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  • Michael Ray
    replied
    D.Mac Here's a link to the belt squat video. https://www.dropbox.com/s/upp7wcm0ho...Squat.mov?dl=0
    Last edited by Michael Ray; 12-02-2018, 12:02 AM.

    Leave a comment:


  • sooghs
    replied
    Good evening Dr. Ray,

    Thank you and the rest of the Barbell Medicine team for your incredible work in synthesizing this beautiful template. I am eager to learn the from the rehabilitation principles and methods you all used in designing it.

    My question is, would such a template be suitable for someone recovering from a partial knee fracture?

    The person of interest is a 60 year-old woman who strength trains recreationally while more keenly pursuing other activities, such as hiking, biking, etc. She is currently out of her cast (no surgery) and pursuing the road back previous levels of strength, pain, and function.

    Many, many thanks!

    Leave a comment:


  • rainevi
    replied
    Hello,

    Thank you for the work on the template. Just began the 8th week of HLM 1.0 and having been experiencing symptoms on my right knee for a while now (more specifically, back of the knee during bottom of squat and deadlift), I've decided to start the knee rehab template and mix it with the upper body from HLM.

    For bilateral movements, I've chosen low bar squat and deadlift, with the reasoning that both of those are causing mild, tolerable symptoms, and I'm comfortable with them. (Deadlift I cannot tolerate at high intensity, but squats are tolerable I'd say.) With these exercises selected, the first workout proved to be a bit challenging. In both of these, I could hardly do 10 reps (out of 15) with 30kg at the given 3-0-3 tempo. Instead of RPE 5-10 throughout the prescribed sets, I ended up doing 10 reps at 8-10 RPE in most of them. Given that hitting 15 reps is a challenge, how should I proceed moving forward?

    As a side note, I think describing the process for exercise selection in the template spreadsheet itself would be a great addition.

    Thanks!

    Leave a comment:


  • Michael Ray
    replied
    Originally posted by Jungle Dave View Post
    I bought the knee template today partly out of curiosity but also to add a bit of conviction to the current rehab I'm doing on my left knee.

    It's very impressive, I like the way the videos take you through each phase.

    I have a couple of questions- first relates to the number of exercises. Are the variety of exercises suggested during phase 2 to lessen stress on the same structures and push adaptation in areas of the knee that the selection of say, merely low bar and DL might not?

    Second one is a bit more prosaic- I put the purchase through today before putting the Black Friday discount on it- is that a case of "tough"?
    Hey Jungle Dave,

    Thanks for purchasing the template and glad you like it.

    Exercise selection was programmed for the needs of strength-based athletes and what we typically see in the literature for HSR for the knee. Squatting and Deadlifting are a part of the templates but we've also included single leg exercises because that's how we see it in the research typically. Anecdotally the thought here is to ensure we are driving adaptation to the symptomatic extremity with single leg exercises.

    Sorry to hear about missing out on the sale. Email: [email protected] and perhaps they can help you out.

    Leave a comment:


  • Michael Ray
    replied
    Originally posted by yi1221 View Post

    Hi, thanks for the response. Fortunately the pain has dissapeared all of a sudden, except maybe for some mild discomfort during knee loading.

    Out of curiosity, about the hip and knee strenthening: I was wondering if it's actually important to get stronger? So would a more trained person need more exercise to see an improvement in symptoms? The PT said I could start exercising lightly on the leg press once I've recovered a bit, starting at body weight but it's so easy I doubt I'm gaining any strength or muscle.
    Yeah, prior training history as it relates to the cited studies on PFPS is a relevant discussion. It's also difficult to quantify strong, and what is strong enough as it relates to framing what is weak. Typically, the approach is are you strong enough to perform the activities you are attempting - which is a load management discussion. It's difficult to give personal advice without consulting with you but if you run the template as prescribed then this will help with managing loads over the next 15-16 weeks. The guiding factors throughout the template is RPE and A:C ratios to help with load management.

    Leave a comment:


  • Jungle Dave
    replied
    I bought the knee template today partly out of curiosity but also to add a bit of conviction to the current rehab I'm doing on my left knee.

    It's very impressive, I like the way the videos take you through each phase.

