You’ll Never Squat Again: Why Physical Therapists and Doctors Should Learn Some Biomechanics

Gene Lawrence is a badass. He’s a 74 year old powerlifter who has set tons of records in his sport. He didn’t start training for powerlifting until he was 69. Last year, he squatted 225, benched 260, and deadlifted 365, all raw. Last year he also tore his left rectus femoris falling down in his driveway.

Gene Lawrence

Gene Lawrence

The doctor who performed his surgery told him he’d never squat again. His physical therapist told him the same. I knew better. I told Gene that within a year he’d probably be squatting his all-time best.

As a lifter, I’ve heard many stories of doctors (and sometimes physical therapists) informing lifters that their careers were finished or that they’d never be able to perform a certain lift ever again. Rarely is this advice appropriate.

Doctors and physical therapists are overly cautious due to liability issues. Their primary concern isn’t about how passionate you are for powerlifting or any other sport, it’s about keeping you injury-free so that they don’t get sued. And the best advice to keep somebody injury-free is to tell them not to lift heavy anymore.

Nevertheless, numerous powerlifters over the years have come back following “career-ending injuries” to set all-time PR’s. Donnie Thompson is the only man to total 3,000 lbs (1,265 lb squat, 950 lb bench, 785 lb deadlift). Many people don’t know this, but several years back Donnie suffered a horrendous back injury and herniated three discs. He could barely walk, but he got out of bed and rehabbed himself every day. Within three months he was back to heavy squatting and setting PR’s. Got that? Setting personal records three months following an injury that herniated 3 discs!

Gene and Donnie

This is Gene Standing Next to Donnie “Mr. 3000″ Thompson

Following his rectus femoris repair surgery, Gene spent approximately 4 months with his physical therapist, strengthening his quads and hips and regaining flexibility. After that, he returned to training with Charles Staley and me. Immediately, Charles and I had him performing tons of bodyweight hip thrusts and back extensions to strengthen his posterior chain. We also started him off on deadlifts. For two weeks it was rack pulls with light weight, and from then on it’s been from the floor. After a month, we implemented bodyweight box squats. Two weeks later we had him performing goblet squats. Two weeks later came the barbell for squats.

In just 4 months of training with us (and 4 months with the physical therapist before that), Gene has recently squatted 215 lbs (20 lbs off of his all-time best), benched 258 lbs (3 lbs off of his all-time best), and deadlifted 330 lbs (35 lbs off of his all-time best at this weight). He’ll soon beat his squat record, just as I predicted. It’s not easy returning from a surgery when you’re 74 years old, but Gene may soon start setting PR’s due to the hard work and consistency he’s put forth (Charles and I put him on a very regimented schedule).

Here’s what Gene’s doctor and physical therapist failed to understand. Powerlifting is what makes Gene tick. It gives him strength, courage, and zeal in life. Gene’s home gym is his pride and joy – it houses his hundreds of powerlifting trophies and plaques. Setting PR’s gives him a reason to get up and train. It’s in his blood. If you’re a fellow lifter, you get it.

What if Gene had listened to his surgeon and PT? He’d probably have quit lifting, which would have negatively impacted his physical health and devastated his psychological well-being.

If you suffer a serious musculoskeletal or soft-tissue injury, here’s what you should do: 1) Never rush the healing of an injury, 2) Embark upon a gradual, progressive rehabilitation program, and 3) Find a doctor and physical therapist who understand strength & conditioning (there are indeed plenty of great doctors and PT’s out there who also understand S&C – these are the types I gravitate toward). Here’s what you should not do: 1) Solely listen to the advice of one doctor or one physical therapist, and 2) Give up on a sport or activity before the rehab process has terminated. Nobody can know for certain how an individual will bounce back following an injury.

Probably ninety percent of doctors don’t even lift. The majority don’t understand strength training, the mental attitude required to be consistent in the gym, and the pride that accompanies weight room strength. Due to their ignorance and fear of heavy strength training, they often utter ridiculous advice.

For example, doctors will usually tell you to stop lifting weights at the slightest sign of danger. Elbow hurts? Don’t lift. Knee hurts? Don’t lift. Back hurts? Don’t lift. Why can’t you just work around the problem? If your knee hurts you can still likely perform weighted back extensions and keep your posterior chain strong. If your elbow hurts you can still train legs, core, and some upper body muscles. If your back hurts you can still perform single leg exercises and certain upper body exercises. There may be times where it’s wise to completely avoid strength training, but this is far more rare than what the doctors tell you, and a savvy lifter can always work around an injury.

Moreover, the vast majority of doctors and PT’s don’t adequately comprehend biomechanics. In our Hip Extension Torque product, Chris and I teach readers how to calculate estimations of torque loading during squats, deadlifts, and other hip extension exercises. I believe that this is a skill that many physical therapists and orthopedic doctors would benefit from – it’s definitely improved my skills as a personal trainer.

squat-deadlift

I can’t tell you how many times I’ve trained a client whose doctor or PT informed them that they weren’t allowed to perform an exercise such as a squat or a deadlift, only to find out that they were prescribing an exercise that put just as much torque loading (or more) on the joint in question as the exercise they condemned. Upon inquiry, I discover that the doctor or PT did not examine the client’s form in order to reach his conclusion; he just offered a blanket statement to cover his ass.

Another common fallacy I see with doctors – they’ll often tell certain clients (let’s say a pregnant lady a back surgery recipient) that they’re never to lift anything greater than a certain weight, for example 30 pounds. However, biomechanics determines the loading on different parts of the body; the interplay between the body position, posture, load, gravity, and inertia need to be considered. A 30-lb kettlebell deadlift positioned directly underneath the center of mass and lifted with proper form with neutral spinal alignment will create far less spinal loading than lifting a 30-lb oddly shaped object positioned out in front of the lifter with a twisted set-up. Contorted body weight exercises can be more harmful for the spine than 135 pound barbell exercises performed with perfect form. Never is a very strong word. With proper progressive training and excellent form, people can usually build themselves up to be quite strong. It would be far more fruitful to teach proper mechanics than to place a limit on loading and thereby instilling a lifelong fear of strength training. Nocebo effects are unnecessary and counterproductive.

The squat is well-tolerated if you understand progression-regression continuums. If you start at the appropriate level and perform the movement properly by sitting back and ensuring that the knees track over the feet, then there’s no reason to worry. You can start with high box squats and work your way down in ROM, then add load in the goblet position. People have to squat in their every day lives, so there’s no avoiding the movement pattern. You can either pretend the squat doesn’t exist, or you can take the time to make sure the individual is squatting correctly; distributing the load properly to the hips in order to spare the knees.

