In this podcast, Drs. Baraki and Feigenbaum review a mystery case where the patient presented with 3 days of progressively worsening left hip pain. He had a similar episode about a year ago that required surgery. Dr. Baraki walks through a differential diagnosis, considering potential causes like infection, crystal-induced arthritis, bleeding disorders, and avascular necrosis. Further testing revealed a bloody joint effusion with high white blood cell count, and an MRI showed synovial proliferation with frond-like projections. What's the diagnosis?

Case: https://journals.lww.com/acsm-csmr/fulltext/2023/09000/pigmented_villonodular_synovitis_recurrence.3.aspx 

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In this podcast, Drs. Baraki and Feigenbaum discuss training during weight loss. While increased exercise can support health, dietary restriction is the primary method for weight loss. They note that strength, muscle mass, and endurance can be maintained during modest calorie deficits, with studies showing significant gains even in large deficits in trained individuals. It was also noted that the size of the energy deficit matters, with small deficits having minimal effects and larger, sustained deficits being detrimental. Practical recommendations include meeting physical activity guidelines, maintaining protein intake of 1.6 g/kg/day, and a moderate calorie deficit of 250-500 calories per day.

Case: https://pmc.ncbi.nlm.nih.gov/articles/PMC4885268/

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In this podcast, Drs. Miles and Feigenbaum review a mystery case where thee patient presented with severe bilateral leg pain after attempting a 620 lb squat. We discuss anabolic steroid use, knee pathology, rehab strategies, and more.

Case: https://pmc.ncbi.nlm.nih.gov/articles/PMC4885268/

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In this podcast, Drs. Baraki and Feigenbaum review a misleading social media post from Comp Train regarding VO2 max, a new study on using heart rate variability (HRV) to guide resistance training programming in older women, and another study correlating American Heart Association's "Life's Essential 8" metrics with testosterone levels and risk of low muscle mass. 

Papers:

https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2024.1472702/full 

https://ajcn.nutrition.org/article/S0002-9165(24)01421-7/fulltext

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Alan Thrall joins Dr. Jordan Feigenbaum on this episode of the Barbell Medicine podcast. Alan, a gym owner and strongman competitor, shares his life update, including his children's activities and gym involvement. They delve into the benefits and risks of strongman training, favorite and least favorite gym equipment, incorporating strongman elements into commercial gym routines, and more. 

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Dr. Jordan Feigenbaum and Dr. Austin Baraki discuss the challenges and benefits of unilateral exercises like Bulgarian split squats, refute Dr. Gabriel Lyon's claim that obesity is due to insufficient muscle mass, and more!

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The podcast discusses what happens when people stop exercising, how much exercise is necessary, and how to program exercise with limited time.

Recommendations for training on limited time:

•  Resistance training: 3-5 sets per muscle group per week of compound exercises at >65% 1RM for strength. Add isolation exercises if desired. 
•  Conditioning: 150 mins/week moderate or 75 mins/week vigorous intensity. Split up however you want. Be careful about doing too much sprint/max intensity work. Gradually build up if desired.
• Strategies for efficient programming include:
•  Modifying warm-ups to be more time-efficient (short rest, less reps, bigger jumps)
• Using supersets of antagonist muscle groups or unrelated movements
•  Employing "every two- or three- minute on the minute" protocols. e.g. E2MOM or E3MOM: 5 @ 8, then 65% x 5 e2mom x 3 sets or > RPE 8
•  Use time caps on sessions, e.g. 20-minutes for movement 1 or work up to 1-rep @ RPE 8 in 8 minutes, then 12 minutes perform maximum sets of 3 to 5 reps with 70% e1RM
• Flexibility in scheduling is key - focus on getting the total amount of work done over a 1-2 month period rather than worrying about perfect weekly routines

Time Crunch Template (Update coming soon!)

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References:

Detraining Podcast

• Wolin 2008
• Sturm 2019
• Garcia-Hermoso 2022
• Benito 2020
• Radaelli 2015
• Grgic 2018
• Nolan 2018
• Chen 2022
• Gavanda 2020
• Hortobagyi 1993
• Halonen 2024
• Mujika 2001
•  Smith 2003
• Encarnacao 2022
• Staron 1991
•  Ivey 2000
• Grgic 2022
• Piercy 2018
• Hamer 2017
• Khurshid 2023
• Schoenfeld 2017
• Krieger 2009
•  Perkin 2019
• Fyfe 2022
• Androulakis-Korakis 2021
• Borde 2015
• Lesinski 2016
• Yang 2018

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In this episode, Drs. Feigenbaum and Baraki discuss a complex case of a 60-year-old female with a history of type 2 diabetes, hypertension, high cholesterol, and pulmonary sarcoidosis presenting with exertional shortness of breath. Initial tests showed a heart rate of 50 bpm, prolonged PR interval, and patchy fibrosis in the heart. What's the diagnosis?

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Case:

https://pmc.ncbi.nlm.nih.gov/articles/PMC7383351/ 

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Dr. Jordan Feigenbaum and Dr. Baraki discuss osteoarthritis (OA), emphasizing its complexity and the importance of a holistic approach. OA affects joints, causing pain, stiffness, and reduced function, with knees being the most commonly affected. Risk factors include age, prior injury, obesity, and inflammation. Diagnosis often relies on clinical history rather than imaging. Treatments include exercise, weight management, and non-pharmacological interventions like knee sleeves. Pharmacological options include topical NSAIDs, oral NSAIDs, and GLP-1 receptor agonists, with a cautious approach to opioids and steroid injections. Surgery may be considered for severe cases, but lifestyle changes and appropriate exercise are crucial for long-term management.

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Resources:

• https://www.barbellmedicine.com/blog/the-barbell-medicine-guide-to-osteoarthritis/
• https://www.barbellmedicine.com/blog/what-do-knee-sleeves-do/
• https://pain-calculator.com/
• https://pmc.ncbi.nlm.nih.gov/articles/PMC2730438/
• https://pubmed.ncbi.nlm.nih.gov/27103611/
• https://pain-calculator.com/treatment/osteoarthritis-pain/viscosupplementation-publicly-funded-trials/
• https://www.nephjc.com/news/nsaids-vs-opioids
• https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard

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In the November 2024 research review, Drs. Jordan Feigenbaum and Austin Baraki discuss the effects of de-training periods in resistance training and the potential benefits of carbon monoxide supplementation for enhancing altitude training. New research investigated 20 weeks of continuous training vs. two 10-week periods of training separated by a 10-week off period. The results are....not what you might expect! The second study explored the use of carbon monoxide to stimulate red blood cell production and what effects it had regarding VO2 max and power output in elite cyclists. Ethical and monitoring concerns are also discussed.

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Case:

• https://pubmed.ncbi.nlm.nih.gov/36205802/

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In the Barbell Medicine Podcast, Drs. Feigenbaum and Baraki discuss a case of a 21-year-old female presenting with severe throat pain after a gym session involving heavy squats and deadlifts. The patient's symptoms worsened over six hours, and she had no fever or cough. Her physical exam and initial lab results were normal, except for a slightly elevated white count.

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Case:

• https://pubmed.ncbi.nlm.nih.gov/36205802/

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