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Tweaked? A 10 Step Program for Minor Training Injuries!

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Everybody gets tweaks, whether they're active or not. The Athlete of Aging's approach to rehab training injuries is to TRAIN. Here's Sully's ten-step approach to rehabbing a tweak so you can stay strong and fit after fifty.
As emphasized in the video, it is extremely important to be certain that you're dealing with a MINOR injury. Sully discusses the red flags that mandate discontinuation of the workout and early evaluation by a health care professional. If no red flags are present to indicate a serious process, training can usually continue, even on the same day, by using a sensible, individualized, and careful approach that maintains the maximum range of motion and force production capacity while limiting the potential for either reinjury from excessive loading, or maladaptive healing from excessive "rest" and immobility.
Our approach is basically a PROGRAM that the athlete can tailor to the specific injury, discomfort, mobility, and other capacities, and includes an increased emphasis on conditioning, accessory work when necessary, and liberal use of analgesics, thermotherapy, wraps, and supports to keep pain on a short leash. While we cannot claim that this rehabilitation program--or any other physical therapy approach--has ever been demonstrated to be superior or even effective in populations (because nobody has ever looked), we have had enormous success using it in older lifters with minor training injuries. We hope our viewers--athletes and coaches--will find it helpful. Let us know how it works for you!
WRITTEN AND PRODUCED by Jonathon Sullivan MD, PhD, SSC
ASSOCIATE PRODUCER: Damian Lang
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WELCOME NEW PATRONS!
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IMAGES:
Michael Müller-Hillebrand commons.wikimedia.org/wiki/Fi...
Connexions
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Jonathon Sullivan
Maj Will Morris, DPT, USA
Lesia McQuade
Damian Lang
RESOURCES:
Trappe et al 2011:
journals.physiology.org/doi/e...
Trappe et al 2013journals.physiology.org/doi/e...
Dr. Sullivan's Article on Infammation in Training:
startingstrength.com/contentf...
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c. 2022 Greysteel LLC
Content is for informational and entertainment purposes only. Consult your physician for questions about your health, diet and exercise.

Опубликовано:

12 авг 2024

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Комментарии : 100

@fredbarnes8176 2 года назад

Excellent Video! I recently injured my back (Outside the Gym), and have been rehabbing using the 1, 3, and 5 rep protocol. This has allowed me to continue working the movements, and training.. I have had a steady improvement and plan to resume my strength training program under the guidance of my coach. highly recommended Fred Barnes MD FACS Orthopedic Surgeon

@GreySteel 2 года назад

Thanks, Dr. Barnes! Awesome.

@mr.e8432 2 года назад

Yeah, once you get over 50 minor tweaks and injuries is part of the game. But it's no excuse not to push yourself and train hard. The 2 things I have changed is I actually pay attention to warming up properly, and cut out the ego lifting.

@GreySteel 2 года назад

Yep. Both excellent tips, and we covered them in our Injury Prevention video: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-CozzvdCJgdE.html Give it a look if you haven't already. Thanks for watching, Mr. E!

@TunnelVisionAthletic 2 года назад

Sully on the way too 100K subs!

@GreySteel 2 года назад

Hope so!

@matthewblumenthal804 2 года назад

I've been lifting weights off and on since I was 16. I'm now almost 70 and am trying desperately to remain strong. That is, not loosing more than I can, as I am definitely weaker than I was in my 20's and 30's. I've led a very active life and have lots of chronic injury. I work around it, because at this point, working through the pain only makes things worse. I take a day or two off when I have to, but resume as soon as I am able. This is good stuff. Helps me maintain motivation to work out. I've watched what happens to people who decide that they are "too old" to exercise. Not pretty. I may go out, but I'll go out swinging.

@joethebar1 2 года назад

I tweaked my lower back a few weeks ago while deadlifting; I knew exactly why it happened. A few days later, I could barely get up out of bed. I decided to go to the gym and see if I could fix it in the squat rack. I began to do perfect squats up to heavy weight and felt great. By the time I was done, that lower back tweak was gone. There isn’t a therapist alive that would have recommended that, but years of lifting has taught me how to navigate injuries

@Joe_P726 2 года назад

Rule 10 is excellent advice. Over the course of my 8 years of barbell training, I've had plenty of tweaks! Accepting that training needs to be adjusted can be difficult the first few times. Enjoying the rehab process and getting back to regular training is very rewarding. I've hit PRs a few times after things healed up and I was back into regular training. Thanks for the video.

