The most common things look different depending on where you happen to be standing. If you view something especially complex from an unfamiliar location, it may be unrecognizable. I ask you to consider trying to understand better, by looking at things from different perspectives – the often asked question, “How are you doing?”, in relationships, training, your career, or a motorcycle trip down the Blue Ridge Parkway. How are you getting along? What’s your progress?
Progress is certainly not a simple thing to assess – it depends, of course, on your perspective.
The regrettable process of going from young to old provides us the opportunity to view activities, places, things, and people from many different angles. Young people view things differently than old people. What is young or old? It depends on where you’re standing.
A friend and I were talking on the phone recently (talking and not texting accurately indicates that we are old). We were discussing a mutual friend’s progress, and I mentioned how quickly it had occurred. He reminded me that “a few years” to our younger friend was a significant portion of a younger person’s life. To him and me, it was simply no time at all.
I have instructed, mentored, learned from, trained, facilitated, and coached a variety of ages in a variety of subjects for a few decades now. I have learned from some truly remarkable people. And every time I think I have experienced the worst instructor presenting the worst material in the worst possible way, I am surprised by someone even worse.
Young people, new to an activity, typically lack accurate personal expectations of progress in that activity. They lack personal knowledge of their own or others’ capabilities. Sometimes they’re overly optimistic, but sometimes they expect less than they are actually capable of. They simply don’t have the life experience to know what is possible. Their expectations of progress in a given activity are influenced by others – coaches, teachers, friends, family, the media, and those more senior in the activity. Progress estimates of the young are often dependent upon the quality of those supposed to be helping them.
I have seen this demonstrated in shooting, lifting, public speaking, and numerous other professional and recreational activities. These outside influences impact the expectations of the young and can continue to impact them after they have grown older. One of the first things we should look for when coaching anyone – or perhaps simply one of the first things we should always look for – is damage and scars left behind from bad learning experiences, whether the learning experience was formal or not. Regardless of the person’s age, an appropriate training program defines the requirements, assesses the difference in the existing state and the desired end state, evaluates and develops training options, delivers the chosen training, and then evaluates the results.
The coaching discussed here is focused on improving the athlete. The methods used to help someone learn are based on helping the person progress. If you don’t know the difference between helping someone get better and a selection process designed to deny access, I invite you to do a bit of research and think about it.
Even after engaging in an effective program with good coaching, you will still have quite a few negative influences sabotaging your efforts. Some of the most memorable events in life are the times we were told stupid shit by people we were expected to believe. Think of all the idiot adults who told you something stupid when you were young. Consider every guy that “knew a guy who did Martial Arts,” every moron coach with bad breath, every bored teacher, every family member who had some spectacularly poor advice, and you can understand the problem. For someone with a miserable teacher in school, I view not being called out and embarrassed in class to the point of tears as very good luck.
“Normalization of Defects” is often described as failing to create efficient systems because of an organization’s satisfaction with “workarounds,” and it absolutely applies every single time we step up to help someone learn. We have to constantly consider the needs of our audience, the materials we are using, and how we present. The measurer is always going to be the individual we are helping. Good enough is not good enough, and especially with youth we have to constantly ask if there is a better way.If an athlete can find the right coach, if he can suffer through the morons trying to keep him down, and if he can make it to the gym to train, he will begin to have an idea of what he’s are capable of. He will begin to understand progress.
Not too long ago, I was on the range with some shooters. It was a pretty diverse group of various skill levels. Some cops, some security types, a few Ninjas with all the cool stuff, and a couple of new shooters. One of the new shooters was very young compared to the rest, a female in jeans and a t-shirt with a borrowed inexpensive holster, magazine pouches and a stock Glock.
We reached a point in the class where we were drawing from the holster, on a buzzer, for a timed single shot into a silhouette target. She was exceptionally fast; fastest on the line. This caused some discussion among a few of the other shooters. One of the most impressively-dressed shooters with exceptionally expensive “kit,” who had spent a lot of time sharing his resume (some of which may even have been true) simply couldn’t understand why this new shooter with the cheap holster was consistently faster on this drill. “She has to be anticipating the buzzer, you see. That’s the only answer.”
“No, she is not anticipating the signal. The reason she is beating you is not very complicated,” I said. “She is faster than you, and that is how she is beating you every single time. She is faster than you…a lot faster.”
I am not going to claim that I could teach her better, because she didn’t have any bad habits to unlearn, or some other pathetic, inaccurate assumption. Sure, we had coached her, helped her learn firearms safety, handgun basics, created a positive environment where she could learn, and provided a well-defined performance measure. We created a learning environment that defined, encouraged, and measured progress. However, my answer is still the same: she was faster because she was faster.
Some wanted to minimize her progress and take away from her performance. Their lame comments about the “real world” and the “street” were like water wings under their precision combat apparel-clad arms, keeping them afloat in their personal pool of confident tactical superiority.
Fortunately, most of the shooters and coaches were different. They reinforced this new shooter and went out of their way to discuss what a superb performance it was. For this young shooter, this new measure was her performance standard. Any progress would be measured against this moment. She expected to do well, and she did.
It is not uncommon to see some people attempt to minimize a young person’s progress, in both athletics and the workplace. It has been my experience that the person minimizing the accomplishment is threatened by it. Don’t allow this behavior around those you are helping learn.
We should encourage progress. We will have fair and honest corrections to make along the way; nonetheless, we focus on the good. For every corrective action we reinforce three or four things done well.
I am currently enjoying watching the career progress of someone young I have had the opportunity to help over the years. She is progressing quickly in a tough work environment and doing very well. Of course there are the anticipated jealous shots and jabs from less accomplished people. I take great delight in pointing out my friend’s success at every opportunity.
Once young athletes begin to understand what they are capable of, be very careful to keep their progress incremental. Move forward one step at a time. It won’t be long before they want to take bigger jumps in weight, or try to shoot faster than their current skill allows. This desire for faster progress has to be managed in a respectful manner.
Keep in mind how many changes someone young is going through. For the young, time goes by slowly even though their growth potential means that change is coming rapidly. By the time they have gotten used to what normal is, normal has changed. People get uneasy in times of change, and youth can sometimes be a constant state of unease.
As coaches, we must learn to over-communicate, to repeat ourselves over and over. Then listen intently to the questions, really listen, no matter how many times you think you answered them. Don’t assume your athlete knows why you are doing what you are doing. Consider that if somebody “just ain’t getting it,” you may be the problem. Always look for a better way. Because younger people have less experience to draw upon, their new experiences are more impactful, and more memorable. Words of encouragement and words of pain will be remembered, perhaps forever.
In Starting Strength, we want to make a little bit of progress for as long as we can. We want to avoid failing. Sure, it’s going to happen, and there are things to be learned from it. But we want our young trainees to learn to view failure from the vantage point of progress, as a part of the process of improving.
