logo
episode-header-image
Nov 20
28m 46s

🔓 PLUS PREVIEW: When to Push Through Pa...

BARBELL MEDICINE
About this episode

Episode Summary

This is a preview of our subscriber-only Ask Us Anything episode, where Dr. Jordan Feigenbaum and Dr. Austin Baraki tackle the most persistent problems in training and nutrition. Hear the science behind managing pain in the gym—determining the threshold for acceptable discomfort versus a true programming error. They also analyze why short-term study findings often fail in the real world, cover the science of pre-exhaust training, and give practical advice on the psychology of managing dietary cravings when transitioning to a healthier diet.

Takeaways

  • Pain Threshold: Learn the 3/10 rule for pain in training: low-level, self-limiting discomfort is common, but anything more should be addressed.
  • Programming Fix: Recurrent pain (e.g., every 5-6 weeks) is often a programming issue caused by a lack of training tolerance, not a technique fault. The solution is modifying the total load, not just changing your form.
  • Training Philosophy: Stop "pushing" harder every session. The best way to progress is to wait for fitness to show up (the lift feels easier) before increasing the load.
  • Pre-Exhaust Science: Find out why techniques like leg extensions before squats are suboptimal for both strength and hypertrophy because they compromise the necessary total training load.
  • Cravings Are Transient: The intense difficulty experienced when switching from ultra-processed, hyper-palatable foods to home-cooked meals is normal (hedonic adaptation) and transient. Understanding that this discomfort will fade is key to long-term adherence.


⏱️ Preview Timestamps

  • 00:00 Introduction & Plus Subscriber Offer
  • 00:40 How Often Should I Feel Pain in Training? (Pain Threshold & Training Tolerance)
  • 09:31 The Science of Pre-Exhaust Training (Why it compromises total load)
  • 16:54 Managing Dietary Cravings When Switching Habits (Hedonic Adaptation)
  • 27:49 Conclusion: Barbell Medicine Plus Offer


🔓 Unlock the Full Episode & Exclusive Benefits

The topics above are only a fraction of what's covered in the full Ask Us Anything episode, which also includes:

  • How to structure high-intensity conditioning intervals and why heart rate is often a poor metric.
  • The science behind Powerlifting peaking and tapering for non-elite athletes.
  • The latest, large-scale meta-analysis on Vitamin D and respiratory infections and why the real-world benefit is highly modest.
  • A full discussion on the discrepancy between short-term studies and real-world results in diet and exercise.


Subscribe Today to Barbell Medicine Plus

When you join Barbell Medicine Plus, you get the full ad-free episode, access to our bonus content library, and major discounts:

  • 25% off all courses and seminars
  • 15% off consultations
  • 10% off all our programs


Want to support the show and get early, ad-free access to all episodes plus exclusive bonus content? Subscribe to Barbell Medicine Plus and get ad-free listening, product discounts, and more. Try it free for 30-days.

Unsure which training plan is right for you? Take the free Barbell Medicine Template Quiz to be matched with the ideal program for your goals and experience level.

For media, support, or general questions, please contact us at support@barbellmedicine.com

Resources


Pain

It is normal and acceptable for lifters to experience low-level, self-limiting discomfort during training. The threshold for acceptable pain is generally considered to be less than 3/10 on the pain scale, provided the discomfort is not sharp, does not cause fear, and is gone within 24 to 48 hours.


The real warning sign is recurrent pain—when the same tweak flares up every 5 to 6 weeks. This is typically not a technique fault but a programming issue—the lifter is demanding more from their body than their current training tolerance allows. The solution is usually to reduce the overall training load, modify the volume/intensity, and rebuild capacity gradually.

  • www.barbellmedicine.com/blog/training-with-pain-a-practical-approach
  • www.barbellmedicine.com/blog/the-barbell-medicine-guide-to-tendinopathy 
  • Shrier, I. (2004). Does stretching help prevent injuries? Clinical Journal of Sports Medicine. DOI: {10.1097/00042752-200405000-00002} (Review discussing prior injury as a key risk factor).
  • Gabbett, T. J. (2016). The training—injury prevention paradox: should athletes be training smarter and harder? British Journal of Sports Medicine. DOI: {10.1136/bjsports-2016-096319} (Discusses role of prior injury and training load).
  • Siewe et al. (2014). Injuries in powerlifting: how common are they and what are their causes? Sports Medicine - Open. DOI: {10.1186/s40798-014-0016-x} (Epidemiology and common injury sites in powerlifting).
  • Calhoon, N. L., & Fry, A. C. (1999). Injury rates and profiles of elite competitive weightlifters. Journal of Strength and Conditioning Research. DOI: {10.1519/00124278-199902000-00010} (Injury rates in weightlifting).
  • Raske, Å., & Norlin, R. (2002). Injury incidence and prevalence among elite weight and powerlifters. Scandinavian Journal of Medicine & Science in Sports. DOI: {10.1034/j.1600-0838.2002.01188.x} (Injury sites in powerlifting).
  • Nijs et al. (2014). Treatment of central sensitization in patients with chronic musculoskeletal pain: new insights and practical implications. Physical Therapy. DOI: {10.2522/ptj.20130360} (Discusses non-mechanical factors like stress on pain).