@GreySteel 2 года назад

You are most welcome. Thanks for watching and sharing your thoughts. I love the idea of "enjoying the rehab process." It IS rewarding. Rehab IS training.

@damianlang1855 2 года назад

Yeah, "enjoying the rehab process".. interesting concept. I'm going to remember that one. Thanks!

@900198619 2 года назад

A "Starr Method" video would be GREAT! Thanks for the info!

@LadyGreyAgeingDisGracefully 2 года назад

Back injury check. Achilles rupture check. Under 50 years check. I’m to young to be broken. Thanks for the help getting stronger while injured. So many doctors have been negative and discouraging about my return to physical health. I’ve been told I’d never work again. I’ll show them.

@barbellgardener 2 года назад

Great job! I just spent 8 months recovering from lower back disc herniation with LOTS of pain and spasms. Never stopped training! Modifications in lifting and as you nicely put; mind games with myself. We are NOT broken, just a bit bent.

@GreySteel 2 года назад

Exactly. Thanks for sharing.

@jimkane4530 4 месяца назад

At 81 I use Celebrex after each heavy workout which is only 1 day a week! Now I have a nagging groin tendon issue on squats that comes back after each squat work out. I just live with it. There doesn't seem to be a cure for this one. You are MY Inspiration!

@bernsteinpaintinginc.8351 2 года назад

Great video! Very helpful! I just tweaked a front deltoid while bench pressing heavy, I’m icing, taking ibuprofen and I’ll try overhead presses today not not even 18 hours after my injury. Can’t stop moving, got to work through it. Thanks again for the inspirational and wise words of wisdom.

@patale1640 2 года назад

Janet moves amazingly for 71!

@GreySteel 2 года назад

She's a strong and committed lady. We're trying to fix that slight knee poke at the bottom, but otherwise she has an almost perfect squat.

@danlauffer8540 2 года назад

I really appreciate your mantra and advice at the end. I'm very thankful that you have kept me on track for now over nine years. The most recurrent tweaks I get are from what I think is arthritis. They may be minor sprains in my thumbs and knees. Up until today, they were confined to my left knee and my left thumb joint. Today I got tweaks in both my right knee and right thumb. Ah, well, I just keep moving and keep training. Thanks for the encouragement.

@sschuyler1 2 года назад

Regular massage has been great for me. At least once a month, and more often from the little aches and pains.

@GreySteel 2 года назад

Massage is great. We couldn't talk about EVERYTHING, but I'm all in favor of massage and manipulation if it helps. THanks for watching.

@beskeptic 2 года назад

I do judo, and ocasionally I got injured... when its a minor thing like just a bruiser or small black, I simply ignore. But when is a JOINT injury that its hurting a lot even during the practice, I dont give second thoughts... doctor and anti inflammatory right after class. But I try to never skip practice, even with a injury I try to work around it and do it less intensive. Only if I had a fever or infectious disease or feeling pretty bad to miss class.

@angeladavies Год назад

Thankyou great video. Not letting pain fester in my mind and snowball to sitting on the couch has been empowering. Moving to decrease scar tissue i didn't know. I try picturing my feet (surgery hummer toe & bunions = 6 screws) saw latest X-ray and healed 100% thus I know nothing wrong so I can walk pain free. Lymphoma biopsy adductor has caused gait to lean one-sided but I picture bones muscles good so keep walking. "Use it or lose it" I believe in.

@scottaaat 9 месяцев назад

I’m watching this while I’m sitting here recovering from covid. The 1/3/5 protocol sounds like a good way to come back from a layoff of a few weeks. I might try that when I’m feeling better again.

@titanmaximum239 2 года назад

I use DonJoy EME on everything. Recently cleared by the FDA for musculoskeletal pain and for post surgical use. No side effects. It is a PSWT (pulsed shortwave therapy) treatment. I mostly use it on my shoulders and elbows. I haven't been to the doctor for cortisone injections since I started using it. It is also sold as KT Recovery Wave.