“They have to learn to get back up!” Yeah, thanks for sharing that, never heard that before, so very insightful. How about we spend some time helping them learn to stay on their feet, then learn how to fall without busting themselves up, then work on the whole getting-back-up thing? Of course, we are going to explain this training plan in detail to the person we are helping. We want them to know and understand the why of what we are doing. They will learn how to get back up if we put it in the appropriate performance progression.
Pretty quickly, you may notice a degree of fearlessness in youth. This is certainly admirable, however something just being hard is not the goal – progress is the goal. Discuss the reasons for the programming in terms of goals and progress. Explain your decisions about why you are both doing things the way you are doing them. If you tell young people they are going to hurt themselves, you are generally ignored, because as you may remember, you thought you were indestructible at that age too.
If a young athlete takes a layoff for whatever reason, he will often expect the same performance out of himself when he returns. These expectations can lead to frustration, slow progress, and even injury. “I know I can do this, I’ve done it before, so why can’t I do it now?” This can be tougher to manage than you think. Like all of what we do, it requires a lot of communication. Ask questions of your athlete, provide honest answers, and provide honest and safe feedback.
Ask them what they want, how they view progress. Then, with them, define a plan to get them back to where they were and beyond. Remind them gently, they have been there before, they know the way. Keep training sessions well organized and moving forward. Limit the time they are waiting for you. No matter a persons age, they are the customers, you are the vendor – respect that. Keep individual sessions short, and work hard to keep them engaged. There are lots of distractions for both young and old. Often I hear that young people are less patient and lack discipline. I think older people have simply gotten better at tolerating idiot instructors and don’t show it as readily as younger customers.
Remember: no matter the age of those you are training, look for evidence of the idiots who have been there before.
Youth provides a different perspective on most things, including progress. To understand how to help, we should understand their perspective the best we can, and see things from their point of view. In the beginning, they often don’t have any idea about what progress to expect, after they’ve been training a few months they may become impatient with the slow steady progress, and if there is a layoff, they will expect the same numbers the first day back. Age and experience will moderate this perspective.
It has been my privilege to help young people, old people, the learning disabled, professionals, novices, people with special needs, people who have fond memories of training, and people who shut down completely at a thoughtless word or gesture because of past horrible learning experiences. I try hard to help others learn, but I still make mistakes, and I have a long way to go.
Discuss in Forums
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Mark Rippetoe and Robert Santana, RD, SSC, discuss aesthetics, training, and nutrition.
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October 21, 2019
Starting Strength Radio
Starting Strength Channel
- Need to gain or lose weight? Starting Strength Coach Robert Santana and Weights and Plates intern April Incolingo explain how to get started.
- Starting Strength Coach and Doctor of Physical Therapy Will Morris presents his concept of Training Barrier Construction during the Starting Strength Nutrition and Rehab Camp held at Wichita Falls Athletic Club in October 2019.
- From the Archives: Reversing Osteoporosis – Patricia talks about her experience training with Starting Strength Coach Shaun Pang at Hygieia Strength and Conditioning after being diagnosed with osteoporosis.
- A Matter of Perspective – John Musser discusses Progress and how perpsective is central both to assessing status and to helping people improve.
- From the Archives: Mark Rippetoe discusses the training mistake he regrets most in Cardell and Dr. Coleman.
From the Coaches
In the Trenches
Dylan Cherin and Jules Gonzalez show off their best Californian impressions during the Nutrition and Rehab workshop held at WFAC. [photo courtesy of Nick Delgadillo]
Rip works with Julia Avila on her squats while she was in town for a Starting Strength Radio shoot last week. [photo courtesy of Rusty Holcomb]
Best of the Week
SS and Jiu Jitsu
Over the last year, I tore my left meniscus and suffered a partial tear to my right MCL (meniscus in Aug 2018 and MCL in March 2019). I finally had my meniscus trimmed Aug 2019 and a few weeks later I was ready to start training again. I’m 6 weeks into your program and my strength gains are coming baking nicely. 2 weeks ago I started training Jiu Jitsu again. My typical classes are Mon, Wed and Friday nights… the same days I lift (I lift early in the am before work). Due to some competitions coming up, many of our grapplers are in comp prep mode and we are rolling pretty hard, which means I’m pretty sore a day or two after class. Do you suggest I continue this current schedule or bump my lifting days a day back to Tues, Thurs, and Sat? I know that I’m going to be sore no matter what, but it doesn’t seem to be affecting my strength when I’m lifting. Thanks for any insight you can provide.
Since I have no way of knowing how hard you’re actually training, I suggest you try it both ways for two weeks each and see which works best for you. Make sure you’re eating enough.
The biggest concern here is not the soreness – further injuring a joint is. Training post-injury with people preparing for competition is not something I’d recommend. If they hurt you (even if it’s just a random fuck up), neither you nor they are going to be better for it.
I have not had a meniscus tear or repair, so I can’t specifically tell you what results you’re going to get. However, training with active competitors is grueling and injuries happen far more often as a result. When I’m injured and want to roll with someone, I make sure they understand I’m not looking to roll like it’s Worlds. If they are training for competition, they may decide they don’t want to roll with me. That’s fine.
How long have you been training jiujitsu?
If you can be disciplined enough to not go ape-shit on the mats on every single roll, it doesn’t matter too much when you lift. Just do the version that will keep you compliant with your workouts in the gym and try to keep your ego in check on the mat. If everyone else is in competition mode and you’re not, you’re just going to get tapped a bunch more.
Thanks for the input… I’m not really concerned about the soreness… that’s temporary because I just got back into rolling hard after after close to a year of light rolling while injured and then recovering from the surgery. My knee feels fine now. My concern is recovery from workouts… I’ll continue with the M, W, F workouts for a few more weeks and then switch to T, T, S and see how I feel and how I’m progressing in the program.
I’ve been training for 13 years. Got promoted to brown belt last year. I tore my meniscus shortly after and my training came to a screeching halt.
I really think that you’re going to be perfectly fine. The advice to take it easy at Jiu Jitsu is for people with less experience rolling. You already know how to manage your stress level on the mat, so lift whenever works best for your schedule to stay compliant three days/week. You’ll move your programming along to advanced novice, and then intermediate, sooner than someone not doing Jiu Jitsu, so just progress your training variables when you need to – don’t miss lifting workouts, eat more than you’re used to, and keep adding weight to the bar workout to workout at first, then twice a week, then once a week.
Then forget what I said.
You know where you stand, and Nick’s advice is right.
Thanks again… The eating more part is the biggest change for me, but it’s been pretty easy because I’ve been starving ever since I got back to training BJJ. Because of the knee surgery in Aug, I started with relatively light weight for most of the movements but am now getting into some challenging weights. The heavy weights plus hard BJJ sessions has me wanting to eat constantly.
BTW, started week 6 of my program today and set my working set on the press was more than I’ve ever done for a 1RM… I guess this stuff works.
