Barbell Medicine Podcast

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Episode #323: Joint Pain (Osteoarthritis) Teaching Rounds Dec 02, 2024

Show notes

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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Episode #322: November 2024 Research Review Nov 29, 2024

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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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Episode #321: Mystery Case (Severe Throat Pain After Lifting) Nov 22, 2024

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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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Episode #320: Programming Teaching Rounds Nov 15, 2024

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Dr. Jordan Feigenbaum and Dr. Austin Baraki discuss the fundamentals of exercise programming. They outline four major evidence-based goals for programming regarding health: strength, power, hypertrophy, and cardiorespiratory fitness. They introduce the WATER model for programming variables: weight (intensity), amount (volume), type (exercise selection), effort, and regulation (how-to regulate these variables). They stress the importance of matching training stimuli to individual needs and preferences, and the benefits of varying training intensities and modalities for comprehensive fitness development.

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Hypertension Podcasts and Articles:

https://www.youtube.com/watch?v=9IEFJ_90vGE
https://www.youtube.com/watch?v=JCPAffRLtNo
https://www.youtube.com/watch?v=kI6QwgKLP0M

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Tech Support on YouTube:

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Episode #319: High Blood Pressure Teaching Rounds (Updated Info!) Nov 08, 2024

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Drs. Feigenbaum and Baraki discuss high intensity interval training.

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Hypertension Podcasts and Articles:

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Episode #318: High Intensity Interval Training Oct 29, 2024

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Drs. Feigenbaum and Baraki discuss high intensity interval training.

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References:

