starr rehab adductor tear

[skinnybones]

Hi.

Male/148lb/48yrs currently sitting with a lump of ice on my right hand adductor.

About an hour ago in my last squat workset of today, 3rd rep, I felt (and my mind might have been playing tricks but also think I heard) my rh adductor muscle tear on the concentric lift up portion of my lift. As I was into a high position by then I managed to lift the weight into the rack before I stumbled off.

The tear feels as if it is right in the middle of the muscle belly. I am currently(right now) icing and after reading the Joe Leppo article intend to rest it until Monday and then start Starr Rehab protocol.

Due to my shoulder playing up and in pain getting in squat position I have since 7Jan bought a safety squat bar and have been using that in place of LBSquat, I am aware this is considered between front/HBSquat and not 'doing the program'. I started low and have microloaded at 1kg(2.2lb) a session to what was 71kg today. (Deadlift is a bit healthier at 106kg, Bench is at 52kg, Press is at 30kg).

My main question is, given the rather low top weight I can squat, at what weight should I start rehab(my SSB is 20kg), and how aggressive should I be in upping the weight to give the proper healing time?

Sorry to be a pain, I could probably search for this, but how much icing is required post Starr rehab lifts?

Third, I understand I should continue to deadlift if possible. I assume to 'feel' my way through warming up to an appropriate weight. I'm probably getting ahead of myself, but if that proved to be normal working weight should I continue upping deadlift.


Many thanks in advance

Andy

[Will Morris]

Hi.

Male/148lb/48yrs currently sitting with a lump of ice on my right hand adductor.

About an hour ago in my last squat workset of today, 3rd rep, I felt (and my mind might have been playing tricks but also think I heard) my rh adductor muscle tear on the concentric lift up portion of my lift. As I was into a high position by then I managed to lift the weight into the rack before I stumbled off.

The tear feels as if it is right in the middle of the muscle belly. I am currently(right now) icing and after reading the Joe Leppo article intend to rest it until Monday and then start Starr Rehab protocol.

Due to my shoulder playing up and in pain getting in squat position I have since 7Jan bought a safety squat bar and have been using that in place of LBSquat, I am aware this is considered between front/HBSquat and not 'doing the program'. I started low and have microloaded at 1kg(2.2lb) a session to what was 71kg today. (Deadlift is a bit healthier at 106kg, Bench is at 52kg, Press is at 30kg).

My main question is, given the rather low top weight I can squat, at what weight should I start rehab(my SSB is 20kg), and how aggressive should I be in upping the weight to give the proper healing time?

Sorry to be a pain, I could probably search for this, but how much icing is required post Starr rehab lifts?

Third, I understand I should continue to deadlift if possible. I assume to 'feel' my way through warming up to an appropriate weight. I'm probably getting ahead of myself, but if that proved to be normal working weight should I continue upping deadlift.


Many thanks in advance

Andy

I've trained through multiple muscle belly tears. The Starr protocol is good, but I (in my experience) had a high rate of reinjury early in my lifting career when I was doing the Starr method for muscle injuries. I have since changed to where I use aggressive compression, and I do short, burst sets at the highest weight I can tolerate. I use the warm up to gauge what I am capable / comfortable with doing, and I do sets of 2 (3 reps at the most), and as long as the pain returns to baseline within 30 seconds to a minute after finishing the set, I know I am safe to continue. I will do 5-7 sets of 2, and I will linearly progress on every workout until I am doing doubles with my pre-injury work sets. Then, I use the next couple of training sessions to increase the in set volume to back to my normal programming.

[Dust Devil]

You're supposed to start with a weight that is uncomfortable, but not painful. For me, that was the empty bar. I started 4 days after my injury with 3 sets of 25. I kept my feet a bit straighter than normal.

Next day, I started with 45, but after two sets, added 10 more pounds to 55.
Next day, I started with 45, then added 10 pounds for each set
Next day, I started with 55, then added 10 pounds for each set.
Next day, I started with 65, then added 10 pounds for each set.
After 10 days of this, I dropped the reps to 15.
After 5 more days, I dropped the reps to 10.
etc, etc.