Best of the Forum
Sport specificity and strength
In PPST, the sport specificity section mentions that we use the barbell movements to develop strength, and strength can be ‘practiced’ in the sport that the trainee chooses.
If strength is the ability to produce force against an external resistance, and if we use the barbell lifts to get stronger, then does it follow that the more weight that someone can do in the barbell lifts the stronger they are?
If you have a power-lifter who’s just finished some squat peaking protocol, and you have a bodybuilder who squats only ONCE a month. Their numbers are: Power-lifter: Squat – 205 kg, Bodybuilder: Squat – 200 kg
Is the power-lifter really stronger than the bodybuilder in this case? I mean if both were to ditch the squat rack and go do some leg extensions/leg press/leg curl (some movement that neither of them has practised before) who do you think could do the most weight on those exercises? who would be “stronger”? Could it be that the bodybuilder is just ‘out of practice’ in his squats — and if were to increase his squat frequency he could easily surpass 205 kg (without gaining muscle mass)?
The question is this: How do you separate the practice of a barbell movement from the strength acquired using that movement if the movement is being used as a test for strength?
Perhaps muscle cross sectional area (over the entire body) is a good proxy for the ‘strength’ of an individual — all other things being equal (CNS efficiency). You’ve certainly mentioned yourself that muscle mass and strength are inseparable. Do you think this is a better ‘gauge’ for strength?
I have read this question 3 times, which is my limit, and I don’t understand it. You guys feel free to interpret.
I’d assume he is asking if utilizing an exercise that builds strength as a test of strength results in a practice-effect that would artificially make a more practiced trainee “stronger” at one point in time than someone who may be stronger but never performs that exercise…
The overall question, I suppose, could be restated as such: if Michael Jordan is the greatest basketball player ever, could a hypothesis exist that a better basketball player did exist but didn’t play basketball…
I believe he is saying that you can’t say the powerlifter is stronger because he has trained the skill of squatting while the bodybuilder only practices it once a month – in his example.
Yes as above. How can you test strength without having a certain element of specificity/practice being present?
Why is specificity required to test strength? Is a man who deadlifts 500 stronger than a man who deadlifts 450?
I don’t know, maybe he’s just better at the deadlift because he’s practised it so much.
Why is strength tied to deadlift numbers? A man who can deadlift 500 isn’t necessarily stronger than a man who deadlifts 450. A man who deadlifts 600 may be very likely to be stronger than a man with a 300 deadlift.
Now if we get both of these lifters on different exercises – now who’s ‘stronger’? Is the 500lb deadlifter ALWAYS going to be able to exert the most force against external resistance in these newer, stranger exercises?
Specificity towards a goal is on a continuum (as described by PPST). If that goal is to dead-lift more weight, and we’re using the dead-lift as the test of strength then specificity becomes relevant to our test, does it not?
What is strength? This is the key to this pointless discussion.
I think, based on the hypothetical situation presented, the powerlifter is stronger because at those loads, the practice effect is likely negligible.
A more realistic scenario: two powerlifters are training for a meet. #1 performs a meet taper and practices heavy triples, doubles, and singles leading up to meet. #2 continues to train fives and does not do a meet taper. Given the same training weights for 5s, is #1 able to perform more on a 1Rm because he is more practiced?…
Yeah, probably. 1RMs are a learned skill.
I think you’re being intentionally obtuse Rip. If the bodybuilder would beat the powerlifter on most other strength tests besides 1RM on squat, bench and deadlift, it’s not unreasonable to consider him generally “stronger” than the powerlifter. It’s not as if 1RM in those lifts is some naturally derived metric, it’s just a convenient metric that usually tells us who has higher strength. The test fails in this specific case.
The definition of strength is the ability (or capacity) to produce force against an external resistance. In order for us to test application of force against an external resistance in a way that can be compared across the population, we must decide on a particular movement pattern. Let’s say the squat or the deadlift since those two have been mentioned. Now, a part of being able to produce force against an external resistance is how talented the lifter is at moving the load/producing force in the most ideal way possible. It is impossible to separate the display of force from the practice of that display. The powerlifter is stronger on the squat than the bodybuilder in your example. Part of that is probably because he is more practiced.
Strength – in the testing sense – is limited to the movement. Someone can be stronger on the deadlift than another. Someone can be stronger on the squat or the bench or the press. The claim that one person is “stronger” than another is a generalization made from many different displays of strength in several different motor patterns that attempt to give a holistic view of their capacity.
The point is not that strength is tied to deadlift numbers, but deadlift numbers are tied to strength. Inasmuch as the increase of deadlift skill improves deadlift numbers, it only means that the muscles are being utilized properly, thus increasing force production. But even technical improvements won’t account for a weak muscle.
What you’re talking about is the ability to express that strength in unfamiliar movements (a skill deficiency). So of course a guy who’s practiced strongman exercises will be better than a slightly stronger guy who doesn’t know how to do it.
“Now if we get both of these lifters on different exercises – now who’s ‘stronger’? Is the 500 lb deadlifter ALWAYS going to be able to exert the most force against external resistance in these newer, stranger exercises?”
If they’re new and strange for everyone being tested, then yes. But by the fact of not being deadlifts or squats, these exercises will be inferior tests of strength because they artificially isolate certain body parts from other body parts and don’t test the body as a system.
If you want to define it as the contractile force produced by a muscle group, then the test would involve only that muscle group. Assuming we decide to test strength, this seems pretty silly unless you’re an arm trainer at Golds.
If you want to test and compare things, the tests must be of the same thing, right? I thought this was obvious.
If we are actually going to compare the strength of two different humans, we have to do it with tests upon which both agree to perform. If we are merely going to type about comparing strength on the internet in order to appear to be Speaking Truth To Power, I guess we can type about it any way we want to.
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Artificially Weak Deadlifts, Part 2: The Arms
by Robert Santana, MS, RD, SSC and Mark Rippetoe
| October 23, 2019
In my previous article, I noted that perceived difficulty is the most common reason for an artificially weak deadlift. Another common reason is that lifters often repeat or reset loads due to an inability to maintain lumbar extension off of the floor. Meanwhile, the squat continues progressing while the lifter continues repeating and resetting the deadlift for several weeks in a row. This results in a squat that equals or exceeds the deadlift.
A weak low back is an obvious contributor to artificial deadlift weakness. The lack of kinesthetic awareness of the low back is a common reason for this that is easily addressed through a combination of verbal and tactile cueing. Inexperience with pulling a load from a completely stationary position off the floor often results in lumbar flexion upon initiation of the pull. Since the role of the low back has been beaten to death in various other articles, videos, and websites, I won’t spend much time on it here. Instead, a discussion of the arms and various power leaks that present between the shoulder and the fingers is something you may not have considered. Properly setting the arms, wrists, and hands into position will contribute to maintaining spinal extension during the initial pull off of the floor.