Sabag A, Little JP, Johnson NA. Low-volume high-intensity interval training for cardiometabolic health. J Physiol. 2022;600(5):1013-1026. doi:10.1113/JP281210
Creemers, Noortje & Foster, Carl & Porcari, John & Cress, M.L. & de Koning, Jos. (2017). The physiological mechanism behind the talk test. Kinesiology. 49. 3-8. 10.26582/k.49.1.15.
MacIntosh BR, Murias JM, Keir DA, Weir JM. What Is Moderate to Vigorous Exercise Intensity?. Front Physiol. 2021;12:682233. Published 2021 Sep 22. doi:10.3389/fphys.2021.682233
Seiler, Stephen & Tønnessen, Espen. (2009). Intervals, Thresholds, and Long Slow Distance: the Role of Intensity and Duration in Endurance Training. SPORTSCIENCE · sportsci.org. 13. 32-53.
Jamnick NA, Pettitt RW, Granata C, Pyne DB, Bishop DJ. An Examination and Critique of Current Methods to Determine Exercise Intensity. Sports Med. 2020;50(10):1729-1756. doi:10.1007/s40279-020-01322-8
Weston KS, Wisløff U, Coombes JS. High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: a systematic review and meta-analysis. Br J Sports Med. 2014;48(16):1227-1234. doi:10.1136/bjsports-2013-092576
Coates AM, Joyner MJ, Little JP, Jones AM, Gibala MJ. A Perspective on High-Intensity Interval Training for Performance and Health. Sports Med. 2023;53(Suppl 1):85-96. doi:10.1007/s40279-023-01938-6
Laukkanen JA, Isiozor NM, Kunutsor SK. Objectively Assessed Cardiorespiratory Fitness and All-Cause Mortality Risk: An Updated Meta-analysis of 37 Cohort Studies Involving 2,258,029 Participants. Mayo Clin Proc. 2022;97(6):1054-1073. doi:10.1016/j.mayocp.2022.02.029
MacInnis MJ, Zacharewicz E, Martin BJ, et al. Superior mitochondrial adaptations in human skeletal muscle after interval compared to continuous single-leg cycling matched for total work. J Physiol. 2017;595(9):2955-2968. doi:10.1113/JP272570
Mølmen, K.S., Almquist, N.W. & Skattebo, Ø. Effects of Exercise Training on Mitochondrial and Capillary Growth in Human Skeletal Muscle: A Systematic Review and Meta-Regression. Sports Med (2024). https://doi.org/10.1007/s40279-024-02120-2
Arboleda-Serna VH, Feito Y, Patiño-Villada FA, Vargas-Romero AV, Arango-Vélez EF. Effects of high-intensity interval training compared to moderate-intensity continuous training on maximal oxygen consumption and blood pressure in healthy men: A randomized controlled trial. Biomedica. 2019;39(3):524-536. Published 2019 Sep 1. doi:10.7705/biomedica.4451
Helgerud J, Høydal K, Wang E, et al. Aerobic high-intensity intervals improve VO2max more than moderate training. Med Sci Sports Exerc. 2007;39(4):665-671. doi:10.1249/mss.0b013e3180304570
Su L, Fu J, Sun S, et al. Effects of HIIT and MICT on cardiovascular risk factors in adults with overweight and/or obesity: A meta-analysis. PLoS One. 2019;14(1):e0210644. Published 2019 Jan 28. doi:10.1371/journal.pone.0210644
Wen D, Utesch T, Wu J, et al. Effects of different protocols of high intensity interval training for VO2max improvements in adults: A meta-analysis of randomised controlled trials. J Sci Med Sport. 2019;22(8):941-947. doi:10.1016/j.jsams.2019.01.013
de Mello MB, Righi NC, Schuch FB, Signori LU, da Silva AMV. Effect of high-intensity interval training protocols on VO2max and HbA1c level in people with type 2 diabetes: A systematic review and meta-analysis. Ann Phys Rehabil Med. 2022;65(5):101586. doi:10.1016/j.rehab.2021.101586
Steele J, Plotkin D, Van Every D, et al. Slow and Steady, or Hard and Fast? A Systematic Review and Meta-Analysis of Studies Comparing Body Composition Changes between Interval Training and Moderate Intensity Continuous Training. Sports (Basel). 2021;9(11):155. Published 2021 Nov 18. doi:10.3390/sports9110155
Hostrup M, Bangsbo J. Limitations in intense exercise performance of athletes - effect of speed endurance training on ion handling and fatigue development. J Physiol. 2017;595(9):2897-2913. doi:10.1113/JP273218
Gibala MJ, MacInnis MJ. Physiological basis of brief, intense interval training to enhance maximal oxygen uptake: a mini-review. Am J Physiol Cell Physiol. 2022;323(5):C1410-C1416. doi:10.1152/ajpcell.00143.2022
Metcalfe RS, Babraj JA, Fawkner SG, Vollaard NB. Towards the minimal amount of exercise for improving metabolic health: beneficial effects of reduced-exertion high-intensity interval training. Eur J Appl Physiol. 2012;112(7):2767-2775. doi:10.1007/s00421-011-2254-z
Gibala MJ, Little JP, Macdonald MJ, Hawley JA. Physiological adaptations to low-volume, high-intensity interval training in health and disease. J Physiol. 2012;590(5):1077-1084. doi:10.1113/jphysiol.2011.224725
Casado A, Foster C, Bakken M, Tjelta LI. Does Lactate-Guided Threshold Interval Training within a High-Volume Low-Intensity Approach Represent the "Next Step" in the Evolution of Distance Running Training?. Int J Environ Res Public Health. 2023;20(5):3782. Published 2023 Feb 21. doi:10.3390/ijerph20053782
Burnley M, Bearden SE, Jones AM. Polarized Training Is Not Optimal for Endurance Athletes. Med Sci Sports Exerc. 2022;54(6):1032-1034. doi:10.1249/MSS.0000000000002869
Casado A, González-Mohíno F, González-Ravé JM, Foster C. Training Periodization, Methods, Intensity Distribution, and Volume in Highly Trained and Elite Distance Runners: A Systematic Review. Int J Sports Physiol Perform. 2022;17(6):820-833. doi:10.1123/ijspp.2021-0435
Foster C, Casado A, Esteve-Lanao J, Haugen T, Seiler S. Polarized Training Is Optimal for Endurance Athletes. Med Sci Sports Exerc. 2022;54(6):1028-1031. doi:10.1249/MSS.0000000000002871
Rønnestad BR, Bakken TA, Thyli V, Hansen J, Ellefsen S, Hammarstrøm D. Increasing Oxygen Uptake in Cross-Country Skiers by Speed Variation in Work Intervals. Int J Sports Physiol Perform. 2022;17(3):384-390. doi:10.1123/ijspp.2021-0226

Episode #317: Biceps Pain From Curling Leads to Weakness and Numbness Oct 25, 2024

Show notes

Drs. Feigenbaum and Baraki discuss a mysterious case of arm pain after curling that gets MUCH worse.

