Strained hamstring while squatting

[Timm66]

I strained my left hamstring while squatting on Tuesday. I was at the bottom of the first rep of my 5th set (sets across), and I felt a sharp pain in the back of my left leg so I set the weight down onto the rack pins.

The weight was 225 lbs and I have used that weight several times before with no problems, with my 5RM being at least 240.

At this point the only time I feel pain is when attempting to squat, or while in the process of sitting down or rising from a seated position.

I figure it will be a few weeks before I can squat again, so I am wondering what I can do in the meantime, and what I can do once I am back to squatting, to prevent this injury from recurring.

[Mark Rippetoe]

Without seeing a video of the squat, it's hard to say what happened to cause the pull. My only guess would be that your other knee may have caved a little as you were driving up, throwing an asymmetric stress on the injured side, but that's just pulled out of my ass. You say that you only feel it when coming up from a squatting position; does this mean that it doesn't hurt to deadlift? If that's true, it is prolly not a hamstring, and you may not mean the "back" of your "leg".

Whatever caused it, here is the tried-and-true injury rehab method for muscle-belly injuries we got from Starr and that has worked for years better than any other method I've ever used. Wait 3-4 days until the pain starts to "blur",which indicates that the immediate process of healing has stopped the bleeding and has started to repair the tissue. Then use an exercise that directly works the injury, i.e. that makes it hurt, in this case the squat. Use the empty bar and do 3 sets of 25 with perfect form, allowing yourself NO favoring the injured side. If it's ready to rehab you will know by the pain: if the pain increases during the set, it's not ready, if it stays the same or feels a little better toward the end of the set, it is ready to work.

The NEXT DAY do it again, and add a small amount of weight, like 45 x 25 x 2 , 55 x 25. Next day, 45 x 25, 55 x 25, 65 x 25. Continue adding weight every day, increasing as much as you can tolerate each workout. It will hurt, and it's supposed to hurt, but you should be able to tell the difference between rehab pain and re-injury. If you can't, you will figure it out soon enough. This method works by flushing blood through the injury while forcing the tissue to reorganize in its normal pattern of contractile architecture.

After 10 days of 25s, go up in weight and down in reps to 15s, then to 10s, and finally to fives. During this time do NO OTHER HEAVY WORK, so that your resources can focus on the injury. You should be fixed in about 2 weeks, squatting more than you hurt yourself with.

This method has the advantage of preventing scar formation in the muscle belly, since the muscle is forced to heal in the context of work and normal contraction, using the movement pattern it normally uses. The important points are 1.) perfect form with 2.) light weights that can be handled for high reps, 3.) every day for two weeks, and 4.) no other heavy work that will interfere with the system-wide processes of healing the tear.

It is also very important through the whole process of healing the injury that ice be used, during the initial phase after the injury and after the workouts. Use it 20 on/20 off, many times a day at first and then tapering off to morning, after the workout, and before bed. Ice is your best friend in a muscle belly injury, holding down inflammation and fluid accumulation ("swelling") while at the same time increasing beneficial blood flow through the injury. But DO NOT USE ICE MORE THAN 20 MINUTES AT A TIME. More than that can cause more damage than it repairs.

This may actually be the most useful post on this entire little forum of mine, and if you use this method exactly you can save yourself many weeks of lost training and long-term problems with muscle-belly scarring. Try it and see.

[Timm66]

Now I'm very confused, since after four days not only has the pain blurred, it is almost gone. I guess it is not a hamstring strain after all, but now I don't know what it was. I can feel a little bit of pain if I lie on my back and pull my left knee up towards my chest with both hands (I get nothing from the right). I imagine this will be gone soon too, as I keep trying to localize the pain but this stretching is actually helping. It seems like is is more towards the inner thigh, maybe halfway around from the back, and about halfway between the knee and groin.

I wasn't sure what to do earlier today so I did my regular workout except squats, and had no trouble at all with deadlifts. I tried some squats at 45x5 and 95x5, and got a little twinge on the last few reps so I didn't want to push it, but maybe I am OK to slowly work back up.

[Matt]

Mark do you have any similar experiences with rehabbing lower back strains? I got loose in the hole of a squat and tweaked my back and I'm trying to find something to speed recovery as I'm meet prepping right now.

thanks

[Mark Rippetoe]

If Timm's pain is gone that quickly, it was not a full tear. Sometimes a few fibers get yanked and it's painful, but there is no "bruising" under the skin that would indicate a major bleed.

It has been my experience that most injuries that do not involve torn connective tissue or fractures respond well to the above method, low backs included. Reverse hypers, 45-degree back extensions, glute/hams and supermans all work well for this if deadlifts are too painful.

[aussiethrower]

what are supermans??

[grv575]

Thanks, this answers a question I had about the last section of PP.

[pdellorto]

Whatever caused it, here is the tried-and-true injury rehab method for muscle-belly injuries we got from Starr and that has worked for years better than any other method I've ever used. Wait 3-4 days until the pain starts to "blur",which indicates that the immediate process of healing has stopped the bleeding and has started to repair the tissue.

Hopefully this isn't a stupid or unanswerable question, but here it goes:

I'm unsure what you mean by "starts to 'blur'". Do you mean the pain begins to shift from acute, sharp pain and into dull aching and soreness? Would the continuing incidence of sharp or acute pains be a sign to rest further?

I ask because I pulled or strained a muscle on the right side of my lower back doing a Crossfit workout. I thought it was a mild pull but a week later I still have sharp pains although not as bad as when it first occured. Attempting even basic exercise motions that involve the back results in sharp pains. I'd like to get onto to the business of rehabbing it. But I'd rather not get back to it too enthusiastically and too early because I misunderstood the signal to get started.

Thanks for your time,

Peter

[Mark Rippetoe]

Starts to "blur" refers to the tendency of healing soft tissue to change from being perceived as sharp and pinpoint to more diffuse and harder to precisely localize. Your injury, however, is not of that type. You have a back injury that will not respond in the short term as described above for muscle bellies, because the vast majority of the time a back injury of this type is not a muscle belly. It is usually a facet joint, a disc, or an associated nerve root and the pain is triggered by movement that tweaks the injury. You'll notice that it doesn't really hurt if you don't move in a way that makes it tweak. In contrast, a muscle belly tear aches all the time till it goes "blurry". You need to see a chiropractor about this, or a decent PT if you can find one.

[pdellorto]

Mark, thank you for the additional explanation. I think I understand now.

Also, thanks for the advice on my injury. I do actually feel a dull ache all the time, but no sharp pains unless I move in certain ways. I'm off to a doctor and I'll get a proper diagnosis before I decide how to proceed with getting better. And eventually stronger.

Thanks again,

Peter