I have a history of pronounced squat and deadlift asymmetry due to having fundamentally asymmetric hips. I have a retroverted right hip, i.e. my femurs project out of my acetabulums at different angles. This has been confirmed via physical therapist in the form of Craig's Test and by MD in the form of X-rays of my hips and pelvis. Probably as a consequence, I also have a spinal scoliosis (confirmed via MRI).
Why do I give a shit? In my 20s I basically just ignored these asymmetries and managed a good amount of productive training. My best lifts in competition were a 155 kg squat, 125 kg bench, and 205 kg deadlift at a bodyweight of ~175 lbs at 5'9" a decade ago or so. Not great, but okay.
The problem arose in my 30s – I began having sharp pains in my left hip with squats and deadlifts, which wound up radically derailing training in these lifts for years. Eventually through lots of time off the acute pain in my left hip seemed to die down, however, whenever I began training squats/deadlifts for real again I'd invariably wind up with sciatica/radicular type symptoms down my left leg. What's extra weird is that nothing actually hurts during the performance of the squats or deadlifts besides an occasional twinge, normally, but in the hours/days following heavy squatting and deadlifts I'd wind up with these symptoms. An annoying buzzing/tingly feeling down my left leg. At that point I wound up getting MRIs of my lower back and left hip, which showed:
The recommendations I got included physical therapy or to try corticosteroid injections in my spine as the pain was deemed likely discogenic. I've tried a lot of PT-esque stuff for my problems, including extremely painful massage from a PT (elbow in glutes) and a shitload of stretching and "mobility" work (Starrett stuff), but nothing has actually prevented my symptoms from returning if/when I actually return to squats and deadlifts.
Any thoughts or suggestions would be helpful. What's odd to me is that I think I manage (and have managed for a long time) to keep a fairly neutral spinal position in both squats and deadlifts, which I'd think would go a long way towards preventing discogenic issues, but my inherent asymmetry may still be exacerbating things.
The pain in your back is probably not purely due to outwardly visible lifting asymmetries. With regard to your retroverted hip, you may need to take an asymmetrical stance. One of your toes may need to point out more than the other. Back pain can be very tricky. As the good Dr. Baraki has pointed out, pain is not always the result of a structural problem. I have a potential solution for you that I doubt you will like, but certainly worked for me – gain weight. I am not kidding. You are a fairly skinny dude. Being bigger and stronger can help with back pain.
I recently responded to a thread in the training forum where the claim was made that there is no difference in quality of life for someone who deadlifts 225 pounds vs. someone who deadlifts 500 pounds. This is false. My back tends to hurt when I get weaker from a layoff. It is happiest when my 1 RM is above 450 lbs. I have at least one disc herniation and have suffered a few back injuries in my time. Getting bigger (going from 172 lbs to 235 lbs at 6'2") and stronger has helped immensely with my back. My back rarely bothers me now. I can sit on a plane for over 15 hours to Australia without a problem.
Here is something for you to consider: put on 20 pounds. Slowly drive your lifts up. It does not have to happen in a hurry. See how you feel. You may find it helpful, believe it or not. If you decide nothing is better, getting back down to a lower weight will not be terribly problematic.
OP, does it not strike you as odd that you have no pain during your loaded, "asymmetrical" movements, and yet everyone wants to blame your pain on these miniscule asymmetries?
As Tom suggested, I am skeptical that your symptoms are caused primarily by structural asymmetry, or that you have primary discogenic pain. I think that you developed nonspecific back pain (as people tend to do), and then incidentally found a bunch of shit on scans and physical exam maneuvers that was conveniently attributable to your pain post-hoc. Not surprisingly, none of the traditional interventions for these issues have helped you.
How are you approaching your programming each time you return to squatting and deadlifting? Is there a weight at which you don't experience pain? Presumably there is, since you were previously able to achieve a 155 kg squat pain-free despite your perceived skeletal inadequacies.
I plan to experiment with isotonic-isometric work a bit to see if it does anything for my bench. Bill Starr's article on the subject lays out the progression from warm-up to work set very well, but I can't tell for sure if he was saying there is only one 8-12s work rep at three different positions or if multiple reps should be used?
I'm thinking I would drop the regular benching for a few weeks while doing bench iso and just supplement with dips. Thoughts?
He had me add a single set of 2-3 reps at the end of a regular bench workout, varying the pin height weekly. Try it the other way, but don't do multiple reps if you use multiple pin heights. These things can really beat the shit out of your tendon insertions.
The Split Snatch –Bill Starr
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