Hip and low back pain — looking for advice

[Angikuni]

Hello Doctors (and BBM community),

First, let me say thank you for all of the content and information you provide, as well as responding to questions here in the forum. I have already learned a ton of useful information, and I am greateful for you sharing your expertise.

I am a 6’0” 33 year old male who weighs 195 lbs. I was running the third week of the Bridge 3.0 after completing the 7 week 4-day hypertrophy program. I felt a tweak on the outer edge of my left hip bone bone when I pulled a heavy single deadlift of 400 lbs @8 (a new PR). I didn’t think anything of it and finished my sets for the day without issue. Over the next week, I would feel pain sharp but manageable pain in my left hip when sqauting and deadlifting. I took weight of the bar but didn’t modify my range of motion for these lifts because I thought the pain was manageable. During the week I had a slight pain in my left hip that was barely noticeable (1/10 on the pain scale). This past Saturday I went to the gym and tried to put more weight back on the bar because I didn’t feel any pain in my hip before my workout. I pulled a single for 335 and felt some reoccurrence of the pain, then backed off to 315 for a set of 4 with sharp but manageable pain, and then further backed off to 275 to set of 4. On the the last rep of the second set of 4, I began to feel a horrible pain in my hip and low back when I approached lock out that caused me to immediately stop. I took some deep breaths and reassured myself, and was able to finish the day with incline bench’s and leg presses.

The major problem now is that I am feeling persistent pain in my left hip and the left side of my low back throughout the day that I would rate as 5/10. There is a constant dull ache in my left hip joint, and I get sharp pains shift position while sitting, when I move from sitting to standing positions (and vice versa), and when I lift my left knee any higher than my typical walking gait or when I have to bend over at the waist. My question for you is: how do I train around this injury given the current persistent level of pain? I am planning to go to the gym to continue benching and pressing, but am unsure how I should train my lower body. Should I not do anything until the pain in my hip subsides? Or are there variant exercises I could do in the meantime to work around the pain?


Thanks again for everything that you do!

Sincerely,
Kevin

[Michael Ray]

Hello Doctors (and BBM community),

First, let me say thank you for all of the content and information you provide, as well as responding to questions here in the forum. I have already learned a ton of useful information, and I am greateful for you sharing your expertise.

I am a 6’0” 33 year old male who weighs 195 lbs. I was running the third week of the Bridge 3.0 after completing the 7 week 4-day hypertrophy program. I felt a tweak on the outer edge of my left hip bone bone when I pulled a heavy single deadlift of 400 lbs @8 (a new PR). I didn’t think anything of it and finished my sets for the day without issue. Over the next week, I would feel pain sharp but manageable pain in my left hip when sqauting and deadlifting. I took weight of the bar but didn’t modify my range of motion for these lifts because I thought the pain was manageable. During the week I had a slight pain in my left hip that was barely noticeable (1/10 on the pain scale). This past Saturday I went to the gym and tried to put more weight back on the bar because I didn’t feel any pain in my hip before my workout. I pulled a single for 335 and felt some reoccurrence of the pain, then backed off to 315 for a set of 4 with sharp but manageable pain, and then further backed off to 275 to set of 4. On the the last rep of the second set of 4, I began to feel a horrible pain in my hip and low back when I approached lock out that caused me to immediately stop. I took some deep breaths and reassured myself, and was able to finish the day with incline bench’s and leg presses.

The major problem now is that I am feeling persistent pain in my left hip and the left side of my low back throughout the day that I would rate as 5/10. There is a constant dull ache in my left hip joint, and I get sharp pains shift position while sitting, when I move from sitting to standing positions (and vice versa), and when I lift my left knee any higher than my typical walking gait or when I have to bend over at the waist. My question for you is: how do I train around this injury given the current persistent level of pain? I am planning to go to the gym to continue benching and pressing, but am unsure how I should train my lower body. Should I not do anything until the pain in my hip subsides? Or are there variant exercises I could do in the meantime to work around the pain?


Thanks again for everything that you do!

Sincerely,
Kevin

Hey Kevin, sorry to hear about the hip and back issue. Typically the recommendation is to modify loading to the area. You can try to titrate up volume a bit more to control external intensity. Instead of singles or fours - take the reps up to 6s or even 8s and then add in a tempo to the movement. See about getting tolerable loading to the area; if symptoms are worsening during or after training then more modifications need to be made. Check out this video - https://www.youtube.com/watch?v=mdwj5ORPmX0

[Angikuni]

Hello Dr. Ray,

I went to the gym today and lifted. I was able to bench at the same weight and reps as last week. Getting into position on the bench was a little uncomfortable, but I felt no pain when I was in position and doing the lift. I tried squatting with an empty bar and my hip pain flared up when I got to about 25% of depth on my first rep. I was able to expand my ROM without pain to about 40% of my normal depth over the course of 6 rep sets. Over the course of 4 sets, I worked up to 180lbs (I had been squatting around 290 for sets of 4 before the injury). I ddin’t attempt to deadlift because even bending over caused my hip to flare up. I did rack pulls for sets of 8, with similar results to the squat. Over the course of the sets I was able to expand my range of motion without pain to the point that I could do a full ROM rack pull by the end of the sets without any pain flare ups.

I am still feeling pain after the work out, particularly when sitting (which is annoying given that I have a desk job), and I am wondering what you would recommend? Should I continue to increase the weight and test my pain-free ROM with accessory accessory exercises until the pain subsides? And are there strategies for managing the persistent pain that occurs throughout the day? As long as there are no other red flags should I just ignore it and carry on?

Thank you!

[Michael Ray]

Hello Dr. Ray,

I went to the gym today and lifted. I was able to bench at the same weight and reps as last week. Getting into position on the bench was a little uncomfortable, but I felt no pain when I was in position and doing the lift. I tried squatting with an empty bar and my hip pain flared up when I got to about 25% of depth on my first rep. I was able to expand my ROM without pain to about 40% of my normal depth over the course of 6 rep sets. Over the course of 4 sets, I worked up to 180lbs (I had been squatting around 290 for sets of 4 before the injury). I ddin’t attempt to deadlift because even bending over caused my hip to flare up. I did rack pulls for sets of 8, with similar results to the squat. Over the course of the sets I was able to expand my range of motion without pain to the point that I could do a full ROM rack pull by the end of the sets without any pain flare ups.

I am still feeling pain after the work out, particularly when sitting (which is annoying given that I have a desk job), and I am wondering what you would recommend? Should I continue to increase the weight and test my pain-free ROM with accessory accessory exercises until the pain subsides? And are there strategies for managing the persistent pain that occurs throughout the day? As long as there are no other red flags should I just ignore it and carry on?

Thank you!

Hey Angikuni , did you watch the video?

It's difficult to give individualistic advice without a consult. Have you had any recent traumas to the area?

Sounds like you are marking progress, which is awesome. I think it's pertinent to state, often our expectation is zero pain but this likely isn't the goal (based on what I know about your current situation) but rather can you load the area with tolerable symptoms (not left feeling unable to go do other life activities afterwards). If you need detailed assistance, we'd be happy to consult with you. https://www.barbellmedicine.com/consults-and-contact/

The symptoms you are experiencing with activities of daily living such as sitting will likely improve with time and it's important to try and minimize hyper-focusing on the symptoms (easier said than done). Often I recommend changing positions/postures often in these scenarios to help with managing symptoms. This isn't because a particular position or posture is bad or good but rather you are becoming sensitized to one after a given amount of time.