Key Takeaways
1. Load Training: The Foundation for Joint Health
Load training (a.k.a. resistance training) is the most effective lever for resolving joint pain and building a resilient body.
Mechanotransduction is key. Load training, or resistance training, is not just about building muscle; it's about how your cells respond to mechanical stress. This process, called mechanotransduction, turns load-bearing activity into structural changes and healing mechanisms in your muscles, joints, and connective tissues. The more load, the greater the response.
Connective tissue needs load. Many believe weight training damages joints, but the opposite is true. Tendon breakdown and joint dysfunction can only be fixed by increasing the load tolerance of connective tissues. This is achieved through well-planned and executed load training, not rest or stretching.
Weightlifting is functional. Weightlifting is not just a vanity-based hobby; it's a learned skill of absolute human necessity. It's about practicing and perfecting basic human movement patterns—squats, presses, rows, and lunges—under loads. This is the most functional and beneficial form of exercise there is.
2. Pain: A Messenger, Not the Enemy
Pain is a messenger, with a complex language difficult to interpret. But its underlying message is always the same: “There’s a problem here!”
Pain is protective. Pain is not just a sensation; it's a protective response to tissue injury. It's a complex neurological and psychological experience that serves as a reminder of what not to do and guides you back to health.
Types of pain. There are three main types of pain:
- Nociceptive pain: Caused by direct tissue damage (e.g., a broken bone)
- Neuropathic pain: Caused by nerve damage or dysfunction (e.g., shooting, tingling pain)
- Centralized pain: When the nervous system amplifies pain signals, often lingering after the original injury has healed
Pain sensitivity. Prolonged inflammation can lead to pain sensitization, where neurons become increasingly responsive to pain signals. This can transition acute pain into chronic pain. It's important to be attuned to pain sensations without letting them occupy your mind.
3. Focus on Healing, Not Just Pain Relief
Instead of aiming to block pain, focus instead on these four goals: modulate inflammation, resolve and prevent tendinopathy, improve synovial fluid health, and protect collagen health.
Treat the cause, not the symptom. Pain relief is treating symptoms, not causes. Instead of aiming to block pain, focus on modulating inflammation, resolving tendinopathy, improving synovial fluid health, and protecting collagen health.
Inflammation is a double-edged sword. Acute inflammation is necessary for healing, but chronic inflammation is detrimental. Manage inflammation by phase:
- Acute phase (week 1): Avoid anti-inflammatories if possible.
- Subacute phase (weeks 2-7): Focus on expanding pain-free ranges of motion.
- Chronic inflammation (weeks 8+): Indicates the source of the problem still exists.
Tendinopathy is not just inflammation. Tendinopathy is a breakdown of the tendon, not just inflammation. The old methods of rest, ice, and NSAIDs don't work. The only treatment is progressive load training.
4. Collagen: The Key to Resilient Connective Tissue
Collagen synthesis is an important concept to understand because it directly impacts injury recovery time, tissue repair quality, future injury risk, and overall joint mobility.
Collagen is the body's scaffolding. Collagen is the second most abundant substance in the human body, providing structural support for organs and soft tissue. It's made of three coiled subunits containing 1,050 amino acids.
Four stages of collagen synthesis:
- Biosynthesis: Production of collagen
- Cross-linking: Building connections between collagen molecules
- Fibril formation: Bundling of collagen chains
- Collagenolysis: Collagen degradation (necessary for remodeling)
Connective tissue types:
- Tendons: Connect muscles to bones
- Ligaments: Connect bones to bones
- Cartilage: Cushions joints
- Intramuscular: Connective tissue within muscles
- Fascia: Sheath surrounding muscles
Understanding these structures and their collagen content is key to building resilient joints.
5. Movement: The Original Mobility
It is my professional opinion as a biomechanist that movement is what most humans are missing more than any other factors, and the bulk of the scientific community has dropped the ball.
Movement trumps exercise. Nonexercise movement—what you do most of the day—is more powerful than structured exercise. Your body adapts to what you do most of the time.
The Lévy walk. The Hadza tribe's foraging patterns, known as the Lévy walk, demonstrate the importance of varied movement. It's characterized by short, sporadic movements combined with longer bouts of travel.
The danger of isolation. Overdependence on isolation exercises and repetitive movements puts you at risk of injury. Instead, focus on compound movements that challenge multiple muscle groups and joint systems together.
6. Mobility Training: Beyond Stretching
Current scientific evidence strongly supports the idea that the development of muscle strength during a training process is not necessarily accompanied by an adequate modulation of tendon stiffness.
Mobility vs. flexibility. Flexibility is the ability of a muscle to stretch passively, while mobility is the ability of a joint to move actively through a full range of motion.
Stretching is not the answer. Studies show that static stretching has no significant effect on injury prevention or performance. It may even increase injury risk.
Muscles lengthen when contracted. Muscles lengthen most effectively when they are contracted while being lengthened. This is why loaded stretching, full range of motion resistance training, and end range isometric contractions are more effective than passive stretching.
7. Corrective Routines: A Daily Practice
All human beings should be able and willing to perform basic maintenance on themselves.
