Glute Medius pain/weakness

[Matt James]

So, just to make sure I'm understanding my strategy, at least in the short term: I'm trading heavier loads for a bit more volume with the 3x3 ID squats and with the DLs on both days in order to let things calm down a little? I will probably end up going back to a lower rep intensity day eventually just for the sake of time, as I often am able to squeeze in 3 out of the 4 workouts on my lunch hour.

I'm also going to take your advice and switch to volume squat/intensity pulls and vice versa. That should make my workout today more tolerable (ID squat, volume pull) and hopefully Tuesday won't be too painful with the overall reduced loads.

Thanks again for giving me programming advice on what started out as an injury thread. Cheers.

[Nick D'Agostino]

This is correct. Keep the isometrics in the warmup for pain management. If things are getting worse you may need a bigger training intervention but you won't know until you try. Also, the loads will creep back up to heavy on the 3x3 over the course of the next month. Let us know how things go!

[Matt James]

Brief early update:
Last Friday's workout (intensity squats, volume pulls) was perfect in terms of loads. I squatted 315x3x3 and pulled 275x5x3. The 3 rep squats helped me manage fatigue and avoid form breakdowns that might have contributed to more pain. For the DLs I ended up feeling plenty of fatigue in the glute med at lockout on my 5th reps but didn't cross the line into intense pain. Everything felt better after the workout than it did before I started. Doing the isometrics as part of the warmup is a big help too (before I had been doing them afterwards, treating them as an assistance rather than a warmup).

Tuesday's intensity DLs felt pretty light at 345x3 with two backoff triples at 315. But I also was able to focus much better on the 5 step setup, especially re-setting for reps 2 and 3. No extra pain. Volume squats were good too. I have the "usual" post squat stiffness/soreness, not the more intense pain I had before, and I didn't have any pain unracking and walking out this time around. I think the biggest takeaway was that Friday's DL volume set me up well for the following intensity day.

All in all it seems (so far) like this slight reset may be just the ticket to let my body catch up to the new programming realities. I'm going to try weekly progression on the DL since I'm starting lighter and see how that shakes out over the next few weeks.

Thanks again.

[Nick D'Agostino]

Your welcome! It sounds like you are on the right track. Keep us updated.

[Matt James]

I wanted to update this thread and also ask another possibly related question.

First, the update: Programming changes prescribed by Nick seem to have done the trick. The acute pain I was initially experiencing is gone, and I am back into PR territory for the squat (340x3x3 last week) and moving forward on the DL (385x3 last week, which felt remarkably easier than the last time I did it).

The question: I mentioned in my original post that I had been having some ongoing pain and weakness in my abductors (both sides but worse on the left). The weakness would manifest at the bottom of the squat, sometimes resulting in failure-- having to set the bar down on the safeties. The weakness is pretty much gone, at least in the sense that I am able to keep my knees shoved out and am able to do my planned sets and reps. I've been doing the isometrics religiously as part of my warmups and I'm sure that is helping. However the pain is still hanging on although I think it is improving slowly. It doesn't necessarily hurt more while I'm squatting but it definitely is more noticeable for a couple days after I squat (both volume and intensity). It's just around the side of the ASIS, maybe half an inch moving from the front to the side. Could be the TFL, although it's sore a little past that too, moving from front to back, which makes me think it may also involve the anterior part of the glute medius. The whole area of tenderness is only about 3" in diameter.

Anyway, all that to say, isometrics help relieve the pain and are allowing me to keep training. As I said, I think it is getting better slowly. Is there anything else I should be doing to try to help this heal, or things I should avoid doing to aggravate it? Squats bother it the most, along with presses, a bit. Deadlift doesn't seem to affect it much if at all. Ibuprofen and/or aspercreme are enough that it doesn't disrupt my sleep any more.

Thanks again for all the help.

[Matt James]

Update to this. Was squatting Sunday, had deloaded slightly because I had been cheating depth by about an inch. So my plan was to do 335x3, 345x3, and potentially 355x3 if I hit depth consistently for the first 2 sets. Last week's intensity day was 365x3 and 365x2x2.

I got 3 solid reps at 335. Moved up to 345 and got 2 good reps. On the third my left hip pretty much gave out as described in the previous post. I tried getting out of the hole but I just wasn't tight enough and it hurt too much. I deloaded back to 335 after resting and got one good rep and had to bail on the second. And my hip has been pretty sore since although foam rolling helped some.

Still doing the isometrics between sets. I'm not really sure what to do at this point. The pain/weakness hits right at the bottom of the movement and getting the knees shoved out properly seems to aggravate it more. I've had better luck over the past few weeks by widening my stance slightly but that didn't seem to help on Sunday.

Possibly pre-aggravated it on Saturday when I took the kids iceskating, although it didn't hurt at all Saturday night or warming up Sunday.

I have video of the 345 set which I'll upload to YT shortly, though the angle's not great and there may not be much to see. Advice? I don't want to stop squatting but this is getting to the point where it's making it hard to keep going. And the seemingly random way it pops up is killing my confidence.

[Matt James]

Here's the video (also posted in the technique forum)
YouTube