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O/T: HEALTH Pains ? Health struggles ? Ask a Surgeon anything

Discussion in 'Health and Fitness' started by Thomas Chauvet, Apr 23, 2019.

  1. Thomas Chauvet
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    Thomas Chauvet Bronze Contributor Read Millionaire Fastlane I've Read UNSCRIPTED

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    Hello everyone,

    I decided to start this thread because I keep lurking in here and I'm tired of getting this much value without contributing. I try to, but I have to say since I've done poorly in this field of fastlaning, I don't feel confident enough to give solid pieces of advice about business.

    However, in my experience, people ask themselves a lot of questions about health in general. Everytime I'm in a conversation with muggles (yeah, sometimes that's how we call people who doesn't work in the healthcare industry ^^), I get asked a lot of questions that I love to answer.

    [​IMG]

    I am an MD in Surgery in France, I am in the near end of my training in Orthopaedic and Trauma Surgery (anything related to locomotive appartus : joints, muscles, bones, tendons, ...). I had a great training with some of world's best surgeons in the field of shoulder surgery and pathology, especially. I can also help you with anything related to Sports medicine and strenght training, and general medical stuff.
    [​IMG]

    I don't know if you guys will have any questions for me but I think it's the only and best way I can provide real value here right now (hopefully it will change in the near future).

    Best regards,

    Thomas, a fellow member of this awesome community.

    PS : If you have any question you don't feel like posting in public, please send a PM, I'll do my best to help you.
     
    Last edited: Apr 24, 2019
  2. tmb22
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    tmb22 New Contributor Read Millionaire Fastlane I've Read UNSCRIPTED FASTLANE INSIDER

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    Hey Thomas, did you happen to work with Giles Walch?
     
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    TonyStark I'm not dead yet Read Millionaire Fastlane I've Read UNSCRIPTED FASTLANE INSIDER Speedway Pass

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    What's your opinion on chiropractors? lol
     
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    Valhalla Bronze Contributor Read Millionaire Fastlane I've Read UNSCRIPTED FASTLANE INSIDER

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    Ok, awesome, I have a few friends who are surgeons and always ask what is the best thing an active person can do to not end up back in the OR?
     
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  5. Thomas Chauvet
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    Thomas Chauvet Bronze Contributor Read Millionaire Fastlane I've Read UNSCRIPTED

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    Yes, Gilles Walch and his team. He doesn't take any fellow for a long period of time any more so I spent most of my time with one of his colleague, Laurent Nove-Josserand, which also has a great reputation worldwide. They are really awesome. Dr Walch probably didn't read TMF but he is definitely a fastlaner, providing tremendous value to his patients and his fellow surgeons, on a great scale (shoulder prosthesis design, and shoulder prosthesis pre-operative planning software, especially). Do you know him ?

    I'm not sure you'll like this one. In the orthopaedic field, we face a lot of people who received treatments by chiropractors, osteopaths. It is an interesting alternative when a more "traditional" approach didn't work. But it is not a very scientific or reproducible system. You can't really measure it. There's not a lot of studies about those techniques. I have to say that we have no training regarding these so what I'm saying is simply about my experience and what senior surgeons told me about this. These techniques, apart from very precise circumstances (a few month after a surgery, or a trauma, for instance), are not deleterous. So if it works for you, or if you're curious about it, and traditional medical approach didn't work, you could totally give it a try or keep going with it. But I would clearly recommand getting a specialized opinion first, because I've seen a lot of patients loosing precious time and opportunity after they saw a chiro, a physio or an osteo, who weren't able to diagnostic a condition that clearly required a surgery or a specific treatment. Perfect exemple is an acute cuff tear after a trauma, which prognosis can hinder greatly after 6 months, especially on a young active patient (<65 years old).

    Well, you just can't prevent an appendicitis. However for musculo-skeletal troubles, I'd say to avoid any repetitive manual labor, which is the worst. I'd also say to listen to the signals your body is sending. If you start to have any pains, after you did some repetitive work, or strenght training, it means you should change something before it's too late. We aren't machines. You can't submit your body, or in the end it's your body that will submit you. If you train or work intelligently, if you adapt when you need to, even temporarily, you'll prevent a lot of unecessary injury. It's just being smart, or common sense ... I like to think of my body as the only and unique car I'll only get for my entire life. Better take care of it if I want it to be performant when I need to, and to go as far as possible in good shape.

