deadlift injury

[DGA]

Coach,

I injured my upper back deadlifting last night. I am having pain in the upper outside muscles of my upper back (on the right side), through the arm pit, and yesterday the pain extended down into the upper arm (triceps). The pain seems to be lateral to the shoulder blade. I am assuming it was the upper lat but don’t know if some other muscles are injured also, like teres major. The injury is not severe, in that there was no visible bleeding or bruising this morning when I got up. It is very painful when I use the injured muscles (i.e. pull on anything). Taking my weights off the bar last might was fun.

The injury happened on the second rep of my third set of heavy DL. I was doing 3x3 with 485. I have been on a modified TSFOSB program that consists of two heavy weeks followed by one light week. This week was my second heavy (loading) week. I typically do two days of SN/C&J and two days of strength work (bench/press/squat/DL) in a week. I am 34 years old, weigh 245 lb, and consider myself a late intermediate/early advanced.

I am planning on doing the Starr protocol and I just re-listened to your askrip #16 video and re-read the article by Joe Leppo. Since the injury occurred while deadlifting, it makes sense to me to use the deadlift for rehab. However, I am concerned that deadlifts will not produce a lot of lactate in the injured area. I think deadlifts will produce lactate in some other areas (forearms, low back, hamstrings) more so than in the lats and upper back.

Should I stick with deadlifts or should I switch to something like rows or pull-downs that target the area more directly?
If I should stick with DL, what weight should I work up to on the first day?
My plan was to drop my other lifts to focus on rehabbing this injury. Should I keep some other stuff in?

I very much appreciate your input here.

Dave

[Mark Rippetoe]

I'm not satisfied with your self-diagnosis. I think you have a spinal tweak, C7-T1 area. If it doesn't resolve quickly, this will need to be checked.

[DGA]

Can you recommend any quick/easy ways to differentiate between a high spinal tweak and a pulled muscle?

[Mark Rippetoe]

Muscles bleed when torn, and spinal shit follows innervation patterns.

[DGA]

So I do have bruising. Either it took a day to show up or I missed it before. When I have my arm extended above my head I have a small patch of bruising just above my armpit. The bruising is higher than I expected and I also would expect it to be more posterior, based on where I am experiencing pain. My pain is triggered by shoulder extension and adduction. When rowing a light DB I get a pulling sensation and pain in the area below my armpit. Both raising my arm overhead and hanging from a bar reproduce that pain. Light pulldowns produce a tearing sensation in the area. I’m pretty sure I have a muscle strain.

When I mentioned triceps before, I should have said upper arm. Pushing with or contracting the triceps produces no pain.

The injury happened on the eccentric portion of the rep, on the side where I had my hand supinated.

How do you recommend I proceed?

[rashid29]

Hello DGA, I talked to one of my professors at med school about your case and I was wondering if you could tell me some more information. Are you able to press your arm overhead? Laterally raise it? Do you have a video of the set where you acquired this injury, or at least a video of your typical deadlift technique?

I don't think you tore a muscle. No bleeding, and a more typical muscle tear is a prime mover. We think that you herniated C7 and it is compressing C7 nerve. That would account for the pain in your underarm and to your triceps. It may be a good idea to get your cervical spine imaged. Many herniated disks resolve on their own.

Nothing in this post constitutes medical advice. Always consult your physician before listening to people on the internet.

[Mark Rippetoe]

Looks like a lat tear.

[rashid29]

Your update made some big changes and I recant my previous statement. I agree with Mark and suspect a Lat tear near the insertion to the humerus.

[Matt Reynolds]

Absolute lat tear. I had the exact same thing on my last heavy deadlift (675lbs), ten days before the Starting Strength meet. It was on my left (supinated side). I also thought it was the tricep at first, and I called Rip who correctly informed me it was a lat tear. No bruising at first, and then the bruising started on late on day 2 and on day 3 was pretty bad. I needed to compete in ten days, so this was extremely poor timing for a muscle belly tear.

Rip wanted me to do chins for the Bill Starr routine but hanging from a pullup bar was incredibly painful at 280lbs of bodyweight.

Instead I did ring rows on day 3. 5 sets of 15.

On days 4-6 I did ring rows and pulldowns (both supinated and pronated) for a ton of reps. (Probably 3x15 each - so a total of 9 sets)

I also started deadlifting a bit on day 5. I started with a double overhand grip and on day 6 switched to a mixed grip and just did sets at 275.

Day 7 I did banded chins and pull-ups to take a little pressure off the lat by essentially reducing my bodyweight. I still did the pulldowns.

Day 8, more deadlifts - this time up to 365 and more chins with the band.

Day 9 - more banded chins.

Day 10....I went into the meet not knowing if I'd be able to deadlift or not. Bruising was still visible. I knew I could squat and knew that even the though the lat was super painful for the press, that I could still press. I thought I would go ahead and do those two lifts anyway and then start warming up the deadlift and go from there....Squat went fine. Press went fine (I did extra stretching on the lat to make sure I could lock out my press, which I struggle with anyway)....then came the deadlift.

I started warming up and used mixed grip from the very beginning to test the lat. Everything felt fine. I kept adding weight to the bar. It kept feeling fine. I ended up opening my deadlift at 650 and it was no problem at all. I pulled 701 for my second and narrowly missed 720 on my third above my knees. Absolutely no additional bruising post meet, and within a week I was back to doing full pull-ups and chins.

It's been fine since.

This stuff actually works.

[DGA]

Awesome info. Thanks Matt for your reply! I am going to give your method a shot. Did you keep training your other stuff while you did the rehab?

I have a push-pull meet in August that I am training for. I was pretty bummed yesterday because I thought I might not be able to do it. But if I can work my way back in 10 days or so I should be fine. I have used the Starr protocol to recover from a big groin tear I got in 2012, so I have full confidence in the method. I was confused about choice of exercise, so seeing what you did was very helpful. I'll check into getting some rings locally, otherwise I will start tonight with dumbbells.

Thanks Rashid for your interest/comments too.