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Thread: Thigh muscle strain - I'm 90% sure this is in the book

  1. #1
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    Default Thigh muscle strain - I'm 90% sure this is in the book

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    For some reason I could not find anything about this when searching the forums or articles, so I apologize in the case that my tech skills were simply inadequate.

    On Wed the 6th, I strained a muscle in my thigh doing squats. Probably the right Vastus Lateralis or Rectus Femoris, my odds are on the lateralis, but this is the first time I've really thought of it beyond it's a muscle strain in my thigh so I may very well be wrong. I squatted on Friday, only 2 sets across at a slightly lighter weight, but the pain made me unbalanced and I wasn't coming up straight out the hole. I also almost missed the last rack due to the imbalance. Additionally, I was unable to lock into the position to start the deadlift on Friday, so I had to pass on that, although I deadlifted just fine on Wednesday.

    I assume the strain is due to lack of sleep, a slight protein deficit in my diet and some added stress last week.

    My question is really simple: What is the rehab process. How much weight should I drop off etc, should I do more reps etc. I recall this being in the book(s) with respect to other injuries, but I do not have physical copies, only the audiobooks, so searching them is a bit tricky. My instinct to just train through it with slightly (10-15% lighter weights) did not go well.

    As an aside, my pain sensitivity is a bit messed up for, among other reasons, being on regular NSAIDS for Anklyosing Spondylitis.

    Data:
    41 / 178 (5'10) / 100-105kg (220-230lbs)
    Week ~8 of NLP
    Squat: 122.5kg x5 x3 (Mon 4th)
    Bench: 96.25kg x5 x3 (Fri 8th)
    DL: 120kg x5 (Wed 6th)

  2. #2
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    First google the Starr Rehab Protocol. Then take a look through the past couple of pages of this forum. Look for things like adductor tear, pec tear, quad tear, etc (really anything that following the pattern of muscle then tear/strain) in the title of the post. You will see how I've modified it from the original suggestion. You will also probably find Will's method of managing muscle belly tears. After reading, come up with a plan and post it here. I will give you feedback on your plan.

  3. #3
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    Thank you for taking time to respond and pointing me in the right direction, and apologies for the slow reply.

    The delay was due to a realization that after writing my initial plan that a lot depended on how my leg felt under load. With that in mind I wrote up my initial draft and left myself some leeway in case things were better than expected.


    From the reading you pointed me at, and my first day of training I have come up with the following plan:

    Starting the Starr protocol 6 days after the initial injury.

    This means squatting every day, initially at a weight I can do for 3 sets of 25 with perfect form, but without it being painful in the injury sense.
    Discomfort and pain is ok, injury type pain is bad - distinguishing them will be the tricky part.
    The Starr protocol specifically disallows other heavy work. So, to maintain other lifts, I will on other regularly scheduled training days be doing the other lifts at 80-90% of previous max, as the injury permits. I.e. the bench should not be a problem, but deadlifts might.

    My inclination was to start at 40kg + bar (I do not know how much it weighs, so I never figure it in my calculations). To make sure I had a better pain sensitivity I reduced my medication slightly for Day 1. Even so, when testing it on Day 1, 40kg was too light. At 50kg+bar I felt very slight pressure in the injured area towards the end of the first set. Thus, After Day 1, my modified initial plan looks as follows:

    Day 1: Squat 50kg x25x3 ; Bench 80kgx5x3 ; Deadlift 90kgx5x3 (I felt some very slight strain in the injured area at 70kg, but there was no problem at 90kg)
    Day 2: Squat 52.5kg x25x3
    Day 3: Squat 55kg x25x3 ; Bench 80kgx5x3 ; Deadlift 90kgx5x3
    Day 4: Squat 57.5kg x25x3
    Day 5: Squat 60kg x25x3 ; Bench 80kgx5x3 ; Deadlift 100kgx5x3
    Day 6: Squat 65kg x20x3
    Day 7: Squat 70kg x20x3
    Day 8: Squat 75kg x20x3 ; Bench 85kgx5x3 ; Deadlift 100kgx5x3
    Day 9: Squat 80kg x20x3
    Day 10: Squat 85kg x15x3 ; Bench 85kgx5x3 ; Deadlifth 100kgx5x3
    Day 11: Squat 90kg x15x3
    Day 12: Squat 95kg x10x3 ; Bench 85kgx5x3 ; Deadlifth 105kgx5x3
    Day 13: Squat 100kg x10x3
    Day 14: Squat 105kg x10x3

    Day 1 of protocol observations:
    - The biggest problem with 25 reps was my lower back, it is no used to that rep number. Luckily I got to break in my new belt, which probably helped.
    - Maintaining form on the second and third sets of the squat was difficult, and I had to fix a favoring of the right leg, even though I couldn't feel anything different in it
    several times.
    - Every muscle is slightly sore on day 2... New volume soreness.
    - I can feel a very slight pressure in the injured area. I'll be off medications until my back is screaming so I have a better sense of what is going on. I'd like to do some piriformis
    muscle stretches to reduce back pain, but I don't know how that will interact with the rehab.