@jakehahn2457 2 года назад

This video just helped me more than I can express here. A deep and very sincere thank you ❤️

@GreySteel 2 года назад

Glad to be of help. Thanks for letting us know.

@Myrmecia 2 года назад

I have been exercising for 65 years and lifting for 57. No injuries for the first 40 years, but a few minor injuries since then. I cannot emphasize too much Sully's advice to keep moving. As I get older I find it tempting to rationalize an "off" day because of the injury. But for minor injuries, keep moving, just as Sully says. You may lift an empty bar or even a broomstick, but if it's not "red flag" level pain, go through the motions.

@daniel-zu4kp 2 года назад

For minor tweaks, I’ll generally go into a de-load week, dropping weight significantly but I’ll also increase calories somewhat. I think it’s also a good time to review the program for balance, making sure quads-hams, back-abs, etc are equally getting attention. Floating around in the pool and stretching is pretty awesome for the joints

@GreySteel 2 года назад

Thanks, Daniel!

@beskeptic 2 года назад

Excellent content!!! Thank you Dr Sully!

@murphyarmstrong3163 2 года назад

Thanks so much for this video. I’m a recent subscriber and think your site is terrific. Im so grateful for all your hard work to present these informative and affirmative messages. I’m a 74 year old O lifter, low weights and frequent tweaks. You really help me.

@Harry_16710 Год назад

Some of the best advice I learned recently - don't rest if it's just a tweak...keep moving. And be careful of those "spontaneous decapitations!"😊💪

@MegaJamesdc 2 года назад

“Don’t be dumb” is excellent advice I’ve only had to hear it about 1500 times before I started to listen…..

@HAL-dm1eh 2 года назад

Nature 'the mother' LMAO! Maybe I got the wrong interpretation from that but there are times (like with my current golfer's elbow) I've felt that way.

@GreySteel 2 года назад

No, you got it. 🤣

@davidjewett9968 Год назад

Thank you for putting this video together. This is the best content I've seen on this subject, there's a book here.

@MCJSA 3 месяца назад

Great segment. Thanks. I haven't let tweeks take me out of the gym, but I've wondered where the line was. This makes that very clear.

@mike2986 2 года назад

I'm ole thinking of working out. Thanks for video.

@jonsheppard4072 2 года назад

Outstanding video. I can see where I just got lucky in with past self-rehabs that were successful. Glad to see/hear an expert discuss it. A lot of good info here. Would also appreciate a video on training when temporarily sick with colds, fever, stomach/digestive issues, etc. Your wisdom would be appreciated here.

@steventrout6832 2 года назад

Thanks for this terrific video, which I received ten days after tweaking my back. So much great advice. With your encouragement, I returned to the gym and got in a surprisingly solid workout. After days away from the gym, I was going stir crazy and feeling all kinds of new minor aches and pain. Tonight, I am feeling sore, but in a good way, and looking forward to getting back at it.

@GreySteel 2 года назад

Excellent. Be judicious and patient, but keep working and you will get past it. Nice work.

@gcruishank9663 7 месяцев назад

I've been lifting for 35 years and usually know when an injury is severe or not and usually when to stop lifting or not. The injuries that are the most difficult are the ones that don't hurt at all during the lift, but then flare up after working out. The tendons/muscles on the right side of my left knee are giving me troubles right now, usually after squats or deads, but they don't hurt during the lifts. I use a TENS device, Theragun, stretching and topicals like Voltaren and they all work. I don't believe in icing a joint though, you need blood flow for healing.

@shaqcardcollector1412 2 года назад

Simply brilliant thank you! What I am very interested in would be a clip that helps to decide if you are too sick to train.

@juleyberglund4129 Год назад

This was incredibly helpful. I heard some details that were what I needed to hear and weren't easy to find on the Tube. Thanks Sully!

@GreySteel Год назад

You are welcome!

@danlauffer8540 Год назад

I broke my arm and this program really works. Well, actually, I did not break my arm but this protocol works.

