This is not a topic specific to men, but it's from Men's Journal. Steroid injections for pain are a mixed bag - sometimes they help and sometimes they can make things worse (when you can't feel the pain, it's very easy to re-injure).

The study discussed below showed that PT (physical therapy) is just as effective as cortisol injections for pain caused by tendonitis, bursitis, or partial rotator cuff tears.

Why You Want to Skip Steroid Shots for Pain

Credit: Getty Images

To relieve nagging shoulder pain, you might want to skip the steroid injections and try physical therapy instead. A new study found that steroid injections are no more effective than PT for treating pain caused by tendonitis, bursitis, or partial rotator cuff tears.

Researchers gave shoulder pain sufferers either one shot of steroids or six PT sessions over three weeks and then monitored their progress throughout the next year. The two treatments worked equally well. On average, both groups saw 50 percent improvement in their pain levels and shoulder functionality. However, almost 40 percent of the injection group required additional shots to ease their pain, and 19 percent wound up needing physical therapy anyway. All of this, plus the fact that there are health risks involved with injections, leads the researchers to side with physical therapy.

RELATED: A Steroid-Free Back Pain Remedy
 
"Although injections can help decrease pain in the short term, they don't address the underlying issue," says lead researcher Daniel Rhon of Brooke Army Medical Center in Texas. "Therefore, you might need more injections and more health care visits in the long run." But getting multiple steroids shots can be risky. "Steroids can weaken and damage tissue if they are used too often," Rhon says. "There's also a low risk of skin reactions and infection."

Physical therapy, on the other hand, does address the root cause of pain and is virtually risk-free, Rhon says. "Manual physical therapy, which includes appropriately prescribed exercises, can certainly help with [the cause of the pain] and should never aggravate symptoms," he says.

This isn't the first study to come down hard on injectable steroids. Last year, Johns Hopkins researchers found that they didn't work any better to ease back and neck pain than injections of a simple saline solution.  

Bottom line? Every case of shoulder pain is different, so you need to thoroughly discuss your treatment options with your doctor. Together, you can weigh out the pros and cons of steroid injections and determine whether that, or perhaps just physical therapy, is the better route. Though Rhon adds, "I think it would rarely hurt to try physical therapy first." 

– Melaina Juntti

Fitness Friday - Fitness News and Information You Can Use

It's Friday, so it must be time for a new selection of fitness articles. This week we begin with two articles on squatting, then we move to preserving muscle and strength during a layoff (or injury), training the shoulders, and an interview with Dr. Fred Hatfield, one of the legendary figures in sports science.

This week we begin with two articles on squats - one from Tony Gentilcore at T-Nation and one from Bill Hartman at his blog.

How Deep Should I Squat?

by Tony Gentilcore
06/10/14



Here's what you need to know...

• It's ignorant to say that everyone should squat to the same depth. Some lifters inherited awesome levers, possess just the right hip anatomy, and are able to squat butt-to-floor with no issues.
• Serious squatters should perform the kneeling rock-back movement screen to see where they fit in on squat depth.
• One problem directly related to squat depth is "butt wink." The butt wink is just a less fancy way of saying posterior pelvic tilt. Butt wink and squat depth can be improved by working on crappy ankle mobility, including glute work in every session, and doing slow goblet squats.

Let's make one point clear: It's completely asinine to say that everyone should squat to the same depth. Some people picked the right parents, inherited awesome levers, possess the appropriate hip anatomy, and are able to squat ass-to-grass with no issues at all. And we all hate those people.

Conversely, there are others out there who, because they're told to do so (usually from some internet jockey who claims to squat over 400 pounds, ass-to-grass, for reps, while juggling chainsaws) or because their manhood is somehow called into question, try to squat deep no matter what. And well, bad things happen. Not everyone is the same, and it's important to understand this. As a coach my "end game" is to work with what I have and to get every single one of my athletes or clients to squat to depth. However, it's not always a good idea to force someone to squat deep when they just don't have the ability to do so safely. While admirable, the end goal for every person shouldn't be to squat deep.