Pre-Exhaustion

The technique of pre-exhastion training (e.g., leg extensions before squats) is generally suboptimal for both strength and hypertrophy.

Compromised Load: Pre-fatiguing the muscle compromises the ability to perform the subsequent compound lift with high intensity and high volume, thereby reducing the total training load. This directly hurts both muscle growth (less mechanical tension) and strength (less high-fidelity force production).

Limited Use Case: This technique is primarily useful in rehab (as a load-limiting or desensitization tool) or for highly specific muscular endurance challenges (e.g., preparing for certain high-rep CrossFit workouts).

  • https://www.barbellmedicine.com/blog/how-to-exercise-when-you-have-no-time/ (training load preservation)
  • Schoenfeld, B. J., et al. (2018). Differential effects of attentional focus strategies during long-term resistance training. European Journal of Sport Science. DOI:10.1080/17461391.2018.1500632 (Discusses mind-muscle connection effectiveness).
  • Schoenfeld, B. J. (2010). The mechanisms of muscle hypertrophy and their application to resistance training. Journal of Strength and Conditioning Research. DOI: 10.1519/JSC.0b013e3181e840f3(Reviews mechanical tension as the primary driver).
  • Fisher, J. P., et al. (2013). The effects of pre-exhaustion, exercise order, and rest intervals in resistance training. Journal of Applied Sports Science Reports. DOI: 10.1016/j.jassr.2013.06.002 (Discusses pre-exhaustion's impact on load).
  • Gentil, P., et al. (2007). Effect of exercise order on upper-body strength and muscle thickness in untrained men. Journal of Strength and Conditioning Research. DOI: 10.1519/R-20415.1 (Found pre-exhaustion did not enhance hypertrophy over traditional training).


Cravings

Switching from ultra-processed, hyper-palatable foods (e.g., pizza, fast food) to a whole-food, home-cooked diet involves temporary challenges due to hedonic adaptation (the brain is adapting away from high food reward).

The difficulty of managing cravings is complex. Switching is often easier when the body is in an energy surplus (biologically supported).

The tension and cravings intensify when the lifter moves into a calorie deficit, activating biological defense mechanisms (hormonal signaling increases hunger). Recognizing that the acute cravings are transient is crucial for maintaining self-efficacy and adherence, as it reinforces the belief that the new, healthier habit will eventually become easier.

  • https://www.barbellmedicine.com/blog/how-to-eat-a-healthy-diet/ 
  • https://www.barbellmedicine.com/blog/how-to-train-while-losing-weight/ 
  • https://www.youtube.com/watch?v=oYeh1xTnlxU&themeRefresh=1 
  • https://www.barbellmedicine.com/blog/does-your-metabolism-change-with-weight-loss/ 
  •  Rosenbaum, M., & Leibel, R. L. (2010). Adaptive thermogenesis in humans. International Journal of Obesity. DOI: {10.1038/ijo.2010.184}
  • Considine, R. V. (2012). Leptin and the regulation of body weight. The Journal of Clinical Investigation. DOI: {10.1172/JCI65051}
  • Sumithran, P., et al. (2011). Long-term persistence of hormonal adaptations to weight loss. New England Journal of Medicine. DOI: {10.1056/NEJMoa1005813}
  • Finlayson, G., et al. (2011). The role of palatability in appetite regulation. Journal of Physiology and Behavior. DOI: {10.1016/j.physbeh.2011.08.016}
  •  Lally, P., et al. (2010). How are habits formed: modelling habit formation in the real world. European Journal of Social Psychology. DOI: {10.1002/ejsp.674}
  • Baumeister, R. F., et al. (1998). Ego depletion: Is the active self a limited resource? Journal of Personality and Social Psychology. DOI: {10.1037/0022-3514.74.5.1252}
  • Spiegel, K., et al. (2004). Brief sleep restriction alters the neuroendocrine profile of ghrelin and leptin. Annals of Internal Medicine. DOI: {10.7326/0003-4811-141-11-200412070-00008}




Our Sponsors:
* Check out Express VPN: https://expressvpn.com/BBM
* Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com
* Check out Factor and use my code bbm50off for a great deal: https://www.factor75.com
* Check out Rosetta Stone and use my code TODAY for a great deal: https://www.rosettastone.com
* Check out Washington Red Raspberries: https://redrazz.org


Support this podcast at — https://redcircle.com/barbell-medicine-podcast/donations