Many lifters with knee problems shouldn’t avoid squats altogether; they should learn how to squat properly with low load joint-friendly squatting variations. If volume, intensity, and frequency are kept low, these drills are usually therapeutic and prevent future injury.

Lifters with back problems shouldn’t automatically avoid hip-hinging. They should learn how to hinge at the hips while preventing excessive motion in the spine and develop their gluteals. Rack pulls, deadlifts, trap bar deadlifts, kettlebell deadlifts, kettlebell swings, 45 degree hypers, back extensions, and even bodyweight reverse hypers are all good choices as long as proper form is utilized. Many individuals do not keep a relatively neutral spine during many of these movements because they compensate for weak glutes by utilizing excessive spinal motion. If these individuals never master hip hinging mechanics, how will their form look when they pick things up off the ground or perform yard work? Again, the solution isn’t to avoid the movements, it’s to teach and ingrain proper mechanics.

There are indeed plenty of situations where certain individuals would be better off avoiding heavy loading with certain exercises. For example, not everyone is well-suited for squatting and deadlifting. But this doesn’t mean that they couldn’t include goblet squats and dynamic effort deadlifts into their warm-ups so their squat and hip-hinge form remains solid throughout life. But these same folks can find other lifts that they tolerate well, for example Bulgarian split squats, hip thrusts, and Russian leg curls, and they can build up incredible size and strength through these lifts.

It is not my intention to bash all doctors and physical therapists. I’m friends with plenty of world-class docs and PT’s who possess incredible knowledge of S&C. But just as with any profession, there’s a huge gap between the top tier and the average doc or PT when it comes to S&C knowledge. The same goes for strength coaches and personal trainers – there’s a huge gap between the top guys in the field and the rookie globo gym employees.

Luckily, Gene has two competent strength coach friends (Charles and me) who know what makes him tick and helped him formulate a plan of action. Last weekend, Gene competed in a PL contest and met a fellow 91 year old powerlifter who inspired him. That’s how I want to be – pullin’ heavy deads til the day I die. Keep doing your thing Gene!

Gene2

Never Give Up Gene!

95 thoughts on “You’ll Never Squat Again: Why Physical Therapists and Doctors Should Learn Some Biomechanics

  1. Dan Pope

    Excellent stuff Bret. I’m an S & C coach, trainer and PT and I definitely agree that this happens quite a bit. Don’t let these individuals who perpetuate the idea that PTs and docs don’t support their patients to do what they love damage the entire profession. My whole career is based around getting people healthy so they can get back to what they love!

    Reply
  2. Nick Nilsson

    Great post – I’m constantly getting questions from people who’ve been told they can’t squat, deadlift, heavy press, you name it. When properly progressed, the body can come back from a lot more than most doctors give credit for.

    I had an occasion where I twisted my so badly the doctor said I would’ve been better off breaking it. I was back in the gym the next day…not working legs but working everything else.

    Reply
  3. Derrick Blanton

    Mr. Lawrence, you sir, are an inspiration! Great job BC and Charles with the coaching assist.

    Because I’m a natural born contrarian, I have to mention that the ill-advised doctor and PT advice to “never lift again” sounds suspiciously similar to recent advice I read somewhere to never train through pain.

    Anyone really think Gene Lawrence didn’t have to walk directly back into the pain cave with clear, sober eyes, as did Donnie Thompson. What’s the other option? Lay in bed all day and hope God brings you a hot dog? (OK, that made absolutely no sense. I apologize.)

    Listen, I’m not one of these weirdos who fetishizes injury, and equates getting hurt with being “diesel”. Injuries suck, period, and should be avoided! But sometimes when you dance on the edge of the cliff, you take a tumble. What’s the old adage, “See the cardiologist, or see the orthopedist. Choose.”

    So great job, BC and CS, making sure that pain was the price of admission to better health, and better training, and not further injury.

    Mr. Lawrence, it’s entirely likely that this post may enter my mind when I reach reps 17-20 of my next BSQ set! (And hopefully not directly before I blow out my back “going for the gold”. LOL!)

    Reply
      1. Alexander

        Dear Mr. Lawrence,

        I am a guy half your age, even less than that. Currently I am trying to come back from a broken knee and a herniated spinal disc, fighting my way out of it. Unfortunately, in Croatia I haven’t found a qualiffied coach so this is proving to be a bigger challenge than I thought it would be. A few days ago I almost gave up and quit my gym membership but luckily I found your story. After reading it and returning to the always inspiring “Brian Jones story on Starting strength” website, something broke inside of me which made me firmly decide – NEVER give up. Never.

        You are an inspiration!
        Many greetings,
        Alex

        P.S. I would be honored if you would let me have your email or other social media contact so I can drop you a few lines from time to time

        Reply
  4. Cheese_berg

    Can you list any of those Athletic and Strength friendly doctors in NY? Or email me their info. My doc said pretty much the squating is over. I don’t accept that statement.

    Thanks

    Reply
  5. Jake Johnson

    Great post Bret, very inspirational.

    It’s always great to see someone like Gene go against the grain and take on what some people would consider “unrealistic”. I’ve been in similar situations with injuries (although I’m not 74 years old) where I’ve been told that I won’t be able to do this or that, but I’m doing those things today and I’m happier than ever.

    Like you said, sometimes you have to get the insights of others before trusting the opinions of a doctor who doesn’t understand the sport of powerlifting and strength training in general.

    Keep up the great work guys.

    Jake

    Reply
  6. Roy

    I too am a contrarian. Sometimes an injury does cause the total loss of an ability. So, what then? What if Gene’s injury had totally put an end to his powerlifting? What would I have thought if he had curled up in his bed, totally lost in the world b/c he couldn’t lift? Is that as heroic? My point is, there are few things in the world that are so important that the loss of them should end one’s happiness or ability to live a good life. I deeply love being in shape and doing the things I currently can do, but if I lose the ability to do them I’m not going to curl up and be “psychologically devastated” forever. I am going to turn my hungry eyes on the the world and find something else to do and love and keep doing that until I keel over. So, this time Gene and his excellent trainers got him through and he’s back doing what he loves. Great and good on ya mate. But, another wise axiom is “keep some perspective.” And if you do lose an ability–keep your drive, move on, and keep living.

    Reply
    1. Derrick Blanton

      Great post, Roy!

      Along the lines of your theme:

      When a lifelong artist succumbs to arthritis and can no longer hold a paintbrush…don’t be surprised if they learn to paint holding the brush in their teeth. When the Def Leppard drummer lost his leg in an accident, he learned to drum with one leg on a special drum set. In some respects, this is Nature finding a way. This is the part of our nature that makes the human condition extraordinary.

      It seems the main variables that we are exploring today are: “When is challenging pain constructive, and when is it destructive?” While considering this question, (which is life altering, btw), how much stock can we put in the advice of the recognized experts in the field? And when it comes to physical fitness, this advice is going to be all over the map.

