Clinical Coach Membership
August Q&A
Questions Covered:
For someone who is not able to handle much total volume per workout due to health issues other than poor conditioning, and assuming 3x a week splits, would it make sense to do one of the big three lifts per session and do a regular volume per lift (3 sets of 5, or 5 sets of 3, or whatever the phase of training calls for plus warm ups), or would it be more beneficial to still hit each lift more times per week but limit each lift to 1 or 2 top/working sets so the total volume is manageable?
I have a general fitness patient with persistent right shoulder and right knee pain. They enjoy general lifting and fitness, are in average physical condition (timeline: 3-4 months for both). Right shoulder: Sensitive to loading, amount of loading doesn't mater. Pushups, quadruped scapula pushups, bench press, overhead press, and deadlifts all cause roughly the same level of pain. Changing amount of loading and RPE doesn't seem to report a difference in pain. Some psychological component to pain, discussing his mindset with the pain has increased awareness of this aspect to his pain. This remains a significant part of rehab. Right knee: Sensitive to loading, amount of loading doesn't matter. A lot of things trigger the pain, including RDLs, deadlifts, squats (half ROM, to parallel, etc), standing alternating toe touches. Exercises that are used to minimize knee loading still cause pain. Changing amount of loading and RPE doesn't seem to report a difference in pain. Decreasing squat ROM does help reduce the pain. Pain varies between medial aspect of patella, patella tendon, and SGT area, most commonly in medial patella. Some psychological component to pain, discussing his mindset with the pain has increased awareness of this aspect to his pain. This remains a significant part of rehab. Attempted interventions include adductors, calves, glutes, core, quads, hams, etc. Unsure of what other additional info to provide. Response to rehab is very atypical of what I expect. He's gotten significantly stronger but no change in pain levels. At this point I may refer out.