion dollars off of the statin market. It's the most widely prescribed drug on the planet. Lipitor, the most widely prescribed drug on the planet. And it is fascinating that to me that there is no evidence that it should be.

Mark Rippetoe:
Yet doctors want you on statins. Ask them why. Well, because it lowers your serum cholesterol. Well, what is an elevated serum cholesterol do? Well, it gives you heart disease. Well. No, it doesn't. Certainly not in every case.

Mark Rippetoe:
I have a friend who's 19 year old daughter showed up at the doctor's office one day with a total cholesterol of 205. And you know, they sent her home with a with a Lipitor prescription.

Mark Rippetoe:
This is such clear medical malpractice that I.. you know. But he didn't seem to think anything was wrong with that. And, you know, man's fairly intelligent, but it was outside his specialty.

Mark Rippetoe:
Have you ever noticed that people with PhDs tend to respect the opinions of other people with PhDs without a lot of critical inspection? Well, this was his situation.

Mark Rippetoe:
So statins are universally recommended by doctors for everybody. And that's just pointless. It's it's not only pointless, it's harmful because statins have lots and lots of side effects. And those of you who are taking them are more familiar with those than I am. And it's that's not a good idea.

Mark Rippetoe:
You're treating a lab value, not a disease. That in itself should raise flags, shouldn't it? You walk in perfectly healthy with no symptoms of any kind of disease. And you show up with a total cholesterol of 230 and they send you home with a statin prescription?

Mark Rippetoe:
Don't let this be done to you just because a doctor told you to do it. There are... you have the internet. Just like you... have same internet I do. Look it up.

[off-camera]:
They attempted to do that with me.

Mark Rippetoe:
They tried to give you a statin?

[off-camera]:
They tried to give me one.

Mark Rippetoe:
What was your cholesterol?

[off-camera]:
I couldn't even tell you honestly because I didn't give a shit.

Mark Rippetoe:
It was some three digit number. And they just weren't interested... in Just take them. Take them the rest of your life.

[off-camera]:
He told me going to make you tired. It's going to make your joints hurt, your muscles sore.

Mark Rippetoe:
It's going to make you tired. It's going to make your joints hurt, your muscles sore, but you need to take him for the rest of your life anyway. Wow.

[off-camera]:
At 31

Mark Rippetoe:
At 31. At the age of 31. Oh, my God. Yeah. You know, you're not the only one that that did that.

Mark Rippetoe:
There's a doctor here in town that'll leave... That'll that'll give you a blood pressure medication if you in his office show up with 140 over 90. With a blood pressure medication. If you show up one time in his office with his incompetent nurse taking your blood pressure and it's 140 over 90. Well, you're obviously hypertensive. Here, fill this prescription. Take it the rest of your life.

Mark Rippetoe:
This is. I'd tell you the guy's name, but I'm not gonna tell them the guy's name because they don't live here, so they don't have to deal with it.

Mark Rippetoe:
But yeah, happens all the time. It's not just here. Happens all the time on the basis of one visit, one lab value, one data point. They're gonna give you a prescription that has side effects - because all prescription drugs have side effects. All prescription drugs have effects. All right. Some of those effects are what we want the drug to do. But there are other things that the drug does that we don't want them to do, that we put up with because of the effects we want from the drug. And on the basis of one data point, the guy writes a prescription. Because I think part of that is, is you're expected to leave with a prescription from the doctor's office because after all, he is a medical doctor, M.D. "Medicine" is important to this model.

[off-camera]:
What's funny about my situation is a week later, a week later, I cleaned up my diet a little bit, went back to a different doctor got bloodwork done. Said I was perfectly fine.

Mark Rippetoe:
Yeah. Two data points. Oh, my God. Yeah, it's amazing.

Mark Rippetoe:
I went to the... I had some bloodwork done one time, I just wanted to see what would happen. And I've always had lower than 200 total cholesterol. I went in to the... I had a pound of liver for breakfast. I ate a pound of liver. I can do that. I like liver if it's good liver. Had a pound of liver at about eleven o'clock in the morning at about 2 o'clock, I had my blood drawn and it came back 205. Total cholesterol 205 and they wanted me to take statins.

Mark Rippetoe:
And it's just so funny. It's just amazing to me. And a lesser man would have listened.

Mark Rippetoe:
Two eggs a week, no more than two eggs a week because you'll get cholesterol. Eggs have cholesterol and you don't want to get cholesterol because if you get cholesterol, you'll have a heart attack and die. Why that cholesterol clogs your arteries.