Rather, the goal should be to develop proper squat mechanics, groove technique in a safe range of motion that's applicable to a particular individual's limitations and anatomy, and most important of all, keep the spine safe. Admittedly, it's not a sexy approach. I'm not going to sit here and wax poetic about some super secret squatting protocol or bust out my protractor and discuss some advanced algorithm to follow. The answer, simply, is to work on "stuff," and eventually squat depth will improve. One problem directly related to squat depth, however, and one that I see far too often, is "butt wink."

* * * * *

Short Topic: There’s a squatting controversy? Seriously?

Bill Hartman | Intelligent Human Performance 

Optimal varies with imposed demands (load, speed, surface, fatigue, visual cues, stance width, pelvic position, hip joint shape, etc.). Squatting is not as simple as knees out being better than knees in or toes out being better than toes straight. 

Variability is the ideal. It would be desirable to be able squat in many different ways and many different foot positions under varying circumstances. 

There is never one ideal. That’s like saying there’s one ideal posture, one way to sit, one way to have sex, or one way to throw a ball. 

In fact, we know that because of the noise built into the nervous system we can’t duplicate the same motion no matter how hard we try even if it looks the same to the naked eye. 

With practice and good coaching, you will determine the optimal for the circumstances and the individual.

* * * * *

The next two articles are also from T-Nation.

How to Keep Muscle During a Layoff

by Christian Thibaudeau
06/11/14



Here's what you need to know...

• Unless you're tied to a hospital bed, you won't lose any muscle mass if you take a week off from training. You may feel smaller or flatter, but it's not because you're losing muscle mass. Rather, your muscle tone has decreased slightly due to the nervous system being less "turned on."
• After a layoff of 2-3 weeks, you might lose 5-10% of your strength, but you won't be losing much muscle mass (if at all) and the loss of strength will be mostly due to lost neural adaptations. Once you go past the 3 weeks, though, it's quite possible to lose muscle mass, but there are many things you can to do to mitigate the loss.
• Contrary to what most people believe, you don't gain "extra strength" by tapering/deloading for a peak. You're simply "revealing" the strength you gained during your hard training cycle.
• Sadly, most people only notice "overtraining" when they start to lose strength and body weight, so their normal reaction is to train more to kick-start the gains. Not only will that not solve the issue, it'll make things worse!

There are generally three situations where a serious lifter would take time off from training:

1. A planned deload to help reach peak performance or to recover from overtraining.
2. A short and planned break (e.g., a vacation or trip).
3. An unplanned layoff (sickness or injury).

The first two are generally done begrudgingly, while the third is often treated as the worst thing possible next to a death sentence. The fact is, deloading and hiatuses from training are things that are part of everybody's life. I've had to stop training due to some health problems and I work with lots of clients who have busy schedules that require time off or at least reduced training. While it's my job to help people get the most out of their training, it's also part of my job to help them retain most of their gains when they're forced out of the gym.

* * * * *

5-4-3-2-1 Shoulder Workout

by Nick Tumminello
6.12.2014



Here's what you need to know...

• You'll be doing 5 sets of the first exercise, 4 sets of the second, 3 sets of the third, 2 sets of the fourth, and 1 set on the fifth.
• The exercises that appear first are the most complex, use the most weight, and therefore require the fewest amount of reps. The exercises that appear at the end are simpler, use less weight, and require more reps.

The numbers (5-4-3-2-1) represents the sequence and number of sets you'll do for each of the exercises. The exercises that get the most sets (5, 4) are the most complex and tend to use the heaviest loads done for the fewest amount of reps. Therefore, they're placed early in the workout when you're most fresh. The less complex movements (i.e., more isolation oriented) exercises are performed for fewer sets (3, 2, 1) are placed later in the workout. These exercises are done for more reps so we use less weight.

* * * * *

Finally, from Breaking Muscle, Craig Marker sat down for an interview with Dr. Fred Hatfield, aka "Dr. Squat."

The 7 Laws of Training According to Dr. Fred Hatfield

Craig Marker
Contributor - Psychology and Research

I recently sat down with Dr. Fred Hatfield, also known as Dr. Squat, to discuss his views on strength and conditioning and how they fit into modern training systems. For those of you unfamiliar, Dr. Hatfield was a great college gymnast and bodybuilder (he was Mr. Mid America, but he didn’t compete in the Mr. America competition because of a powerlifting meet).