It took me 23 days after injury to start deadlifting again. And it took me about 4 months to get my squat back to where it was. The adductor still felt a little weird, but stretching before squatting helped and I used that adductor machine at the gym at high reps. These two things made the pain go away for good.

[skinnybones]

Ok, so I have 'sort of' followed the Starr Protocol and re-tweaked the injury twice.

First time I didn't feel confident about reps of 25 and thought I might 'bounce' a bit too much trying to get through the reps too quickly or lose focus. So I started with sets of 15. Everything went well for almost 2 weeks raising weights and lowering reps until I did something stupid and tried a slightly different stance and depth without reducing the weight. That resulted in a bad tweak to the injury though not to near the extent of the original pull. So I restarted Starr from scratch a couple of days later. Now 7 days in I have retweaked again, though to be honest this one feels very minor and I may even be able to squat again tomorrow. I think I have raised the weights too quickly this time and maybe squatted to deep(Remembering I am using a safety squat bar which is a halfway between high bar/front squat)

Are these retweaks common, Wills answer would certainly make it seem so. I don't feel confident to try his method and have zero knowledge of using compression on an injury.

My intention is to drop the weight a bit, and continue a high rep programme ala 'Starr' but be less aggressive this time in raising the weight. Instead of focusing on getting the squat numbers up so fast, I'm gonna baby the squat numbers up to lessen the chance of another reinjury whilst hopefully still keeping down the chance of scar tissue, and focus on deadlift for the next few weeks(which doesn't seem to affect my adductor anywhere near as much though as yet I've not gone higher than 85% previous max during the last weeks).

Does this sound an ok goal/way ahead. Given 2 tweaks I am assuming it is very important now not to reinjure the same area yet again.

[Nick D'Agostino]

Unfortunately retweaks do happen when managing any injury. What you wrote out sounds like a good plan. I would decrease squatting frequency to 2-3x/week and make smaller jumps than you have been. Spend 1-2 weeks at each rep range before lowering. Start at 15, then go to 12, then 10, then 8, then 6 then 5. If the bounce is the thing that is reaggravting the injury I would pause for the first two week to let things calm down and start to rebound again around 10 reps. When dropping a rep range (like going from 10s to 8s) do not increase the weight more than 10%. Good luck and keep us updated!

[skinnybones]

Unfortunately retweaks do happen when managing any injury. What you wrote out sounds like a good plan. I would decrease squatting frequency to 2-3x/week and make smaller jumps than you have been. Spend 1-2 weeks at each rep range before lowering. Start at 15, then go to 12, then 10, then 8, then 6 then 5. If the bounce is the thing that is reaggravting the injury I would pause for the first two week to let things calm down and start to rebound again around 10 reps. When dropping a rep range (like going from 10s to 8s) do not increase the weight more than 10%. Good luck and keep us updated!

Thanks for the quick reply. Glad to know these 'retweaks' are not completely unusual.(I think I've just been too impatient although even a mundane dishwasher fitting aggravated the injury last week so keeping the outside world away is a problem too). I will go to 3 x per week squatting as you recommend as it will lead nicely into my normal Mon-Wed-Fri and also the ramping up levels you have prescribed would give a much longer 6-12 weeks length of rehab.

I think I will write myself out a program of about 8 weeks to get back to 5's at about 80 percent max and then take it from there depending on how I feel.

I will keep the thread updated. Next report will hopefully be that I have got back to linear progression on my deadlift whilst mid (longer) squat rehab process. I think that's an achievable goal within 2 or 3 weeks without being too dangerous to my adductor.

[Alexander Dargatz]

I've trained through multiple muscle belly tears. The Starr protocol is good, but I (in my experience) had a high rate of reinjury early in my lifting career when I was doing the Starr method for muscle injuries. I have since changed to where I use aggressive compression, and I do short, burst sets at the highest weight I can tolerate. I use the warm up to gauge what I am capable / comfortable with doing, and I do sets of 2 (3 reps at the most), and as long as the pain returns to baseline within 30 seconds to a minute after finishing the set, I know I am safe to continue. I will do 5-7 sets of 2, and I will linearly progress on every workout until I am doing doubles with my pre-injury work sets. Then, I use the next couple of training sessions to increase the in set volume to back to my normal programming.