It amazes me how often the hands are overlooked when assessing pulls from the floor. The hands are the direct point of contact between the lifter and the barbell. It is clear and obvious that a secure grip is essential to move the bar from the floor to the lockout position. A correct grip results in the bar being placed on the proximal phalanges somewhere between the middle and proximal interphalangeal creases.
This is just below the interphalangeal joints (i.e. the region at the finger-side of the palm of your hand where your calluses form). I have seen many lifters at all levels of advancement attempt to hold the bar in the center of the palm. This results in the bar sliding down the hands into the fingers upon the initiation of the pull. This is often accompanied by flexion of the phalanges, metacarpals, and wrists, all of which combine to produce a downward change in the position of the bar in the grip if the weight is heavy enough, resulting in a power leak.
Slack in the hands leads to a loss of spinal extension during the initial pull off the floor. This probably occurs due to the back sensing the loss of tightness at the beginning of the kinetic chain. The kinetic chain begins with the hands, followed by the wrists, forearms, elbows, upper arms, shoulders, trapezius, and eventually the thoracic and lumbar erectors, in line before the hips and knees which actually generate the force of the pull. It is well known that the back will not pull what the hands cannot hold on to – this is probably a safety “feedback loop” that prevents injury.So if gravity pulls the bar down out of the grip, the thoracic and lumbar spine tends to follow the loss of power transfer. In essence, a “domino effect” down the kinetic chain starts with the barbell sliding down in the hands and ends with flexion of the spinal erectors.
The wrists are the next anatomical structure up the chain. Wrist extension often accompanies soft fingers. This is often an artifact of the lifter leaning on the bar, essentially resting in compression on the bar prior to the pull. This could stem from listening to coaching instructions during the first deadlift session, or from the lifter attempting to preserve contact with the palm and the barbell as in the squat, bench press, or press. Pulling from this position results in the wrists falling into a neutral position, the grip not starting the pull tight, the bar sliding down the hands, the spine losing extension, and possibly torn calluses. For the coach, a useful tactile cue is to pull up on the trainee’s arm and forearm until the wrists, hands and fingers are fully stretched. Be sure to instruct the lifter to maintain his grip on the bar while you do this, otherwise he will release the bar as soon as you apply pressure. The verbal cue would be “Pull the slack out of your wrists and arms.”
Bent elbows on a deadlift are fairly easy to identify and correct. It is common for many lifters to set up with bent elbows. This often occurs because the lifter is either resting on the bar, or attempting to retract the scapulas because he was told to do so in a social media post, not paying any attention to his elbows. Emphasizing Step 4 along with the tactile cue described above often corrects this issue quickly. Another reason this occurs is because the lifter “shoves the knees out” in Step 3 excessively, resulting in the knees unlocking the elbows. The correction for this is to instruct the lifter to straighten out the arms and to merely “touch the arms” with the knees. This is one of those examples of an obvious and easy fix through reminders and tactile cueing.
The shoulders represent the proximal end of the arm-wrist-hand system and the most commonly addressed. Step 4 on the 5-step instruction addresses the shoulders when the lifter is instructed to “lift the chest.” This is not the same thing as “shrugging” or retracting the shoulder blades, which should not occur – the traps and rhomboids are used isometrically in a deadlift, not in concentric contraction. By lifting the chest, the shoulders are pulled up away from the floor, which results in an extended thoracic spine. This should also pull up on the arms, elbows, wrists, and hands if done properly. However, this is often done incorrectly and oftentimes the lifter raises the chest but fails to lock out the remaining structures of the arms. If this occurs, be sure to check your lifter’s hands, fingers, elbows and shoulders and make sure they are fully extended while keeping the chest up.
And any pull that starts with slop in the fingers, hands, wrists, elbows, and shoulders is a pull started from the chest artificially close to the bar, with the back angle too horizontal in an inefficient position that increases the ROM of the pull unnecessarily. A deadlift should use the shortest ROM possible, so more weight can be lifted, and this is why we pull with the closest grip outside the legs we can manage. Don’t undo this advantage by failing to pull with the “longest” arms you can manage.
The timing of breathing is a “non-arm” power leak. We all know that we need to hold our breath during all lifts. However, it has been my experience that nearly all novices hate holding their breath on deadlifts. The breath is often taken as an involuntary cue to start pulling the bar off of the floor (i.e. “grip-and-rip”). Painful as it may be, the setup of the deadlift should take place with a held breath. One way to do this is to breathe before bending over to take the grip. A more common and easier method is to avoid setting up until the inhalation is completed. For those with belly fat, it may help to roll the bar away to stretch the torso out in the bent-over position, thus allowing for a deeper inhalation, followed by rolling the bar back in to the mid-foot position for the start of the deadlift. This is commonly performed in strongman competitions, but is not recommended for novice lifters since it usually results in the bar being pulled with hips too low and the bar forward of the mid-foot.
Once the breath is held, lift the chest, fully extend the arms, wrists, and hands, hold this for 1 second, then begin pulling. That 1-second hold will likely be perceived as 5 seconds, and is the most important step in the setup, because it gives you time to make sure the low back is in extension before your pull. In other words, you must perform an isometric pull against the bar in the correct pulling position before the actual deadlift. The perception of an eternal static hold is normal, and you may get dizzy the first few times you do this. Eventually it becomes normal and you won’t pull any other way.
The deadlift is technically the simplest lift we perform, but also one of the easiest to make mistakes on. As a result, many lifters get stuck constantly repeating and resetting loads due to an inability to maintain an extended lumbar spine. The most common errors related to initial low-back flexion are often the result of power leaks in the arms and improper breathing. By fully extending the fingers, hands, wrists, and arms, the spine will more easily maintain an extended lumbar position. Holding the breath and performing an isometric pull prior to the dynamic will complete the setup process. The result is more weight on the bar and thus a stronger back and improved aesthetic appearance of the upper body. So next time you deadlift, hold your breath, stretch your arms, and “pull before you pull.”
Discuss in Forums
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“…the laws of chance dictate that some people with berries are going to get under the bar. Many if not most of them are going to hold their breath. When they do, blood pressure will shoot up, increasing the intravascular stress on the aneurysm. Doesn’t the Valsalva pose a clear and present danger to them?…The first approach is to consider the dynamics of aneurysmal rupture in the setting of resistance training with Valsalva—the physiological evidence. The second approach is to survey the epidemiologic data—the clinical experience of what actually happens to human populations when they lift under Valsalva. We will consider each in turn.”
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Starting Strength Coach and Doctor of Physical Therapy Will Morris describes kinesiophobia in terms of standard rehab and physical therapy practice.
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Starting Strength Coach Nick Delgadillo clears up your confusion on the spine of the scapula and where the bar should go on your back for the squat.
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November 18, 2019
Starting Strength Radio
Starting Strength Channel
- Strength Training and BJJ – Jeff Hairston, SSC and brown belt under the Mendes Brothers at Art of Jiu Jitsu discuss strength and BJJ with The Strength Co. owner Grant Broggi.
