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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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Coaching & Consulting

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

Michael Ray 0
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Training
December 14, 2018

The Shoulder, Part III: Internal Impingement

by Dr. Michael Ray and Dr. Austin Baraki In part 2 of our shoulder series we discussed the topic of “shoulder impingement”, which is commonly understood as the mechanical compression of the tissues beneath the acromion process, resulting in pain or dysfunction -- better known as external impingement. We described the biomechanical theory behind this diagnosis, and examined the available research evidence on the topic. Ultimately, we found a lack of compelling evidence -- and in fact, a substantial amount of contradictory evidence -- for our historical mechanically-focused understanding of this topic. Another lesser-known type of impingement, known as “internal” impingement,…
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Alan Flanagan 0
0
Nutrition
January 17, 2019

Nutrition Science, Part I: How Did We Get Here?

Introduction To anyone versed in biomedicine, the so-called “hierarchy of evidence” is well-established and unquestioned. The randomized, double-blind, placebo-controlled trial (RCT) is considered the gold standard trial design, because it offers the ability to randomly allocate a treatment, minimize potential sources of bias, and compare the exposure or intervention of interest to a placebo. There is absolutely nothing wrong with this model, or this hierarchy … if the subject of inquiry is pharmaceutical drugs or the molecular mechanisms of disease. At its core, the biomedical model is based on a presupposition that all disease can be studied with such a reductionist…
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bbmedicine 4
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MobilityTrainingUncategorized
November 20, 2018

The Shoulder, Part II: External Impingement

by Dr. Austin Baraki, Dr. Michael Ray, and Dr. Derek Miles. In the first article of this series we discussed the concept of “normal” or “abnormal” scapular movement (i.e., scapular dyskinesis), which is the pathomechanical foundation upon which other shoulder-related diagnoses and narratives are built. “Shoulder impingement” is one of these ideas that is commonly discussed in the coaching, rehab, and orthopedic worlds. The narrative describes soft tissue structures around the shoulder (e.g., rotator cuff tendons and bursae) becoming compressed between the bony surfaces of the joint. Two types are discussed in the scientific literature: “internal” and “external” impingement. Let’s…
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Austin Baraki 3
0
Training
November 6, 2018

The Shoulder, Part I: Scapular Dyskinesis

https://www.youtube.com/watch?v=AcTGfGy9_ZY&feature=youtu.be The shoulder joint is complex, and pain affecting its use in daily activities and sport is common. This article series will review common shoulder diagnoses, critically assess the associated narratives provided to patients, and describe their impact on real-world outcomes. We will begin with the assessment of the scapula and its movement. The interaction between the scapula, thorax, and humerus during shoulder movement has been termed “scapulohumeral rhythm” or “glenohumeral rhythm”. The underlying assumption in this context is that normal scapulohumeral rhythm is well-defined in humans. Scapular dyskinesis, then, refers to any abnormality or deviation from “normal” kinematics of…
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Jordan Feigenbaum 3
2
Training
October 6, 2018

The Pendulum of Specificity in Application: Part I

Updated 10.06.2018  This article was originally published in September of 2014 as the first of four blog posts addressing  The Principle of Specificity. Since then, the coaches at Barbell Medicine have learned a great deal more about the topic and felt that these posts deserved an update and expansion. We'll be releasing the updated articles and corresponding YouTube videos throughout the month of October. In an effort to show how our thinking has evolved, I am highlighting the parts of the article that are being updated using italics and quotation marks accompanied by the updated commentary in the normal font with additional clarifying…
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Michael Ray 10
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Mobility
August 21, 2018

Mobility Explained

https://youtu.be/9kA_6cut5mk Rolling through Instagram or Facebook, we find narratives and interventions claiming to improve something called “mobility”. We can select from options including stretching, foam rolling / body tempering, lacrosse ball smashing, voodoo flossing, power tools converted to guns being sold as therapeutic, and the list goes on. The level of marketing would make even Donald Draper of Mad Men proud. But are these implements doing what we think they are? Are we just hidden pliable versions of Gumby walking around, waiting for our supple potential to be released? Or, are we committing the post hoc ergo propter hoc fallacy?…
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Austin Baraki 7
0
Training
August 14, 2018

When Logic Fails: Part 1

https://www.youtube.com/watch?v=zJRii7EL5jI&feature=youtu.be Take home points: In the context of complex systems, logical analysis can be useful in generating hypotheses, but not for drawing conclusions with a high degree of confidence, because there are almost always confounding factors that have not been discovered or accounted for. We must therefore always be cautious with the claims and conclusions we draw from our own observational experience. This is why scientists and evidence-based practitioners carefully qualify their statements in order to avoid overstepping, and should clearly identify conjecture that lacks supporting evidence. In contrast, we must be deeply suspicious of anyone making very confident claims…
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Jordan Feigenbaum 21
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Nutrition
July 20, 2018

How To Measure Your Waist Correctly

https://www.youtube.com/watch?v=PuwS7uL2s3I&feature=youtu.be If you've been paying attention to our latest podcasts, articles, Q/A's, and other content then you've likely heard us discuss the importance of waist circumference in determining who is a good candidate for weight gain and who could stand to lose a bit of weight. Waist circumference is a quick, low-cost piece of data with reams of scientific evidence relating the distance around your abdomen with health outcomes like premature death, diabetes, heart disease, stroke risk, etc. While the aforementioned disease processes have many variables contributing to their development and burden, we have large, well-designed studies showing that males…
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Sarah Al-Khayyal 5
0
RecoveryTraining
July 6, 2018

Navigating Potholes: My Back Pain Experience

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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Austin Baraki 4
1
Training
June 23, 2018

Fear, Catastrophizing, and Training

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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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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