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Squat Training Modification with hip flexor tendinopathy

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  • Squat Training Modification with hip flexor tendinopathy

    Hello,

    Lately for the last few weeks I have been experiencing a right hip flexor annoyance as I approach parallel and more when I go below parallel in a squat. This annoyance is happening also when I do a leg press machine even with lower loading.

    I have already read the article on hip pain primarily on relief for the hip flexor tendinopathy. I do some bodyweight bulgarian split squats before I start squatting and in between lighter warm up sets and it seems to help slightly at the moment.

    Current Routine:

    Day 1:
    Competition Squat: [email protected], 77.5% AMRAP to RPE 7
    Leg Press: 4 sets of 8-12 @ RPE 7-8

    Day 2:
    2ct Pause Squat: [email protected], 80% AMRAP to RPE 8
    Leg Press: 4 sets of 6-10 @ RPE 7-8


    Next Block:
    Day 1:
    Competition Squat: [email protected], 77.5% AMRAP to RPE 7
    Leg Press: 3 sets of 8-12 @ RPE 7-8

    Day 2:
    Pin Squat (above parallel or at parallel): [email protected], 80% AMRAP to RPE 8
    Platz Squat: 3 sets of 6-10 @ RPE 7-8


    First line of change I am considering is lowering the volume on the hypertrophy exercises, and swap out 1 day of leg press for something like a platz squat to have more variety and lower loading. I feel the leg press is good for developing the quads but the loading can be fairly high sometimes.

    The example above was something I wanted to plan out for without being too nonspecific for powerlifting purpose and also not making too many changes between blocks. Once I see how much workload is tolerable , I want to slowly go lower in my depth.


    Would volume and exercise selection be the best factor to prioritize modifying in this case?

    Would the above modifications go in line with what you guys talk about in your podcast regarding programming especially around tweaks and injuries?

    Thank you for your time.

  • #2
    Sorry to hear about the issue you're currently having. I think this is likely best served via a consult with our pain and rehab team so that they can take into consideration all of the specifics pertinent to your case.

    As far as what I think someone should do in general, I think it might be easiest to look at where people go wrong during their rehab phases.
    1. Not taking enough weight off the bar. I would absolutely not do any singles here because I see little value given the context. I would also be thinking in the 50-60% range or even lighter for the exercises you're going to do, which typically requires higher rep ranges (10-15) to get to RPE 7-8.
    2. Not changing the exercise enough to reduce symptoms significantly. I don't see how your plan addresses the pain with squatting and leg press considering you're still doing a comp squat, leg press, and then pin squat to similar depths. I'd be looking at either altering the ROM, Tempo, or exercise selection more.
    3. Not following a plan to return to normal activity. In other words, people will do tempo 10's for 3 weeks, feel better, then go back to 1 @ 8 without any sort of bridge connecting the two. I feel that this is a mistake.
    In any case, here is a helpful article on what to do about pain in training: https://www.barbellmedicine.com/blog...ining-what-do/



    Barbell Medicine "With you from bench to bedside"
    ///Website /// Instagram /// Peri™ Rx /// Whey Rx /// Barbell Medicine Podcast/// Newsletter /// Seminars ///

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    • #3
      Thanks for the prompt reply and advice Jordan,

      Just had some comments and want some clarity on your points

      1. I can physically squat, it can just be more uncomfortable with more rom and heavier loading. Would it be a better bet to not go straight to 50-60% and maybe try around 70-80% if it is bearable and do top sets with lower RPE ( like [email protected]) etc in terms of maintaining as much strength as possible?

      2. For exercise selection in this case, would it be a good bet for exercises like leg extensions? Ive noticed if I bias knee extension heavily and adjust my technique, there is no pain ( IE toes forward narrow stance Platz squat) and maybe for pin squats i can have it higher (maybe like several inches above parallel)

      3. Im assuming a bridge to transition from rehab phase to a normal training is something offered in your consultation and rehab team. Any podcast on this topic of transition or bridge?

      Thank you again.

      Comment


      • #4
        JL,

        I understood that you were able to squat, albeit with some discomfort. I don't see an advantage to trying 70-80% given these symptoms, no. I don't think you're likely to lose much strength either given the typical time course here, sustained activity, etc.

        For exercise selections, I don't have a problem with leg extensions, though I don't know that this necessarily helps either. IOW, I'd feel more strongly about using it if you couldn't do anything else to train your legs.

        Bridging from rehab to normal activity is discussed in generalities, as each specifics case can be different. I also believe it's discussed in the "Pain in Training: What Do?" article. I think you may benefit from a consult for specifics unique to you the individual.

        -Jordan

        Barbell Medicine "With you from bench to bedside"
        ///Website /// Instagram /// Peri™ Rx /// Whey Rx /// Barbell Medicine Podcast/// Newsletter /// Seminars ///

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