    I have a couple of questions- first relates to the number of exercises. Are the variety of exercises suggested during phase 2 to lessen stress on the same structures and push adaptation in areas of the knee that the selection of say, merely low bar and DL might not?

    Second one is a bit more prosaic- I put the purchase through today before putting the Black Friday discount on it- is that a case of "tough"?

    Leave a comment:


  • yi1221
    replied
    Originally posted by Michael Ray View Post

    Hey,

    Based on the information you've supplied, I do think the knee rehab template would be appropriate for you. PFPS is a rather vague diagnosis of pain around the patella, typically activity related. We have evidence risk factors for developing PFPS include hip and knee musculature "weakness" (we'd need to try and define what is meant by weakness) and the go to treatment is hip and knee strengthening exercises (oddly enough). This template can deliver what is recommended for PFPS but I do think it's important pain is reframed based on what we currently know and understand regarding the topic. You may benefit from a consultation with us just so we can ensure you meet your goals when implementing the template (https://www.barbellmedicine.com/consults-and-contact/). The consult would also allow us an opportunity to discuss managing loading and fatigue of cycling in addition to completing the template. Happy to discuss further.
    Hi, thanks for the response. Fortunately the pain has dissapeared all of a sudden, except maybe for some mild discomfort during knee loading.

    Out of curiosity, about the hip and knee strenthening: I was wondering if it's actually important to get stronger? So would a more trained person need more exercise to see an improvement in symptoms? The PT said I could start exercising lightly on the leg press once I've recovered a bit, starting at body weight but it's so easy I doubt I'm gaining any strength or muscle.

    Leave a comment:


  • mdelvecchio
    commented on 's reply
    Hey Marc - it's my experience that while the old templates worked when converted to Numbers, the new ones do not and are hopelessly tied to MS Excel in order to be functional. It's unfortunate, as Excel on mobile devices now requires a subscription (subscriptions suck).

    Ideally BBM is working w/ an app developer to present these templates in a more suitable app format, as the level of functionality they're putting into the MS Excel sheets rivals an app, but fails to deliver as good of a UX as an app.

  • Michael Ray
    replied
    Originally posted by D.Mac View Post
    Hi. Just downloaded the template and a few questions regarding exercises I have never done before.
    Bulgarian squat: the video showed the person placing his knee far past his toe which is discouraged in SS LBS (using his TUBOW). Is this ok or is it going to exacerbate my knee pain?
    Belt squat: I'm going to buy a "dip belt" from rogue for this. Do I use the same form as I would for a LB squat technique? I assume I'll need to stand on some plates to create some space for the weight to lower down.
    Split Squat: Seems to be a lot of confusion between this and Bulgarian SS's when looking up in the web. I gather that I kneel down with my "working leg" at 90 degrees and just raise my knee off the floor?
    I noticed Phase 3 uses leg presses. I'm working out in my basement. Any substitution for this lift?
    Sorry for the basic questions, but I found out after reading Starting Strength that there are a lot of hidden nuances in exercises!
    Hey D.Mac,

    Thanks for purchasing the template.

    I understand you may have been informed previously to not allow the knee go past the toes because "X" but this is not correct and there is nothing inherently wrong with allowing this to happen. With that said, in the beginning stages some people may be highly sensitized and forward travel of the knee may not feel great and may need to be minimized initially and then slowly challenged over time.

    Belt squats - We use the "dip belt" at my gym for belt squats; works just fine. Regarding technique, I typically cue the movement similar to a high-bar squat. With that said, just unlock your hips and knees and sit into the bottom of the position; simultaneously your knees should travel forward as hips are going down and back while trying to maintain an upright torso. Usually we have athletes stand on boxes to ensure the weight doesn't hit the ground and they can go through full range of motion. We also usually recommend being near a stable surface that is high enough for you to hold onto for assistance. We usually setup close to the rig and use a barbell at the appropriate height for assistance. Give me a few days and I can see about getting a video uploaded going over the main points for the movement.

    Split squat - these are not Bulgarian split squats (rear foot elevated). Take a lunge position (which I call split squat position) and lower down and then stand back-up. I do not call this a lunge because there isn't a forward or reverse movement (walking). Interestingly enough, language on movement tends to vary across communities.

