Lat Rehab

[DGA]

I tore my right lat two days ago on 6/28/2016 doing deadlifts. This was discussed on Ripp's Q&A recently deadlift injury. I got a rough idea of what to do from Matt Reynolds, who tore his lat in the same way before the Starting Strength meet. I am going to post my progress here. I will be using a derivative of the Starr protocol.

Back ground:
I am 34 years old, weigh about 250 lb, and have been lifting weights since I was about 10, mostly bodybuilding stuff and some HS type lifting. in 2008 I learned the O-lifts and competed. I took a year off in 2010 and then decided to get back into lifting and started the novice progression in 2011. Although my training has been plagued with injuries and a few lay-offs for personal reasons (having a kid, moving, etc.) I was heavily slanted towards the O-lifts.

I was doing a hybrid TSFOSB program before I tore my lat. Basically two heavy weeks and then a light week.

Day 1: SN, box CL, jerk
Day 2: squat, bench, light press, Nordic curls
Day 3: box SN, C&J
Day 4: DL, press, front squat, light bench, Nordic curls

I would do some other assistance work like abs, shoulder raises, band pull-aparts, and lat pulldowns on the off days.

I tore my lat on the second rep of the third set of DL (3x3) pulling 485. Matt Reynolds used a combination of rows, lat pull-downs (and later band assisted chins), and deadlifts for his rehab. I will be following suit.

[DGA]

2016-06-30

Reynolds recommended starting out with ring rows. I don't have rings, and I train at home, so I decided to start today with dumbbells. I ordered some rings from amazon, and they should be here tomorrow.

DB row: 25'sx25x4;
lat pull: 40x25;
lat pull (chin-grip): 40x25;
band shoulder extension: bluex25x3;

I did a fair amount of playing around with stuff today, just to see how things feel. I tried the rows bent over with both arms at the same time, 1-arm at a time kneeling on a bench, and laying on a bench that was set off the ground. The one's I felt most in my lat were the latter, so they are probably the best for me right now. These were pretty light. The lat pulls were pretty light also, but the chin grip ones felt a little uncomfortable on my wrist. The band pulls didn't feel like they were doing anything, so I will probably drop those.

[DGA]

2016-07-01

My rings came today. They are pretty easy to adjust, so I can progressively lower them as a way to increase the resistance. Today I had them hanging 4' from the top of my rack, but I had my feet propped back. Tomorrow I will move my feet instead of dropping the rings.

ring row: BWx15x3;
lat pull: 60x15x3;
lat pull (supinated): 50x15x3;

The ring rows really hurt. The lat pulls did too. I really need to work on my wrist flexibility for the chin-grip lat pulls.

[DGA]

2016-07-02

I started doing DL again, really light. Usually I do hook grip (double overhand) up until the mid-300's and then switch to alternating grip. To specifically put more stress on the injured lat, I am doing all my sets with my right hand supinated. I definitely felt the DL in my injured lat. Also, I moved my foot position on ring rows as opposed to lowering the straps. These were tough. Lat pulls didn't hurt as much and didn't feel heavy. I also decided to do bench and DE press today.

DL: 175x5x3;
ring row: BWx15x3;
lat pull: 70x15x3;
lat pull (supinated): 70x15x3;
bench: overwarm-up to 341x1; 293.5x5x3; 246x10 (last set narrow grip)
DE press: over warm-up to 215x1; 145x3x8 on-the-minute;

[DGA]

I have decided to try and train some of my other lifts concurrently with the lat rehab. I will forego snatches and clean & jerks until I have recovered. I am thinking I will follow something like this:

Day 1: squat
Day 2: bench, DE press
Day 3: squat
Day 4: press, DE bench

I may end up adjusting this because I am planning on deadlifting almost every day for a while.

[DGA]

2016-07-03

DL were easy, but more painful than yesterday. The pain was not bad, but I was hoping it would be less painful. I moved the rings down 1.5" today. The supinated grip was not any easier on my wrists.