    And also, I let go of my desire to ride a motorcycle ^^. This is an occupational hazard of course, but those are so dangerous. If you do, wear all the protection, it changes everything. I've seen people who fell at 200km/h (125 mph) on a circuit, who didn't have a single scratch because they had everything you can have to protect yourself on a motorbike. On the contrary, I've seen young lads falling at 25 mph and getting an amputation because they were in flip-flops. Yes, it can be this bad.

    When your body lets you down, it severely impairs your ability to go fastlane, or anything else. Great blog post about it from Josh Kaufman yesterday ( 2018 Annual Review – Josh Kaufman ).

    Thank you for your comments and question, so cool !
     
  6. Laoshi
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    Hey Thomas, can you recommend some good spine exercies for people working a lot, sitting at the computer?
     
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    hello thomas
    i have had several arthroscopic knee operations that stemmed from the same problem. The quality of orthopaedic surgery in the USA is substandard to that of germany, france and Nordic countries (unless you are super rich or pro athletes). The VA is a mess here and others can attest to their level of care. (purely about economics. the best surgeons dont work for uncle sam lol)
    They have given me the runaround and gave me the wrong rehab measures. I still have some screws and pins that give problems only when it is extremely cold.
    I have a meeting with the doctor and specialist here in norway in may. I wanted to know what specifically to ask them regarding possible further options? I cannot run as well anymore and the cartilage surrounding my meniscus is completely atrophied. The tendon that helps range of motion is also weak and continues to be. No matter how many leg extensions or presses i do, nothing works. It is really frustrating. I have a video i can show you of how i am not able to fully extend my left leg without my patella shifting place. The original prognosis was a torn meniscus but i doubt it. I am really infuriated with the level of ridiculousness I have dealt with because of shitty american healthcare system... It is really appalling.

    hope you are doing well in your ventures btw.
     
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    After brain surgery how is the top of the head put back together? Staples? Hot glue gun?
     
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    Bourbons Bronze Contributor

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    Ohh, interesting field..!

    I have a question...

    Doing this lateral arm raise movement, with my right arm, holding any sort of weight or pushing against resistance, really hurts with a sharp pain.

    Pain is on the outward facing very top of my arm, before it curves round to be the top of my shoulder.

    Hurts less when doing other weights, like military press.

    Been like this for years.

    What do?
     
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  10. ZCP
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    @Thomas Chauvet thanks, brother!

    40-ish year old male. Have exercised regularly for last 18 mo. Decent shape. Working some weight training. Have done 5x5, starting strength, 531, etc. in the past.

    Am curious of a doctor's thoughts .........

    Could you suggest a 4 to 8 week exercise / weight lifting plan for adding muscle to my legs? (While preventing lower back injury, excessive fat gain, etc.)
    ... exercises?
    ... frequency?
    ... intervals? set structure? % of max?
    ... time of day?
    ... calorie / carb intake ideas patterned around training?
    ... do something like defranco agile8 beforehand?
    ... do cardio after?

    DM me if too much. Would be happy to pay you for your time / advice? Trying to fit it all in with lab results, Tlevels, nutritionist, supplements, etc. .......
     
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  11. Thomas Chauvet
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    Thomas Chauvet Bronze Contributor Read Millionaire Fastlane I've Read UNSCRIPTED

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    Yes, of course.
    First of all I'd recommend to set an alarm every hour or every 25min if you work with the pomodoro technique, and each time it comes off, get up, walk a few steps, and stretch as you feel like.
    I wouldn't recommend any specific reinforcement exercise, but anykind of physical activity 2 or 3 times a week, like hiking, swimming, ... can help prevent of deal with most back pains (usually abdominal muscles weakness).
    Stretching should be part of your daily routine, especially if you sit all day. I'd recommend those exercises :

    Urdvha Mukha Svanasana
    [​IMG]
    Makarâsana

    View: https://youtu.be/0o0kNeOyH98?t=255


    Supta Vajrasana
    [​IMG]



    And this one, which is the one exercise we recommend for shoulder rehab, it also does wonders for the upper back :

    upload_2019-4-24_16-58-17.png

    (ou should try to put your hand up and behind). This one you can do all day long while sitting, you'll benefit from it greatly.