Good posture is key. Good posture is about maintaining a neutral spine and proper alignment of joints. It's not just about standing up straight; it's about how you hold yourself during movement.
Common postural faults:
- Forward head protrusion
- Kyphosis (rounded upper back)
- Lordosis (excessive low back curve)
- Flat back
- Knee valgus (knock knees)
- Foot overpronation
Posture checklist: Use a checklist to quickly assess your posture and return it to neutral position. This includes feet, knees, hips, shoulders, and head.
8. Preventing the Big Three: Back, Shoulders, and Knees
It isn’t the mountain ahead that wears you out—it’s the grain of sand in your shoe.
The Big Three. The three most common pain points are the low back, shoulders, and knees. Addressing these areas is crucial for overall health and fitness.
Low back pain:
- Activate your glutes.
- Mobilize the joints surrounding your low back.
- Teach your body to hip hinge properly.
- Build your transverse abdominis muscle.
- Brace your core before heavy movements.
- Build muscular endurance in your low back.
- Avoid excessive compression.
- Don't sit still.
- Walk every day.
Shoulder pain:
- Mobilize your lats.
- Practice ideal shoulder positioning.
- Improve external rotation.
- Build stabilizing strength in your rotator cuff muscles.
- Improve thoracic mobility.
- Get your scapula moving.
- Build upper back strength and endurance.
Knee pain:
- Clean up your knee track.
- Activate your glutes and hip abductors.
- Build end-range hamstring strength.
- Improve hip mobility and control.
- Build knee load capacity.
- Improve ankle mobility.
- Activate your feet.
9. Injury Recovery: A Strategic Approach
The medical system is woefully inadequate for dealing with back pain.
The problem with rest. Passive rest can be counterproductive. Active rest, which includes low-intensity movement, is more effective for healing.
Movement after injury:
- Understand the two categories of postinjury training: training around the injury and rehabilitating the injury.
- Use pain as your guide.
- Establish pain-free ranges of motion ASAP.
- Be clear about your movement priorities: stability, movement mechanics, mobility, strength, and endurance.
- Be safe in your progressions of intensity and frequency.
RICE vs. PEACE and LOVE. The old RICE method (rest, ice, compression, elevation) has been replaced by PEACE and LOVE (protection, elevation, avoid anti-inflammatories, compression, education, load, optimism, vascularization, exercise).
10. Periodization: The Key to Sustainable Progress
Current scientific evidence strongly supports the idea that the development of muscle strength during a training process is not necessarily accompanied by an adequate modulation of tendon stiffness.
Periodization is key. Periodization is the systematic, cyclical planning of training. It's what enables you to assemble all the parts into a working machine.
Types of periodization:
- Linear: Starts with high volume and low intensity, then progresses to low volume and high intensity.
- Undulating: Alters loads and repetition schemes throughout the week.
- Block: Focuses on one major performance goal for several weeks at a time.
Periodization variables:
- Training volume: The total amount of work you do.
- Training frequency: How often you train.
- Training intensity: How hard you train.
Built from Broken periodization: A four-week cycle that combines the best aspects of all three methods:
- Week 1: Connective tissue remodeling
- Week 2: Hypertrophy with heavy slow resistance training
- Week 3: Strength training
- Week 4: Endurance + energy loading (deload week)
11. Mastering the Movements: A Foundation for Strength
Current scientific evidence strongly supports the idea that the development of muscle strength during a training process is not necessarily accompanied by an adequate modulation of tendon stiffness.
Exercise database. This chapter provides instructions for all movements in the training program, categorized into primary movement sections.
Equipment and gym access. The exercises were chosen based on the assumption that you have access to equipment at most gyms. However, modifications are provided for at-home and travel workouts.
Supportive equipment. Weightlifting belts, braces, wraps, and sleeves should only be used for extra joint stability on heavy lifts or to guard a pre-existing injury.
Missing exercises. The barbell bench press, barbell squat, and barbell deadlift are not included in the program. These exercises are often the source of joint pain and injury.
Sets, reps, and rest schemes. The program uses a mix of rep ranges based on training goals. Rest periods are kept short (1-2 minutes) to maximize efficiency.
12. The BFB Program: A Path to Lasting Fitness
Training is designed to improve athletes, not break them down.
Target audience. The program is designed for masters athletes, novices, recreational fitness enthusiasts, seasoned weightlifters, endurance athletes, and skill athletes.
Workout structure:
- Dynamic warm-up and mobility training (10-15 minutes)
- Resistance training (30-45 minutes)
- Active isolated stretching (2-3 minutes)
Training programs:
- Beginner: Two days per week
- Intermediate: Three days per week
- Advanced: Four days per week
Key takeaways:
- Prioritize movement quality over quantity.
- Focus on building a strong foundation.
- Be patient and consistent.
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Review Summary
Built from Broken receives high praise for its comprehensive, science-based approach to joint health and injury prevention. Readers appreciate the detailed explanations, practical exercises, and training programs tailored to different fitness levels. Many find it helpful for addressing chronic pain and improving overall physical fitness. The book is lauded for its well-researched content, clear writing style, and actionable advice. While some found it dense or lengthy, most readers consider it an invaluable resource for understanding and optimizing joint health, especially for those dealing with injuries or aging-related issues.
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