The patient generally presents with leg stiffness, weakness in the hip flexors, and impaired foot dorsiflexion in the second through fourth decades, although symptoms may be apparent in infancy or not until late adulthood. The gait disturbance progresses insidiously and continuously. Patients may also have paresthesia and mildly decreased vibratory sense below the knees and urinary urgency and incontinence late in the disease. On neurological examination, generally there are no abnormalities of the corticobulbar tracts or upper extremities, except possibly brisk deep tendon reflexes. In the lower extremities, deep tendon reflexes are pathologically increased and there is decreased hip flexion and ankle dorsiflexion. Crossed adductor reflexes, ankle clonus (Video 82, Cross‐Adductor Reflex; Video 84, Sustained Clonus), and extensor plantar responses are present. Hoffman's and Tromner's signs, as well as pes cavus, may be present. Occasionally, slight dysmetria may be seen on finger‐to‐nose testing in patients with long‐standing disease.
The first thing you need is a weight training program that signals the muscle building process to begin. Research has shown that a well designed program will generate this “signal” via a combination of progressive tension overload (as in, getting stronger over time), metabolic stress (as in, fatiguing the muscle and getting “the pump”), and muscular damage (as in, actual damage to the muscle tissue itself).
The high levels of muscle growth and repair achieved by bodybuilders require a specialized diet. Generally speaking, bodybuilders require more calories than the average person of the same weight to provide the protein and energy requirements needed to support their training and increase muscle mass. In preparation of a contest, a sub-maintenance level of food energy is combined with cardiovascular exercise to lose body fat. Proteins, carbohydrates and fats are the three major macronutrients that the human body needs in order to build muscle.[24] The ratios of calories from carbohydrates, proteins, and fats vary depending on the goals of the bodybuilder.[25] 

Don’t make the mistake of trying to bulk up when you should be on a diet. While you might have muscle on your mind, most people need to get leaner first. If you’re fat and you start eating for size, you’re only going to get fatter. Get rid of the excess blubber first, to the point where you can see some abs, and then worry about getting big. You should be as low as 12% body fat before you change your diet up to focus on mass gain. That will ensure that your insulin sensitivity is high. When it is, you can eat more carbs and your body won’t store them as fat.
Stand with your feet slightly wider than shoulder width with a kettlebell about a foot in front of you. With your weight in your heels, hinge at your hips while lowering your hands to the kettlebell handle. Grab the kettlebell with an overhand grip,  “Hike” the kettlebell back between your legs, catching the force of the moving kettlebell with your hips. Exhale as you swing the kettlebell forward by thrusting your hips, straightening your legs, and squeezing your glutes and abs. Once the kettlebell reaches chest height, inhale as you allow it to fall, and guide it back to the “hiked” position.
Don’t give up. One day missed is one day longer. Start now to get ahead. Don’t worry about the eyes of other people. Do you. Focus on what you want. See it before it happens. Stay consistent in your ways and everything will fall into place. Trust the process, but experiment. Love and appreciate your abilities and help others as much as possible. I believe in you.
You see, there is only so much muscle that the human body is capable of building in a given period of time. So, if you supply your body with MORE calories than it’s actually capable of putting towards the process of building new muscle… it’s not going to magically lead to additional muscle being built. It’s just going to lead to additional fat being gained.
A: Eat more frequently, drink less liquids while eating (they compete for stomach volume along with food), eat from larger plates and bowls, add lime or lemon juice to your water with meals (can help to increase production of hydrochloric acid that breaks down food), and consume more liquid calories (especially around the workout if appetite is suffering the rest of the day).
The spine has a natural curvature in it in order to function correctly. With their attachment on the spine and pelvis, tight hip flexors can cause an unnatural curve of the spine called hyperlordosis. Hyperlordosis affects the way forces are distributed in the spine and can cause pain and soreness in the lower back. Other common problems that are associated with hyperlordosis are weak abdominal muscles, weak hamstrings, tight low back muscles, as well as tight hip flexors. This can lead to hip flexor and groin strains and hamstring strains…..an all around mess!
The two workouts listed above are completely free and highly recommended. If, however, you’re looking for additional workouts, my book – Superior Muscle Growth – contains ALL of the muscle building routines that I’ve personally used and designed for others (11 different workouts, 40+ different versions). Feel free to check it out to learn more about what’s included.
How to do it: Begin with your head, neck, and shoulders comfortably fixed against a stability or Swiss ball and both feet firmly planted on the ground, knees bent at 90°. (This is also known as table top position.) Either stretch your arms straight up above your chest with your hands clasped to maximize the balance and stability challenge, or down on either side in case you begin to slip or tip over. As with the other bridge motions, simply lower your hips toward the floor then drive them toward the ceiling. Lower and repeat.
  Take note to see if the thigh rests down parallel to the ground (Picture 2) or if it stays up in the air (Picture 1) (You will need someone to be nearby to see what your leg does). Perform on both sides and compare. If the thigh does not stay raised up in the air then there is no true hip flexor tightness and stretching does not need to be performed. If one of the thigh/legs stays up noticeably higher than the other, then stretching will need to be performed. If your leg is able to hang down comfortably parallel to the ground or lower then you passed the test!
Even if you have a schedule that allows for a 5-day workout split, many people (I’d even call it the majority) simply don’t have the recovery capacity needed to make that work. This could be due to genetics, age, injury history, various lifestyle factors (sleep, stress, etc.) and more. In these cases, better results would be seen with 3-4 workouts per week instead.
Several muscles cross the front of the hip and create hip flexion, pulling the thigh and trunk toward each other, but probably the most important is the iliopsoas. It is actually composed of two muscles, the iliacus and the psoas, which lie deep in the back of the abdomen. If you looked at the front of a body with the internal organs removed, you would see the psoas lying alongside the spine, attached to the sides of the lumbar vertebrae. The iliacus originates on the inner bowl of the pelvis. Both muscles cross the floor of the pelvis, emerge at the outer edges of the pubic bones, and finally insert on the inner upper femur (thighbone). Because the muscles are buried so deep, we can't see or touch them, so it's easy to understand why there is much confusion about their location and action.