    It seems that you have a complex problem depending of several, different things.
    Did you get any surgery, why, what was done exactly ? Do you have any history of patella true/absolute instability (going outside the knee completely) ?
    How is your quadriceps right now, compared to the other side (easy way to find is the measure circumference of both thighs) ? If it is atrophied, which is frequently the case after trauma or surgery, it could lessen the stability of your patella, resulting in pain. Pain means you don't use your quad much, so it weakens, so your patella is less stable, which is more painful... It's a classic vicious circle. First, you need to calm the pain. If you need to stop your activity for a while, do so. Then, when the pain is much lower, you should try to do some articular running-in (stationnary bike without resistance), and reinforce your quadriceps with the help of a good physiotherapist. If you have a relative patella instability (and it seems to be the case, regarding what you're saying), it should really help a lot, it's not a problem, you'll be able to make things right with a little time and method.
    If your problem is from a true/absolute patella instability, or from the cartilage, I can't tell without seeing your xray, knowing your medical history and your age, and getting a hand on your knee. Sorry. Be sure to bring all your medical documents on your appointments, every surgery report, xray, MRI ... You can always send me a PM with those, I'll tell you if I can help you more at a distance.

    The skin is incised and then sutures like any other surgery (skin staples or suture wires). For the bone, they use trans-osseous sutures (through holes in the bone) or this :
    View: https://www.youtube.com/watch?v=MRhI-NLMUZk


    In the shoulder, most of time the location of the pain is a useless information since it's not very specific of any kind of lesion.
    We don't recommend any lateral arm raise because it's not a movement you may use in every day life, and it puts a lot of constraints on the cuff tendons. So, especially if the other exercises are not painful, I would recommend you to stop doing those. If you're worried about it, ask you GP to get you an ultrasonography to check that you don't have any cuff rupture.
    My advice would be, in general, to avoid any exercise that cause you pain. Like this you will prevent most injuries. If you can switch to other exercises that aren't painful, do this until pain is resolved. If any exercise is painful and you need full rest, it means something's wrong in your training method, and you have to rest first to recover, then change it (either, wrong execution of the exercises, bad exercises, or too heavy lifts ; btw, you don't need too heavy lifts to be very bulky but that's another debate).
     
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  12. Thomas Chauvet
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    Thomas Chauvet Bronze Contributor Read Millionaire Fastlane I've Read UNSCRIPTED

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    You're welcome, thank you for your answer to this topic :)

    TBH, most (99% or more) physicians have no specific knowledge whatsoever in strenght training. Of course we study muscle physiology, but not enough to be able to give people optimized specific training programs. So here I can only tell advice from my personal experience and training, which is to me, in line with my medical training, but it's only my point of view.

    Good job on exercising regurlarly dude. 18 month is really great, you're in long term, it's the hardest.

    I can give you some pieces of advice for strenght training, because I happen to have an interest in it also. I know a lot about the Lafay Method. It's a french doctor in philosophy who developped it over the course of the last 20 years. I think it's translated in english (actually, it's not on amazon, so I don't think so : Olivier Lafay ).

    I can't tell you if it's the fastest or easiest or most optimized method to get his shape, but I can tell that from my orthopaedist surgeon point of view, it's definitely the best one.

    He uses a short rest time between sets to compensate for not using heavy weights. Most of the exercises are bodyweight. But you can use the same principles with a squat bar if you want.

    First, of course, measure your performance in terms of strenght, bodyfat %, and body measurements, to check your progress.

    Then try this :
    1 set of 6 series of single leg squat. 25 sec rest between sets. Flex at 90° max at first, if it's too easy, flex totally. Hold yourself with the tip of the fingers, so that you don't fall but you can't lift yourself with the arms. Train one leg totally, rest for 3 min, then train the other leg. (video :
    View: https://www.youtube.com/watch?v=nd0rSsMprR4
    )
    1 set of 4 series of jump squats (2 legs). same rep number. 25 sec rest between sets.

    Lafay principles : start very easy. add 1 rep to each set every training (monday, 5-5-5-5-5-5, wednesday, 6-6-6-6-6-6, friday 7-7-7-7-7-7). After 2 complete weeks, the middle training should be at 70% of your last set (monday 10-10-10-10-10-10, wednesday 7-7-7-7-7-7, friday 11-11-11-11-11-11). You can keep adding reps if you fail to reach target number on the last 2 sets (eg 9-9-9-9-8-6). When you can't progress anymore (or before that if you want to), restart to a lower rep count. It's called a loop. If you started at 5-5-5-5-5-5, restart at 5. On the second loop, if you for instance went up to 13, you can restart at 7 or 8. You'll see that at the end of your loop, you'll go higher than your first plateau. Depending on when you hit those plateau, in 8 weeks you will probably do one or two loops, may be more if you started too high.

    It works the same with weights.
    I can't tell a starting number, since it depends of your actual physical capacity, so you may have to do some testing, but it should feel easy at least for the first week.

    Lafay's method is pretty controversial in the world of strenght training, but he definitely have proved the effectiveness and sustainability of his method ( Photos et vidéos hommes – Méthode Lafay ). He's aiming for long term and health.