      Sometimes the mental toughness (aka- “stubbornness”) necessary to make physical adaptations will boomerang and cause injuries, similar to when the body’s immune system will go overboard and start attacking the body’s healthy cells.

      In most cases, on balance, it is still better to have that immune system. Not having one makes for an ugly demise.

      This stubbornness also works in reverse, though. Someone very close to me is struggling with a literal cascade of health problems, many related to poor lifestyle choices. It is difficult to watch. This person has stubbornly and willfully chosen to avoid exercise of all types, finding it painful and unpleasant.

      This is the mindset gratefully seizes on the axiom: “don’t train through pain”, as a lifetime pass to avoid physical discomfort. (The consequences for taking this pass are real. Make no mistake.)

      Once your mind is made up, either way, it is far stronger than the physical body. Great discussion!

      Reply
    2. Bret Post author

      Good comment Roy. I fear that Gene would have succumbed to his second passion – eating ice cream! ;)

      I agree, I sometimes wonder what I’d do if I couldn’t train anymore. I’d focus on my research I suppose. I don’t even want to think of that possibility though! My worst fear. But life goes on and you find something else to make you tick.

      Reply
  7. Jonathan Fass

    I believe that this post suffers from numerous examples of fallacious reasoning that makes its applicability to all “Physical Therapists and doctors” limited and its claims overall questionable. The basic theme is based on a “Hasty Generalization” fallacy, because both the inspiration for the post (a single PT and a single MD) as well as your self-selected observational examples of “many stories” of PTs and MDs are both lacking in rigorous experimental control and may, in fact, be an incredibly insignificant and misleading representation of the total population of PTs and MDs (in fact, it is entirely possible that these cases are examples of *non* sports-specialists, who would hardly be representative of competently trained PTs and MDs. Is this, then, a fair example of all “PTs and MDs” needing to “learn *some* biomechanics” or is it a cherry-picked example of your own confirmation bias?)

    This post cannot and should not be taken seriously because of the above failings of basic and reproducible findings, and anecdotal evidence cannot be considered evidence for any blanket statement on the qualifications or knowledge base of these or any professionals in question. I would respectfully suggest that you take a few moments to download “The Strength of Evidence Podcast” which deals heavily in critical thinking and the practice of using real evidence – not anecdotal, casual observational evidence – in decision-making and thought: http://strengthofevidence.com/

    Respectfully, Jonathan Fass, PT, DPT, CSCS

    Reply
    1. nell

      Bret’s not cherry-picking, I’d say he’s giving a realistic representation of what patients face. I’ll add my anecdotal experience. I’ve tried to heal myself and stay strong, but it’s only led to further injury. I do actually need a PT. But I have no idea where to look.

      I’ve wasted time and money on the 90% tens/ultrasound PTs. I see websites advertising Such-and-Such Method (TM), which puts me off — does any other paramedical profession commercially patent therapies in that way? I’m not interested in subscribing to a philosophy for the sake of it, because the PT invested in that kind of training or thinks it’s marketable.

      I want to know if given treatments actually work for the specific injuries I have — that there’s an evidence base behind a particular treatment choice.

      I want assurance that the PT knows, for instance, that chronic tendonitis (inflammation) is idiotic as an idea, & that at least a decade of research has talked about tendinopathy (failed healing). I’ve had to pay for many a consult to figure out that they don’t know it. And while they’re screwing around and taking my money, I deal with pain that impacts my daily life; it get worse; surgery starts getting talked about; my hams remain woefully neglected.

      I believe conservative treatments can work (because I’ve read the journals it seems my local PTs haven’t), but accessing physios who know about them is a challenge. Have also looked at the sports clinics serious athletes use, and don’t know what to make of that either – most of them are headed by chiropractors (?!). Definitely want to stay away from the surgeon, who seems overconfident — the journals I’ve read aren’t backing him up either. None of them actually seem to care if what they do is effective or not. They don’t have to live with the consequences.

      The worst is not knowing who to trust. I’ve never been paranoid or inclined to anger, but believe me I’m fed up. I seriously wish I could believe in acupuncture or whatever, would at least benefit from a placebo effect.

      In short, PTs, if you want us to trust and pay you, get rid of the charlatans and tighten up your research. Or at least read what’s already been written.

      Roy and Derrick, appreciated your comments, a lot.

      Bret: what can patient/consumers look for in terms of signs of a 10%er? Why don’t kinesiologists and PTs work more closely together? Finally, any thoughts on lifting for connective tissue/hypermobility syndromes? The consensus seems to be to keep resistance *really* low, and help out stabilizers with repetition (10-20), rather than overload (some say, to stop at 25 lbs). But it seems to me that more volume might be just as bad. What about Pilates as an adjunct to lifting, or instead of it, if in a rehab state? Thanks!

      Reply
      1. AH

        Who do you think has put out the vast majority of the ‘osis’ (which is what you meant to say instead of opathy) vs ‘itis’ research? As far as finding a good PT, you can find board-certified specialists through the APTA website. These are PTs that have qualified through both experience and a rigorous exam that requires a high level of research knowledge. I’d look for ortho (OCS) or sports (SCS) with someone that has both obviously being your top choice. Hope this helps.

        Reply
  8. Angela

    Great post. I can relate a lot.

    I stopped trusting MDs in my second year of med school. I had it all and I was just 21. Piriformis syndrome. ITB syndrome. Lumbar pain. Neck pain. Every answer I got from my doctors (who happened to be my teachers) was to stop weight training, stop running and stop living! So I got depressed, until I decided I’d fix myself. I’m not where I want to be (yet) in terms of training, but I live in a southern european country without any competent PT (don’t even ask about strength coaches)… So I’m all DIY. I’ve been pain free from years, I’m stronger and more coordinated than I was and I will be able to go heavy on my lifting someday. There’s no secret: foam roll the hell out of my kinks, learning to breath, learning to move, learning to release my hip flexors… And tons of glute activation.

    I wish I could say that doctors ban people from doing exercises because they’re worried about being sued, but the sad truth is they have no clue. When I’m asked about the things I do to be healthy and I care to ellaborate a bit fellow fellow students and physicians (even physios) look at me like I’m talking about crystal healing and chakra stuff.

