Follow-up To Hamstring Tendonitis Conversation With Dr Miles

Hello,

This is a follow-up to the below thread.

https://forum.barbellmedicine.com/forums/pain-and-rehab-q-a-with-dr-derek-miles-and-dr-michael-ray/22502-my-last-try-at-figuring-out-this-hamstring-issue-before-i-give-up-on-powerlifting

Since this time I have made some slight improvements (275lb deadlift single pain is what 225lb deadlift pain felt like).

While I understand this is a very lengthy injury and will likely take a lot of time to get better, I feel as though the progress has been very slow.

I just finished the 12 week strength and tried to go slow and as heavy as pain would allow to load the hamstrings for any deadlift movements throughout. This would mean I was deadlifting approx 2-4 times a week based on the programs week.

My question is, since I workout at home and have a home gym which I have access to everyday, should I be doing more deadlifting and/or accessory work to try and load and desensitize my hamstrings more/quicker.

IE: Since I don’t have to travel to lift a barbell, should I do deadlifts everyday seeing as my current max (based on pain with proper form) is fairly light compared to any of my other lifts and won’t really effect my overall fatigue very much?

I’m quite certain that I fall under the category Dr Lorimer explains as having too large a buffer which has been created over the past several years and I therefore need to desensitize this and decrease the buffer and was wondering if increased exposure could help?

Thanks,
Adam

Adam,
Sometimes it is hard to see the progress you have made. If, over the course of three months, you have went from 225 to 275 that is over a 20% improvement. Progress is very slow as you mentioned and often, the shortest tendinopathy protocol you will see in the literature is 3 months. You will get there. To your specific question, I would not recommend increasing deadlifting frequency beyond 2x/week. There is always a window of tolerance and typically for deadlift, more than twice a week is not warranted. Especially with the potential for another 2 days of accessory work. What has your split for deadlifts been like during the template?

Thanks for the information! I know I have to be patient with this thing but wanted to see if there was anything I could to speed this up.

I had been doing exactly what the Strength template calls for which I believe was generally competition deadlifts 1x per week with a deadlift accessory 1-2 times a week. I’m starting the 7 week hypertrophy program again now which I believe is very similar in terms of deadlift frequency.

One thing I have noted is my hamstring condition seems to vary wildly from day to day. I think I recall reading that this is quite normal with tendon issues but wanted to confirm. Some days I can work up to 275 with very little pain (comparatively) and others I will start to shake during the lift from pretty bad pain when I get around 225. There seems to be no discernible link that I can attribute to whether it will be a good or bad day which is quite odd.

Finally another interesting point I have noted is that the pain seems to greatly subside as I move through my sets. For example, if I’m doing 5 sets of 5 with 225, the first set will be a 7 on the pain scale and prior to learning more about pain science, I would have stopped thinking I would injure myself (and likely why its been so many years not getting better). The next set would be a 6.5, next a 6, then a 5 then a 4 on the pain scale as I finish and I would feel like I could do many more sets with very little pain.

Thanks so much,
Adam

In follow up, I have also noticed the pain is the absolute worst in the last 5% of the deadlift and I can feel both hamstrings almost pop like the feeling you get when you crack your fingers at the very top of the lift every rep. After the set there is like a dull ache in the area I felt the pop. Maybe this is nothing but it peaked my curiosity.

A large degree of variance in symptoms is relatively normal day to day as typically overall activity fluctuates from day to day as well. The symptoms being more prevalent during lock out is also not uncommon. I fully expect you to continue to make progress over the coming weeks.