- Quit Putting Your Plates on the Bar the Wrong Way! Mark Rippetoe explains why the plates face in when loading a barbell and face out when loading a plate tree. Get it right.
- From the Archives: In Back Rehab: A Case Study, Lt Col Mac Ward describes how he rehabbed his back by getting it stronger during deployment.
In the Trenches
Anthony taking 275 for a ride during the Squat and Deadlift Training Camp at Broward Barbell Center in Plantation, Florida this past weekend. [photo courtesy of Pete Troupos]
Eli at the top of his deadlift, rocking that sweet ’stache at the same event. [photo courtesy of Pete Troupos]
Best of the Week
Wi-Fi Internet and Sleep Disturbance
I wanted to post this here in case it may help some who are struggling with sleep. It will be a mix of anecdotal evidence along with minor hypotheses in consideration of my professional engineering background.
The other day, I was going to have someone move into the apartment so I switched from a guest room I was staying in to the master bedroom where the wi-fi box is located. After a nice jog (I know) I was feeling sleepy and ready to get to bed after a nice day. While almost asleep, I felt a jolt as I was on the verge of sleep and woke up, like a defibrillator. I decided it may be the Wi-Fi which was in the room so I moved back to the guest bedroom and went to sleep there while closing the door. Sleep was a bit better away from the Wi-Fi radiator (Wi-Fi radiates off of the modem). The second piece of anecdotal evidence, is that I was playing a DOS game on my computer, and when I had the Wi-Fi on, the game ran super choppy like it was overloaded, after turning the Wi-Fi off, the Dos game runs smoothly like it was supposed to. The Wi-Fi was literally frying my frail made in China laptop.
The next morning I woke up and dusted off my metric conversion textbook and to my surprise (I know it shouldn’t be) I realize that 5Gigahertz is a 5 billion cycles per second signal. I’m sure the magnitude of frequency is low, but the sheer speed of the signal wave I’m hypothesizing may have an effect upon the heart, brain and the blood, (I’m sure everything, but those are the important ones). The heart is an electro-magnetic organ, metallic in nature, run by electric signals sent by the brain. I think for me the 5G Wi-Fi may have been affecting me as I have had trouble sleeping the last 4-5 years. Since unplugging the Wi-Fi on Friday, my sleep has been decent the past 3 days. I think I’ll also post an update later on if this sustains. Additionally, I believe that the hemoglobin that transports oxygen to our cells is also affected by the 5 G radiations. Iron in our blood that carries oxygen is metallic, meaning it has its own electric field, and would therefore be affected by 5 billion cycles per second in my opinion. I’m sure it affects the brain as well, which is also a highly metallic organ, even more so now that we focus so much on education. If you look up a chart, “New Cases of Diabetes Diagnosed Among U.S. Adults Aged 18-79 Years, 1980-2009” you’ll see that in the early 90s there was a minor spike in new diagnoses (IMO the introduction of the desktop computer, but I don’t think that’s bad, we adapted and the new cases leveled off) but in 1998 the cases took off in a linear upward fashion at a pretty good slope. Wi-Fi was invented for retail use in 1997-1998. I remember that I never used it because I was a nerd, and the Wi-Fi didn’t run the games over the internet very well so we used the cable modem with wires plugged into it. But later on certainly I was exposed to wi-fi.
I believe that people are being exposed to a whole host of health issues (metabolic food cravings, inability to sleep, anxiety) due to these radio waves microwaving us. The human body is certainly electro-magnetic, that is science, and to ignore the possible effects of a FIVE BILLION cycle per second radio wave on a highly complex electro-magnetic system would be folly in my opinion. Trust me, I’m a professional engineer LOL. Either way, the main point of this post is to let people know if you are really having a hard time sleeping, maybe try turning off your Wi-Fi box. I’m not saying don’t use the internet, I’m saying wire in, take out the radio waves and see if that helps. It may help with pre-diabetic symptoms as well (which I was having). I’ll post an update a week from now if there’s any interest.
Ever considered the radiation output of that huge bright yellow thing, or cosmic radiation?
So what? You realize that visible light is also an electromagnetic wave with frequencies on the order of hundreds of Terahertz? That’s 5 orders of magnitude greater than your little wifi signal. And visible light isn’t the only wavelength of radiation we are constantly bombarded with.
All electromagnetic waves travel at the same speed – namely the speed of light. Visible light is hitting you at the same speed as the wifi signal.
If your wifi is “affecting” you like that, you better just get yourself situated in a lead box right the fuck now, lest all that higher energy, ionizing, higher intensity source of radiation that we call the sun royally fucks your shit up. Just try not to lick the walls.
Don’t be fooled: the government wants you to think that foil hats will protect you, but foil hats actually concentrate frequencies that are reserved for government use: On the Effectiveness of Aluminium Foil Helmets: An Empirical Study.
I would recommend enclosing your home in a Faraday cage, sleeping in an Orgone Collector, and wearing a titanium colander on your head if you absolutely must venture outside.
I don’t think you guys understand: The man is a Professional Engineer.
I want to know why “professional engineer” needs to go to a “metric conversion textbook” to figure out that 5 gigahertz is 5 billion cycles per second.
Professional engineers don’t refer to themselves as such.
A cage mainly shields against the electric field, but not the magnetic field. Plus the cage is only good for the frequencies it’s designed to shield, so best to line his whole room with a continuous metal surface so there is no potential difference and so he is completely shielded electrically. For the magnetic field, he’ll have to redirect the magnetic field with an outer skin of magnetic material with high permeability. If anything, a tedious application of Maxwell’s equations will surely give him a good night’s sleep- it always does me.
We are talking about waves here, aka oscillating fields, not static. If one day you manage to read the equations without falling asleep partway, you will find that oscillating E and B fields are coupled together (see the Faraday and Ampère equations). If you kill the electric field, it’s going to cancel the magnetic field too.
Being a “professional” doctor of physics, not medicine, it’s a bit out of my area of expertise. But, in a case of self-diagnosed electro-sensitivity, wouldn’t an homeopathic treatment be just as effective as living in a Faraday cage to treat the “symptoms”? It would be much cheaper and more convenient, with the added bonus that any homeopathic medicine would work just as effectively regardless of whatever is written on the label.
Best of the Forum
In one of your recent podcasts (#35, I think), you related the story of how you refused to go talk to a group of parents of high school athletes because you thought it would be a useless endeavor to try to educate the “stupid parents.” How does this square with the fact that you regularly write articles and produce podcasts on this and other websites such as PJ Media (where I first learned about SS in 2014, thanks to Instapundit), pointing out the advantages of the SS model? Clearly you believe that there is some merit in trying to convince people that the SS model works and would benefit them, or else you wouldn’t waste your time with the articles. If you think the readers of your articles could learn something, why wouldn’t the parents learn something hearing it directly from you?