    It's a pleasure to give some piece of advice to such an amazing contributor to this forum, I hope you will try it and it will help you.

    About this :
    Frequency, ideally I'd say at least 3 times a week, it's a proven cutoff for muscle development, but if you can do 2 times a week it's already a million times better than 0. However if you train 2 times a week and feel disappointed about results, try 3 times a week (with a 70% training in the middle if it's too tiring).

    For time of day, do what's convenient for you, it's hard already to train 3 times a week, it's not that important. If you can, avoid late evening since it will prevent you from sleeping (3 hours training free before going to sleep is good).

    About food intake, it depends of your objectives. The priority should be the total quantity of calories eaten by day, whenever you eat it. If you can, protein intake <30min after training limits muscle catabolism. I think this, is more important than timing of carb intake. For carbs I'd recommend eating them not too early (max 1h) before your training, since it takes some time to digest it, but I don't think it's worth worrying too much about.

    Didn't know about agile8, it seems interesting. Warming up is really, really major to avoid injuries, you should definetely pay great attention to it. It seems to include some stretches which is great (Just be wary that stretching for more than 5 secs before a training can limit performance. After training I'd recommend to stretch way longer, from 30s to more than 1min).

    About Cardio, I don't think it's a good thing to do it after your strengh session. If you want your muscle to grow (in volume, or in strenght), you have to train them, but not too hard. Doing cardio and strenght on the same day put them under too much stress, you will hinder greatly your progress. Usually the main mistake of lifters are that they don't rest enough.

    Pay attention to the amount of sleep you get, too. Muscle are developed while you rest in your sleep. Elite athletes often sleeps up to 10 hours a night.
     
    Last edited: Apr 24, 2019
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  13. tmb22
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    tmb22 New Contributor Read Millionaire Fastlane I've Read UNSCRIPTED FASTLANE INSIDER

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    I am a Tornier rep in the states, so very familiar with his work obviously
     
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  14. Thomas Chauvet
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    Thomas Chauvet Bronze Contributor Read Millionaire Fastlane I've Read UNSCRIPTED

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    Hahaha! That's crazy. I bet you are

    Envoyé de mon SM-G955F en utilisant Tapatalk
     
  15. Thomas Chauvet
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    Thomas Chauvet Bronze Contributor Read Millionaire Fastlane I've Read UNSCRIPTED

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    Hey @ZCP, did you get the chance to read my answer? What do you think? Are you going to try it?

    Envoyé de mon SM-G955F en utilisant Tapatalk
     
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    Thoughts on dealing with chronic gastritis and a cascade stomach likely caused due to anxiety/stress/too much sitting?
     
  17. Thomas Baptiste
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    I've been hitting the gym pretty hard lately. I've observed this regular painless popping sound my shoulder makes that I never experienced before. Any suggestions as to what's really going on? I read up that it may be bursitis but I don't feel any pain, it's just concerning that my shoulder pops Everytime I do a shoulder exercise or even move the shoulder.

    - kind regards from one Thomas to another.
     
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    Last edited: Apr 30, 2019
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  19. Thomas Chauvet
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    Thomas Chauvet Bronze Contributor Read Millionaire Fastlane I've Read UNSCRIPTED

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    Are you sure that is really due to stress ? It is an elimination diagnosis, meaning that you should first verify it's not another cause : Helicobacter pylorii infection, diaphragmatic herniae, ...

    When it's done, there's not any magical trick to remove it overnight, but some things can help :
    _ avoiding coffee : it opens the barrier between stomach and oesophagus (dilatating lower esophageal sphincter's muscles), thus making the acid production from the stomach going up and burning it. You can always try to start drinking some back when you feel better, and avoiding it on the periods you get gastritis
    _ 3 hours between last meal and sleep
    _ putting a pillow under the top of your mattress (under your head), so that your mattress is slightly inclined downwards (if you find a more effective way than the pillow, go with it)
    _learn techniques to combat stress when you feel stressed OR when you get gastritis. Sometimes you won't feel stressed or anxious at all, but you'll get gastritis ; it can mean you're mega stressed even if you don't feel it.
    one that I like is Schultz's autogenic training ( Autogenic training - Simple English Wikipedia, the free encyclopedia ), or breathing meditation. When you're training and you're in the rush in the middle of your day, simply breathing slowly, focusing on it and recognizing you may be stressed can simply stop it in a few minutes.
     