Mark Rippetoe:
Artery clogging saturated fats. Remember how saturated fats were were a structural poison, you know, for how many years were saturated fats a structural poison and all doctors recommended against the ingestion of any saturated fat whatsoever. And then fin... someone actually read the fucking Framingham study and decided that, well, you know, there isn't any evidence for that. And now butter's fine and coconut oil is fine. And you know.

Mark Rippetoe:
I mean, how do we... How do we fry eggs? Well, in butter or bacon fat. Bacon grease, fried eggs. That's what you eat.

[off-camera]:
You're making me hungry.

Mark Rippetoe:
Yeah, I know. I mean, for breakfast, you know, eight fried eggs. And the way you fry them... You know what you do? You put the butter in there. I really I think I like butter better. You put the butter in the skillet and then you you you cook four of these eggs at a time. And what you do is if you get the pan kind of hot. And you get the the white kind of crispy and brown around the outside of the thing. Right. And the white on top of the yolk will still be runny. So you flip it once and just set the yolk on top of that. Set the white on top of the yolk. Put it in the plate. And that way you've got all the all the white cooked and the yellow still runny. And you make eight eggs like that and you and you eat them with salt and pepper. Oh, that's so good.

Mark Rippetoe:
But only two eggs a week. All right.

Mark Rippetoe:
Oh, God, that's my little list here.

Mark Rippetoe:
And we've we've asked you to contribute to shit doctors say and we've got some some stuff that we've accumulated from SpeakUp, from our little SpeakUp feed. And I thought I'd read... I thought I'd read some of these today just so that everyone will know I'm not making all this shit up, ok.

Mark Rippetoe:
"After my MI - myocardial infarction - my cardiologist told me not to lift anything heavier than twenty-five pounds. Don't lift anything heavier than twenty-five pounds."

Mark Rippetoe:
Because that's what causes heart attacks, is lifting 26 pounds.

Mark Rippetoe:
"When I told him I was flying home and had put on my carry-on in the overhead compartment, he said I could lift up to fifty-five pounds, but just once. I told him I had to put my wife's bags in the overhead compartment too. So he said, OK, but only two." [Laughter]

[off-camera]:
The logical is just...

Mark Rippetoe:
Shit, doctors say, right?

[off-camera]:
You can't make that up.

Mark Rippetoe:
No! No, you can't make this up.

Mark Rippetoe:
"Had doctors tell two of my football players that they were cleared" Cleared, released, "For full participation in football, but not strength training." [Laughter]

Mark Rippetoe:
It's OK to slam into each other on the field, but don't do slow, controlled, progressive barbell training in the weight room because that'll kill you. That will kill you. You're not cleared for that. You're not released for that.

Mark Rippetoe:
"One athlete head off-season knee surgery and the other has had some back problems." So they can play football. They can tackle and run and throw and jump and smash and slaughter and have it. But don't do squats.

[off-camera]:
But don't get that knee stronger.

Mark Rippetoe:
Bad, bad for your knees.

[off-camera]:
Don't get that knee stronger. Don't get that back stronger.

Mark Rippetoe:
Don't get that back... Don't load that back. Backs will explode. Backs explode every day.

[off-camera]:
But a 300-pound lineman can just slam into you..

Mark Rippetoe:
Three hundred pound lineman running into you, that's just fine.

Mark Rippetoe:
Oh, my God. They say the same thing about soccer too. Oh, yeah. You play soccer. You run into another kid on the field at a combined velocity of 20 miles an hour and that's just fine, right? But deadlifts. No, no, no, you don't understand.

[off-camera]:
Oh, soccer players are a bunch of pussies anyway.

Mark Rippetoe:
Generally speaking, that's true.

Mark Rippetoe:
All right. "Doctor said I should take statins and stop using the internet for information." [Laughter and snorting]

Mark Rippetoe:
Oh, that's good, because what might the internet tell you about statins? Something different than he told you about statins? And we can't have that because after all...he is a doctor.

Mark Rippetoe:
We ought to have a shirt that says: "Well" No. No. It should say "And after all, he is a doctor." Find some clever way to work that into a shirt.

[off-camera]:
We'll work on it.

Mark Rippetoe:
All right. Guy says, "I had an orthopedic surgeon tell me the best thing for my knees would be to strengthen them. When I asked about squats with weights, he said, just make sure you never go below parallel that's really bad for your knees.".

