Bulk, what do?
As someone who has historically struggled with gaining weight slowly, what are some pragmatic tips for bulking slow and steady? I know the deficit should be quite small, but since I find tracking calories a chore, I often end up overeating by a lot, or not enough to actually gain weight.
Rehabbing DSN Entrapment
What would be your approach to rehabbing/releasing a pinched dorsal scapular nerve and how can I prevent it from happening repeatedly? For additional context, I've pinched it at least 3 times in the last 6 months. Once from doing push-ups, again from doing pull-ups, and most recently from doing strict OHP. Each time I pinch it, it usually takes a few weeks for the pain to subside. It usually feels better during training and I'm still able to do overhead press and other pressing movements. Would you recommend seeing a chiropractor?
Is a BF% goal worth chasing?
I have managed to go from 94 kg to 82 kg through diet and exercise. My BMI (24.2) and waist circumference (90 cm) are both below thresholds. My scale says I’m 22% BF. I know it’s not accurate but I’m willing to go with it. From a general health and performance standpoint, is there any benefit in reaching a specific BF %?
Cardio fitness guidelines
With the cardio fitness guidelines recommending 150-300 minutes moderate intensity and/or 75-150 minutes vigorous intensity weekly, why is it that none of the BBM templates meet this minimum? And how would you program to maximize cardio without interfering with strength and hypertrophy gains?
Ig Nobel Winner on Blue Zones
Feel free to comment on the Ig Nobel Winner as you like, as I don't have that concrete of a question. According to this research, most data on supercentenarians is at least deeply flawed. Should this influence my opinion on the "mediterranean diet"? Which for me means something like: include fish regularly, don't eat too much and also eat together or some kind of social aspect? Or is there other data that research or opinions are based on, that might be similarly flawed in your opinion? Article in the NYT: https://www.nytimes.com/2024/09/13/world/australia/ig-nobel-awards.html Thanks & all the best
Behavior Change Counseling
Could you share your thoughts and tips on some best practices for counseling patients on behavior change for exercise and/or nutrition? Perhaps even a mock patient scenario in place of a case study one episode in which Austin counsels Jordan playing a patient with obesity or DM2 for example.
Genetic & Extrinsic Influences on the Composition of Weight Reduction
Are there any genetic (e.g. age, race, ethnicity, gender, body type, etc.) or extrinsic (e.g. rate of weight loss, types of exercise, supplementation, etc.) factors that influence the ratio of fat to muscle loss in total weight reduction?
Decision to add “BBM Plus” and LFS
A bit off the usual topics, but I’m interested in the process that led to you deciding to add a paid option to the podcast. Maybe the answer is as simple as “I looked at trends in subscribers”, but I’d be interested to hear. If I’m allowed a second I have a LFS question. As far as a signal that one should increase load - should one look strictly at the RPE of the first set or consider how many sets, at the prescribed RPE, it takes one to complete the prescribed reps after that initial set?
Eating at maintenance after a cut
Hey man! At one point you mentioned to me that data suggest that after a period of deficit, surplus calories tend first to replace energy stores, ie fat. So the recommendation is at the end of a cut is to eat at maintenance at least 4 weeks before attempting any bulk. I've mentioned this to numerous people, and a few have asked for references. Do you have any particular citations that describe these findings. Thx and glad to hear your travels are going well
Exercise after a lymphadenectomy
A patient recently diagnosed with breast cancer had a lymph node dissection, she was instructed to avoid exercise. My question is, is all exercise counter indicated regardless of intensity and volume, and is it permanent or is there a time period after which the patient is allowed to start training but with some restrictions?
Navigating ER Care
The case files are by far my favorite part of the pod (or any pod). Sadly, in my life I've had quite a few loved ones in and out of the hospital, and the quality of diagnostic care they've received in that time has been variable. I'd be curious what advice Austin would give to patients on what they can do, if anything, to facilitate quality care for a loved one in the ER without getting in the way. I'd also love to know what advice he might give to someone who lives in an area with multiple hospitals to choose from on which one they should prefer, assuming the medical emergency is not of the type where every second counts and they can choose a slightly further option.
Recommended Podcasts
In the last AMA I mentioned how the case files were my favorite part of any podcast and Austin suggested that I might need better choices for my listening pleasure. Later in the episode he mentioned how there are numerous podcasts he listens to, both for education and for entertainment. That leads me to put two and two together and politely demand that you both provide your top listening recommendations, whether on fitness, health, medicine, or other. So that you don't have to worry about inadvertently offending anyone, I will say up front that I do not expect your recommendations to be an exhaustive of the list of excellent podcasts that exist, but rather a subset of whatever comes to mind at this moment.
Neuromuscular Specificity's Negation of "General Strength"....?
Dr. Baraki made an IG post on November 4, 2024 discussing his programming for building up to his 501 x 10 squat set. Within this post he mentions "strength is most specific to the way it is trained, including movement patterns, velocities, and many other variables. IMO there is really no such thing as 'general strength', but we can leave that hot take for another day." I would love to hear the hot take around this concept, especially as someone who is currently running Barbell Medicine's General Strength & Conditioning 2 program. I also hear several influencers use "general" and "functional" strength interchangeably, which I can only assume is misleading?
Why are unilateral squatting movement so exhausting?
It is widely believed and also widely experienced that unilateral squat exercises such as bulgarians, are extremely taxing. I personally find them almost more limited by cardiovascular than muscular ability. Why are they so hard? Is finding them hard a sign of lacking cardiovascular conditioning? Would the fact that heart and lungs become the limiting factor prompt you to not use them in a program?
Difference between men and women in tolerating training and proximity to failure
In some old Q&A on youtube, Jordan mentioned sex differences between men and women when it comes to the ability to recover between heavy lifts (i.e. near-maxes repeatedly) and I also seem to remember comments on women being able to tolerate more training volume and/or proximity to failure. I think Jordan argued that this is partly due to the role of testosterone at the neuromuscular junction. Do you have good citations for this and do you (still) believe that this should inform priors on how to program for men and women?
The reality of programming and utilizing scientific evidence
When programming for an athlete, how do you find the right balance between implementing evidence based strategies, anecdotal experiences, and individual responses? The underlying thought here is that scientific research usually just covers the effects of very basic variables (like rep ranges, intensity, exercise selection). Long-term progression however, requires attention in a more complex way, e.g. by combining said variables over the course of multiple weeks, utilizing periodization, and many more aspects.
Session RPE
I've recently started using the Barbell Medicine App on Android. I do really like the app, but stumble over the Session RPE that you can enter each training session. In the instructional material linked in the app, especially the article "What is RPE in Lifting?", I can't find more information on the Session RPE parameter. Could you tell us more on how to rate a Session RPE? What Session RPE is the aim? Maybe examples, similar to Figures 1 and 2 from the article "What is RPE in Lifting?"? Thanks