I have a new client with DISH in her late 70’s. She has only been training with me about 5 weeks. She was concerned about the deadlift and asked her doctor. I was happy that the doctor said she can deadlift but said to just “keep it light”. Would you have any concerns if we are using a slow, steady progression and paying attention to any symptoms? After hearing from the doctor she is willing to do them but simply put an arbitrary weight on there. She had done 40lbs with no issues but now says 30 is the most. I will not force anything she is not comfortable doing.
Nate
Nate,
Thanks for the post. I don’t think it would be reasonable to overrule the physician who’s seeing this patient regularly and caring for her. However, I do not know the reason for the “keep it light” recommendation. Is this light in absolute or relative terms? Why 30 pounds? What is the physician worried about and how does that stack up against the risks of insufficient activity? I suspect outside of the latter, the physician is unlikely to have answers. What about picking up a grandkid who weighs 31-pounds?!
Diffuse Idiopathic Skeletal Hyperostosis (DISH) is not something I personally have much experience in with respect to management. I do know the limited trials investigating exercise and physical therapy seem show a benefit in function and decrease in symptoms, though none of them were lifting heavy (in any sense of the word). I also believe there’s some question around this diagnosis as to whether or not it’s an incidental finding on imaging vs. causal of symptoms. That’s not particularly instructive for how-to train a person with DISH, but it does influence the way I think about the risk of exercise from this condition.
Sorry I can’t be more helpful!
-Jordan
Jordan,
No, this is very helpful. I will not go against the physicians recommendation. I was happy when my client came back she was willing to do deadlifts. We did do them light and I am hopeful she will be willing to progress as she sees she feels fine. I just wanted to make sure there wasn’t something I was missing with this condition. It seems like this lady takes on the identity of the diagnosis and it becomes part of her personality.
Thank you for all you do,
Nate