@sammack9149 3 месяца назад

Im not over fifty, but I've had bad knees since I was a teenager. I did something to my knee, once again, a couple weeks ago. I'm going to try this method of rehab until I can get it looked at by a specialist. Big fan of the channel by the way, its been incredibly useful for my young but not so resilient joints

@GreySteel 3 месяца назад

Sorry for your trouble. Let us know about your progress.

@sammack9149 2 месяца назад

The 5-3-1 method seems to be working quite well! My tweak was a couple of weeks ago now and after doing this I think Im ready to resume my NLP, at a weight reduction for the squat starting out. Thanks for the advice!

@rdmckeever7645 2 года назад

Great coaching! "Life: a metaphor for training." Definitely stealing that line...

@K4R3N Месяц назад

Thank Sully

@johnspartan9839 Год назад

Doc Sully has convinced me to get off my dead a** and start pushing some weight around. I developed a real fear of squatting since I got older. Now at 65 I'm looking to return to the gym and incorporating the squat movement back into the mix.

@karlpk3907 2 года назад

Thanks Sully for this great video with all the sensible advice. I am 70, training at Chicago Strength and Conditioning, having worked with Dave Abdemoulaie since 2016. A couple months ago, I had a pain on my upper left abdomen, and it was hard to figure out if training caused it. I just couldn't remember if it was post deadlift or not-- I was deadlifting in the 275 ish range. Anyway, it came and went, sometimes aggravated by deadlift, sometimes not. But it appeared with some regularity, so I did what you suggest -- consult a healthcare professional, my good GP. I told him, I wondered if it was my pancreas, he agreed that we should take a look with at a Lysase test. Negative. The pain persisted, more acute, than chronic, so he order and upper CAT scan. Everything internally just fine, which had been my worry. So we agreed it probably is some muscle strain and even now it comes and goes, but I still deadlift. So your advice about seeing an HCP is advice I followed even before you gave it!!! FYI, Dave had programmed one of the alternative programs describe in Barbell Prescription. Finally, Sully, you need to get in contact with Peter Attia, who is an anti-aging doctor with a huge following on youtube who does long form interviews with doctors and researchers in anti-aging medicine. As an accomplished MD with a PhD, you seem to me an ideal interview subject. Attia is a huge believer in pressing and deadlifting, though he prefers a trap bar. You two ought to get together.

@damianlang1855 2 года назад

Hi Karl, I am Sully's assistant. Per your recommendation I've been researching Peter Attia, and you're very right, he speaks our exact language. I'll try to figure out a way to let him know about us. Thanks for the tip!

@karlpk3907 2 года назад

@@damianlang1855 Here's a recent segment that Peter Attia did with Layne Norton, also a PhD and champion bodybuilder and powerlifter. ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-R-Ltg1dl2jM.html Layne's website/business is aimed at the serious bodybuilder. Specifically, you and Sully should watch these segments 1:22:23 - The metabolic benefits of exercise, muscle mass, and protein intake 1:28:17 - The impact of lean muscle and strength on lifespan and healthspan 1:37:03 - Hypothetical case study #1: Training program for 50-year-old female 1:41:07 - Muscle protein synthesis in a trained athlete vs. untrained individual following a resistance training program Peter's great comment: "I have a saying that never in the history of civilization has a 90 year old person said I wish I had less muscle." Layne's great comment: "People say you're going to be in pain when you're older (with lifting). Well, you're going to be in pain regardless, so what would you rather be? In pain and weak? Or in pain and strong." At 1:30, Layne talks about a study with "frail elderly." Sully should check that out. Finally, at around 1:32, Peter talks about the his "death bars" chart. He says it is "basically causes of death by decade. Once you call out accidental deaths you realize something really interesting. . .Accidental deaths are basically the same. . . with 10 year olds to 20 year olds and 80 year olds to 90 year olds. They all have the same number of accidental deaths per year more or less. What differs dramatically is the type of accident so in young people -- it is disproportionately sadly overdoses that are the lion's share followed by automotive accidents. In the oldest subset of the population, it becomes almost entirely accidental falls.”

@Daishar07 2 года назад

Such a great video! Quality content delivered in a succinct, digestible format

@GreySteel 2 года назад

Thank you!

@ricklewis686 Год назад

Thanks!

@mtharri 2 года назад

Love watching All your videos very informative and lots of useful information

@GreySteel 2 года назад

Thanks!