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For more of our stuff:

Tech Support on YouTube:

https://www.youtube.com/watch?v=EDuf2vIU7JY

Got Pain? Contact Us:

https://www.barbellmedicine.com/contact-us-coaching-inquiry/

References:

Koenig SJ, Toth AP, Martinez S, Fletcher JW, Goldner RD. Traumatic pseudoaneurysm of the brachial artery caused by an osteochondroma, mimicking biceps rupture in a weightlifter: a case report. Am J Sports Med. 2004;32(4):1049-1053. doi:10.1177/0363546503258768

Episode #316: Body Roundness Index Oct 21, 2024

Show notes

Dr. Feigenbaum talks about the body roundness index and compares it to BMI.

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Tech Support on YouTube:

https://www.youtube.com/watch?v=EDuf2vIU7JY

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References:

https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
Boutari C, Mantzoros CS. A 2022 update on the epidemiology of obesity and a call to action: as its twin COVID-19 pandemic appears to be receding, the obesity and dysmetabolism pandemic continues to rage on. Metabolism. 2022 Aug;133:155217. doi: 10.1016/j.metabol.2022.155217. Epub 2022 May 15. PMID: 35584732; PMCID: PMC9107388.
Ciemins EL, Joshi V, Cuddeback JK, Kushner RF, Horn DB, Garvey WT. Diagnosing Obesity as a First Step to Weight Loss: An Observational Study. Obesity (Silver Spring). 2020 Dec;28(12):2305-2309. doi: 10.1002/oby.22954. Epub 2020 Oct 7. PMID: 33029901; PMCID: PMC7756722.
Garvey WT, Mechanick JI, Brett EM, Garber AJ, Hurley DL, Jastreboff AM, Nadolsky K, Pessah-Pollack R, Plodkowski R; Reviewers of the AACE/ACE Obesity Clinical Practice Guidelines. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY COMPREHENSIVE CLINICAL PRACTICE GUIDELINES FOR MEDICAL CARE OF PATIENTS WITH OBESITY. Endocr Pract. 2016 Jul;22 Suppl 3:1-203. doi: 10.4158/EP161365.GL. Epub 2016 May 24. PMID: 27219496.
Gruzdeva O, Borodkina D, Uchasova E, Dyleva Y, Barbarash O. Localization of fat depots and cardiovascular risk. Lipids Health Dis. 2018 Sep 15;17(1):218. doi: 10.1186/s12944-018-0856-8. PMID: 30219068; PMCID: PMC6138918.
Romero-Corral A, Somers VK, Sierra-Johnson J, Thomas RJ, Collazo-Clavell ML, Korinek J, Allison TG, Batsis JA, Sert-Kuniyoshi FH, Lopez-Jimenez F. Accuracy of body mass index in diagnosing obesity in the adult general population. Int J Obes (Lond). 2008 Jun;32(6):959-66. doi: 10.1038/ijo.2008.11. Epub 2008 Feb 19. PMID: 18283284; PMCID: PMC2877506.
Mulligan AA, Lentjes MAH, Luben RN, Wareham NJ, Khaw KT. Changes in waist circumference and risk of all-cause and CVD mortality: results from the European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk) cohort study. BMC Cardiovasc Disord. 2019 Oct 28;19(1):238. doi: 10.1186/s12872-019-1223-z. PMID: 31660867; PMCID: PMC6819575.
Abate N, Garg A, Peshock RM, Stray-Gundersen J, Grundy SM. Relationships of generalized and regional adiposity to insulin sensitivity in men. J Clin Invest. 1995 Jul;96(1):88-98. doi: 10.1172/JCI118083. PMID: 7615840; PMCID: PMC185176.
Antonopoulos AS, Tousoulis D. The molecular mechanisms of obesity paradox. Cardiovasc Res. 2017 Jul 1;113(9):1074-1086. doi: 10.1093/cvr/cvx106. PMID: 28549096
