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Navigating Potholes: My Back Pain Experience

By | Recovery, Training | One Comment

I’ll spare you my lengthy back pain origin story and set the scene in 3 bullet points: Pre-back pain, I was a pretty killer athlete with a promising future in powerlifting and strongman. Also pre-back pain, I partially tore my hamstring tendon, which led to hamstring and hip pain. I rehabbed my way back to the platform from this injury, but its lasting impact lay in the consequent mistreatment of my back pain by medical professionals. One day in the Spring of 2016, I “tweaked” my back on a heavy axle deadlift in a strongman show. I finished the competition…

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Fear, Catastrophizing, and Training

By | Training | 3 Comments

Introduction Regular followers are likely familiar with our interest in a “biopsychosocial” approach to both training and injury, particularly the modifiable psychological factors that can have significant effects on performance, recovery, and subsequent adaptation. One important phenomenon we discuss frequently in the context of acute injury and persistent pain is catastrophizing. Catastrophizing is a complex psychological process (sometimes described as a cognitive distortion) in which an individual appraises a situation in a maladaptive, excessively negative way — for example, immediately thinking of the “worst-case scenario”. It consists of three fundamental components: 1)    Rumination, e.g.: “I can’t stop thinking about how…

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Novice Bench and Press Plug-In

By | Training | 24 Comments

Note: We published this protocol in the Barbell Medicine newsletter in March of 2018, but have since added some additional context, explanation, and recommendations for this intervention. Be sure and sign up for our newsletter to stay up to date on all the latest content! A novice lifter is someone who can add weight to the exercises being performed each time they train, typically every 48 hours. Ideally, the increased load functions as both a display of the strength previously developed as well as a training stress designed to facilitate further improvement. As the novice phase comes to a close however,…

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She lost over 25 pounds and stepped on stage. Here’s what she learned.

By | Uncategorized | 6 Comments

Prologue  Alexis Irwin has been a client of mine for some time now. Together, we’ve successfully added hundreds of pounds to her lifts in total and improved technique, but the weight loss end of the bargain was always a little harder for some reason. Fast forward to late January when Alexis approached me about competing in a bikini show. If you’re a faithful Barbell Medicine reader you know this isn’t really my forte’, as I’ve only prepped a handful of clients for this sort of thing. That said, I thought it would be a good way to boost compliance for…

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Does YOUR metabolism change with weight loss?

By | Nutrition | 6 Comments

Yes. Your metabolism changes when you lose weight. Some of these changes are good, e.g. decreased fasting blood sugar, improved cholesterol measures, decreased storage of fat in places you don’t want it like your liver and waist, etc. Not all of the metabolic changes are good however, and in recent times there has been much discussion and handwringing over the role of metabolic adaptation (sometimes referred to as “metabolic damage”) in the setting of weight loss. The idea is, given that body mass is controlled by the balance of energy expenditure versus energy intake, that in periods of caloric restriction,…

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A Novel Approach For Replacing USELESS RPE

By | Training | 9 Comments

It has been said that using Rate of Perceived Exertion (RPE) is useless for strength and conditioning, which has caused quite a stir between the Barbell Medicine crew and other coaching organizations because we had been using this tool with our clients to manage loading, training fatigue, and the intensity of conditioning efforts up until very recently. New data has come to light that have forced us to reevaluate our stance on RPE and ultimately replace it with a novel method that we’ve been working- The Baraki Exertion Scale (Figure 1). Figure 1: The Baraki Exertion Scale is visually represented…

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Placebo Sleep?

By | Recovery | 9 Comments

A 2014 paper by Draganich & Erdal studied the effect of sleep on cognitive functioning in 164 undergraduate students – with an interesting twist. Participants were given a questionnaire in which they ranked how deeply they had slept the prior night on a scale of 1-10. Subjects received education about REM sleep and cognitive function, then were intentionally deceived by the experimenters to believe that measuring certain physiologic parameters would allow calculate how much time they spent in REM sleep the night before. Subjects were attached to various sophisticated-appearing monitors, and were allowed to watch their brainwave activity by EEG…

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An Open Letter About Leaving Starting Strength

By | News | 58 Comments

In late February, 2018 of this year, after a series of back and forth emails, I informed Rip et al that I was resigning from Starting Strength. Since then, there has been a large amount of chatter on the Internet about what happened and what’s next. This letter aims to address both topics. To really understand what happened we need a brief backstory about the beginnings of Barbell Medicine. From 2008-2012 I was working as Director of Education for a large personal training company in Missouri while also coaching full-time and completing my Master’s Degree in Clinical Anatomy and Physiology….

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The Importance of Singles

By | Training | One Comment

A little over one year ago I reached out to Austin Baraki in desperate need of coaching. Thankfully, he didn’t hesitate to accept the task and we immediately got to work. At first, he “triaged” my situation by correcting a number of technical errors that he observed after watching some of my training footage. After that, he made several changes to my current training routine; cutting out a lot of “fluff” and putting more emphasis on the things that mattered: the main lifts and their close variations. All of this made sense but one aspect of the program that stood…

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The science of where YOUR pain comes from.

By | News, Recovery, Training | 2 Comments

Longtime followers will be well aware that chronic back pain is a widely prevalent, complex, and often disabling problem (see here, here, and here). A wide array of specialized interventions have been developed over the years, and many of these have taken hold in clinical practice without strong evidence for their effectiveness. This paper discusses recent data from trials on radiofrequency denervation as a treatment for selected patients with chronic back pain. The idea is to identify a suspected structural “nociceptive driver”, such as an arthritic facet joint or sacroiliac joint. This peripheral focus of noxious stimulus is often also…

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