    Reply
  9. Will Freeman

    I like the first comment. The post was good, but a little generalized, perhaps too much. I work as a physical therapist and the fact that I read this site on a somewhat regular basis let’s you know where I am as far as whether someone should be squatting or not. In that respect I absolutely agree with Bret. I also acknowledge that you can find plenty of therapists that fit the mold described in the post. However, I still didn’t like the slap in the face to my profession. It’s like saying personal trainers and strength people don’t have a clue about “medical” patients. I personally know that last statement to be false. There are plenty of persontal trainers and strength coaches who I would trust more than some therapists I work with. The problem with both professions are the “professionals” who think they already know everything and don’t take take the steps to learn more; to take the objective view to question themselves and find whether they are right or wrong instead of just doing the same old thing because that’s the way the’ve always done it. Apparently it happens to doctors too, since there are still those who think squatting is bad for you…as if the patient doesn’t squat everytime they get out of bed or get off the commode, or out of the car. So I just wanted to put it out there that there are those of us who have a clue…more than a few of us.

    Reply
    1. Bret Post author

      Hi Will, I’ve given two glute seminars to groups of 30+ physical therapists, I have tons of physio-friends around the world, and I even scour physical therapy journals. So I’m well aware of all the great physical therapists out there. But as a personal trainer/strength coach, I can’t tell you how many terrible stories we hear from our clients. I’ve also had experiences with physios who ran assembly lines – ultrasound, EMS, ice etc. and tried to bill your insurance company for every possible thing without even knowing the actual problem or attempting to get to the root of the problem. Oh, the stories I could share!

      But it’s no different from any profession. The typical personal trainer at the local commercial gym is horrendous. I should have spelled that out more clearly. Cheers, BC

      Reply
  10. Michael J Carr, PT

    Great post Brett. I usually tell my patients that squats don’t hurt your knees, the way “you” squat hurts your knees.
    Athletes need to treated by an orthopedic physical therapist, preferrably one who works with lifters. Sports medicine is getting more specialized and I just don’t think a general population PT is going to cut it. Research your therapist and ask them some questions prior to your evaluation. Then follow up with a good trainer after discharge.
    Good luck

    Reply
  11. Laurie

    Thank you Bret. You know my story: Broken femur in 4 places and two hip replacements within 30-days. After 4 months I’m squatting leg pressing and lunging with a smile! You’re awesome. Thank you for sharing the truth to the world!

    Reply
  12. Emily

    Great post Bret. Brilliant. I read something similar on the Starting Strength site about a gentleman who fell off a roof and incurred severe pilon fractures in both legs. His name is Brian Jones. You can read his story her: http://startingstrength.com/index.php/site/article/barbell_training_as_rehab#.UbttUZz3OSI

    Basically, everyone told him he would never be able to walk again. Now he is setting Powerlifting records. He takes mental and physical strength to get back up after an injury, no matter how big or how small. In 2010, my back finally gave out on me one day. All I did was bend over the sink to brush my teeth. The next thing I knew I was sprawled on my bathroom floor, my back in spasms, my body in spasm from my right shoulder all the way down to my foot. It was like one big charlie horse. I stayed on my stomach for a week, unable to walk, sit, drive, eat. I lost weight. I looked sick. For over 5 years, I spent my life on my back with my legs on a chair every few months when my back would act up. I went to my back doctor. PT. I went back to my back doctor. More PT. The last time I went to her in May of 2010, after I had just finished three months of PT, she gave me a prescription for a back brace. Screw this, I said. Once out of acute pain, I got into the gym in June of 2010. I learned to squat properly. I learned to deadlift. I learned to press, bench and did barbell glute bridges and hip thrust thanks to you Bret. By the following May, I had was close to a 200 lb deadlift. This is someone who deadlift 95 lbs for the first time the year before and saw stars and swore she would never be able to lift more than that. NEVER, ever would I wear a back brace. And I didn’t. I just got stronger. I started dancing again (I had to stop in 2009 due to my back and never thought I would ever dance again.) and joined a new company the end of 2011, one year after I started lifting.

    Someone (a “trainer” I met at my PT office) asked me why in the world would I want to lift 200lbs? I mean, that could really hurt you, she said. Because, I said, if I can lift 200lbs, everything in my life just gets easier. She didn’t get it. And she may never get it. But I did. And my clients get it. And they get stronger everyday. I just got one of my new clients to do a box squat (she has had knee surgery on both knees.) She came to me and told me “I can’t squat.” Three classes later, she is box squatting. And coming back tomorrow for more.

    Sorry for the rambling comment Bret….but this post really got me excited! Thanks for reading. ;)

    Emily

    Reply
  13. Emily

    Sorry…..one more comment. ;)

    I had a new client start with me about two weeks ago. He is a spine doctor, a surgeon I believe. He came by my place, met me, got really excited to start, couldn’t wait and then proceeded to tell me that the worst thing someone can do for their knees is squat and deadlift. I was stunned. I thought, you did not just say that in my house? But I smiled and politely said that none of my clients have ever complained about their knees and in fact, most of their knee pain (if they had any when they started) goes away when they learn to perform the movement correctly. I basically said, when you teach someone how to move properly, magic happens. ;) He started with me. I watched him squat and then taught him how to squat properly. Guess what? No knee pain. Doctors are funny creatures. ;-)

    Reply
  14. Kyle

    A good article, nice to see something other than “glutes!”

    Regarding medical advice, one thing to consider is that even if the medical professional does know plenty about strength and conditioning, they won’t be present during the patient’s workouts. Thus consideration of safe form comes to their minds – the person may be able to do a 135lb deadlift safely with good form, but will they use good form?

    Working in the gym, there’s a difference between the workouts I give to general gym members and those I give to my personal training clients. The general gym member will be shown how to do it in one or two sessions, and then go off and do it on their own. The PT client will be supervised for one or more of their workouts each week, with me watching every rep. Obviously, the general gym member will be given less technically complex movements to do.

    For example, most of my PT clients do a low-bar back squat, my general gym members do a high-bar. The low-bar just takes longer to learn and get used to, people working out alone will try it, feel uncomfortable and usually never do it again. Whatever the merits of the different kinds of squatting, squatting is always better than not squatting, so I give them the squat I think they’ll actually be able to do safely and effectively.

    If a general gym member presents with herniated discs, I’m not going to give them a barbell deadlift to do. Whereas a PT client, after some preparation, sure.

    When I ring up a PT client’s doctor or physiotherapist and discuss things with them, quite often the “do nothing!” advice gets tempered somewhat. Once they know someone more or less competent will be watching every rep, they become more confident about the person’s prospects of recovery.

    Reply
    1. Bret Post author

      Trust me, I understand. That’s why I started up GetGlutes with Kellie and Marianne. We go to great lengths filming videos of ourselves showing and discussing proper form, common mistakes, cues, etc. In person I know my clients will use good form, but when I write articles and blogposts, I can’t help but wonder how many of my readers’ form looks. But we do the best we can. And I’d never tell somebody to never train just because I can’t be there to watch them. I’d try to refer them to someone locally who I trusted. So we see eye to eye on this.

