Low Bar Squat--Adductor/Hamstring Strain

Pain & Rehab Forum [Moderated]
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Hi BBM crew

First post! I’d like to thank you for making all of this happen. It’s nice to have doctors who are also serious lifters with lots of knowledge on the subject. I also bought your Low Back Pain template (not for me) and it has been working really well.

I think I strained my right adductor/hamstring while doing heavy squats today. It happened on my first set and I was working up to a heavy 5. As I approached my last rep, I felt a bit of a pull on the way down but I still managed to get the last rep and called it a day. The pain is more medial and proximal and close to where the sitbones are. Movements that would make the pain worse are lunges and split squats. I tried squatting with just my bodyweight but it’s less pain. Theres a slight discomfort when walking up the stairs and it’s a really tight pull when I sit on the floor and straddle my legs. Overall, I would describe the sensation as a dull, tight pain regardless if I stay still or not. So far there’s no bruising so my guess is that it’s just a mild strain.

This is my first time ever dedicating low bar squat since I have been an exclusive high bar squatter with 7 years of training. I’ve been working my LB since October. I had a bucket handle tear in my left knee back in 2015 which I thankfully rehabbed my way out of and hasn’t locked up ever since. After that episode I never felt fully confident in squatting heavy loads with more knee flexion so this is my primary reason for switching to LB. I’m glad I did, until this.

My goal is to surpass my high bar numbers with my low bar. I have no intention of maxing out for this lift since I train at home. My LB number is currently the same as my HB for a set of 5 which is 270lbs but two sets less. It sucks because I was really looking forward to surpassing my HB numbers today. After reading some posts in the forums I’d like to share my gameplan and could you please let me know if it’s okay? I’ve had this strain a long time ago so I’m thinking the theres more chances of this happening again in the future.

Just a sidenote, when I did my very first LB training session, my hamstrings were very very sore. After that, I was fine. Is this a normal thing?

Stats:
Male
Age 36
Weight-160lbs (from 155)
Height-5’5"

Current Training Split:
I wave load my primary lifts which has been really working well so far

I do a 4 day split because of time constraints and I also haven’t been progressing well with a full body regimen. 2 weeks ago it was a 5 3 1 rep scheme and light Olympic Lifts were done prior to my main strength work for all days, but I’ve now cut back to 2x/week to save energy. I’m now on 3 2 1, except for squat since I can still keep going. Deadlifts are done for one top set only.

Day 1:

A1) Heavy Bench 3,2,1—3,2,1
B1) Medium Press 3 sets of 6
B2) Chins 3x7-10

Day 2:

A1) LBBS—5,3,1—5,3,1
B1) Power Clean + Jerk 5x1+2 (This used to be first, but I flipped it so I’m fresh for squat)
C1) Nordic Curl eccentrics 3x5 @ 501

Day 3:

A1) Press 3,2,1—3,2,1
B1) CG Bench 3x6
B2) BB Rows 3x8

Day 4:

A1) LBBS—3x6 (10-15% back off from Day 2’s top set of 5)
B1) Power Snatch 5x2
C1) Deadlift 1x3-5

My Gameplan

I’m not going to stop my upper body lifts since I have pressing goals too so Day 1 and Day 3 would still be the same.

I’m going to see how it feels as the days go by. It has already been a few hours since my morning training session and now it just feels tight and dull pain. It doesn’t interfere with my daily activities so I have a good feeling that this is just minor.

So I’m thinking of two ways to go about this. Option 1 is to just modify my squat to an overload movement so my body doesn’t forget what it feels like to have a heavy load on my back. Since I train at home and only have squat stand with safety pins, I might opt to either do Box Squat but higher level, or Quarter Pin Front Squat. I’m not sure if I can do Pin Back Squats because I need to see where the bar lands each time to prevent my squat stands from tipping over. Although I have a feeling this option might be stupid haha. Still want to hear your thoughts though. I have no plans of getting a power rack because of space.