Mark Rippetoe:
Because after all, your knees weren't designed to bend in a position that goes below parallel. You know, it doesn't matter what the knee angle is. It's just hips below parallel, that's the criteria that we're interested in in terms of... I don't understand it. What?

[off-camera]:
How does he get off the pot?

Mark Rippetoe:
How does he get off the pot? He builds it up til it's above parallel. They make seats like that for old people, you know.

Mark Rippetoe:
Everyone should have one. Everyone should be on statins and everyone should get a toilet seat that builds the seat up so that you're above parallel when you get up because it's bad for your knees to go below parallel.

Mark Rippetoe:
All right. "Injured my rotator cuff helping a friend move. Pain when leave. This is when I was in college. Parents wanted me to go to the doctor to get it checked out. The doctor told me to stay far away from any weights. I needed resistance training. He what he means is you needed you need resistant training. I asked what that meant. He said resistance training is working your muscle against a resistance like a band. I asked, is weight lifting resistance training too? Doc said no. That's how you reinjure it. Trust me, I'm a doctor.

Mark Rippetoe:
And these are just anecdotal reports. They're just anecdotal. They're not peer-reviewed. Probably bullshit, right?

Mark Rippetoe:
"Three months after ACL reconstruction, my orthopedic surgeon was concerned that my quad muscle wasn't coming back. He accused me of not doing physical therapy. I said, 'Doc, PT sends you reports every two weeks. They had me in the gym lifting weights every other day.' Surgeon said, 'Lifting weights will not bring your muscle back. You need to do cardio. Tell me, are you jogging?'"

[off-camera]:
I like the idea that his...

Mark Rippetoe:
Oh god, just goddamn it this can't be...

Mark Rippetoe:
All right. "In the exam room there's a picture of the surgeon crossing the line... finish line of a marathon.".

[off-camera]:
Of course there is. I love the idea that his quad just disappeared.

Mark Rippetoe:
It just disappeared, but lifting weights won't make it come back. Yeah, right.

[off-camera]:
You've got to find it on a treadmill.

Mark Rippetoe:
What did you... Did these people know anything about what their job is? No. We'll talk about that in a minute. No, let's see here.

[off-camera]:
His quad disappeared.

Mark Rippetoe:
"Had some minor meniscus surgery a few years ago at age 51 and after pre-op appointment, doctors assistant" Who are even smarter than doctors "Told me, 'After surgery, you can start lifting again as soon as you want, but just do upper body stuff like lat pulldowns and leg presses.".

Mark Rippetoe:
Upper body stuff. I think the PAs are even smarter than the doctors.

Mark Rippetoe:
"10 days post-op, I squatted 315 for five. Next week I went in to follow up with the doctor. He said, 'Everything looks good. You're all ready to get back to it.'".

Mark Rippetoe:
Here's good advice from a doctor, "You have the back of an 80 year old, it's all downhill from here. Don't lift over 50 pounds and get an office job with the standup desk."

Mark Rippetoe:
These people are in. Control of your life. They know what's best for you.

Mark Rippetoe:
"Actually had a doctor tell me while in college wrestling after a knee scope in the late 80s when he was in his twenties, that the inside my knee looked like the muscle tone of an 18 year old with the bones of a 50 year old. I thought for sure he'd tell me to consider quitting wrestling, but I was really dreading hearing that the weights will destroy your joints speech."

Mark Rippetoe:
"Instead the doctor told me, 'I know you're almost done with your college career, so I'm hoping you don't pursue anything in wrestling or football-related for a hobby.'"

Mark Rippetoe:
"I mentioned that I love lifting weights and he hoped and I hope he doesn't expect me to stop that and he said, 'Oh no, you'd need to keep lifting for as long as you live. Your muscles and strength level right now are pretty much holding your joints together. If you stop lifting, you're going to turn into a bitchy, old arthritic man.'"

Mark Rippetoe:
"I'll never forget that doctor appointment. I've never stopped lifting. He's one in a million." No, not really, John.

Mark Rippetoe:
Oh, here's one. "Keep your skin dry, but moisturize it. But not too much."

Mark Rippetoe:
Oh, God damn. "You really shouldn't be squatting any more than one hundred and thirty five unless you're a powerlifter. This is my chiropractor when I told him I can't get weight to get my squats back up into 300 after my car accident. 'You don't need to be lifting more than 135."

Mark Rippetoe:
"One of my clients mentioned to his doctor that his back was sore and his doctor told him not to do deadlifts or squats anymore and not to use his back until you get your back stronger."

Mark Rippetoe:
Oh, it's amazing.