      Reply
  15. Jen

    Thanks for talking the time to post this article. A very informative read, which couldn’t have come at a better time for me & a few of my PT clients who have received dodgy advice from overly cautious & ignorant GPs.
    Thanks again.

    Reply
  16. David

    Interesting post about pushing past perceived limits and/or naysayers, but way generalized.
    Disagree with what you say about doctors. Plenty I know are S & C aware, but that’s not their focus, and not what they do. Just like you don’t diagnose life-threatening medical issues. Better to make a positive point without negative examples.

    Reply
    1. Bret Post author

      David, there’s a difference. I refer folks who have medical issues to doctors and physical therapists. I don’t tell them to never train again. When you say, “many,” what percentage of doctors to you feel are well-versed in S&C? 10%? 20%? And if they aren’t well-versed and are dismissive of it, then they’re doing a disservice to their patients. Sure I generalized in my article, but I’ve probably heard over 100 stories like this throughout my 15+ year career as a personal trainer. This topic warrants discussion.

      Reply
  17. Jess

    YES!!! I got licensed last year as a physical therapist assistant, and certified as a personal trainer several years back. I always thought the two professions were united well, but apparently a lot of therapists don’t understand that lifting CAN be extremely beneficial. I know my own supervising therapist insists “deadlifts are horrible for your back!!!” but I disagree if the patient is performing the variation best suited for them. Great article, as usual!

    Reply
  18. kit_l@mac.com

    Great article Bret; a typo:

    Doctors and physical therapists are overly cautions due to liability issues.

    “cautious” is what you meant, I believe.

    We use the term “CYA” here (cover your arse) to describe the overly safe/cautious recommendation of many health professionals. Far better in my view to say, ‘let’s take it one step at a time, and see what can happen’.

    Cheers, KL

    Reply
    1. Bret Post author

      Doh! Thanks for the correction Kit. I even proof-read the post but I still miss mistakes with my own work. Great philosophy – take it one step at a time and see where it leads! Cheers, BC

      Reply
  19. Will

    Mr Lawrence, you are truly inspiring. Here in Australia, PT is the casual way to call a Personal Trainer, while “Physiotherapist” or, simply “Physio”, is what in North America is known as “PT” , short for “Physical Therapist”, right? Obviously, Bret, you must be well aware of such “semantic” difference, so please correct me if i’m wrong.
    I was lucky enough to meet the Hip Thrust “Father” in person, lecturing in the First FMA Conference (Coffs Harbour, Australia, 2011) and Bret was kind enough to spread knowledge in the same way he is now, once again, sharing Mr Lawrence’s story today. Bret, thank you so much.
    Now, it’s interesting how some Physios have plenty of knowledge when it comes to anatomy and physiology. However, it is almost sad to see them prescribe unnecessary “isolation” drills or prohibiting “forever” compound like the 3 big ones… Others, more sensible and humble attitude, can recognise there are some seasoned Coaches or Personal Trainers with the knowledge, competency and experience to share with them one or two things about exercise prescription and demonstrate that it doesn’t exist one “magical drill” that fixes all the troubles.
    Anyway, my point is, at University, Medicine doctors and Physiotherapists don’t have the chance to have so much “academic field experiences” as S&C coaches and Personal Trainers do, while learning the job… Therefore, it would be great if they could appreciate that -as we actually spend more time with patients and-, instead of prohibiting movement, they should demonstrate more often the ethic gesture of referring patients to competent professionals like us. Nothing wrong with admitting ignorance about a subject. Nevertheless, it is wise to ask or refer when you don’t know. In the end, the patient is the priority, not the egos… Or, in colloquial words, it is what others might call “the art of delegation”, which basically means that you might ignore the way to cook paella but you can show raw wisdom is you decide to call the most capable chef available to give you a helping hand. Thanks for reading. Cheers. Will

    Reply
    1. Bret Post author

      Exactly Will. Thanks for clarifying the PT/Physio discrepancy, I did know that and should have thought of that when writing the post. What you said is exactly how I feel – if docs truly care about their clients, they should take the time to find good local trainers/coaches/physical therapists to refer their clients to, rather than tossing out blanket statements and limitations that induce fear for life. After reading about the spectacular recoveries in just the comments in this blogpost, I feel it’s negligent to ever tell a patient that they’ll never be able to do something ever again unless it’s utterly unrealistic.

      Reply
  20. Carlos J Berio, PT, DPT, MS, CMTPT, CSCS

    I must agree with a large majority of this post. I’ve been writing and speaking for years about the role that more PTs, especially the one’s who continue to claim that returning people to their high-level, pain-free, quality movement is their passion.
    This post sheds a bright light on the area(s) in which my PT colleagues can FAR better serve their clients and the public by becoming more well versed and experienced; even as it falls well within the wheelhouse of most ‘movement specialists, PTs and moreso (IMO) “sports physicians” cover their tails by prescribing sweeping changes to good solid movement as theraputic.

    Of course, if we didn’t do any moving we’d all be pain free. I’m fortunate to have more than 15 years of experience in the S&C field that compliments my PT practice.

    I feel that many EXCELLENT S&C coaches have a right to beat on the table about the place where PTs SHOULD be gaining expertise but choose not too to the detriment of our clients and our discipine.

    Reply
    1. Bret Post author

      Much appreciated Carlos – PTs should definitely try to learn more from the strength coaches (well, the better ones that is). Thanks!

      Reply
  21. ggs

    Wow…Interesting post…Life is full of twist and turns…turn back the clock 30yrs…I was in a head on collision with a drunk driver….I had the best job in the world worked I in a gym and was early into weightlifting…. but my docs and Pt both recommended I find another passion…stay away from the weights they advised..Like a dummy I followed there advice….Jump forward 26yrs….My son graduates from MUSC with a PHD in physical therapy…He suggests I get back in the gym and take it one step at a time…Three years later and I am looking forward to the rest of my lifting life…Now my goal is to be that 91yr old Grandmother who kicks it in the weight room…Thanks for your posts and your insight… it is always appreciated..

    Reply
    1. Bret Post author

      Incredible. Very unfortunate that you were dealt this advice, but luckily your son helped you realize that it was foolish. Great attitude ggs!

      Reply
  22. Jacob Soeholm

    In Denmark we do not, as medical professionals, have to cover our well-shaped glutes for legal purposes (actually we do, but not out of fear of being accused of malpractice ;)). Still, many of my fellow physicians and the physical therapists are quite ignorant as far as heavy, basic training goes, and most would caution against it if asked about it by a patient.
    I think part of this is because physicians (I can’t talk on behalf of the physical therapists) tend to err on the side of caution, if asked about something we know little about. Which is, most often, a good idea – do no harm.

