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Training

The Shoulder, Part III: Internal Impingement

By | Training | No Comments

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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The Shoulder, Part II: External Impingement

By | Mobility, Training, Uncategorized | 3 Comments

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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The Shoulder, Part I: Scapular Dyskinesis

By | Training | One Comment

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 the…

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The Pendulum of Specificity in Application: Part I

By | Training | 2 Comments

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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When Logic Fails: Part 1

By | Training | 6 Comments

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 in…

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Navigating Potholes: My Back Pain Experience

By | Recovery, Training | 5 Comments

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 | 54 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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A Novel Approach For Replacing USELESS RPE

By | Training | 10 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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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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