Hi there. I’ve had proximal hamstring tendinopathy on and off for about a year. I had a good run of about 6-7 months mostly symptom free (settling within 24 hours when occasionally provoked) and was finally lifting respectable weights again (for me, but pitiful for most people on here!) after having started again with just the bar about July last year.
Having had another flare (pain when sitting, lasting >24 hours for maybe 3 weeks), I decided to download the hip rehab template. I tried session 1 today but couldn’t get on with the high bar pin squats, my high bar squats aren’t great at the best of times and tend to do sinister things to my knees, which is definitely what I need right now.
Would it be appropriate to switch out the BB squat regressions in the first few weeks to a BB split squat, starting with just the bar, if these don’t increase symptoms in the 24 hour window? Or DB with rear foot elevated? I also think practising a lift I have done less often will allow me to be more positive about the programme, so I can think of it as improving a new skill rather than being ‘4 steps back’ as high bar produces tightness in the area at parallel from 35kg, which is very disheartening especially when I have had several quite dramatic restarts since I started training last January.
I think the symptoms increased around the time I finally reached 62kg squats through the world‘s slowest LP (shameful, I know, but this is a lifetime PR). Last time I had a flare was when I got to 60kg last June and had to go back to squatting the bar. Around the same time I reached 62kg back squat I made a jump up from about 85kg hip thrusts with a one second hold at the top, which I could manage for 15 reps, to 92g- 95kg with a 3 second hold at the top, which I could manage for 12 reps albeit at RPE 9 compared to a usual 7-8. I understand slow hip thrusts are seen as a ‘good’ exercise for the injury, but could it be that this sudden increase caused the flare rather than slowly increasing the squat (‘bad’ for the injury in general rehab thinking)? If so, how much of a weight reduction in hip thrust would be appropriate as a starting point? I’m nervous that dropping the weight too low will create more harm in terms of too little stimulus for the tendons in that region.
Finally, my bulk has had to be sidelined for now, and am adjusting calories to my apparent maintainence. At what stage would a bulk be productive again in terms of regularly hitting a certain RPE? I can still train upper body as normal but my upper body is already reasonably developed with a skinny lower due to all the restarts!
Thank you BB medicine for not providing the usual ‘lifting weights will make it worse, CEASE ALL MOVEMENT’ rhetoric. Just having some kind of ‘game plan’ on paper has been a huge lift for my mental health 