    But I think the main point in this articles is the amazing capacity of the human body to recover from even the most severe injuries.
    And that most of the experience we as doctors have with rehabilitation are based on vast majority of patients, who just don’t like to exercise. I see most rehabilitation programs as a “program minimum” and most people will not follow these to the letter. And if supervised by a physical therapist, will only do what is required and nothing more.

    The best rehab results I have seen (granted I’m an Infectious Disease specialist, not a surgeon) have been achieved by fellow meatheads who REALLY wanted to train and did all they were asked to do and more.

    As Dave Tate says: “Passion trumps everything”.

    Reply
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  24. Steffan Griffin

    Hi Bret,

    Big fan of the site and your articles, just a thought as I’m a third year medical student. Whilst I agree that doctors especially should posses a basic competency in biomechanics/exercise science, I don’t think you can necessarily blame the doctors themselves for the advice regarding lifting that they prescribe.

    There is simply no teaching during the degree regarding this, and with so little time in primary care consultations where most MSK injuries are dealt with, you can’t blame them for taking a safety-first approach – especially with the risk of litigation – as much as I don’t agree with it. What’s needed is a referral system to accredited physios/PT that could safely advise the patient on an exercise regime, or otherwise make it compulsory for doctors to posses a basic knowledge in S&C science.

    Good article though, just wanted to give my side of it too.

    Cheers

    Reply
  25. Adam O'Brien

    Great article Bret. I completely agree on all points. I have an experience similar to Gene. I was born with idiopathic scoliosis which progressed to a curvature of 45 and 32 degrees by the time I was 17. I ended up having surgery to fix my back. They fused my thoracic spine from T1 to T12 and inserted 2 titanium Harrington rods. The doctors told me I would never play baseball again competitively and I should not lift anything more than 50lbs off the ground for the rest if my life. I followed a similar approach as Gene and worked by butt off and ended up playing college baseball. My experience influenced me so much that it inspired me to become a strength and conditioning coach and help others in similar situations. O yeah and as of right now my Deadlift PR is 465lbs.

    Reply
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  27. Gina McNeal

    I think the important thing here (and this is what I tell my personal training clients) is to find a physical therapist who is focused on restoring function rather than simply rehabbing an injury in a standard way. What do you want to be able to do when you get done with PT? Sit in your office chair all day? Walk with friends? Play rugby every weekend? The rehab has to be based on the end goal. My own PT works with the Alvin Ailey Dance Company and travels with them on tour. Can you imagine if she said, “Sorry, you can’t (fill in the blank) anymore” to one of the dancers??

    Reply
  28. David B

    This is an interesting article. I’ve had back pain for around 1 year and got a diagnosis of a really mild scoliosis in my upper back. I’ve been told that loading by putting things on my back/torso like back squatting and front squatting is out of the question for the rest of my life (I’m 22) by my physio. Yet other squat movements and deadlifts are ok. I want to trust my physio as their the expert in the room but I know that there are powerlifters with severe scoliosis, its hard to know the way forward.

    Reply
    1. nik

      not that i’m an expert in decision-making but i was basically told that ‘i have the neck of a 35 year old’ at 22 – along with a rotated pelvis and a whole lot of other ‘tsk-tsk medical head-shaking problems’ -.-‘. ha ha. that is NOT ENCOURAGING by any means, but i do feel that much as we would like to trust someone with a ‘professional certificate’ wholeheartedly, trusting oneself and one’s instincts, matters, too. some of them are just lackadaisical or overworked.

      i pretty much tried everything from chairopractic to functional fitness and energy ‘healing’ (helps to get ya positive and ‘see’ clearer and removes all the self-defeating blocks and negative programming and getting in touch with yourself… as i have discovered, there is definitely wisdom in hippie culture ha ha)… just put it out there, you’ll find a solution eventually or it’ll find you!

      xx

      Reply
  29. Ash

    Another thing to consider is confirmation bias. People are more likely to share complaints about something going wrong then they are to share complements about something going right. This has been documented/researched in the service industry (which is why customer service is so important), so it is expected that you would get more complaints about doctors/PTs than you would complements.

    Reply
  30. nik

    ‘estrogen-soaked weaklings’… haha… great article but for that one descriptive term that makes the writer sound like his father basically farted him out of his ass LOL… thanks, thanks for leaving out the females in this one -.-‘

    thanks for sharing!!! very helpful and encouraging. i was pretty much bedridden and wasting away a few years ago with problems across my entire body and nervous system – spent heaps of $ that i didn’t really have on shitty physios who didn’t know what they were doing and pretty much didn’t do very much at all –

    until a massage therapist noticed it was probably because of my right foot being about 1cm ‘flatter’ than the left foot’s arch… thereby causing considerable torque (since my right pelvis is rotated outta hinge) and muscular imbalance/over-compensations across the whole body. basically i’m twisted like those curved macaroni whatchamacallit.

    so they arranged for me to see a kinesiologist who basically confirms this but what next is up in the air. would dearly love to be able to run and leap again and climb trees & do flips and weights like i used to – with heaps more efficiency this time!

    i have tried a functional fitness trainer but he didn’t seem to know what he was doing, either. meanwhile keep training and the right solution/persons will come along i guess!

    grreat blog!! cheerios <3

    Reply
  31. Simon

    Hi Bret. Fantastic article. Wish you didn’t have to put the line “estrogen-soaked weaklings” in there though, it kind of brings the whole thing down. Despite any science correlating testosterone and strength, don’t you think we can give the tired stereotypes of “estrogen/femininity = weakness” and “testosterone/masculinity = aggression” a rest?

    Reply
  32. stark

    I do not understand why estrogen has anything to do with doctors who are liability averse. I mean, I understand wanting to say wild and crazy things to get more blog readership (hell, it is how Fox sustains a news organization), but maybe you should consult a Dr. to educate yourself on what a hormone does, instead of turning it into an insult because it is associated with women?

    I am no Dr., but we can all play one on the internet.

    Reply
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  34. Agnes

    Bret do you know any exercise friendly specialists/trainers in Chicago area ? Let me tell you my story.I am 28 and at the age of 16 I had spinal fusion that fused 15 of my vertabraes,from lumbar to thoracic. Up to age 16 I was always very active and this surgery had changed it forever. I had 6 ribs cut along with part of my hip to provide bone matrial to help the fusion fuse as one. For the last few years I had been exercising on and off learning on my own mistakes what works for me and what does not. I was never cleaerd to exercise as many other like me I was tolf not to lift anything and dont even think of physical activity. Now I can run and ski and do many things I thought I will never do.I am trying also to lift weights ,but no squats or deadlifts for me ,nor back building exercises for me. When I squat I use ironmind hip belt and hold barebell on the belt so all the weight rests on my hips.Do you know on anyone who could give me some advice on workout program? I read your amazing book and I wish I could know which of these exercises will be safe for me,any advice? Please let me know. So far I am doing well on glute bridges and hip thursts with ball under my back using bodyweight. I use ball because no bench will accomodate my hardware well.Its very hard for me to find workout partners/trainers because everyone is too scared to work with me, I am doing my best with form but it’s hard to notice it all alone.Please let me know ! Thank you!