Do you see no difference in writing a piece for the media that maybe 5% of the people who see it will read and of those maybe 20% will understand, and me personally getting in the car and driving to a meeting of parents here in Wichita Falls, perhaps 20% of whom know who I am and of those perhaps 50% willing to believe me when I tell them that their Head Coach has been incorrectly managing their S&C program? Which scenario makes the most sense for the numbers/time/gasoline/aggravation?
Also people who are reading Rip’s articles are people who are generally interested in learning about strength and getting stronger. A room full of parents, whom the vast majority if not all of them, are not always going to be interested in getting stronger or the process. It just falls on deaf ears and blank stares, or in some cases the Dad who played college ball somewhere pipes in because he “knows” better than Rip. I know we see the advantages of Rip speaking to parents, but that’s because we are already interested in the program and in getting stronger.
Which scenario makes more sense is of course entirely up to you. I might have misunderstood as I thought the coach was trying to get the parents to see that what he wanted to do was the correct path and you were to be there to bolster that argument.
Your articles are written with extreme clarity and conciseness, which requires quite a bit of time and effort (for me, at least). In the video of your lecture “The Case for the Starting Strength Model,” you spoke, seemingly effortlessly, for over 45 minutes (without notes). Now I have no idea of the background prep that went into that lecture, but my impression is that an informal get together with the parents would be like falling off a log to you. But again, I’m not the one putting in the effort to either write the articles or give a lecture.
In any case, my larger point was that I was surprised you thought that talking to people in general was an almost complete waste of time, despite all the effort you put into writing articles that very clearly and strongly make the case for the SS model. They certainly worked on me. This of course is different than getting people to actually get under the bar and follow the program once they are there. That’s something the person doing the lifting has to actually want, as has been noted here many times.
But again, I suppose I shouldn’t be surprised. I’ve been lifting at my gym for over two years now and am the only one I’ve ever seen squatting over three plates and deadlifting over four. Several people have commented on how they are impressed with the weights I’m moving (I know they are not much compared to most people here) and I give them a brief rundown of the SS model and how well it’s worked for me. But I still have the squat rack to myself pretty much every time I go.
I did this kind of thing for years here in my local area with parents. It’s a waste of time. If you want to do local public speaking type deals (which are effective) get yourself in front of older people (50+). You’ll convert much better.
I spent about 5 minutes making a mental outline for that lecture, because that’s all that was necessary after 40 years of preparation. I am a very effective communicator, and people often mistake being articulate for intelligence – not the same thing. I would go so far as to say that there is nobody in this business more capable of communicating this message than I am. It’s still a waste of time, because of who I’d be trying to communicate with. Audience selection is the most critical component of communication.
Rip (and others), Thanks for the thoughtful responses (I was worried I was coming off sounding like a bit of a dick there). You are indeed an effective communicator, but if your methods hadn’t gotten me to a 440 lb deadlift at 55 years old, I wouldn’t still be listening.
Human nature is interesting.
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You’re coming off a muscle-building phase, or “bulking phase,” as many may refer to it. You’ve worked hard to put on mass. You’ve been focused and consistent with your workouts, and you’ve gotten noticeably stronger and denser. The time has come to unveil the muscles you’ve built. You want to shed some body fat, but you’re not too stoked about losing your hard-earned gains. How do you go about preserving muscle and also keeping your performance as high as you can?
You must be in a caloric deficit to lose fat. There is no way around it. Here’s what you need to do in order to lean out while maximizing muscle retention:
1. Start with the Most Calories Possible in Your Deficit
The most basic way to create a caloric deficit is to multiply your body weight in pounds by 10-13. Yes, it’s a wide range, but it’s just an estimated starting point—your caloric requirements may be higher or lower based on your age, gender, lifestyle, and goals. I suggest you start on the higher end of the spectrum to give yourself more calories to work with from the beginning.
Say you weigh 150 pounds. Your magic number is 1,950: 150 x 13 = 1,950 calories. So you need to consume 1,950 calories per day in order to lose body fat.
Since body weight is dynamic and fluctuates throughout the week, do not cut calories dramatically if your weight stays the same for a few days. Monitor your weight daily for two weeks in order to make objective decisions. If you’ve lost weight, great! Don’t change a thing. If you’ve stayed the same, drop your intake by 150 calories (which puts you at body weight in pounds x 12).
For most people, losing 0.5-1 percent per week is appropriate. At that pace, you’ll be more likely to keep up your performance at the gym and hold on to more muscle.
2. Eat Your Carbohydrates When You Need Them Most
Nutrient timing has greater importance when you’re in a calorie deficit and trying to maintain muscle mass. You want to make sure that the majority of your carbs (along with some protein) are contained in your pre-workout and post-workout meals.
Some people enjoy having a solid meal of complex carbs and protein 1-2 hours pre-workout, while others enjoy having simple carbs and fast-digesting protein about 30 minutes before. Try both and see what works best for you.
The recommended amount of carbs to get before and after training depends on your overall carb intake, tolerance, and preferences. I have found that consuming a pre-workout meal containing no less than 40-75 grams of carb has helped me to manage fatigue and perform optimally in the gym.
3. Keep Your Protein Consumption High
Higher protein diets increase satiety, create a greater thermic effect, improve mood and cognitive functions, and promote muscle building and recovery.[1-4] These are all things you want, especially when you’re restricting calories.
My recommendation is to eat 0.8-1.2 grams of protein per pound of body weight per day. So, for a 150-pound individual, this means 150 grams of protein per day. The recommended amount of protein before and after training is around 0.18-0.23 grams per pound of body weight, so about 30 grams each for a 150-pound individual.
The easiest way to go about it is to consume protein in every meal. Simply divide your total protein intake by the number of meals that you plan to eat per day. If you need to consume 150 grams of protein and you eat four meals per day, each meal should contain 37 grams of protein.
4. Utilize Refeeds Only as Needed
“Refeeds” are higher calorie days in which you focus on getting a surplus of carbs for the purpose of helping you adhere to the diet. It also assists with muscle retention. The structure of your refeeds will depend on where you are in your diet, your activity level, and your preferences, among other factors.
First, however, let’s talk about what refeeds aren’t. They are not all-you-can-eat buffets or a test of how much junk food you can consume in a single day. Refeeds are mainly to give you the psychological benefit of a break in dieting, and the opportunity to eat more may translate into better gym performance.
My suggestion is to add refeeds to your diet under two conditions:
- You’ve been consistently losing weight for at least four weeks.
- You’re feeling fatigued and lethargic.
In that case, experiment with adding 1,000-2,000 calories on a specific day each week. If you end up needing 2,000 calories, you can opt to have two days where you add 1,000 calories each instead.
As far as the specifics of a refeed go, some people enjoy having carb-focused refeeds, while others benefit more from adding a combination of fats and carbs. At the end of the day, what matters is that you took a break from a caloric deficit, increased calories for 24-48 hours in a structured manner, and now feel more energized and ready to continue with your fat-loss efforts.