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  20. Thomas Chauvet
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    Thomas Chauvet Bronze Contributor Read Millionaire Fastlane I've Read UNSCRIPTED

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    I was not at all familiar with it. It definitely makes some sense, I think that from a purely mecanichal standpoint it is very probably true that equilibrium is attained via tensegrity. Actually, maintening an equilibrium is a daily preoccupation in our surgeries, even if we don't use the same terms or refer to this precise theory. However, from a biological point of view (vascular, cellular, etc), this theory is way harder to demonstrate, IMHO. It is an interesting "deep" science theory, but I can't see any immediate application related to medecine and surgery practice.

    Where did you heard about it ?
     
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  21. Thomas Chauvet
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    Gilles Walch himself has the habit to say "the more it cracks, the less it's bad" :D. If you don't find any pain, you don't have to worry much. Bursitis cannot exist without pain. A popping sound doesn't mean anything in itself. Most of the time it's just air exiting the articulation due to movement.
    It might be a small shoulder instability, thought. Do you feel your shoulder moving inside the articulation while you hear the popping sound? Do you happen to have some hyperlaxity ( Beighton score ) ? Do you feel like your shoulder could "pop out" or dislocate in some movements ?
    When you have a pathological instability, it's painful and makes you feel uncomfortable (apprehension). But you can have a "physiological" benign instability if you're hyperlax, which you should not worry about.
    That would be easy to tell with a physical examination by a shoulder physician or surgeon.
     
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    Hey thomas, I’m french like you happy there’s another french aiming at Fastlane goal like me here , What’s your goal in the following year ?
    I’m quite sportive but I have an hard time losing fat localised at the bottom of my (belly) any advices ?
    For 3 weeks I have been working at carrefour and it is terrible my back’s hurt me but not so much happily I stopped my contract today, but now each time I’m doing abs or running i feel a little on my back or even a pain/pressure what should I do ?
    Stop sport or maybe only swimming ?
    One more question (sorry if they’re too many, I don’t have big arms and I stopped to train theme long ago however I have a lot of strength and I can’t explain maybe you can and so I wanted to ask you some exercise to gain more strength.
     
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  23. Thomas Chauvet
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    Thomas Chauvet Bronze Contributor Read Millionaire Fastlane I've Read UNSCRIPTED

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    Hey, I see you didn't post a lot of messages here so I guess you're pretty new, welcome ! Nice to see another french indeed !
    Thanks for asking, in following year I'd like to set definitely on an idea (I've had trouble to select one ^^) and just launch and pivot from there. I won't be able to spend full time on it but I'd like to grow it slowly and steadily on sane bases so I can spend more time on it when my head of clinic contract will be finished in 2 years and a half. I'm heading for long term anyway ;)

    For the flat belly it's because most sports routines don't target the transverse muscle enough, despite it's this muscle that flattens the abdomen. Check out this video :

    View: https://www.youtube.com/watch?v=CHIe4kC1X98

    If you do it consistently for 1 month, you'll get amazing results (take before and after pictures)

    For your back, I'd recommend to check with your doctor if he can give you some anti inflammtory meds and little painkillers, get sportive rest for 1 week or so but stay active (do not stay in bed or in a chair all day), and see if it gets better from there. Some stretches every day or 2 times a day (morning and evening) can help too, check the one I showed on this thread earlier!

    Strenght is not always related to volume. There is 2 different ways for muscles to grow. If you used them for manual labor, and even more if you use them for small charges but long efforts, they will grow more in strenght but less in volume. Volume growing is also highly related to eating... To get big arms you have to get more volume in all of your body, and to eat more.

    You should check Lafay's method, I'd definitely recommend it. There's a lot of people who got more than 40cm arms with this ( 45 centimètres et même davantage (la démocratisation des gros bras) - Méthode Lafay )

    I'd love to set up a TMF meeting somewhere in France, what do you think ? Would you attend it ?
     
    Sheens likes this.
  24. Dieriba
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    Dieriba New Contributor FASTLANE INSIDER

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    Thank for your answer and I’ll be there for sure, would be so interesting to have a like-minded meeting.
    I think you misunderstood me about arms actually I don’t want to have big arms I rather want increasing my strength without my arms becoming those of bodybuilder’s.
     
  25. Thomas Chauvet
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    Thomas Chauvet Bronze Contributor Read Millionaire Fastlane I've Read UNSCRIPTED

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    Oh sorry, my bad. Then it's exactly the opposite : you have to train with low weights and long series (more than 15 repetitions). Don't add weight or do a more difficult exercise until you can read 20 or even 25 reps. You should also focus on developping your whole upper body, which will give you more strenght than just training your arms in isolation. I personnally like weight-training : pumps, tractions, dips...
     

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