Hi Drs - Big fan of barbell medicine and I’ve been wanting to get your perspective on this for some time.
My boyfriend (we are both 22) has been suffering from autoimmune disease for years. His flare up in between biologics (after developing antibodies to the one he’d been on for years), caused contractures in both knees and elbows. He just had surgery and is in PT to achieve extension in the knees, but may never regain full flexion.
Powerlifting-style training is a huge part of my life and I’d love for him to come to the gym with me if it could be helpful for him. He’s concerned about a few things here:
1- Interfering with PT for his knees
2- Whether the stress lifting places on his body could cause another flare up (historically, his joints have felt worse after exertion)
3- Training with limited range of motion
I was wondering if you had thoughts on any of these, especially 2, as I know this disease can sometimes evade typical wisdom. I know these may be best directed to his rheumatologist, but thought it couldn’t hurt to post.
1- This is unlikely, but would depend on the specifics of how the training (and PT) are programmed. I doubt that his PT would have any concerns about him pursuing other forms of physical activity, however.
2- I don’t know what specific condition(s) he has; it is always possible for people to experience pain when doing “too much, too soon”, so again this comes down to a matter of programming. There is no reason why reasonably programmed exercise in a patient on treatment for autoimmune/inflammatory conditions should precipitate an immune flare, however.
3- I’m not sure what concern this is getting at. People should train through the range of motion they can tolerate; if that is not so-called “full” range in his case, that is OK.
Thanks for the perspective!
The concern with 2 is less pain and more actual damage, when he used to hike (already on monthly remicade) his knees would fill up with fluid that had to be drained.
Range of motion comes into play as far as certain exercises being off the table, eg he can’t squat in any significant way — but I see your point that this is just a matter of programming.
It’s helpful to hear you don’t necessarily see inherent issues — do you know where to go for relevant programming (sports med, pt, etc), and is this in scope of the BBM team?