    Reply
  35. Matt Hsu

    Fantastic post, Bret. I laughed out loud at the estrogen-soaked weaklings line.

    By age 22, I had horrific pain in my hands, elbows, wrists, knees, and back from following my doctor’s and PT’s advice to rest, rest, rest for years (in response to a string of sports injuries).

    After many years of various treatments, the only things that seemed to help were those that addressed my muscle imbalances. I found a Rolfer who helped me clear up some of those imbalances, but the greatest gains have come from doing exercises that have helped me re-establish better movement patterns and restore the strength I lost from squashing my shrinking back-side.

    Now I make sure some level of strength training gets introduced to just about every client I ever work with who’s concerned about pain or posture.

    Keep spreading the gospel of glutes! :-)

    Reply
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  37. Rebecca

    Just re-read this article and I can just agree that it is in manu of the issues you have picked up on that the differences between good doctors/PTs lies. I tore my ACL two years back and for the first year I saw both a doctor and a PT who weren’t really specialized in my type pf injury nor had any experience with younger, active people. And while I “recovered” and got back to strength training, I still couldn’t do any real running (which is something I absolutely love to do). So I switched both doctor and PT and found myself with two individuals who knew more than I could ever have hoped for. And although my doctor is great, it is my PT who has made all the difference in the world. That woman knows my body better than I do and it took her no time at all to find my weak spots (and fix them/make sure I fix them).

    With thst being said, I also have to comment on a phrase in the text above that I found to be quite out of place:

    “Ninety percent of doctors are estrogen-soaked weaklings who couldn’t fight their way out of a wet paper bag”.

    As part of the ~50% of the population who have higher levels of oestrogen than the other 50%, this is kind of insulting to me. I really hope that it is supposed to be ironic, as “estrogen-soaked weaklings” sounds more like something a bitter and uneducated man who doesn’t think women should be allowed outside the house would say;)

    Reply
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  39. Charles

    Im an orthopedic surgeon who does crossfit every day. Im very pro-exercise and can always find a way for folks to work around injuries.

    Reply
    1. Joe

      That’s fantastic Charles! I wish there were more surgeons out there like yourself. Where are you located? What parts do you specialize in?

      Reply
  40. Tim Arndt

    I was just recently referred to this blog so I’m a lil late. The title immediately made me think of the one thing I hate most that docs prescribe: don’t lift anything over ____lbs. So glad you pointed this problem out. If they had any idea of what torque was and how affects our joints they wouldn’t make blanket statements like that. I’ve had clients whose docs told them similar things.

    Moment arms…they matter! LOL

    I recently had a client whose chiro doc convinced her to stop exercising completely b/c it was putting excess stress on her back despite the fact that she was exercising pain free. She happened to have a mistep off a curb that tweaked her back. :)

    Reply
  41. Joe Miller

    I like this post, particularly if you couple this posting with the “Easing Into Things” and “Fitness is not Religion…” posts.

    I am a past 40 (46) person getting into resistance training in a serious manner. Naturally I am concerned about slipping discs and what not — any injury that could sideline me for a significant amount of time. Squats can be scary, but this posting and the other two postings I mention, make it ‘OK’ to do some other types of exercises if you don’t feel ready for the squat.

    Thanks Bret for another great post.

    Reply
  42. BJ Aznar

    Excellent stuff, Bret. As a PT who works on a staff of 8 PT’s and PTA’s, we tend to specialize in one aspect of rehab and tend to forget others. Fortunately in my clinic we have teams so that people can work the appropriate specialists (Ortho, Neuro, Vestibular, etc.). Unfortunately, some places don’t have that luxury and a PT can become a “jack of all trades”, knowing just enough to be dangerous. a patient/client needs to be an advocate for himself so that he can see the appropriate people. I’m not going to ask my dentist for advice regarding my heart and I’m not asking a cardiologist about his opinions on my liver.
    I laughed aloud when you said “Ninety percent of doctors are estrogen-soaked weaklings who couldn’t fight their way out of a wet paper bag.” You can say the same for pretty much all medical professionals if you’ve ever visited a hospital. A few years ago the Biggest Loser TV show had a PT on there, and I was embarrassed for him.

    I’m glad for all of your articles and the efforts you’ve made in your research. I’m glad it’s being made public regarding the importance of glute strength for all people and not just athletes. I’m also glad you’re calling out people and their fears regarding “unsafe exercises.” As one who has 2 herniated discs himself, I regularly squat and deadlift heavy, and see no dangers in doing them provided they’re done correctly and have strong glutes. And guess what? I have no radiculopathy (sciatica) or back pain. I have to practice what I preach to all my patients after all :)

    Reply
  43. Rob

    This article is really interesting to me. I recently (5 months ago) separated my shoulder playing rugby. It was a grade 5 separation with ligament tears and some muscle damage. I had my last surgery to remove the plate and screws three weeks ago. I think my rugby playing days are over (maybe at 47 I should not be trying to out do 20yr olds anyway!) but I could really use some advice on getting back into peak muscle fitness.

    Reply
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  49. Juma

    Hi Bret! What about after open abdominal surgery? I recently had an open abdominal surgery, but experienced some complications (Got an anastomose leakage) and the surgiens had problems closing my abdominal wall because of exess fluid retention caused by peritonitis. They had to perform a total of 8 surgeries to close my abdominal wall. I recently returned to the gym (post op 4 months) working out with some dumbells and machines. Still the surgien keep telling me to avoid exercises like squats, deadlift or i general everything that can cause excess stress on my abdominals, because they fear i will develope a incisional hernia. Whats your opinion about this?

    Reply
  50. Joe

    Bret –

    Good post!

    Your paragraph about squatters with knee problems caught my eye. Is there a subset of squat-types which are less likely to place pressure on the back of the kneecaps? I have roughed up the cartilage on the back of my kneecap and need to avoid putting too much pressure on it.

    Do you have a tool analogous to your hip extension torque calculator for knees?

    –Joe

    Reply
    1. Joe

      I should add — I am looking for exercises to strengthen my quadriceps without placing too much pressure on my kneecaps.

      Reply
  51. Wilson

    Hi Bret:

    Thanks for this great piece of information. I have an herniated lumbar disk but somehow I manage to recover and go back to training, although I had to remove some exercises that I love (like deadlifts). Is it possible that you share some of Donnie’s recovery training and how to progress from one stage to the other? That would mean the life to me.

