Starr Rehab for Quadriceps strain

[MattM]

Hi Coaches,

A week and a half ago I strained my left quadriceps whilst squatting. It was the during the last couple of reps of a set and I felt pain in the quad. The remainder of the day and the following day I was in significant pain e.g. walking up and down stairs was pretty difficult. The pain gradually subsided over the next few days and I was barely aware of it during everyday activities 4-5 days later. I then tried to squat again but was unable to get through my second warm up set (50kg / 110lb) - 1st warm-up with bar seemed ok. Having left it for a few more days, my quad now feels OK apart from an occasional niggle. However, I don't think I'm up to squatting heavy with it yet. I was wondering about using the Starr Rehab Protocol and have a few questions:
1. Is the Starr Rehab Protocol the right thing to use for this kind of injury?
2. Have I waited too long before starting the protocol? (The page on the wiki says 3-4 days and it is now 10 days. I wasn't aware of the Starr Protocol until now)
3. Due to work and family commitments, I can't get to the gym every day. Is it worth doing some bodyweight squats at home on the days that I can't make it to the gym?

Many thanks

Matt

[Nick Delgadillo]

Probably not. As I understand it, the idea behind the Starr protocol is to promote proper healing in a muscle belly injury before scar tissue starts forming however the fuck it wants to. Does it get better when it warms up? If so, you may want to try it and see what happens. I think a more appropriate approach at this stage, though, is to work on it with a lacrosse ball, strong fingers, power rack safety pin. Bust it up a bit and see how it feels.

[MattM]

Hi Nick,

Thanks for the advice - very helpful. It does get better when it warms up so, as you suggested, I tried out the Starr Protocol. I've also been massaging as you suggested and also making some use of ice to reduce inflammation. Everything was going well, with a gradual reduction in pain - until yesterday. In accordance with the Starr Protocol I started with the empty bar for 3 sets of 25 and gradually increased each day. Yesterday was sets of 25 with 30, 35 & 40kg (66, 77, 88lbs). On the last set I felt a bit of discomfort for the first few reps but as the set went on it felt better. Unfortunately, since the workout I have felt more pain again. Although not as painful as the first time around this definitely feels like a re-injury. So, I intend to stop the Starr Protocol at this point. I'd appreciate some more advice on what to do at this stage. My current thinking is the following:
1. A few days rest from the gym
2. Continue with the massage. I've been doing this 3-4 times a day for about 10 mins each time. Is that right or should I be doing something different?
3. Continue with ice until the pain starts to subside

Does that sound like a reasonable plan or would you suggest something different?

What should I do about training from this point? Obviously, I can continue with the upper body lifts but this injury impacts squats, deadlifts and power cleans. How long should I rest before trying these exercises again and what should I do when I restart? Should I be pain free before re-starting?

In case it helps, some brief info on my background. I'm 37, been training for over 15 years but pretty new to SS (and low-bar squats) having only discovered it a few months ago. With hindsight my previous training was mediocre at best and I've made more progress since starting SS than I had for years.

Thanks for any advice you are able to offer.

Matt

[Tom Campitelli]

Bumping for Delgadillo.

[Nick Delgadillo]

Is it worse than the initial injury a few weeks ago? Please bear in mind that this is pretty difficult to do over the internet and if you think it's serious enough, you should see a medical professional.

With that out of the way, here's what I would do. Keep icing and massaging. Your schedule looks fine for that. After a few days, when the pain starts to dull, I'd give the Starr Protocol another go. At the slightest indication that something isn't going right, I'd stop and go see a doc. If you have an injury that precludes you from squatting and pulling, do your best to work around it. RDL's, maybe? Definitely prowler pushes and get your Bro on with the upper body lifts.

[Nick Delgadillo]

Bumping for Delgadillo.

Thanks, Tom!

[MattM]

Thanks Nick - that's really helpful. I fully understand the issue with doing this over the Internet, after all you can't examine me remotely. It's not as bad as the initial injury and is gradually improving each day. So, I'll follow what you suggested and if it either gets worse again or stops improving I'll go and get some medical advice.

Thanks

Matt

[Nick Delgadillo]

Awesome, man. Good luck and let us know how it goes.