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BARBELL MEDICINE

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Featured Post

An Open Letter About Leaving Starting Strength

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.

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Our team of professional coaches will guide you through both nutrition coaching and online program design with remote coaching. With oversight at every level, you will be assigned a team of people making sure you get the best service.

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Our team of professional coaches will guide you through both nutrition coaching and online program design with remote coaching. With oversight at every level, you will be assigned a team of people making sure you get the best service.

Learn More

Latest From The Blog

Training
May 29, 2019

The Beginner Prescription

You will receive an email with your PDF shortly. In the meantime, you can download it directly here. For an introduction to this program, please check out The Barbell Medicine Podcast: Episode #58: Programming For Beginners (and other musings on training) Introduction & Goals At Barbell Medicine, our mission is to promote health and successful aging by bringing the best of modern medicine together with strength, conditioning, and nutrition. With this document, we want to provide an answer to the question, “Where do I start with exercise to improve my health?”  Health is “the ability to adapt and self-manage in…
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Training
June 5, 2019

Strength Training for Endurance Athletes Part II: Principles of Resistance Training

In part I of this series, we discussed the role of resistance training in the management of common injuries in endurance athletes, as well as its role for injury risk reduction. In part II, we will move on to examine the effects of resistance training on endurance performance. The Interference Effect A common concern among endurance athletes is that resistance training will hamper their performance -- not unlike lifters’ concerns about conditioning/endurance activities affecting their strength. This is frequently described as the “interference effect”, but this is still a product of how the situation is framed. Eddens 2018 For example,…
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Training
May 21, 2019

Strength Training for Endurance Athletes Part I: Injury Risk Reduction

https://youtu.be/mA8U-otQlp8 Introduction This series may be a bit of a break away from the typical Barbell Medicine article, as many of our readers are primarily interested in strength sports and barbell training. It is adapted from a talk given at the American Physical Therapy Association Combined Sections Meeting in January 2019. While it is great that so many individuals are interested in barbell training as their primary means of physical activity, there are many other beneficial ways to be active. If someone wishes to focus on endurance activities (e.g., running, rowing, cycling, swimming, triathlon) there is still good evidence for…
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Recovery
April 1, 2019

Recovering From an Injury: Embrace the Process

Introduction Setbacks are an inevitable part of the long-term training process. Progress is driven by applying more training stimulus over time to induce adaptation -- and this stimulus always carries an inherent risk of injury. Although there are effective strategies we can use to mitigate the risk of injury, preventing injuries entirely is impossible. Furthermore, preventing the experience of pain is not only impossible, but undesirable, given the importance of pain as a protective mechanism for survival. Pain and adversity are therefore a part of life, a normal human experience. Learning how to respond to and overcome these situations is…
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Nutrition
March 22, 2019

Handling Hunger

If you’ve ever tried to lose weight, have ever missed a meal, or have even just driven by your favorite bakery…chances are you’ve experienced hunger. Hunger can be annoying, distracting, and is frequently blamed as “diet derailing,” yet it’s part of our normal physiology and something that can’t be avoided entirely. Background Hunger is defined as a feeling of discomfort caused by lack of food, followed by a desire to eat. Conversely, satiety is the feeling of being full and no longer desiring a meal. Hunger and satiety both stem from the interactions of biological, psychological, and social factors, which…
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Recovery
February 27, 2019

Crepitus: Expectations vs. Reality

Crepitus is the menacingly-named phenomenon of noises produced by a joint during movement. It is common to hear snaps, crackles, and pops when flexing or extending a knee or an elbow. At times, these noises can be accompanied by a sensation of mechanical stiffness. When combined, these can cause distress, evoking deep-seated fears people have about their bodies “wearing out”. It leads many to seek consultation with a health care provider, even in the absence of pain or functional limitation. The good news is that not only is crepitus very common, it does not necessarily portend dire outcomes, nor should…
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Nutrition
February 8, 2019

Nutrition Science, Part IV – Moving Forward: Improving the approach

It is important to note that the assumptions discussed in the last article are not arbitrary to the biomedical model, but legitimized through common sense in the context of a given research topic (32). A common-sense approach to nutrition, therefore, is one which can legitimize a modified approach to scientific inquiry into diet-disease relationships. Although not exhaustive, a number of potential features and alternatives could modify the approach. The first is to move away from the narrow focus on isolated nutrients/compounds, to emphasizing food as the exposure of interest and design “whole-diet” interventions which reflect that the fundamental unit in…
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Nutrition
February 1, 2019

Nutrition Science, Part III – The Awkward Fit: RCTs and Nutrition Science

In the second part of this article series we discussed the utility, limitations, and misconceptions related to the prospective cohort design for nutrition science. As discussed in part I, the reductionist biomedical model and its gold standard randomized controlled trial (RCT) is ill-equipped for studying complex dietary patterns in a way that can effectively inform public policy. In this article we will examine the randomized controlled nutrition trial design in more detail. ..there are fundamental differences between the subject of inquiry for which the RCT model evolved to investigate (drugs) and the subject of inquiry to which it is now…
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Training
January 28, 2019

Shoulder, Part IV: The Rotator Cuff Teardown

Reviewed & Edited by Austin Baraki, MD Introduction The “rotator cuff” is a set of four muscles around the glenohumeral joint including the supraspinatus, infraspinatus, subscapularis, and teres minor (see figure). These muscles all originate from the scapula, insert at various points on the humerus, and serve multiple coordinated functions including abduction, adduction internal rotation, external rotation, and stabilization. Each muscle is considered to have its own unique action on scapulohumeral movement (sometimes described as scapulohumeral rhythm, as discussed in the first installment of the shoulder series here). Unfortunately, the cuff muscles are often viewed as both the source and…
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Nutrition
January 22, 2019

Nutrition Science, Part II: The Prospective Cohort Design

In the first article in this series we discussed the history of nutrition science and traced its evolution alongside the biomedical model. We also introduced the discussion of nutritional epidemiology in comparison to the “gold standard” biomedical trial design: the randomized controlled trial. In this second article, we’ll discuss the utility, limitations, and misunderstandings about the prospective cohort study design for nutrition science. Prospective cohort studies are the only practical research design to investigate the long-term relationship between diet and disease, particularly with the preponderance of current evidence in nutrition indicating that whole diet patterns are more informative of diet-disease…
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Featured Media

Your doctor is wrong about creatine. Jordan and Rip discuss common misinformation and conventional medical wisdom about creatine, the insulin spike resulting from protein consumption, and muscle protein synthesis on Episode 40 of the Starting Strength Podcast.

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