Mark Rippetoe:
Here's a woman that says lifting heavy was probably the worst thing you could do after having a baby. Doctor told her the worst thing you can do after having a baby. Do you know how hard having the baby is on your body? And that once you've had a baby, you can't lift anything heavy anymore because of the damage done by the pregnancy?

Mark Rippetoe:
I wonder what kind of condition women who have had four or five kids are in. Do they ever heal up? I guess they can't. Because once you're hurt, you know, you're... By having babies. Then you're hurt from now on.

Mark Rippetoe:
Guy says, "My mom's doctor told her regarding her new exercise routine that if she sees any sort of change like increased muscle tone, then she's lifting too much."

Mark Rippetoe:
[Points to paper] Says that right here, I have no reason to doubt this guy. You know, I mean, that as crazy as that sounds that's not as... That's not beyond the possibility of a doctor having told her that.

Mark Rippetoe:
"Doctor told my diabetic mother not to worry about giving up Mountain Dew because we just need to use more insulin."

Mark Rippetoe:
Yeah. Now, I've heard that on several occasions, I've heard doctors say, look, diabetes is not a problem, I mean we've got insulin.

[off-camera]:
That is insane.

Mark Rippetoe:
Well, they just - choose one from column A, choose one from B.

[off-camera]:
I want to know what kind resorts that these pharmaceutical companies are sending these doctors to to sell these fucking drugs.

Mark Rippetoe:
I don't know. Good question. Or I don't know. You know, I don't know. Well, that is an excellent question.

Mark Rippetoe:
Here's a woman that says the doctor told her "You need to take statins to lower your cholesterol for probably the rest of your life."

Mark Rippetoe:
She was 15 when the doctor told her this, and once again, there are no female demographics that have shown any benefit whatsoever from the administration of statins and certainly not an adolescent girl.

Mark Rippetoe:
This is just absolutely amazing. It's absolutely amazing.

Mark Rippetoe:
"In my early 20s, I had a lot of back pain. Had a doctor diagnosed the issue. She told me, 'It seems kind of disc-ee' and that I would have lifelong back issues and would have to do her prescribed stretches three times a day for the rest of my life. She also told me I couldn't be seated more than 30 minutes without getting up to stretch, including in car rides. None of that turned out to be true. I'm in my mid 40s, little to no back pain and do every activity I want, including deadlifts."

Mark Rippetoe:
Right?

Mark Rippetoe:
"Wife was told she has osteoporosis and needs to do weight bearing exercise to fight it.".

Mark Rippetoe:
Good advice. Right?

Mark Rippetoe:
"When asked for specifics, he... He replied, 'just walk more.' More than these several miles a week she already walks, right? Okay.

Mark Rippetoe:
"Pediatrician asked my 14 year old son if he lift weights. He says yes. She asks how much you give an answer with substance to her vague question. He says he squats 250. Pediatrician screeches 'Do you want your heart to explode?'"

Mark Rippetoe:
"Subsequently, subsequent visits with a cardiologist verified that a) his heart had not and would not explode and that b) he had an athlete's heart, often confused with potentially fatal congenital or disease-induced wall thickening. Right. His heart was in excellent shape due to lifting and other physical activity."

Mark Rippetoe:
"Long story, but he had to detrain to prove that to her." The pediatrician.

[off-camera]:
Who is a weightlifting expert.

Mark Rippetoe:
Who is a weightlifting expert apparently.

Mark Rippetoe:
It's been my experience that pediatricians are, if not the worst, among the worst in terms of medical specialties operating in the market right now. They are almost universally God-complex, inexperienced, undereducated fools impressed with their own analytic ability far in excess of the evidence. And I just... you know. I've heard so many scary-ass things from them.

Mark Rippetoe:
My favorite story is pediatrician here in town, exceptionally bad. Told one of my kids one time - oh it's been 20 years ago - and this kid is a he's a good kid, good friend of mine still. Dr. Big kid. He was like at the age of 13 he was 5'8", you know, one ninety five. Great big kid.

Mark Rippetoe:
Pediatrician told him - and I still remember this like it was yesterday - I said, what did he... what did she tell you? And he said she said... no this is the male guy. He said he said, "I'd hate to see you jeopardize your career in athletics by lifting a bunch of weights."

Mark Rippetoe:
Yes, you know.

[off-camera]:
Can't make it up.

Mark Rippetoe:
So the question presents itself is... why - I'm asking you people watching this thing, you people listening here. Why if you know for sure that what these people are telling you is bullshit - and you don't have to be hyper-intelligent to understand that it's bullshit.