Jensen MD. American College of Cardiology/American Heart Association Task Force on Practice Guidelines; Obesity Society. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014 Jun 24;129(25 Suppl 2):S102-38. doi: 10.1161/01.cir.0000437739.71477.ee. Epub 2013 Nov 12. Erratum in: Circulation. 2014 Jun 24;129(25 Suppl 2):S139-40. PMID: 24222017; PMCID: PMC5819889.
Sommer I, Teufer B, Szelag M, Nussbaumer-Streit B, Titscher V, Klerings I, Gartlehner G. The performance of anthropometric tools to determine obesity: a systematic review and meta-analysis. Sci Rep. 2020 Jul 29;10(1):12699. doi: 10.1038/s41598-020-69498-7. PMID: 32728050.
Zhu S, Heshka S, Wang Z, Shen W, Allison DB, Ross R, Heymsfield SB. Combination of BMI and Waist Circumference for Identifying Cardiovascular Risk Factors in Whites. Obes Res. 2004 Apr;12(4):633-45. PMID: 15090631.
Thomas DM, Bredlau C, Bosy-Westphal A, Mueller M, Shen W, Gallagher D, Maeda Y, McDougall A, Peterson CM, Ravussin E, Heymsfield SB. Relationships between body roundness with body fat and visceral adipose tissue emerging from a new geometrical model. Obesity (Silver Spring). 2013 Nov;21(11):2264-71. doi: 10.1002/oby.20408. Epub 2013 Jun 11. PMID: 23519954; PMCID: PMC3692604.
Zhang X, Ma N, Lin Q, et al. Body Roundness Index and All-Cause Mortality Among US Adults. JAMA Netw Open. 2024;7(6):e2415051. doi:10.1001/jamanetworkopen.2024.15051 Zhang X, Ma N, Lin Q, et al. Body Roundness Index and All-Cause Mortality Among US Adults. JAMA Netw Open. 2024;7(6):e2415051.
Rico-Martín S, Calderón-García JF, Sánchez-Rey P, Franco-Antonio C, Martínez Alvarez M, Sánchez Muñoz-Torrero JF. Effectiveness of body roundness index in predicting metabolic syndrome: A systematic review and meta-analysis. Obes Rev. 2020 Jul;21(7):e13023. doi: 10.1111/obr.13023. Epub 2020 Apr 8. PMID: 32267621.
Zhou D, Liu X, Huang Y, Feng Y. A nonlinear association between body roundness index and all-cause mortality and cardiovascular mortality in general population. Public Health Nutr. 2022 Nov;25(11):3008-3015. doi: 10.1017/S1368980022001768. Epub 2022 Aug 19. PMID: 35983642; PMCID: PMC9991644.
Cai X, Song S, Hu J, Zhu Q, Yang W, Hong J, Luo Q, Yao X, Li N. Body roundness index improves the predictive value of cardiovascular disease risk in hypertensive patients with obstructive sleep apnea: a cohort study. Clin Exp Hypertens. 2023 Dec 31;45(1):2259132. doi: 10.1080/10641963.2023.2259132. Epub 2023 Oct 8. PMID: 37805984.
Wu L, Pu H, Zhang M, Hu H, Wan Q. Non-linear relationship between the body roundness index and incident type 2diabetes in Japan: a secondary retrospective analysis. J Transl Med. 2022 Mar 7;20(1):110. doi: 10.1186/s12967-022-03321-x. PMID: 35255926; PMCID: PMC8900386.
Zhang Y, Gao W, Ren R, Liu Y, Li B, Wang A, Tang X, Yan L, Luo Z, Qin G, Chen L, Wan Q, Gao Z, Wang W, Ning G, Mu Y. Body roundness index is related to the low estimated glomerular filtration rate in Chinese population: A cross-sectional study. Front Endocrinol (Lausanne). 2023 Mar 28;14:1148662. doi: 10.3389/fendo.2023.1148662. PMID: 37056676; PMCID: PMC10086436.