Advertising Inquiries: https://redcircle.com/brands

Privacy & Opt-Out: https://redcircle.com/privacy
Up next
Nov 14
Q&A: Cholesterol Lowering, Volume vs. Intensity For Hypertrophy Volume, Zone 2 Efficiency, and More
<h1>Barbell Medicine Q&amp;A: Cholesterol, Hypertrophy Volume, and Training Efficiency</h1><p><br></p><h2>Episode Summary</h2><p><br></p><p>In this Q&amp;A session, Dr. Jordan Feigenbaum addresses listener questions on optimizing training, managing health metrics, and navigating ... Show More
19m 39s
Nov 11
Episode #374: Mental Strategies: Neuroscience, Visualization, and Developing Resilience with Anne-Sophie Fluri
<h1> Mental Strategies: Neuroscience, Visualization, and Developing Resilience</h1><p><strong>Episode Summary: Training Your Brain for Performance and Health</strong></p><p>Dr. Jordan Feigenbaum welcomes <strong>Anne-Sophie Fluri</strong>, a neuroscientist with a background in ex ... Show More
1h 12m
Nov 7
Q&A Deep Dive: Measuring Fat Loss, Testosterone vs. GainzZz, the Carnivore Diet, and More
<h1>🎙️ Q&amp;A Deep Dive: The Critical Cutoff for Fat Loss, Safety, and Strength</h1><h2>📝 Episode Summary: BMI, Training Safety, and Evidence-Based Nutrition</h2><p><br></p><p>In this mini-sode, Dr. Jordan Feigenbaum answers core questions on performance and health. The discus ... Show More
20m 12s
Recommended Episodes
Jul 2025
Bonus Episode: Treating High Blood Pressure at the UltraWellness Center
This special bonus episode features Dr. Cindy Geyer from the UltraWellness Center, diving into how functional medicine approaches high blood pressure — and why treating the root cause means looking far beyond salt and stress. In this conversation, Dr. Geyer walks through the case ... Show More
51m 12s
Sep 19
193 - Elevate Your Guideline Knowledge, Not Your BP: The New 2025 Hypertension Guidelines
In this episode, we review the newly published 2025 ACC/AHA hypertension guidelines. Key Concepts Instead of the Pooled Cohort Equations (PCE) from 2013, the 2025 hypertension guidelines recommend a new risk equation called PREVENT, which incorporates new risk factors and does no ... Show More
35m 7s
Sep 2023
Hypertension - What’s New?
<p>Doctors Lisa and Sara talk to Dr Aseem Mishra to discuss changes in the guidelines for Hypertension. The discussion includes advice on how to get the most accurate diagnosis and measurements for blood pressures, the importance of counselling patients well, and advice on medica ... Show More
40m 9s
Dec 2024
122. Stress Your Way to Better Health with Hormesis
What if the stress you’re avoiding is actually the key to unlocking your peak performance? In this Ultimate Human short episode, Gary Brecka explores the fascinating science of hormesis – nature’s secret weapon for enhancing human potential through controlled stress exposure. Lea ... Show More
13m 59s
Oct 2024
Why Lowering Cholesterol Won’t Save You: A New Approach to Heart Health with Dr. Aseem Malhotra
"Focusing on cholesterol is a waste of time in preventing heart disease. The real issue is insulin resistance." – Dr. Aseem Malhotra In this eye-opening episode, I sit down with Dr. Aseem Malhotra, a cardiologist whose bold research is shaking up conventional wisdom on heart hea ... Show More
54m 8s
Jun 2025
How to lower blood pressure, improve heart health and reduce dementia risk | Prof. Tim Spector
What if your blood pressure — even just a little too high — is quietly damaging your brain? What if it’s increasing your risk of a heart attack or stroke, without you ever feeling a thing? In this episode, Professor Tim Spector reveals why blood pressure is one of the most overlo ... Show More
53m 48s
Apr 2023
Dr Joseph Radich | How to Fix a Broken Sick Care System, Cutting Edge Health Bio-Hacks, Reducing High Blood Pressure & More! KKP: 573
Today, I am blessed to have Dr Joseph Radich. Dr Radich founded R3 Health, a safe and trustworthy VIP experience designed to solve its members' health, medical, and lifestyle problems. They believe that individualized healthcare is the key to achieving optimal and balanced wellne ... Show More
58m 40s
Mar 2025
#338 ‒ Peter's takeaways on aerobic exercise and VO2 max, insulin resistance, rising healthcare costs, treating children with autism and ADHD, and strength training | Quarterly Podcast Summary #4
<p><a href= "https://peterattiamd.com/qps4/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=250303-pod-qps4&utm_content=250303-pod-qps4-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href= "https://peterattiamd.com/subscribe/?utm_source=podcast-feed&ut ... Show More
27m 41s
Sep 22
#188 Orthostatic Hypotension Part 2: Gray Matters Segment
<p>Medications for orthostatic hypotension! When to initiate treatment, how to use them safely, and what to do when new issues arise during treatment. How do those change if someone has autonomic failure? What do you do when your patient has hypertension AND also has orthostatic ... Show More
35m 35s
Aug 2024
Episode 918: Automated Blood Pressure Cuffs
<p dir="ltr"><strong>Contributor: Aaron Lessen, MD</strong></p> <p dir="ltr"><strong>Educational Pearls:</strong></p> <p dir="ltr">How does an automated blood pressure cuff work?</p> <ul> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Automated blood pressure cuff ... Show More
2m 53s