    Specific questions:
    I could not tell from the information I looked at what triggers the change in volume. It looked like just the number of days, whereas it would make sense that it had more to do with a % of 5REM.
    Additionally, what the weight increase should be was also not entirely clear. I prefer to be conservative as I don't mind slow steady recovery and progress, so my first draft had steady 2.5kg increases, which did not seem to be the intended progression of the protocol.

    Sorry for the long post, but it felt like you were giving me an essay test question where I needed to show my work.

  4. #4
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    Not a bad protocol. Switch the style of loading from sets across (using the same weight for all the sets) to a pyramid up to a single top set. Start with 15 reps and decrease the number of reps by 2-3 every 2-3 training sessions. So the rep progression downward should like 15, 12, 10, 8, 6, 5. Once you are at 5 reps, switch back to 3 sets of 5 across and continue your LP. You do not have to go up 2.5 kilos every time. You can take a bigger jump in the beginning if you are feeling better. Decisions during the rehab process are dependent on how you are responding to the rehab process. What allows you to take a bigger jump or an extra day of rest is how you are responding to the stress.

  5. #5
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    Ok, I am not 100% sure I understood that, so let me quickly check back to see I if I got it right:

    The primary rehab exercise is the squat, and on that exercise, instead of [weight]x25x3 I should be doing a single set with a steadily decreasing rep count through the rehab protocol time.

    Day 3 Original would be 55kg x 25x3, and Day 3 modified would be simply 55kg x 15.
    Day 5 Original would be 60kg x 25x3, and Day 5 modified would be something like 60kg x12
    Day 7 Original would be 70kg x 25x3, and Day 7 modified would be either 70kg x10 if everything is fine on day 5 and 6
    etc.

    I'll do day 3 and 4 with single sets of 25 instead of sets across for the squat, and then start dropping the count and moving up the weight a bit more aggressively as you suggest and as the body permits.

    Part of the reason I chose 2.5kg increments was because 75 reps was a lot. With a lower rep count I can move a bit faster up. Also, I was more worried about the first 4-5 days as I still had a bit of pain getting up off the floor and such, but that is mostly gone now, and replaced with muscle soreness (big surprise.. >_<)

    I assume the other lifts are fine as noted?

  6. #6
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    Still keep training every 48-72 hours (not every day). I want you to do 2-3 consecutive workouts with the same rep range before decreasing to the lower range. If you are having a bad day and your thigh is getting aggravated (or worse) as you warm up, go lighter and just focus on high-quality reps that day and then go back to making the scheduled increase in the next session. For the other lifts, I would just make a small increment every time you train.
    Last edited by Nick D'Agostino; 05-14-2020 at 09:07 AM.

  7. #7
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    Ok, got it. I'll report back in a week or if something changes in a significant way, but yesterday's workout went fine. I could feel the injured area both during the squats and deadlifts, but there were no major problems.
    During the squat I continually had to work on correcting for favoring the strained thigh, but on the deadlift it just feels like a tension, like someone is pressing a pen or a dowel gently down on your leg (not the point), but about 1cm under the surface.

    Two questions:
    1. Should I wait to start working on learning the press until my injury is completely healed, or is it ok to start working on it while I'm injured. (I can't do the press in my garage, but the weather is good enough now to move my stuff outside and do it there).
    2. Prior to the whole corona situation and starting the SS NLP I was doing a bit of stretching for lower back pain and to maintain spinal mobility to stave off some of effects of anklyosing spondylitis. As Rip's approach is very similar to what you would do for running, where stretching is likely to increase injury risk, I made a point of committing to this. At what point, or is there even a point where, should I add stretches back into my routine?

  8. #8
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    starting strength coach development program
    1. You can start learning the press now.
    2. Managing the symptoms of ankylosing spondylitis is a very individual thing. If you have stretching to be beneficial in the past, I would keep doing it. If you do not think it's been helpful compared to continuing to move around, then stop doing it and try a different intervention and see how you feel. Giving you specific advice on how to manage your AS is outside the scope of this forum.

    Hope this helps!

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