Numbness in hands during 303 Tempo Squats

Medical Q&A [Moderated]
1

I found this thread: https://forum.barbellmedicine.com/forums/medical-q-a-with-dr-jordan-feigenbaum-and-dr-austin-baraki/3565-numb-fingers-after-three-oh-threes but wanted to dig a little deeper due to form adjustments having no effect as well as other circumstances I’ll elaborate on below.

Doing week 1 of The Bridge this week, and today was day 3. On the 303 squats, somewhere around rep 4, both my hands start to tingle and feel numb. The sensation is from the heel of my palm to the tips of all my fingers in both hands (so pretty much the whole hand.) This occurred with the empty bar, 95 lbs., and 135 lbs, after which I called it. I had tried multiple sets at each weight with varying head/neck position, grip width and wrist position, but the onset stayed the same, roughly around rep 4-5. I also tried just standing without the bar, retracting my scapula and holding my hands just above shoulder level with forearms roughly perpendicular to the ground (similar to a squat grip/rack position.) My hands both get tingly/numb after about 45 seconds in this position and the sensation gets worse/stronger the longer I hold my hands there. Numbness goes away pretty quickly after lowering my hands. Lasts longer the longer they were numb.

Years ago, doing high rep squats (12+) would cause the same problem (I haven’t done high rep squats in a long time, but assume they still would) and attempting some 303 squats a few weeks back while trying out some different supplemental squats resulted in the same issue (although I didn’t try out different form tweaks at the time.) I also wake up with one or both hands completely numb (“asleep”) pretty frequently.

So three questions:

  1. Any thoughts on other adjustments to make that might alleviate the problem and allow me to do 303s?

  2. If I’m going to replace 303 Squats on The Bridge, what would be a couple of good options for that supplemental squat?

  3. Is this something I should consider getting checked out? I’m not too worried about it, but up until now it hasn’t really kept me from doing anything.

Potentially useful background:

32/M/6’3"/221 (down from 232 about 8 wks ago.)
Waist at naval 37" (down from 39.5)
No spinal/back/neck injury history or MRI
Significant history of shoulder (both shoulders) trauma over the past 14 years playing recreational sports treated non-surgically (bursitis, grade 2 AC separation, various pain that I didn’t seek medical attention for and just limited activity for periods of time.)
Bilateral tendinitis/tendinopathy-like symptoms in both arms (in the vicinity of the proximal brachialis tendon) on and off for about 5 years. Currently off.

Training history:
2009-2017 - Multiple LP runs interrupted by injury or illness, some 5-3-1, crossfit, other nonsense
2017 - Wolf Method for a brief stint last winter after a 6 week LP
2018 - Some intermediate programming I wrote for myself based on the intermediate template Jordan posted a while back and adjusted as needed based on my understanding of your programming podcasts.
Just started The Bridge

Recent best lifts:
Squat - 425x1@10
Press - 163x1@9
DL - 500x1@9
Bench - 180x5@8 (1 ct pause) - been very cautious with this due to tendinitis mentioned above.

Hope y’all are doing well. I really appreciate all the content you put out and the work you’re doing in the lifting and medical communities.
Thanks,
Chris

2

Hey there!

First, I’d like to point out that this was an exceptionally well-presented question :slight_smile: so thanks for that.

You present an interesting case. As I started reading from the beginning I started to suspect some sort of nerve compression based on where you were holding the bar against your wrists. But your description of standing there without the bar, holding your hands in a specific position reproducing symptoms obviously makes this less likely. It still makes me think of some sort of entrapment/compressive neuropathy, however the “whole-hand” distribution is a bit unusual here.

Other things that fit in the diagnostic “bucket” here include things like carpal, ulnar, or cubital tunnel syndromes … though again these tend to produce numbness in specific distributions, rather than indiscriminately causing your whole hand to be numb. Another consideration would be something originating in the neck - however, you don’t seem to describe neuropathic/radicular symptoms in any other part of the neck, shoulders, or arms (unless your reported “tendinitis” is actually related to this and not a tendon issue at all … which I doubt) and have no history of neck issues. The localized and positional nature of the numbness makes other “systemic” causes of numbness/paresthesia unlikely.

So, for your questions:

  1. I’d try a high bar squat.

  2. If the high bar squat works, try tempo high bar squats. If not, you could use a front squat, belt squat, or (less preferably) a leg press.

  3. This is entirely up to you and your willingness 1) to undergo EMG/NCV testing, potentially neck imaging if deemed appropriate, and 2) to undergo some sort of intervention (like surgery) if a treatable cause was identified.

3

Thanks Austin. I know you guys put a lot of work into this forum, so I tried to put some effort into my post.

I tried out some high bar squats with just the bar. Onset took a bit longer (closer to the 45 seconds that it took without the bar than the 30 or so with the LBS), but was still present. I might play around with my grip some more, but will probably just sub a different movement in the short term.

As far as testing and surgery (assuming no additional symptoms presenting), I’m not planning on going that route. I asked in case this might have been indicative of something more serious going on.

Also wanted to say thanks for the info the last time I posted (https://forum.barbellmedicine.com/forums/medical-q-a-with-dr-jordan-feigenbaum-and-dr-austin-baraki/5324-modify-training-or-diet-while-on-short-cycle-of-prednisone). The thread was closed by the time things had run there course, so I didn’t follow up. Trainnig went fine for the course of the prednisone. I did have some persistent muscle cramps that lasted longer than I would’ve liked post-cycle, but that didn’t really impact life or training.