Mark Rippetoe:
It just if... something that tells you something they tell you goes against your own experience as a living human being. Why would you pay attention to it?

Mark Rippetoe:
You know, if... if you let somebody operate on your shoulder and you keep it completely immobile for six weeks like they tell you to do, you don't move it at all. You do what you're told by the surgeon and you don't move it at all. And then six weeks later, it's time to rehab the damn thing and it won't move... This is your fault.

Mark Rippetoe:
You're not supposed to be that stupid. This happens a lot in shoulder situations. You know, it happens quite a bit. But whose fault is it?

Mark Rippetoe:
Does it make really any fundamental sense to you that you can't move your shoulder for six weeks? Especially considering the fact that you actually moved it, right? I mean, you didn't take it... You didn't fail take shower for six weeks, did you? You had your sling off. You were in the shower. You moved it round. It didn't kill you. Right?

Mark Rippetoe:
But you were afraid to actually experiment with it. And and gradually expand the range of motion, even two weeks post-op? Until you could swing it in bigger circles and then you didn't experiment with picking it up? Picking your hand up to wash your face?

Mark Rippetoe:
You know, you did all that. So you know that what the guy told you was bullshit, but you did it anyway. Whose fault is it? Well, you know, some of the responsibility lies with you, doesn't it?

Mark Rippetoe:
But a large part of the responsibility lies with the fact that we choose to give doctors authority that they don't rightly possess. That's our fault, too. But they're happy to abuse that authority.

Mark Rippetoe:
Why do they do this? Why do they? What is the explanation? Why are doctors in a situation where they have all of this authority that we've see to do them and they abuse it so thoroughly? What is the problem with doctors?

Mark Rippetoe:
Well, I asked Dr. Bradford to give us a statement about this. And in her normal frank way, she has given me the following thing. Now I'm going to... this is, this is harsh. OK. But it's the truth for a huge majority of doctors. Now we have good friends that are doctors that aren't like this, but even those guys will admit that this is true for most doctors.

Mark Rippetoe:
Dr. Bradford says, "Most doctors are midwits - 115, 120 I.Q. - above average, but not especially smart and therefore quite defensive about it. They're selected by the process for conformity. Getting grades, the ability to do assignments in regimented, modern classrooms and they are trained rigorously."

Mark Rippetoe:
And by that she means not educated, but trained.

Mark Rippetoe:
"So you have a person who thinks of themselves as intelligent. Who's gotten feedback from the System that they are smarter and better, that is based on the ability to conform and give the 'correct' answer. Not only that, but they have to give an answer instead of saying, 'I don't know. Or that I need to research that and get back to you.' They're trained to have an answer. The answer. The answer that you therefore need to follow.

Mark Rippetoe:
"The monopoly on medicine was given to the profession by the government sometime ago. They sold out for defined authority in the health care system. This made them even more a part of the System.

Mark Rippetoe:
"The most dangerous part of that is that this combined the power of controlling other people - both patients and other subdomain professionals in the health care system - with personalities trained to assume that they should be in control.".

Mark Rippetoe:
"How often does a doctor admit to being wrong? Not knowing something? How often do they demand rather than suggest? How many times has a doctor told you what you should do? As if they are in control of you rather than simply the consultant that they ought to be? How did they react when you point out a problem? For example, the nurse that took your blood pressure incorrectly or other information such as a research article or that your cost-benefit analysis weighs things differently?

Mark Rippetoe:
"For example, you want the joint replaced, but they think it's fine for you to be crippled and in pain for several more years instead. Or you'll... or you'd rather not start taking that drug based on one lab measurement."

Mark Rippetoe:
You know, that's a that really is a serious thing here. And I think, you know, those of you that that are intelligent enough to go to the doctor and actually question the procedures that occurred, you in office have had this experience.

Mark Rippetoe:
You point out to the doctor that comes in finally to see you about forty-five minutes after your appointment was supposed to start, that his nurse took your blood pressure with a cuff that's too small and that your 145 over 98 might not be the correct blood pressure.

Mark Rippetoe:
Well he's all offended. And he's not offended, he's not offended because you're insulting the competence of his nurse because he knows she's an idiot too. He's offended that you dare have an opinion about some aspect of what he is in charge of today. That's what it is. Right?

Mark Rippetoe:
"My experience," this is this is Dr. Bradford continuing. "My experience is that any questioning or disagreement is met with resentment and anger. Even simply asking for more information is typically viewed as challenging their authority. Any perception of disrespect and you get backlash. They're more touchy about this than the police and that's saying quite a bit. It's really a good thing that MD can't pull you over."