@jamesianv 10 месяцев назад

i stop moving for 48 hours, dont even stretch it, and use a cane or sling, and then start moving just into the pain. every 2 hours. a bit of cross fiber massage. then start a linier progression slowly adding weights when full range of motion is achieved. I think the 48 hour RICE rule is important.

@damianlang1855 2 года назад

Excellent info! Who that trains hasn't experienced tweaks?

@GreySteel 2 года назад

Nobody. It's the cost of doing business.

@nickminneti825 4 месяца назад

Ugh, tweaks. First one I got, I figured I blew out a disc...how could a muscle swelled up and rubbing on the muscle sheath cause that much pain??? Now, I always have NSAID's ready and waiting for when a weekend of yard work didn't mix with my workouts. I actually IMMEDIATELY take a big dose...as in in the gym, before the next set. The sooner the swelling of a tweak is treated, the faster it'll be back to pain free. I always seem to work through it. I call it being a meathead. Dynamic warm ups...yup- I agree with that now. I spend 20-30 min doing a full body warm up of all the major joints. Shoulder and hip impingement is a fact of life since my 30's twenty years ago. I can get through it with lots of bands and flapping limbs like I'm having s seizure. Getting older is fun and looks hilarious in the gym. Nice video, good "reality " for both ends of the minor injury reaction...too little reaction and too much. There's the right amount in the middle there, somewhere.

@duncanhamilton-martin3666 Год назад

100% sensible advice

@Johnet61 10 месяцев назад

I tweaked my lower back this morning in my last deadlift rep, so this video is super interesting. I have taken Tylenol twice and ibuprofen in between. I used an ice pack and tried to keep gently moving my back. It feels about 70% better this evening. Fortunately, it’s Friday so I have a couple of days off before my next workout. I will follow your suggestions on getting back to my program.

@Mettejks 2 года назад

Excellent advice as always, I will remember this. The last few times I have tweaked something I definitely did stop moving. And it probably took way longer than necessary to heal. Love the video, a bit more sceptical when it comes to the type of fonts used. (What *were* those blue fonts? Original Star Wars fonts?)

@GreySteel 2 года назад

We're trying to settle into a standard font. Guess that's a down vote! Thanks for the feedback, and thanks for watching!

@joethebar1 2 года назад

Always find a movement where there’s no pain in the affected area. Work through the injury.

@mikeandlisabanjofiddle8280 2 года назад

Been dealing with a hyperextended dominant arm elbow from martial arts for about 2 months. I’ve been using a brace while training and sleeping, ibuprofen and some moderate resistance and controlled movements. Seems to be improving but slowly. Great advice in the video. Thanks.

@GreySteel 2 года назад

Thanks!

@greghawkins3985 2 года назад

what you describe may be what I developed. Somehow fell up a ski hills while still sliding down, used my forearm to break the Fall, and seriously stretched upper triceps and the tendon insertions. Like doing an explosive triceps extension with a dumbell - and I was the dumbell. Rest, ice, meds and brace then as Dr said, just went through basic unloaded range of motion for 2 weeks. Maybe I was doing my own version of the Starr pgm without knowing it. Didnt need to be a hero! After 3 weeks could swing bells at 50% weight and volume, 4 weeks could do snatch and strict press, 7 weeks can do pushups again, but am left with a curious click at the elbow and Popeye elbow ( olecranon bursitis) which now after 10 weeks is pretty much gone. At 67 though conditioning is lost quickly. ( but also had COVID in the middle of all this)

@DarthThumb 2 года назад

I really like your approach. I wish gyms here had programs aimed toward "older" athletes. I live in College Station, Texas home to Texas A&M with its 65,000 students the area gyms get the 18-22 age group and most trainers are in that age group and don't know how to train us greysteelers.

@GreySteel 2 года назад

We're working on it, Bob.

@James-bf9bx 2 года назад

I did an SI joint, deadlifting. Heard it pop. Wasn't smart - kept going. Very sore after cooling down. I trained lighter for a week or two then got back to 100%. I still have mild nagging pain but doesn't stop me from training. My hack: I focussed a lot on core exercises to strengthen around the injury (and a warm-ups). Seems to help...

