Coming Back After Adductor Injury & Leg Length Imbalance – Need Advice on Programming [Knee Rehab Program]

Pain & Rehab Forum [Moderated]
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Hello everyone, new on here.

I’m a 25 yo male, like to work out, although I’ve been out of the gym for a bit now due to a minor injury, according to my orthopedist a torn left adductor in what presented like knee pain for me. Fortunately, I rarely have any pain now, and my goal is to start lifting normally again, and I’ve been training with the Barbell Medicine Knee Rehab Program.

My previous training:
I was running Starting Strength, so mainly squats, bench/overhead press, deadlifts, and power cleans, alternating as per the program, which I enjoyed, as it was good and concentrated effort.

The issue now:
That approach felt untenable with the injury for now. Visiting the orthopedist, she suggested I focus on single-leg exercises, as bilateral lifts might reinforce imbalances and asymmetry. What plays into this is that I appear to also have a functional leg difference, meaning my ‘healthy’ right leg is 1 cm longer. This also made my squat asymmetrical, i.e. I veer my slightly more outwards with it when going down. I’m doing stretching targeting my piriformis and adductors as recommended by her.

Right now, I’m in Phase 2 of the Barbell Medicine Knee Rehab Template (which I used previously for a different issue), but that phase is heavy on bilateral movements. I’m uncertain if I should stick with it, modify it, or switch to something more focused on unilateral work and addressing asymmetry.

To be honest, I find rehab-style training very tedious — especially the slow, high-rep recovery work. This may also be due to being a rather stressed-out law student, the concentrated and good effort with Starting Strength I enjoyed a lot.
But I am very determined to return to consistent training and eventually get back under the bar, but due to what my orthopedist said and the differing Knee Rehab Program, which after all is programmed unspecifically for any knee problem, I’m unsure how to continue and am in a sort of paralysis by analysis.

The question now for me is:: Should I continue with the Knee Rehab template? Or tweak it toward more single-leg emphasis, and if so, how?

Any guidance would be greatly appreciated. I had used the Barbell Medicine shoulder injury program after being out of the gym for years, which I’m extremely thankful to have found, and have had very good experience with, as well as the knee program in the past.

In any case, I miss working out regularly, and want to get back ASAP with a plan I can stick to and trust works for my situation.

Other than going to the Gym, I like playing football, where I don’t encounter any pain running etc. The relevance of the injury is only limited to the gym.

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Hi there! Thanks for the post and for joining the forum.

I would favor continuing the knee rehab program, as well as doing phase 3 as well. I think the slowed tempo of the first two phases is a good way to control training load while also exposing you to the movement patterns you want to eventually train. The 3rd phase is a great bridge back to unrestricted training.

I also think there is sufficient unilateral work in there and would not generally favor more outside of personal preference or sports specific considerations. I am not hearing/reading any evidence of significant asymmetry. I also do not suspect your leg length discrepancy is causal of what you report on your squat, as that’s a pretty small difference that is very common. Usually, leg length discrepancies aren’t terribly apparent until > 20cm (3/4"), but anything is possible.

Lastly, I would not plan on returning to Starting Strength after the knee rehab program. It is likely that program and its progression model are causal. There are lots of other programs that will yield better results.

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I appreciate the response! :slight_smile:

I got the injury while deadlifting. I overestimated how much I could lift, and as I tried to pull the weight, my form broke down, with my left knee moving inward to sustain the load.

As I plan to get back to regular training after finishing the rehab program, is there any specific program you would recommend, or alternatively, what feature of the Starting Strength program makes it less suitable, so I can avoid such programs?

I believe you have posts/an podcast episode on the topic of choosing the right programs, will look into those as well.

Best regards :slight_smile:

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After the rehab program, you should pick a training plan that fits your goals, preferences, and your current fitness levels. We have a template quiz that may help guide you. I’d likely default to the General Strength and Conditioning 1 program for this application.

Regarding SSLP, my major criticisms are as follows:

  • Hyper-specialized exercise selection with only 4-5 movements. This likely increases injury risk and worsens movement proficiency.
  • Narrow focus on 5 reps, which does not sufficiently train all types of strength. Would be better to train multiple different rep ranges for broader development.
  • No autoregulation to determine the load, e.g. add 5lbs even if it’s harder, likely increases risk of injury without reliably leading to better training outcomes. Humans generally don’t get stronger in a linear fashion. Adding weight should not make the effort harder if you’re actually stronger.
  • No conditioning

I could keep going, but it really is a compromised program. If it gets people into lifting, that’s cool. I just think there are better options.

-Jordan

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