Dr. Hatfield is probably best known for his world record squat of 1,014lbs set in 1987 when he was the age of 45. He was also the founder of Men’s Fitness magazine and the International Sports Sciences Association, and he has written over sixty books. He knows squat and a whole lot more.

See you next week.

Fitness Friday - Fitness News and Information You Can Use

For this week's Fitness Friday, we have an article on workout nutrition (before, during, and after), another opinion on Crossift, two articles from T-Nation - one on squatting, the other on shoulders - and we finish with an article from Bodybuilding.com on core work.

First up, from Brian St. Pierre at Precision Nutrition, here is the newest thinking on workout nutrition, pre-, peri-, and post-. John Berardi, founder of Precision Nutrition, helped Biotest design some of the earliest effective post-workout nutrition products, and he has continued working in this realm ever since.

Workout nutrition: What to eat before, during, and after exercise

By Brian St. Pierre

We all know that what you eat is important. But what about when you eat? Especially if you’re active?

In this article, we’ll review the evidence on workout nutrition and give you practical recommendations for what to eat before, during, and after exercise.

Quick summary

By eating a healthy, well-considered meal 1-2 hours before exercise, and another healthy, well-considered meal within 1-2 hours after exercise, most people can meet their workout nutrition needs without anything else.

In other words:

If you’re a healthy person who exercises regularly, you probably don’t need special workout nutrition strategies.

Athletes have special needs

Of course, if you’re…

• An endurance athlete. You train for high-level competition. You log a lot of high intensity miles each week. For you, carbohydrate and calorie needs are likely higher. You could add a protein + carbohydrate (P+C) drink during your training.
• Training as a bodybuilder. You lift weights with serious muscle growth in mind. You want to gain weight. Your protein and calorie needs are likely higher. You could also add a protein + carbohydrate (P+C) drink during your training.
• Getting ready for a fitness competition. You accumulate a lot of exercise hours. You’re trying to drop to a single-digit body fat percentage. For you, carb intake should be lower. You’d benefit from the performance-enhancing, muscle-preserving branched-chain-amino acids (BCAA) during your training.

Here’s a handy table that outlines our recommendations by goal and by body type.

Read the whole article.

* * * * *

Here is another opinion on Crossfit, since everyone seems to have one. This time it's Dr. Jose Antonio, a well-known research in sports science.

CrossFit – My Fiddy Cents

By Jose Antonio PhD FISSN



I’ve been asked so much about CrossFit that I figured I’d share my fiddy cents worth. Now mind you, naysayers have suggested to me that “if you haven’t tried CrossFit, then you shouldn’t criticize it.” WTF? That’s the dumbest thing (okay, not the dumbest, but it’s in my top 25) I’ve ever heard. So let me use that sterling logic. If I can’t run a 9.9 sec 100 meter dash, then I can’t comment on sprinting. If I haven’t actually finished a marathon in 2 hr 30 min or less, then I can’t comment on that either. So only those who climb Mt Everest have an understanding of altitude physiology? And if you want to compete in the Iditarod Trail Sled Dog Race, then I guess only dogs can comment on that. Those pre-conceived notions make about as much sense as fighting Mike Tyson with two arms tied behind your back. It’s just plain dumbass.



News Flash: if you understand the underlying physiology and biochemistry of any exercise or sport (i.e., overload, specificity, progression, etc), then you should be able to provide sound and evidence-based advice. It’s called SCIENCE.

Moving on.

Read the whole article.

* * * * *

Two articles from T-Nation this week, one is a brutal way to improve your squats, and the other is from Eric Cressey on how to build "bullet-proof" shoulders.

The 185 Rep Squat Workout 

by Dennis Weis
04/10/14 



Here's what you need to know...

•  High-rep squats were once a staple of legendary bodybuilders. Why? Because they worked!

•  High reps improve cardiovascular function, muscular bulk and definition, articulation and mobility of joints, coordination, and mental toughness.

•  Leg specialization of this kind has a tremendous anabolic effect on other muscle groups as well. Bodybuilders have experienced a solid 1-inch gain on their upper arms, usually accompanied by a 10-pound muscle mass gain.

Pain. Suffering. Lactic-acid paralysis. Some workouts not only tax your muscles and trigger hypertrophy, they also challenge your mental toughness, testing your courage and even your character. This is one of those workouts.