    Excelent job!

    Reply
  52. Rafael

    Hello Bret,

    I too am seeking a knowledgeable physical therapist in the Miami or Tallahassee Florida areas. Any help would be greatly appreciated!

    Reply
  53. Bryant

    I’m a MD (internal medicine doc) fir the military who found this post because I’ve herniated a disk but feel my dead lifts were an awesomely productive lift for general strength and revving up anabolic physiologic response. I’ve had the benefit of seeing 1000’s of older military retired patients and what deferent activity levels and strategies in life, as well as their young active duty counterparts and what the long term and short term effects of different physical activity or lack thereof produces. despite this experience and my medical training, I find that I still wish I had the knowledge of a good, experienced athletic trainer, and that they truly usually can help an athletic patient more than I as a doc can with many problems, I agree of course that not all PT are equal or any profession. We all have our areas of knowledge, but the ignorance of most physicians about strength training is very real. We don’t spend much time on it in general medical education unless we do sports medicine fellowship training. Honestly it’s not considered a priority topic because usually it has nothing to do with life or death.

    Most docs won’t know much about optimizing balance between strength progress and safety. The problem in part is that well designed studies for a lot of these topics just aren’t out there yet, and we have to rely on anecdotal evidence and case studies as the best available for now, and most docs haven’t read up on a lot of sports injury and returning to sports topics to know what limited info is out there. I’ve had my share of injuries (bilateral femur fractures , radius fracture, ACL tear and repair) most recently I’ve tweaked my back For the last of about 5 times so far in life, and I suspect I had a disk herniation that I ignored during the 1st injury and so on and was able to return to football, lifting, martial arts, etc. I totally believe I working around injuries and adapting activity rather than just throwing I the towel on fitness. I counsel many of my overzealous patients as they hit their 40s or 50s or 60s to keep doing their sports, adapt, but enjoy and if they get to the point the cant stand it, we go for surgical options if necessary, with the plan to get back to what they like whenever posible. Ive got a Retired army Spec Ops buddy in his 70s who is still freakishly strong and built like a tank. I say go ahead and lift with your pacemaker, although he was wise enough to give up his handstand push-ups after the pacer placement. With all of this though, I myself am unsure the best course for my own conditioning practices. I gave up back squats and regular straightbar deads due to knee pain and lower back pain, but found I could do lighter shrug bar dreads and get the benefits of axial loading until recently. I re injured my back as I mentioned above with an attempt to increase back up my dead lift into the 300 lb range though through shrug bar. Don’t think I rounded much, but dreads, cleans, squat have all hurt my back. Wish I would have avoided origional injury by proper coaching on my form on these early on, but here I am like so many others. I’ve found planks, lateral planks, unilateral leg work, pistols, high rep deep body weight squats, wrestlers bridges and bridging backward push-ups, lunges, and shrug bar shrugs for axial loading seem to allow me to work around, but I plan to ban myself from high bar or low bar back squats, all deads other than moderate weight high rack pulls. Due to AC joint pain I also go light to medium on my bench and go for reps, with power lifting rather than bodybuilder form as it seems better for my shoulders. Like Bret says in the original post, there’s always a work around somehow, but as life goes on I find I work around more and more.

    Thanks for the post and many folks useful responses, and hopefully everyone’s anecdotal workarounds will someday be more thoroughly tested and add to the body of medical and training knowledge.

    Reply
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  57. jonnie

    i came across this article doing research for a presentation on deadlifts. I’m a personal trainer studying to be an RD and an exercise physiologist. I’ve had so many clients come to me saying their doctors told them not to squat or deadlift. One client in particular has fibromyalgia, celiac disease, and her body tenses up abnormally, causing a lot of pain. Her PT told her not to deadlift, and shes up to deadlifting 105 for sets of 12 easily, and her PT says that he’s impressed and I must know proper form. Yeah, obviously…. if you do it correctly, with the correct progression, and correct accessory work, deadlifts will benefit the client no matter what condition. Thank you for setting the record straight! much respect to you.

    Reply
  58. MC

    I am glad this was reposted. I was told a few years ago after a surgery that I should never lift more than 25 lbs for the rest of my life! Luckily my surgeon told me there was no research to support this guideline. So I gradually built up and am back to my pre-surgery strength and then some.

    Reply
  59. Kristopher Bosch

    Great post Brett! I agree that thus happens way too often, and mamy healthcare professionals do not recognize the power that their words have on patients. I am a PT/ATC, and got away from the ‘conservative programming for everyone’ idea. You have to base treatment, progressions, and goals on the individual patient/athlete. One of the biggest issues with this is that in many PT clinics, the patient rarely sees the actual PT and the PT &/or person supervising the exercise components may mot have a good S&C background. I love the comments above about putting together a ‘Strength friendly’ providers list, amd certainly would be up to rep Las Vegas! Many may disagree with this last bit, but my only caution would be that people do not take this as advice skip on the PT part and just get right to working with the strength coach. A combined approach where the two work together in the best interests of the patient/athlete is ideal. Bottom line is that people are far more capable than we give them credit for!

    Reply
  60. JD

    The level of ignorance about weightlifting and CrossFit is huge, and a lot of time the ones who don’t know what they are talking about are some of the most vocal haters.

    Reply
  61. Concita Thomas

    Thank you for writing this. I have always wondered the very same thing you wrote… How can someone NOT squat if they are sitting in a chair and getting up every day.

    I sincerely believed that most anything can be safe if regressed to the appropriate level and this article helped me be able to put into words what I have always believed intuitively. It also gives me great follow up questions for my clients’ docs and PTs to understand their biggest concern with any forbidden movement (load, ROM, etcetera) so that we can either all get on the same page OR realize that my client may need a different health professional on her team. Thanks!

    Reply
  62. Travis

    Great read! I am a DPT, and I absolutely agree with this post and believe that many MD’s and PT’s are too quick to advise patients to cease activities with any perceived risk, legitimate or not. These recommendations have been handed down over the years from older practitioners who had little understanding of exercise progression and performance enhancement beyond discharge from therapy/rehab. Unfortunately, this continues today as many fall back on these “safe” albeit misinformed guidelines. I plan on discussing this topic further on my site in the near future.

    Reply
  63. Amanda

    I agree lifting safely and using correct form are necessary . I’ve had to adapt from picking things off the floor from just bending over at the hips to doing a full squat because I’m 8 months pregnant ,learning how to properly squat in high school weight lifting class has given me the ability to strengthen my legs ,thighs and still be able to pick things off the floor ,abet slowly . i wish you had included pictures of the different ways of properly adjusting a squat to compensate and get around certain injuries ,that would have been helpful !

    Reply
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