    Phase 3 - Remember, you can select the exercises you want to do at the top of the phase tab (See photo). If you don't have a leg press then there are other options. Let me know if you have any other questions.

    Leave a comment:


  • Michael Ray
    replied
    Originally posted by marc.mccabe View Post
    I just downloaded this template, but none of the video links work. I'm using a mac, opening the template in Numbers. Thanks for any help.
    Is the template working for you now without issue? I'm not sure the template is compatible with Numbers but should work with excel. I have a Mac and iPhone and the template loads in excel on both without issue.

    Leave a comment:


  • Michael Ray
    replied
    Originally posted by Jon Loper View Post
    Hi, Thanks for the template. It looks awesome!

    I am just wondering how to do the isometric single leg loading in phase one.

    For example, for the split squat should I perform 5x45 sec each leg and then rest 2 min? Also, should I elevate my front leg so that it is slightly below parallel and have my rear knee just off the ground?

    Furthermore, it seems that the main goals of phase one are to decrease pain and recruit more motor units in the affected leg in preparation for phase two. Therefore, do I load the isometric exercises to an RPE of 10 using as much external load as possible if I can do so without adverse symptoms and continue to progressively overload it in phase two? In other words, does a RPE of 10 with isometric training mean that I should choose an appropriate external load that I fail at the 45-second mark?

    Thanks for your help!

    Jon Loper
    Hey Jon,

    It depends on your level of sensitization. The goal is to perform all 5 sets for :45 seconds however, this can be altered based on your symptoms. You should perform a 2 minute rest between each set of isometric holds, a set would include holding the position for :45 seconds on your left leg and on your right. You certainly can perform a front foot elevated split squat but this isn't necessary. Your rear knee should be just off the ground. Phase 1's only goal is to introduce loading to the area while mitigating symptoms. However, if you are able to pass the biofeedback test without issue then phase 1 can be skipped. If you decide to perform phase 1, then you should reach an RPE 10. External load may not be necessary for some people but may be doable for others. "In other words, does a RPE of 10 with isometric training mean that I should choose an appropriate external load that I fail at the 45-second mark?" - Yes. However, I wouldn't try to transfer any external load to phase 2. Once you start HSR, external loading will likely be drastically changed due to tempo.

    Leave a comment:


  • D.Mac
    replied
    Hi. Just downloaded the template and a few questions regarding exercises I have never done before.
    Bulgarian squat: the video showed the person placing his knee far past his toe which is discouraged in SS LBS (using his TUBOW). Is this ok or is it going to exacerbate my knee pain?
    Belt squat: I'm going to buy a "dip belt" from rogue for this. Do I use the same form as I would for a LB squat technique? I assume I'll need to stand on some plates to create some space for the weight to lower down.
    Split Squat: Seems to be a lot of confusion between this and Bulgarian SS's when looking up in the web. I gather that I kneel down with my "working leg" at 90 degrees and just raise my knee off the floor?
    I noticed Phase 3 uses leg presses. I'm working out in my basement. Any substitution for this lift?
    Sorry for the basic questions, but I found out after reading Starting Strength that there are a lot of hidden nuances in exercises!

    Leave a comment:


  • marc.mccabe
    commented on 's reply
    I downloaded this to my phone and was able to access everything I needed to

  • marc.mccabe
    replied
    I just downloaded this template, but none of the video links work. I'm using a mac, opening the template in Numbers. Thanks for any help.

    Leave a comment:


  • Jon Loper
    replied
    Hi, Thanks for the template. It looks awesome!

    I am just wondering how to do the isometric single leg loading in phase one.

    For example, for the split squat should I perform 5x45 sec each leg and then rest 2 min? Also, should I elevate my front leg so that it is slightly below parallel and have my rear knee just off the ground?

    Furthermore, it seems that the main goals of phase one are to decrease pain and recruit more motor units in the affected leg in preparation for phase two. Therefore, do I load the isometric exercises to an RPE of 10 using as much external load as possible if I can do so without adverse symptoms and continue to progressively overload it in phase two? In other words, does a RPE of 10 with isometric training mean that I should choose an appropriate external load that I fail at the 45-second mark?

    Thanks for your help!

    Jon Loper

    Leave a comment:

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