DL: 205x5x3;
ring row: BWx15x3;
lat pull: 80x15x3;
lat pull (supinated): 80x15x3;

Overall, so far so good.

[DGA]

2016-07-04

DL were less painful than yesterday, so that is a step in the right direction. I moved the rings down 1.5" again. I am fatigued by the end of the lat pulls, but they are not heavy. This is also Day 1 of my new split, so I did squats (3x5).

DL: 235x5x3;
ring row: BWx15x3;
lat pull: 90x15x3;
lat pull (supinated): 90x15x3;
squat: over warm-up to 405x1; 345x5x3;

[DGA]

2016-07-05

I really felt DL and lat pulls in my lat today. Lat pulls are getting tough, and my grip is pretty fried by the end of the workout. I moved the rings down another 1.5". It has been exactly one week since the injury. Based only on DL numbers, I am at about 55% of my pre-injury function. I was totally exhausted all day today. I didn't quite get my 5x5 on press.

DL: 265x5x3;
ring row: BWx15x3;
lat pull: 105x15x3;
lat pull (supinated): 105x15x3;
press: over warm-up to 220x1; 207.5x5,5,5,4,4;
DE bench: 198x3x8;

[DGA]

Today was tough. I am tired from training every day. Today I had a lot of muscle soreness.

DL warm-ups felt heavy, but my work sets went up easy and they weren't painful. Still a lot of pain with the lat pulls, and with the normal grip ones I wasn't able to pull the last few reps all the way down to my chest on the last set. I may have to drop reps in order to keep moving the weight up. I'll probably try for 15's again tomorrow. I moved the rings down another 1.5" today.

DL: 269x5x3;
ring row: BWx15x3;
lat pull: 115x15x3;
lat pull (supinated): 115x15x3;

[DGA]

My bruise keeps getting bigger. The first small spot was about quarter or half-dollar size and showed up about a day and a half after the injury. It was located just above my armpit (with my arm extended overhead). Now I have bruising halfway up the back of my upper arm (on the inside), down well past below my armpit, and even on the back, near my scapula. My initial thought was that this was a small tear, but the bruise has gotten bigger everyday.

I have had a lot of muscle tears, big and small. I don't always see bleeding. My first big muscle tear was in 2000, I tore my hamstring. The bleeding took a few days to show up and was not that noticeable. It only lasted a few days before it disappeared. In 2012 I tore my groin really badly. The bleeding showed up quickly. I had bruising from my knee to my belly button, and it lasted a long time. I have also had strains or tears in my calf, oblique, pec, groin and hamstring that did not result in noticeable bruising. This does not mean that there was no bleeding, but there was no visible bleeding. I have had multiple strains in my groin (prior to 2012) and hamstrings. These are very likely re-tears of an older injury that was not rehabbed properly. I wish I knew about the Starr protocol when I was playing sports in high school and college.

I have found a couple of supplements that help (or seem to help) with injuries in general and muscle strains in particular. The first is Cissus quadrangularis. I try and take this whenever I get injured. It seems to help me recover at a faster rate. It is an herbal supplement, and the active ingredient is the basis for a few drugs that are used to increase connective tissue and bone healing. The mechanism of action involves an increase in calcium absorption by the tissues, so they actually decrease blood calcium levels. With muscle strains I also take 1-2 grams of bromelain every 4-5 hours. I read a post a few years ago on a bodybuilding forum that suggested bromelain could help reduce scar tissue formation after a muscle strain. It may be bro-science, but I have used it for my last couple muscle tears and it seems to help. Bromelain is an antioxidant protein that is bioavailable. It is relatively cheap and it usually isolated from pineapple. And of course there is always vitamin I. I don't always take ibuprofen. I use a shorter, high-dose protocol when I do, usually 5-6 days. By the end of it I usually am starting to have some GI issues. There are some arguments against taking ibuprofen for injuries like muscle strains in that they theoretically could interfere with healing by disrupting the tissue remodeling. But the science on that is not a settled issue.