@yoeyyoey8937 2 года назад

The starr protocol is controversial because it’s more of a theoretical template than a rigorous and reliable methodology for specific types of injuries. For example, the starr protocol is supposed to take about two weeks before you’re back to regular training, but your mileage may vary with the sets and rep progression scheme and within what timeframe it happens. My experience with this is that last year I totally fried up my hip flexors and got to the point where I could squat 0 pounds, so I decided I didn’t have much to lose, it was either surgeries and long recovery process where I can’t train, or to try to see what I can do for myself. So I did the starr protocol by starting with air squats, got that to 25 for 3 sets, then started progressing by adding 5 pounds from there and reducing reps, which turned out to be a bit more of an art than a science, and takes a lot of patience. Two months later and now I am squatting 200 for sets across with minimal pain, while 6 months ago I was almost convinced I would never be able to squat hardly anything near 100 pounds for the rest of my life. So basically it works but you have to tailor it to the situation and go low and slow as you assess how much you are improving and what steps to take next.

@GreySteel 2 года назад

Thanks for sharing your experience. Appreciate it!

@farmerwayne1404 2 года назад

Good stuff, Doc! Ill try the 20% rule next time. Btw, are you saying ibu+ Tylenol together or separately? Pizza and whiskey? Oh no...Red wine and 🍕. And a nice big fresh salad. Thanks for the information 👍

@GreySteel 2 года назад

Tylenol + NSAID together. Works well.

@sandrasattin4824 2 года назад

Great advice, as a physician in my 60s, with many tweaks, I endorse this approach. (Hey doc-great video, but can we do away with the background music?)

@waltersobchak6546 Год назад

Thank you so much. To answer your question: Voltadol Forte Gel (Europe)

@gimmyherbert8217 2 года назад

The pain lessons if you keep going to weight training strength train ....helps resist father time longer

@johnknestis3851 2 года назад

I get noticeable relief from an inversion table.

@franko2348 2 года назад

Not a hack, but post work out, off-day yoga has been tremendous for me. Good health to all! (also how did you know about the whiskey and pizza?)

@nickashton3584 2 года назад

what do you guys think about Doug McGuff body by science big five protocol

@povilasmarko 3 месяца назад

I seem to get wrist tendon pain when bench pressing - either I’m rolling the weight back over my hand as I lift - or I have weak wrists and need straps? Ant tips to make sure hands are straight on the light and not taking the weight that should be carried by arms/ shoulders / chest?

@waynenoll1967 2 года назад

I have an old elliptical in my garage. Is this ok for HIIT? Can’t afford a bike right now and no room for a prowler. I usually get on it and go for a steady pace for 5 minutes then 30 seconds as hard as I can go, followed by 90 seconds of steady pace, then 30 and 90 for 15 minutes. Usually 7 or so “sets”. Thoughts?

@pixelty 2 года назад

11:45 what does he mean by: “unlocked wrists or elbows”?

@markcummings2471 2 года назад

My left elbow keeps hurting shoulder elbow

@dangoldstein152 2 года назад

Sully, great video, but please let off the Star Trek font - it's really hard to read.

@GreySteel 2 года назад

Yeah, we're getting pushback on that. No more, we promise.

@jeffreyabelson7171 2 года назад

I have a stiff back - it actually feels better after deadlifts - but the moment I'm back sitting it hurts - I take a hot shower, have a back "brace" and take advils - but it is concerning as I feel it when I ride my bike and that never bothered me before

@GreySteel 2 года назад

Could be pyriformis, sciatica, or other. Get it checked, but don't stop moving! Glad the deadlifts help. Sitting is the worst.

@thomashugus5686 2 года назад

Stop deadlifting silly!

@jeffreyabelson7171 2 года назад

@@thomashugus5686 fuck THAT - it feels BETTER after deadlifting

@GreySteel 2 года назад

@@thomashugus5686 Worst possible advice. Or do I need to recalibrate my Sarcas-O-Meter?

@Myrmecia 2 года назад

@@thomashugus5686 No, stop bicycling. There is a culture built up around the bicycle that makes it difficult to step back - or even drop it forever - if that's what's necessary. As Sully mentioned, there are many alternatives to exercise types that cause problems.