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Prison food isn’t as bad as people think. Prisoners often get three meals a day. Meals need to meet a certain amount of calories. You don’t need that much protein to build muscle, but prisoners can buy protein powder (and also extra food like oatmeal). Prisoners aren’t underfed in most western countries. The diet may not be optimal, but it’s sufficient to build muscle.

Don’t take sets to the point of failure—where you absolutely can’t perform another rep. You should never get to where you’re turning purple and screaming like you’re getting interviewed by “Mean” Gene Okerlund before WrestleMania. Most of the time, you want to end your sets two reps before total failure. Not sure when that is? The moment your form breaks down, or you’re pretty sure it’s going to break down, end the set.
From a standing position on your left foot, hinge forward from your hips keeping your back flat and right leg in straight behind it, and core braced. Reach your right hand toward your left foot. Then, engage your glutes and hamstrings on your left leg to drive yourself back up to standing and swing your right knee up and through toward your chest. Stand as tall as possible and hold that end position for 2-3 seconds before repeating. This entire exercise is about “sticking” the knee drive hold at the end, so don’t rush through it. Repeat for required reps, then switch sides.
The iliopsoas muscle is the prime hip flexor and shortening may affect the lower back, pelvis, and/or hip joint. Caution should be taken during this release due to the sensitive area in which the therapist's hand pushes, i.e. proximity to the appendix, possible abdominal aortic abnormalities, potential tissue weaknesses predisposing to inguinal hernias, ovarian conditions, or general irritation/inflammation of the gastrointestinal system; hence, this release may occasionally be replaced by the regular therapeutic stretch presented in Chapter 7 (see Fig. 7.14).
As a parting thought, we can’t emphasize enough the importance of consistency and staying focused. Your workouts shouldn’t be two-hour affairs—each visit to the gym needs to be fast-paced and intense. With that as your guide and following the heavy-duty blueprint laid out here, we can’t promise it’ll be easy, but the results should be worth every drop of sweat. Just think, 10 more muscular pounds may be a mere month away.
Simply put, glute activation is waking up your glutes. It makes the connection from your brain to your muscle and gets the muscle fired up and ready to do some work. Glute activation should be done prior to your workout, but it can also be done as an active rest between sets. And trust me when I say that doing some glute activation prior to your squats, lunges, and deadlifts will result in an excellent glute workout! 

Achy knees are often written off as an inevitable side effect of getting older. And while it’s true knee pain has many age-related causes (namely, arthritis), chances are weak glutes are a big part of the problem, Kline says. If you’ve been diagnosed with arthritis, strengthening your glutes can at least help offset some of the pain you might experience, she says.
If you’re a beginner, you should train with three full-body workouts per week. In each one, do a compound pushing movement (like a bench press), a compound pulling movement (like a chinup), and a compound lower-body exercise (squat, trap-bar deadlift, for example). If you want to add in 1–2 other exercises like loaded carries or kettlebell swings as a finisher, that’s fine, but three exercises is enough to work the whole body.

The spine has a natural curvature in it in order to function correctly. With their attachment on the spine and pelvis, tight hip flexors can cause an unnatural curve of the spine called hyperlordosis. Hyperlordosis affects the way forces are distributed in the spine and can cause pain and soreness in the lower back. Other common problems that are associated with hyperlordosis are weak abdominal muscles, weak hamstrings, tight low back muscles, as well as tight hip flexors. This can lead to hip flexor and groin strains and hamstring strains…..an all around mess!
If you’re a beginner, you should train with three full-body workouts per week. In each one, do a compound pushing movement (like a bench press), a compound pulling movement (like a chinup), and a compound lower-body exercise (squat, trap-bar deadlift, for example). If you want to add in 1–2 other exercises like loaded carries or kettlebell swings as a finisher, that’s fine, but three exercises is enough to work the whole body.
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