what the shit did i do

[tweakxc03]

A couple of weeks ago I was deadlifting heavy sets of 8. It was hard as balls, but felt fine. Maybe the 7th or 8th rep of the third set was a bit of a grind and I felt a little twinge in my upper left shoulder/lat area, but not painful enough to prevent me from finishing the rest of my workout. Anatomy pic makes me think Teres Major. 3 or 4 days later, pullups were painful, so I backed off and just did 3-4 sets of 20 on lat pulldowns to try and pump some blood in there. Rowing movements don't seem to bother it at all.

Then I ended up getting sick as balls and laid up on the couch for a week on prednisone, hydrocodone and antibiotics with no lifting last week.

I chalked up the weird lat pain to just soreness or a mild strain or whatever. Started warming up on deadlifts again yesterday. Everything felt fine, zero pain until I got to my work sets - 3x5s at 170kgs. Even though the first rep felt surprisingly easy off the floor, I felt that twinge again and bagged the set. I stripped the bar down to 70kgs for 3x20, then lat pulldowns for another 3x20. The area isn't sore... modestly sharp/achy aggravation in that same area.

Does this sound like a mild strain or am I just being a pussy? I am 33yrs old, 6'4 225 (admittedly underweight). I tend to get banged up easily for some reason. No discoloration or anything like that. Is this something I should just train around for a couple weeks? Do a shortened Starr Rehab?

Thanks

[Steve Hill]

Hopefully you were dying of pneumonia, as the prednisone prescription is not helpful to muscle growth (it is a catabolic steroid - you may want to read up on it. In this case, the Wikipedia article on it is NOT very helpful, use the googles and search on catabolic steroids).

Sounds like some type of tweak. Teres major maybe, lat maybe. Are you able to palpate it and localize? Point to the spot on the doll where you are touching yourself please.

My other, and larger, question is why are you doing so many reps of DL? This could be contributory. You HAD to know we would call you out on this - right?

[tweakxc03]

I had a severely infected tonsil with necrotic tissue at the back of my throat. The prednisone was a 5 day course that I'm off of now - still finishing my antibiotics course. I lost about 7 pounds over the course of that week, gained about 2 back so far.

As for the deadlift volume, I'm doing Andy's PowerBuilding program (3 sets of 8-5-2 weekly rotation). I also can't squat right now, only deadlift and push a sled pending an MRI this week for a possible torn hip labrum.

I can kind of palpate it but it's hard to reach. It's right up near my armpit on my back. The act of keeping the bar back against the legs with the lats is when I feel it the most.

As for location, do you want me to post a picture or something?

[Steve Hill]

I had a severely infected tonsil with necrotic tissue at the back of my throat. The prednisone was a 5 day course that I'm off of now - still finishing my antibiotics course. I lost about 7 pounds over the course of that week, gained about 2 back so far.

As for the deadlift volume, I'm doing Andy's PowerBuilding program (3 sets of 8-5-2 weekly rotation). I also can't squat right now, only deadlift and push a sled pending an MRI this week for a possible torn hip labrum.

I can kind of palpate it but it's hard to reach. It's right up near my armpit on my back. The act of keeping the bar back against the legs with the lats is when I feel it the most.

As for location, do you want me to post a picture or something?

It would be useful to know if the pain is near an origin or insertion of a muscle group. If the pain is in the muscle belly, then you have your answer as to what it most likely is (strain) since you do not report any blood deposition.

Is a modified Starr rehab appropriate? I don't see anything wrong with lifting at a weight at which you do not feel pain, and progressing from there, at a level of pain you can tolerate. The rule of thumb is that if the pain gets better during training, you continue. If it gets worse, you stop and reassess.

As for your torn labrum - was this an acute or chronic injury? Most labrum tears in the hip are chronic - resulting from wear (a repetitive strain injury, essentially) from the labrum being smashed between the femoral neck and the acetablum. It's interesting that sled-pushing does not aggravate it but squatting does, since flexion of the hip joint is primarily causative, and repetition is what makes it worse.

[tweakxc03]

The pain seems to be in the muscle belly - so it probably is a strain.

As for the hip issue - it may or may not be labrum. The pain started off basically as what I thought to be a sore groin/adductor muscle, originating up high in the groin and then down into the muscle belly. It occurred the day after squats and power cleans and just got worse. I tried pretty much everything - stretching (made it worse), 4-5 days of heavy NSAIDs, active recovery, squatting lighter weight, (gasp) leg presses, even dry needling. Nothing worked and it got to a point where rolling over in bed would wake me up in the middle of the night. I tried doing nothing at all for 6 weeks. It would start to get better then re-aggravate easily. After about 3 months of this I went to the ortho for X-ray who then recommended MRI. The X-ray revealed a small amount of arthritis, but that's all. Given the sudden onset of the pain it seems unlikely to me that arthritis is the cause.

Basically anything that makes the adductor contract seems to piss it off. Explosive movements like jerks, power cleans or power snatches are out of the question. I will say that the pain is almost totally gone as of now, but I can still feel it a little bit the day after deadlifting. Pushing the sled doesn't seem to aggravate it at all since the degree of hip flexion is pretty muted.

I would kill 6 or 7 people just to be able to squat again, much less clean or snatch. The last time I squatted at all was probably July or August.

[Cole Gorton]

I never dead lift more than one heavy set of five. It just has never ended well for me even if its feeling good that day.

[Steve Hill]

The pain seems to be in the muscle belly - so it probably is a strain.

As for the hip issue - it may or may not be labrum. The pain started off basically as what I thought to be a sore groin/adductor muscle, originating up high in the groin and then down into the muscle belly. It occurred the day after squats and power cleans and just got worse. I tried pretty much everything - stretching (made it worse), 4-5 days of heavy NSAIDs, active recovery, squatting lighter weight, (gasp) leg presses, even dry needling. Nothing worked and it got to a point where rolling over in bed would wake me up in the middle of the night. I tried doing nothing at all for 6 weeks. It would start to get better then re-aggravate easily. After about 3 months of this I went to the ortho for X-ray who then recommended MRI. The X-ray revealed a small amount of arthritis, but that's all. Given the sudden onset of the pain it seems unlikely to me that arthritis is the cause.

Basically anything that makes the adductor contract seems to piss it off. Explosive movements like jerks, power cleans or power snatches are out of the question. I will say that the pain is almost totally gone as of now, but I can still feel it a little bit the day after deadlifting. Pushing the sled doesn't seem to aggravate it at all since the degree of hip flexion is pretty muted.

I would kill 6 or 7 people just to be able to squat again, much less clean or snatch. The last time I squatted at all was probably July or August.

The general process for diagnosis of a labral tear in the hip is a dye-contrast MRI. Usually an anesthetic is also injected as, if it relieves the pain the patient is experiencing, this can also be diagnostic. Absent the MRI results, you and the doctor are just guessing.

[tweakxc03]

MRI with contrast revealed partial labrum tear and partial thickness chondromalacia. Forwarding me to a specialist to see about getting it scoped.

Has anybody had experience with stem cell injections? Regenex apparently does this a lot with labrum tears but i have no idea if it is voodoo.

[Steve Hill]

Will Morris and Petrizzo have some pretty good posts up in Rip's forum about repairs / outcomes, but I think they are mainly FAI stuff. Go look. I'll try to dig them up later.

UPDATE: here's one: Femoral Acetabular Impingement question