Z-Block

190x5. 34 y.o., 5’11, 260. Tweaked my neck recently by cheating reps and pushing it into the bench so I’ve moved the weight down a bit and have been focusing on keeping the head 1/2 inch off the bench.

I have issues with keeping the bar even as well which is evident in the video. My left shoulder has always given me problems but fortunately it’s not so bad pain wise that I can’t train through it. However, I do feel like it could be contributing to the bit of lag I experience between the arms while driving the bar up. Hopefully this isn’t the case and it’s moreso an obvious technique issue I haven’t identified.

Any feedback or tips greatly appreciated thank you!

Mark Rippetoe

Your feet are pretty loose on the floor. There is no good connection between the floor and the bar.

asm44

I've asked a few questions on reflux before, and you give good and helpful answers so I hope you don't mind another.

I have a loose LES (diagnosed via endoscopy), and as a result chronic inflammation in my throat. I have no damage below my throat or any other standard GERD symptoms. I suspect the loose LES may be from many years of forcing myself to eat right before bed, and the resulting chronic stress on the valve (I really wanted to be bigger and stronger), but I don't know. I've stopped eating 4 hours before bed and hopefully it can recover.

I just did a pH manometry test, and the results show that I have severe nighttime reflux reaching my throat, and am in the upper 90%th percentile for reflux of all people who take the test. Interestingly, the reflux only occurs when I'm asleep, and if I'm lying-down but awake, I'm not refluxing.

I think my doctor is one of the better ones. He is an ENT and a head surgeon and says I need to take some kind of action. I do not want to take PPIs or have surgery, but I thought H2-blockers may be a more reasonable alternative, as they do not carry the side-effects of reducing acid production 24/7, due to their shorter half-life (I'd take them only at night).

I mentioned your Vitamin C fix as a potential alternative, and my Dr. said he thinks I first need to get the inflammation under control, and can then test out if that works, but suggests medication to start. I've tried taking the Vitamin C in the past, but my condition is so chronic, that I suspect I can only see results after a long trial period.

Do you have any thoughts on long-term H2-blocker use?

Mark Rippetoe

What medications have you taken for it, and what other medications are you taking? Diet? Age? Height/bodyweight?

asm44

I've tried PPIs for a few weeks and alginates like gaviscon advance. I didn't notice an improvement, and also didn't know if the problem was even acid (instead of other gastric reflux types like pepsin-based), so I stopped. This problem started 8 years ago as a sore throat when waking up every morning, and I had no idea that the issue was reflux until recently.

I don't take any medications. I eat mostly meat, vegetables, rice, eggs and dairy, and pretty clean. I don't notice any correlation between what I eat and refluxing. I'm almost 30, 6'0 and 205lbs. I mostly hoverered around 220 before dropping nighttime eating. At that heavier bodyweight I had been pretty strong, squatting in the mid 500s, pulling in mid 600s, pressing bodyweight. Now, my lifts have dropped with my bodyweight, but I'm staying reasonably strong and my health is my main concern.

I was so fond of nighttime eating because I have trouble eating earlier in the day, as I have issues with nausea and lack of appetite. I suspect these problems are related, although issues with nausea/belching/early satiety/lack of appetite have been going on since I was 16.

I thought I had an hiatal hernia, but that was just a doctor misreading my endoscopy report. The only anatomical issue found in my endoscopy is a somewhat loose LES.

I've gotten 40mg of famotidine prescribed from my doctor.

I've also been looking into getting a Stretta procedure if you know what that is.

Thanks for your help.

Here is the pH study if it's of interest, the rise in pH in the early morning is me being awake for a few hours, but still lying down in bed, it falls again after I fall back asleep.

Mark Rippetoe

A combination of ranitidine and omeprazole before bed works for me very well when I need it.

asm44

I guess I will try out the famotidine then. Ranitidine is no longer available anywhere after it was discovered the manufacturing process was contaminating it with NDMA.

Do you combine the ranitidine and omeprazole with vitamin C?

Mark Rippetoe

Sometimes. Try it. You haven't been good at trying things, have you?