5. Do Not Favor Cardio Over Strength
Many people make the mistake of adding intense cardiovascular exercise in order to burn more calories. There’s nothing wrong with this, as adding cardiovascular exercise helps keep fat-burning pathways open and is a great way to use up additional calories. Still, if cardio compromises your strength training, I suggest you rethink your strategy. Most of us already live and work in high-stress environments, so it doesn’t make much sense to add even more stress to your system by performing draining, high-intensity cardio while trying to maintain your gains.
Instead, try increasing your daily NEAT, or non-exercise activity thermogenesis. I’ve found that walking 8,000-10,000 steps per day essentially takes care of my additional calorie burning without compromising my performance at the gym.
6. Prioritize Compound Movements
There is absolutely no reason to cut all compound movements from your program while you’re in a fat-loss phase. Focusing only on isolation movements, high repetitions, and “feeling the burn” doesn’t translate into burning more fat in that specific area. What helped you gain the muscle is what’s going to help you keep it. Continue doing squats, deadlifts, rows, chin-ups, and presses. Try to keep up as much of the training volume as you can, for as long as you can.
Your performance depends upon your training age and your specific training program, but as a general rule, you should be able to maintain most of your intensity at the gym (or even add to it) up to a certain point in your diet, until it’s time to end your diet and start focusing on building again. I’ve found that more often than not, what limits someone’s intensity in the gym is more about the psyche and less about the physiological state.
When you go to the gym, believe in your abilities and work hard. As I mentioned before, what helped you gain the muscle is what’s going to help you keep it.
7. Take a Creatine Supplement
Creatine is one of the most well-researched and safest supplements available. Briefly, creatine is a natural substance that turns into creatine phosphate in the body. Creatine phosphate helps make ATP, which is the energy muscles need in order to contract.
In short, supplementing with creatine helps increase muscle, power, and strength—things you want to hang on to as your body weight drops. You can take in creatine through foods like meat, but you would have to eat a substantially large amount of it to get the creatine levels your body needs to see benefits. Daily consumption of 3-5 grams of creatine monohydrate is sufficient for most people.
8. Prioritize Sleep and Manage Stress
Sleep and stress management are extremely important for your energy and quality of life, but they become of greater importance when calories are restricted. For thousands of years of human history, losing weight was a threat to survival. The human body perceives restriction of calories as a threat to its survival even though it’s not anymore. Still, you need to promote a safe environment in the body to allow fat loss to occur.
Specifically, lack of sleep may lead to changes in hormones that can increase hunger.[6-8] Similarly, high secretions of cortisol and other stress hormones can mask weight loss by retaining water in the body and may lead to increased hunger.[9,10]
With this in mind, be sure to find time to relax, tap into a parasympathetic mode, and do things you enjoy that will reduce stress and promote feelings of well-being and happiness—reading a book, talking to a close friend, playing video games, drawing, etc. Additionally, make it a habit to go to sleep and wake up at the same time each day, getting 7-9 hours of quality sleep. Not only will practicing these habits make it easier to lose fat, but it will also have a positive effect on many other aspects of your life.
9. Assess Your Progress Bi-weekly
One of the main tips for preserving muscle is to focus on slow and consistent fat loss. The following assessment tools used together can provide the most accurate snapshot of your progress as you work through a dieting phase:
- Tracking body weight daily
- Taking measurements—specifically waist and hips—every two weeks
- Taking front, side, and back progress pictures every two weeks
Sometimes the scale won’t budge, but visual changes are apparent, so it’s important to have several assessment tools that measure your progress and not rely on only one. Evaluate your progress every two weeks and adjust your diet and/or activity plan as needed.
As a general rule, let your diet take care of fat loss, and your strength training program take care of muscle retention.
Need more nutritional advice? Head over to the Foundations of Fitness Nutrition course and arm yourself with everything macros, gaining or losing weight, and more—available only on Bodybuilding.com All Access.
- Soenen, S., & Westerterp-Plantenga, M. S. (2008). Proteins and satiety: Implications for weight management. Current Opinion in Clinical Nutrition and Metabolic Care, 11(6), 747-751.
- Aragon, A. A., & Schoenfeld, B. J. (2013). Nutrient timing revisited: is there a post-exercise anabolic window?. Journal of the International Society of Sports Nutrition, 10(1), 5.
- Crovetti, R., Porrini, M., Santangelo, A., & Testolin, G. (1998). The influence of thermic effect of food on satiety. European Journal of Clinical Nutrition, 52(7), 482-488.
- Helms, E. R., Zinn, C., Rowlands, D. S., Naidoo, R., & Cronin, J. (2015). High-protein, low-fat, short-term diet results in less stress and fatigue than moderate-protein, moderate-fat diet during weight loss in male weightlifters: A pilot study. International Journal of Sport Nutrition and Exercise Metabolism, 25(2), 163-170.
- Buford, T. W., Kreider, R. B., Stout, J. R., Greenwood, M., Campbell, B., Spano, M., … & Antonio, J. (2007). International Society of Sports Nutrition position stand: creatine supplementation and exercise. Journal of the International Society of Sports Nutrition, 4(1), 6.
- Greer, S. M., Goldstein, A. N., & Walker, M. P. (2013). The impact of sleep deprivation on food desire in the human brain. Nature Communications, 4(1).
- Spiegel, K., Tasali, E., Penev, P., & Van Cauter, E. (2004). Brief communication: sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Annals of Internal Medicine, 141(11), 846-850.
- Nedeltcheva, A. V., Kilkus, J. M., Imperial, J., Schoeller, D. A., & Penev, P. D. (2010). Insufficient sleep undermines dietary efforts to reduce adiposity. Annals of Internal Medicine, 153(7), 435-441.
- Dugue, B., Leppänen, E. A., Teppo, F. A. M., Fyhrquist, F., & Gräsbeck, R. (1993). Effects of psychological stress on plasma interleukins-1 beta and 6, C-reactive protein, tumour necrosis factor alpha, anti-diuretic hormone and serum cortisol. Scandinavian Journal of Clinical and Laboratory Investigation, 53(6), 555-561.
- Segar, W. E., & Moore, W. W. (1968). The regulation of antidiuretic hormone release in man: I. Effects of change in position and ambient temperature on blood ADH levels. The Journal of Clinical Investigation, 47(9), 2143-2151.
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November 04, 2019
- Starting Strength Gyms is excited to announce that the first franchise gym in California is coming in 2020 – Starting Strength Los Angeles. For updates, join their mailing list: Mailing List Sign-up
Starting Strength Radio
Starting Strength Channel
- Kinesiophobia – Starting Strength Coach and Doctor of Physical Therapy Will Morris describes kinesiophobia in terms of standard rehab and physical therapy practice.
- Starting Strength Coach Nick Delgadillo clears up your confusion on the spine of the scapula and where the bar should go on your back for the squat.
From the Coaches
- What happens at a Squat & Deadlift Camp? Watch this video from the last one in Woodmere, NY.
