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Thread: Debilitating bicep/arm pain and numbness after squatting

  1. #1
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    Default Debilitating bicep/arm pain and numbness after squatting

    Dear Mark

    I've tried to be a good noob and search for this topic already but I've not found a matching solution (though there seem to be a number of people with similar symptoms but no posted resolution).

    I'm hoping you can help me to resolve the cause of pain which is stymying my workouts. Here are the full details:

    - Age, Gender, current training status
    36, M, 95kg (209lb), 6'2", Advanced novice (did about 7 months of SS last year before this pain caused me to have a 'short break' which turned into a 7 month break. I've been back training again for about 2-3 months and have recently reached the level I was at before.
    Currently squatting 130kg (287lb) x5 x3.

    - Chief Complaint
    Primarily bicep pain and numbness AFTER squatting. As the weight has been closing on and beating my PR pain has come back. Initially it's in the right bicep but starts to radiate along the arm as the sessions have got harder. Last time I stopped it affected both arms along their length.

    - Narrative describing the mechanism of injury:
    The pain gradually starts after finishing the squat set. It's a dull ache that becomes more painful over a few minutes and makes my arms weak. Initially it manifests in my right bicep but last time spread along the arm over a series of workouts and also affected the left arm too. At worst they were so weak and painful a few minutes after that I could barely lift or move them, like I'd been given a 'dead arm'.

    My last session before my 7 month break, the pain ran from the inside of my shoulder, down inside my bicep, along the forearm and to my middle finger on each hand. It made the finger go numb for a few hours.

    It robs me of all strength, runing further exercises. Last session I got trapped under my last warmup set on bench and couldn't get it off my chest (attempted warmup was 70kg x2, planned workset would have been 78kg x5 x3, I previously lifte 76kg x5 x3 last session). I couldn't even do one pull up after (usually about 7).

    - Pain (on a scale of 1-10),
    Initially about 2-3 immediately after finishing, rising to about 8 at its worst occurrence.

    - Describe the pain
    Deep aching, like an extreme dead arm, includes some numbness, especially if it radiates to the fingers.

    - What makes it better?
    I've been trying different grip widths and albow angles. I'm very flexible and used to use a very narrow grip but have widened it considerably. That seemed to ease it sometimes but other sessions I'll take the same grip and it will hurt after.

    - What makes it worse?
    It only occurs as I close in on weights near my PR. I can't see what else may be causing it. I've watched the squat bar placement and grip video and thought I was using that technique but it's still happening.

    - How do your symptoms behave throughout the day?
    The peak of the ache tails off within about 10 minutes and gradually subsides over a few hours. I have had some residual pain the following day, maybe a 1 or 2 out of 10.

    I recently posted a few form checks. Of those I was happiest with the bar placement and grip in this one: http://www.youtube.com/watch?v=kYyp0Nt4VX0
    (That's a wide grip compared to what I can do)

    This is my standard placement that I try to replicate every workout. That particular session I only got mild pain and it didn't stop me performing the other exercises but the last workout (132kg) I went 4, 0, 3 and then couldn't do any other lifts or pulls.

    I didn't video my last set as we were short of time and I didn't expect this issue to come back and bite me so hard. I will video the next ones.

    I hope I'm not wasting your time in asking about something which has already been solved somewhere I've not found. Is there anything you can see or suggest that might help? I will record all new attempts so I can show the results.

  2. #2
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    Sounds like Thoracic Outlet Syndrome. Look it up.


  3. #3

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    Quote Originally Posted by Mark Rippetoe View Post
    Sounds like Thoracic Outlet Syndrome. Look it up.
    I have experienced some of this too. I have numbness in my right forearm and hand. This is sometimes right after squatting and sometimes the day after. The description for Thoracic Outlet Syndrome matches. It is also consistent with the doctor telling me I had a pinched nerve.

  4. #4
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    A pinched nerve? He said that?


  5. #5

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    Quote Originally Posted by Mark Rippetoe View Post
    A pinched nerve? He said that?
    Yup

  6. #6
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    An astonishing medical mind. You paid him?


  7. #7
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    With your permission Rip, I wanted to share my 2 cents on this topic. It has been discussed many times on the forum, and this seems like the typical bicep tendinitis. I've had it during SS (exactly same symptoms), like many others because of the incorrect placement and holding of the bar in the squat. I strongly suggest the OP to watch the useful video of Rip explaining bar placement in the resources page:

    http://startingstrength.com/index.ph...t_bar_position

    It will take a couple of weeks for the pain to completely vanish, even after correcting form because the tendinitis has appeared. The usual Ibuprofen protocol may be useful during this time, but form correction is the primary focus. Also a slightly wider grip of the bar in the squat position may be necessary, and OP should experiment a little bit to find the exact grip width.

  8. #8
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    Thank you for taking the time to read and make a suggestion. That certainly matches the symptoms and potentially the cause (Weightlifting is mentioned on the Wiki entry, along with other sports).

    For the benefit of anyone else reading, I've read around and found THIS explanation which sugguests to me that a pinched nerve and TOS are not mutually exclusive.

    It seems that one manifestation of TOS called Neurogenic thoracic outlet syndrome (NTOS) is a pinched nerve. The difference between a 'classic' pinched nerve and TOS seems to be the site of the 'pinching' (I think it's between either the spine or the brachial plexus). I may have that totally wrong but that's my current understanding.

    On the back of your diagnostic suggestion I've booked into the doc's next week. I'll report back with any useful developments in case it's helpful to others with similar symptoms.

    I determined to not stop training as I've never felt as strong and healthy as I do now. IF I can't find a workable position to continue LP on low bar squats whilst I try to get a resolution for this problem, what would be my best course of action to continue training (before I hopefully return to pushing PRs on low bar)?
    - Maintain low bar squats (x5 x3) at the highest weight I can do without triggering symptoms.
    - Front, high-bar or another type of squat on LP.
    - Something else entirely.

    Thanks for your help.

    (BTW, If this is covered elsewhere then sorry for not finding it and I will be happy to be pointed in the right direction. There's nothing in the FAQ and there are SO many discussions of squat alternatives for different reasons that it's hard to separate the wheat from the chaff.)

  9. #9

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    Quote Originally Posted by Mark Rippetoe View Post
    An astonishing medical mind. You paid him?
    Yeah. The first time it happened, I had numbness in both arms and hands. I thought I might have had a stroke or something.

  10. #10
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    I've never heard of bilateral TOS. I suppose it happens, but I'm with Leonidas. Post a video of your grip in the squat.


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