I have seen your opinion on this a few times now. I value your professional opinion very highly, thank you for sharing your knowledge and experience here!
I want to add my personal take, because I believe there is a caveat for your method, at least for some people (like me).

I have had three muscle tears in recent years, two small to medium (pectoralis and adductor) and a large one (adductor, on the other side). I have used the Starr protocol very successfully (fast and complete healing) each time, so my inclination to try a different method is low, even if it might be even better.

The potential problem I see with your method, if I were to try it, that I would not trust myself to pick the correct weight and not re-injure myself. "The highest weight tolerable" for me would be to see how far I can go, which would likely result in going too far. Or, knowing myself, I'd maybe be too cautious and pick a weight too low.
With 25 reps on the other hand, I can feel if the pain stays the same, increases or decreases during the set. Granted, you need the ability to focus on form for 25 reps, which is the problem with this method. I think I can do that. I can definitely do that better than estimating the correct weight for doubles. I believe you when you say higher weight and lower reps work better, but then I think you (personally) can better judge what weight to use than I or maybe other lifters could. In the absence of a coach, for me training at home, I think the Starr protocol works well and safely.

Hm. Do you think it would make any sense to start with 25 reps as in the Starr protocol, but increase weight faster and decrease reps sooner, sort of a mix between the two methods?

[Nick D'Agostino]

Thanks for the quick reply. Glad to know these 'retweaks' are not completely unusual.(I think I've just been too impatient although even a mundane dishwasher fitting aggravated the injury last week so keeping the outside world away is a problem too). I will go to 3 x per week squatting as you recommend as it will lead nicely into my normal Mon-Wed-Fri and also the ramping up levels you have prescribed would give a much longer 6-12 weeks length of rehab.

I think I will write myself out a program of about 8 weeks to get back to 5's at about 80 percent max and then take it from there depending on how I feel.

I will keep the thread updated. Next report will hopefully be that I have got back to linear progression on my deadlift whilst mid (longer) squat rehab process. I think that's an achievable goal within 2 or 3 weeks without being too dangerous to my adductor.

Sounds like a plan man! Let us know how it goes.

[Dust Devil]

Glad to know these 'retweaks' are not completely unusual.

I'll repeat my suggestion of using the adductor machine, if you have one available. The advantage it holds over actual squatting is that you can carefully control the amount of stress you apply to the adductors, so retweaking is very unlikely. In a squat, the involvement of the adductors depends heavily on technique, as you've seen, and retweaking is easy.

[skinnybones]

I'll repeat my suggestion of using the adductor machine, if you have one available. The advantage it holds over actual squatting is that you can carefully control the amount of stress you apply to the adductors, so retweaking is very unlikely. In a squat, the involvement of the adductors depends heavily on technique, as you've seen, and retweaking is easy.

Unfortunately I'm training at home so don't have access to one. I take your point though, and it does seem that just a little bit of difference in stance etc varies the load on the adductors quite a lot. I am going to keep my squats exactly the same in the next few weeks by concentrating on not changing stance and also going 'touch and go' to a box so as not to go too deep too early.

I'm not sure Bill Starr ever intended his 2 week rehab to be applicable to adductors, I was reading an article the other day where he had expressed an adductor 'ding' took a long time to heal. Also he seemed to find a high percentage of newbies (like me) had very weak adductors and needed to work on them (although he reckoned they could be strengthened reasonably quickly). He was recommending wide stance squats and also the adductor machine that you mentioned.

I think for my original 'ding' I probably had weak adductors, and it didn't really show up until 'pop' when I did something just a little bit different and overloaded them.

Anyway, enough rambling as I wasn't going to post till 2 or 3 weeks time, but 'self isolating' after my girlfriend has been sent off work (even though shes blatantly only got a common cold) is already monotonous.