Option 2 would be to forget about intensity but build it back up through volume. I would probably do something like Tempo Squat for 3 sets of 8 for both Day 2 and 4, and just build it back up by adding sets. If I can, I might even squat for all training sessions just to get blood flow going. For this option, it really doesn’t matter if it’s HB, LB, or FS as long as I can squat pain free.

The same will go for my deadlift. If it doesn’t bother the injury site then I won’t change anything, but if it does, I’ll try Block Pulls from mid shin, or just back off in weight.

My plan is to run this for about 4-6 weeks, but this episode definitely has messed with my mind about squats again.

I’ll add these accesories. These are the only ones I can think of. 1. I’ll continue with Nordic Curl eccentrics
2. Light lunges, ie, Bulgarian Split Squats, Front Foot Elevated or Side Lunges
3. If Lunges don’t work, then Step Ups
4. Band or Supine hamstring curls ( I don’t have any other hamstring apparatus)
5. Pancake Good morning (the exercises some olympic lifters use)
6. the Copenhagen adductor exercise (not sure what it’s called, but your working leg is elevated on a bench and in a side plank position)
7. Romanian Deadlift, Seated GM, Landmine Belt Squats.
8. 20min LISS after every session for blood flow Last words:

The weird thing is that on my last warm up set, I felt a crack on my tailbone and the sit bones region. It wasn’t a painful one. It just felt like one of those cracking the knuckles sensation and in fact it felt quite good. However for some reason, something felt off right after that crack. I still did my first set and lo and behold, this happened. Probably just coincidence but I couldn’t help but think that maybe I should’ve followed my instincts and just called it a day after my warm up. I know there’s probably no science behind this but just wanted to share that thought. Anyways, it happened.

Sorry for the long post! Please let me know what you think of my gameplan.

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Update. It’s a bit worse now, probably because I already cooled down. It actually hurts when I flex my hip (bringing my knee up) whether if I’m standing, or lying down. I actually think its my adductor and not hamstring. I don’t think I’ll be able to squat or deadlift heavy for now.

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This is certainly a thorough post. Without delving in to extremely specific information I am going to offer some general advice. By definition, a “strain” is now being referred to as a muscle injury as “strain” is more the mechanism than what happens. In colloquial terms, it does mean that you tore some of your muscle (the degree to which this occurs does not matter as much). From a rehab perspective, the main goals are to let things calm down (you can almost consider this an extreme case of DOMS) and reestablish strength in the injured muscle. For this to occur, I would not recommend performing overload movements in the beginning. Think of it like this, if you had this injury and that side is now at ~80% strength and the uninjured is at 100%, you are likely fine to train with weight <80% but overloading movements is likely to increase the risk of re-injury.

Your option 2 is likely a much better idea. I would also recommend adding in some end range eccentric exercises either via a nordic hamstring curl or RDLs with a focus on the eccentric portion. From a home gym set up, it is a bit difficult to really “test” hamstring strength side to side, but even performing something like a single leg glute bridge for max reps to 2 reps in reserve can at least give you a proxy of strength. For example, if you perform 20 reps on one side and 16 on the other, it gives you that 80% I talked about earlier. The goal is not 100%, but I would recommend shooting for at least 90% before busting out the heavy singles.

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Thank you. yes you’re right. I wouldn’t even dare to overload right now as it’s more painful this morning. I’ll go with option 2 but done very gradually. I’ll work what you suggested (eccentrics, tempo,etc).

Would you say it’s safe to start rebuilding strength via linear progression once I’m pain free?

I’m thinking of doing something like this:

Phase 1: rehab phase, however long it takes until I’m pain free using suggested modalities

Phase 2: Use Beginner Prescription for my squat and deadlift. Perhaps run it for twice for a total of 8 weeks, or purchase Beginner Template. Tempo work in the beginning while it’s still light then gradually move on to normal lifting speed as it gets heavier. My press and bench carry on as usual. They will probably be a bit ahead but that’s ok.

then back to normal.

5

It’s often hard to really accurately forecast timelines for these injuries. That being said, I would be comfortable saying it would really surprise me if you needed 16 weeks prior to return to your previous training. I don’t know that I would expect a linear progression and often I would advise leaving a larger margin of error for the first few weeks as you get back into heavy training.