High-rep leg specialization is a badge of hardcore bodybuilding and will shred you down to the essence of who you are. My personal bests over the years were 305 x 75, 405 x 27, and 455 x 15 at a bodyweight of 212-pounds or under.

The dramatic training results of many old-school bodybuilding stars such as Steve Reeves, Larry Scott, Reg Park (who did up to 50 reps per set), John Grimek, and many others, is undeniable proof of the benefits of high reps. High reps improve cardiovascular function, respiratory efficiency, muscular bulk and definition, articulation and mobility of joints, coordination, and endurance. With high-rep back squats, your mind has to play a big part too, because they're just too damn hard to do without full-throated commitment.

Read the whole article.

* * * * *

How to Build Bulletproof Shoulders

by Eric Cressey
04/09/14


Here's what you need to know...

•  Landmine presses are an effective "middle of the road"exercise between overhead work and true horizontal pressing exercises.

•  If you're dead-set on returning to barbell overhead pressing as you come back from a shoulder injury, test the waters with a bottoms-up kettlebell variation first.

•  Athletes need to earn the right to train lats. You aren't allowed to do pull-ups or pulldowns until you pass the back-to-wall shoulder flexion test. No exceptions allowed.

•  Don't train the rotator cuff to failure. Fatigue is your enemy when you're trying to establish a strong and effective rotator cuff.

A lot of athletes refer to me as the "Shoulder Guy." This is probably because I've personally evaluated more than 3,000 shoulders. With that experience comes a lot of new expertise in the shoulder arena. Below, you'll find three examples of new things we're doing to keep shoulders healthy and performing at high levels.

Read the whole article. By the way, for those who remember him, that is Lee Priest in the picture above. He used to advocate 25 sets of biceps curls in magazine articles (Flex usually). Insanity for anyone not loaded to the gills on steroids and growth hormone.

* * * * *

Finally, Ben Bruno writing over at Bodybuilding.com has an excellent article filled with new and painful core exercises. Hours of fun for the whole family.

8 Moves For A Crazy-Strong Core

by Ben Bruno Apr 09, 2014


Website: benbruno.com

Many compound lifters scoff at abdominal exercises and argue that heavy squats and deadlifts work the core sufficiently. I think this is a mistake. Sure, the core gets taxed during heavy compound movements, but it's often the hidden weak link and limiting factor that keeps lifters from reaching new PRs.

In other words, a stronger core inevitably leads to bigger lifts. If it helps, think of it this way: Squats and deadlifts work the glutes and hamstrings a hell of a lot, but most serious lifters still do supplemental posterior chain work. Why should the core be any different?

There's a catch, though. Crunches, basic planks, and side planks aren't going to provide the stimulus necessary for strong lifters to get stronger, because they're simply too easy. You need to challenge yourself with difficult, high-tension core exercises to see improvement across the board.

Here are eight demanding exercises to take both your abdominal strength and your overall strength to the next level!

Read the whole article.

Fitness Friday - Fitness News and Information You Can Use

If it's Friday, and I think it is, it must be time for some good fitness info. In this week's edition, we have a great article on using bodyweight exercises for strength and size from Jason Ferruggia, two great articles from T-Nation (one on the "Olympic deadlift" and one on cortisol), and a final article from Eric Cressey on coming back from injury to do overhead presses.

Top 20 Bodyweight Exercises for Building Muscle and Strength

Jason Ferruggia

 

Bodyweight exercises need to be part of your program if you want to get jacked.
 
But not just pushups, sit ups and high rep calisthenics.
 
That’s beginner stuff that won’t build any real muscle.
 
We’re talking about really working hard on high tension, advanced bodyweight exercises that can only be done for somewhere between five and ten reps, on average.
 
The nice thing about these is that they’re very natural and can usually be done pain free by most people.
 
They can be added to any program along with barbells, dumbbells and strongman implements.
 
That’s the ultimate combination for building high performance mass.
 
Or you can use nothing but bodyweight exercises. The choice is yours.
 
Below is a list of my top 20 bodyweight exercises for size and strength. 

*****

This article from T-Nation has provided me with a new exercise I very much like, the Olympic deadlift.