Mark Rippetoe:
Oh, yeah. There is a PSA on the radio I hear all the time about how you're going to the doctor and how the how the medical the American Medical Association wants to assure you that you're supposed to ask questions in the doctor's office. And the doctor is talking to a girl and she says, "Do you have any questions?" And the girl goes,"No.".

Mark Rippetoe:
I've asked questions, I always ask questions on those rare occasions when in a situation where I go to the doctor. They don't want you to ask questions. Try it, try it and see what happens.

Mark Rippetoe:
Once again, this is not all of them. I've had good experiences with a lot of doctors, but I've had far more bad experiences with far more doctors. And they don't really... They're not interested in your questions because your questions get interpreted as undermining their authority.

Mark Rippetoe:
Here's a story from stef again. "At fifteen I dislocated a knee with a high forced landing on concrete. This was interpreted at the orthopedic office as the outside muscles being too strong. They proposed weakening the two strong muscles - note that muscle strength was not evaluated in any way - and other structures with a lateral release. After declining..."

Mark Rippetoe:
And I've heard of this before. This is not... she didn't make this up. It's not the first time it's happened.

Mark Rippetoe:
"After declining this option, I was told that I should never run or jump again."

Mark Rippetoe:
So the reason I wanted to do this today is because this is a problem that we deal with all the time in in our business, in the business strength and conditioning. All of our coaches have got to deal with the aftermath of doctor visits with their patients and and with strength training clients and the assumption coming in with the client is that the doctor is the authority. Because they've been taught that the doctor's the authority, they don't know anything about the strength coach's background. And granted, there are lots of problems and strength and conditioning as well. I'm talking about competent coaches, the kind that we deal with and we educate and we produce that.

Mark Rippetoe:
If if you come in to the visit and you really think that the doctor is in control of your body and that you haven't been released to do anything? What I always recommend to our coaches is to get them out of the gym. Get them out of the gym. Anything that goes wrong that would have gone wrong anyway you're gonna get the blame for. Don't argue with them, get them out of there.

Mark Rippetoe:
If a client comes into the visit, into the first appointment with you with any kind of limitations that they feel have been imposed upon them by the doctor that just did the surgery or the consultation. Don't argue with them. No, there is no point in it. There's absolutely no point in it. They can come back when they when they when they're "released," when they regain their agency. And and we'll we'll deal with them then.

Mark Rippetoe:
But there's not really any point in trying to fight this this perception of authority that the medical profession has taken great pains to cultivate in the general population. It doesn't make any sense to try to to try to fix that because you can't do it. And we we tell our people, just leave. There are other people to train. Okay. There are other people to train.

Mark Rippetoe:
So I hope this has been some some enlightening information for you. I want you to back this up and listen to stef's analysis here again, as to why this this problem exists. It's systemic. It's not going away ever. It's not going to go away. You cannot expect this cohort to let go of power and authority.

Mark Rippetoe:
Power and authority grows. It does not diminish by itself. So give this some thought next time you're at the doctor and the doctor tells you something stupid. Shit doctors say is just that.

Mark Rippetoe:
And it's your responsibility as the patient and the payer of the bill and the evaluator of your own situation to to take on the task of evaluating what the person told you. Just like you would from a plumber or an electrician or a car salesman. Not everything people say is true. And you have to be responsible enough for yourself to do the work. T

Mark Rippetoe:
hanks for joining us today on Starting Strength Radio. We'll see you next time.

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Mark Rippetoe presents silly advice from doctors passed on by Starting Strength Radio fans.

  • 00:00 Introduction
  • 01:54 Comments from the Haters!
  • 02:56 Shit doctors say
  • 04:55 Commonly heard nonsense
  • 05:22 – Don't lift more than 10 pounds
  • 09:14 – Why don't you just lift lighter weight and do more repetitions?
  • 11:02 – Lifting weights slows you down
  • 11:50 – Don't lift overhead
  • 14:10 – You'll never ______ again
  • 20:31 – My doctor just "released me"
  • 29:43 – Can't get stronger after 50
  • 32:02 – Everybody ought to take statins
  • 40:10 – Two eggs a week
  • 42:36 Nonsense reported by listeners
  • 1:00:10 Why do you pay any attention to it?
  • 1:02:52 Why do they do it?
  • 1:08:22 Asking questions?
  • 1:10:33 Dealing with "SDS"

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