My wife is looking to start barbell training - awesome.
She has HNPP - Hereditary Neuropathy with liability to pressure palsies.
The limitations are that if she has continual pressure on one area, she will lose feeling in that area. A concern therefore is where the barbell would rest once weights are sufficiently heavy to trigger a palsy.
She knows herself what can cause issue - we spoke about deadlifts as an example and while gripping is fine, straps would be out (for example).
Any thoughts on whether barbell training is appropriate at all? My thoughts are yes so long as symptoms are looked out for and loads/time under load managed to avoid a palsy.
That said, I question whether a linear progression is even possible, since as she gets stronger the pressure on the tissue would increase, putting her at more risk of loss of feeling.
Do you have any thought or experience on whether barbells are appropriate, if so, what programming should be taken into account and if not what a suitable training alternative might be?
Hi there and welcome to the forum.
Unfortunately this is an entirely new condition to me that I’ve actually never heard of, so I had to look a bit of information up about it. A few questions:
- Does she have any idea of how long said “pressure” needs to be maintained in order to trigger the problem?
- Is the problem primarily a loss of sensation, or weakness/paralysis? Or both?
- How long does this problem (sensory and/or motor weakness) last before resolving?
If the main issue is motor weakness, and if it doesn’t take much time to set it off AND/OR if it takes a long time to recover, I would probably not use barbell training in this context.
If the main issue is sensory-only (i.e, paresthesia/tingling), if it takes a long time to set it off AND/OR if it recovers rapidly, it would likely still be a reasonable option.
If barbell (or any strength training) is pursued, programming should probably revolve around relatively low-rep sets, and exercise selection may need to be modified to tolerance.
Hope that provides at least some help.
Hi Austin,
Yes that’s helpful thanks. To answer the qs:
- Varies, but decreases as pressure increases. E.g, holding a hand bag won’t trigger immediately, whereas holding a shopping bag could onset within a few minute
- Loss of sensation, no weakness or paralysis
- Again varies, from a couple hours up to days. This is is the longer or more intense the pressure applied, the higher the likelihood of a permanent loss of sensation.
She’s seeing a neurologist, but they don’t really have an answer.