The Olympic Deadlift

by Amit Sapir
3/26/2014

 

Here's what you need to know...

• The Olympic deadlift is a hybrid of the deadlift and the traditional Olympic clean pull.
• What makes this exercise different from the traditional deadlift is that it involves a much greater range of motion. Think vertical jump, except your feet don't leave the floor.
• Since the Olympic deadlift and the conventional deadlift share some similarities, you can transition straight into deadlifts after finishing your Olympic deads without a warm up.
• Olympic deadlifts will build huge calves, traps, and hamstrings without working on them directly in separate exercises. They'll also improve your conditioning.

The "Olympic deadlift" is an exercise I created that's a hybrid between deadlifts and the traditional Olympic clean pull. The grip width and the starting position is the same as it is for a regular deadlift with the bar above your toes and your shoulders over the bar, but your finishing position is like the end of a clean pull where you end up on your toes and your shoulders almost touch your ears. There's also a pause at the end of the movement to put more emphasis on the calves and traps.

*****

Cortisol is a necessary hormone in the human body, but too much of a good thing is a bad thing. Excess cortisol can result in muscle breakdown and other undesirable effects. This article from T-Nation offers a good primer on cortisol.

The Two Faces of Cortisol

by Dr. Jade Teta
03/26/14



Here's what you need to know...

• Cortisol, despite its bad reputation, is required for optimal health and actually burns fat, under the right circumstances.
• Chronically elevated or continuously suppressed cortisol can be destructive. The key is balance.
• You WANT cortisol high while you're exercising. During exercise, cortisol works with your other fat burning hormones to increase fat release.
• Cortisol can cause cravings for junk foods – simultaneously shutting off the goal oriented centers of the brain and ramping up the reward centers of the brain. Bad combo for dieters.
• The three best ways to control cortisol are diet, exercise, and lifestyle. The three easiest ways to assess if cortisol is balanced is by paying attention to hunger, energy, and cravings (HEC).

How Many Calories Does Stress Have?

I'll admit, this is a silly question. You can't eat stress! But this question makes a critical point about metabolism that the entire health and fitness world seems to miss: calories don't control metabolism, hormones do. And when it comes to hormones, the stress hormone cortisol is critical.

Not only can stress hormones impact how many calories you eat in a day, they can also impact the quality of calories you choose to eat and even influence how, and where, those calories might get stored or burned from. But if all that is true, how does the whole thing actually work? And what can you do about it?

Understanding Cortisol

The best way to think about hormones is as cellular messengers. They deliver information about what's happening outside the body to cells inside the body. A good way to think about cortisol is as the 911 hormone. It sends a message similar to first responders like firefighters and police officers. Cortisol plays both a protective role and adaptation role. It works against inflammation and also releases the body's sugar and fat stores to meet the demands of stress. Anything that poses a potential threat to the body will result in cortisol being called in to help.

*****

Eric Cressey has a developed a well-deserved reputation as the "shoulder guy." In this recent post, he shares some of his knowledge on how to get back to overhead pressing for those coming back from a shoulder injury.

How to Build Back to Overhead Pressing

Written on March 27, 2014, by Eric Cressey

 

A lot of people refer to me as the “Shoulder Guy.” This came about, in part, because of the “Shoulder Savers” series I authored all the way back in 2006. In spite of the fact that they’re almost eight years old now, I still get emailers and seminar participants saying that those three articles were complete game-changers.

Well, since that time, I’ve personally evaluated more than 3,000 shoulders. And, with that experience comes a lot of new expertise in the shoulder arena. Today, I'd like to share one observation I've made. First, though, I have to tell a quick story to set the stage.

My role of the “shoulder guy” was actually somewhat born out of necessity, as I have a right shoulder that is structurally a mess (bone spurs, partial thickness rotator cuff tear, and very likely a labral tear and cranky, degenerative biceps tendon). Still, I’ve managed to work around it to move some solid weight around for a guy my size, and it doesn’t give me any problems at rest unless I do something stupid – most notably overhead pressing, and even incline pressing. Still, I miss my overhead work, so I tinker and experiment with things quite a bit to see what works. Last year, I talked about how landmine presses had been working. Effectively, they’re a nice “middle of the road” between overhead work and true horizontal pressing exercises.