In the Trenches
Patrick deadlifts 405 at Starting Strength Austin’s Day of the Deadlift competition. [photo courtesy of Ashley Schaefer]
Best of the Week
Why don’t more places run SS programs
Mark first let me say I’m a big fan and appreciate everything you have done for myself and everyone else over the decades.
That being said I’m always curious why more colleges, high schools, professional athletes, strength gyms, strongman competitors, etc, don’t promote SS? The programs work and there is a ton of evidence to back them up. Is it because I live in WA? Down in Texas are more schools and athletes running your programs? Do you think it has to do with your opinions? I don’t know it just has been bugging me for a few years that I never hear more people (at least where I live) supporting and promoting SS.
It’s not fashionable now. Functional Training is fashionable, so that’s what gets done.
Is SS more popular in TX?
I usually train in my garage but when I do go to the gym I go to a local powerlifting/strongman gym mainly to use their strongman equipment. I literally don’t ever talk to or see anyone that runs a SS or a PPST program and that is the closest thing around here for a strength gym.
Is it because I live in WA? In TX are more people and “Strength Athletes” running your programs? When ever I mention it to someone they are very dismissive even though I lift more than 90% of them and have beaten them in Strongman comps.
I guess I’m asking if this is just a local thing here where powerlifters and strongman are dismissive of the programs? I find myself constantly having to defend PPST programming when I mention that is what I train with.
This is not a powerlifting or strongman program. Why would you expect to see them doing it?
I get SS is not a Strongman/powerlifting program but there are several programs in Practical Programming for Strength Training that seem pretty good for those purposes.
True. But I’m not the approved Powerlifting guy.
Best of the Forum
What to do with this shit? (Thanks, Doc.)
David A. Rowe
Situation: my dad is in his mid sixties and has spent the last few decades eating and drinking as he pleased. Shocker, his A1C began to creep up recently given that he does more far “politic’n” and far less farm work and physical labor. Well, if there’s one thing that can be said about him… he never half-asses anything. In fact, overkill would be an understatement. The doc told him to diet by cutting carbs and eating more lean meats and salads. He also told him that a little alcohol would help lower his blood sugar. Keep in mind, he’s been a borderline alcoholic his entire life. The only thing keeping him from going under with that has been his freakish resistance/tolerance for alcohol and every medication he’s ever taken.
Now here we sit, a half a year later. He’s gone from 220-230 lbs to 170. He’s eating nothing but steak and salad, but has cut his steak portion down to 4 oz as his doctor told him 160 would be fantastic. Between a big accident involving a 400 lbs rock crushing his foot and a fall he took in the 80s that screwed up his SI joint (never repaired… just tons of corticoid injections with no improvement since the accident), he’s convinced he’ll never be able to lift… even though he spent years self employed and doing hard physical labor. His A1C is in the 5s. He’s addicted to the numbers, but just a month ago could barely get through a day helping me clean out my garage and was down for two days after. Last week he almost passed out in Walmart. He’s going through a handle of whiskey every 2-3 days.
I had a very hard talk with him about it, but I may have screwed up when he kept saying, “Well, my doctor says…” to which I finally replied “Well your doctor’s a fucking idiot.” Has a doctor ever looked up from a chart, taken a hard look at the patient and said, “My god, your body composition is horrible. Your muscular atrophy is terrible! You’ve got an eating disorder! You’re drinking HOW MUCH?”
What the fuck do I do with this?
An excellent question for the board. My disgust with most members of the Fraternal Order of Gods On Earth, i.e. doctors, has grown more intense recently, and I’m convinced that most of them would do far less harm/far more good as plumbers, carpenters, or real estate salesmen. More to the point, people like your dad, i.e. the majority of people, are far FAR too willing to cede their own personal sovereignty to a bunch of people who cheated to make “A”s in undergrad. Because, “After all, he IS a doctor.” And I have no idea how to make people smarter.
Well, Rip’s painting with a pretty broad brush here vis-a-vis doctors. I’ll leave it at that, except to say I know at least one doctor who earned his fucking As.
That being said: Yes, we put too much faith in doctors and allopathic medicine…and that’s not all the fault of doctors. And you know…there are other doctors out there. Perhaps another opinion is indicated?
My mother was told by a doctor that she had a better chance of surviving cancer if she became vegan. She isn’t vegan, because we called her oncologist who talked some sense into her. She still insists on seeing her PCP because she’s gone to him for so many years.
My brother is currently “a doctor in training” and tells me the info is worse than you’d think. You’re taught how potassium reacts in the body and that it’s important, but you are taught nothing of how to prescribe nutritional info to a patient.
The country is desperate for medical professionals. What do you think happens when there is a huge demand for something and no quality check on the supply? Can we really make it more difficult (and expensive) than it already is to become a doctor?
That’s not remotely borderline, even if you’re not using ‘handle’ to refer to the 1.75l bottles (and “freakish tolerance” should be as suspect as “having the wrong physical proportions to do SS”). I bet his doctor has no idea he’s drinking that much.
I tried to apply the usual caveats, “most, majority” etc., as conscientiously as possible while still conveying the enormity of the problem: that most doctors are not particularly helpful and most patients are credulous irresponsible fools who get what they deserve. I realize this impresses most people as excessive cynicism, yet I stand by my point. If every doctor was Sully, shit would be different.
I’d like to know if the doctor asked.
Yes, to be fair, you did. I’m not sure I’d say most doctors are lame…but we do have fundamental problems, as this case illustrates.
Here’s the thing, American Medical education at the medical school and residency level sucks. Really really bad. They really have no idea how to make good doctors. It’s all pretty much self study, which kinda works out because they select for people who are driven to begin with. You’re lucky if you can find a few sympaticos along the way who can actually teach you something. On the other hand, American Medical education is also probably the best in the world.
Your story kinda reminds me of an old frail lady who got cancer and said, “This is great! I’m finally able to lose some of this weight!” Telling people to lose weight is probably not the right approach. As you can see, the weight isn’t as important as muscle mass. The elderly – whether fat or skinny – who lose muscle mass are in for a world of pain. I just discharged a lady who has terrible osteoporosis, L2 compression fracture several months ago. And now L1 collapsed against that nice new kyphoplasty (this is common). She wants to go on hospice because she’s too week and in too much pain to do any physical therapy, and it’s probably too late for her. Her daughters (who have been camping out at the bedside telling me everything I’m doing is wrong (this is also common among daughters and wives)) actually argued her out of inpatient physical therapy. One said, “I don’t care how strong her biceps are! I just want her to walk!” I had a hard time trying to explain to her that if she can’t move, she will decline, not “improve with rest.”
As for the drinking thing… You gotta cut us some slack on that one. Patients lie. And as you point out, if you say, “a glass of red wine might improve your blood pressure,” (studies are dubious, but I’m not against it), then pretty soon, they’re drinking a handle a day! Whatever that is.
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