Quad/Hip Pain After Training, Not During

Pain & Rehab Forum [Moderated]
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Hi All.

Been a follower of the BBM stuff for many years, but this is my first post.

For the past few months I’ve been dealing with a weird pain in my upper lateral quad near the IT band insertion. It doesn’t bother me at all during training as long as there is sufficient rest in between squat training, but it flares up to a pretty significant degree between sessions.

I’ve been backing off of the RPE over the past 6 or so weeks in an attempt to lower the stress on teh area, but it seems there a more significant pull back will be needed. For example, on Monday I completely painlessly squatted 275 x 5 @ 4-5 max and then 205 x 5 x 3 with no other quad work, and the pain in the area flared up to 5-6/10 the next day. I’ve also cut the quad “overload” work I’d been doing (belt squats and leg press) as they were the one thing that would be a bit painful during training. It initially seemed like one of those random aches/pains that would go away fairly quickly, but it’s been around 12 weeks now with no improvement so I think a more rigid approach is due.

My specific question is this: what (if anything) changes in a rehab approach when there is zero pain during training, but a pretty significant degree of it afterwards. Does the general “do not exceed ~2/3 pain” approach still hold true? I am going to pull back on the RPE and add a tempo to all of my knee dominant quad work, but am having trouble understanding how to judge the loading parameters without being able to use pain during the session as a gauge.

Thanks

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Hi there,

This is a pretty common experience. The short answer / bottom line is, even though you feel fine during training, that flare-up afterwards indicates that the stress was more than the area was ready for.

You simply need to keep pulling back until you find an entry point based not only on how it feels during the session, but the next day as well. This might mean that you deliberately try to “under-shoot” in the short term, even at the risk of pulling back more than you actually “need” to.

For example, I might work up to one set of 8-10 reps of 3-0-0 tempo squat @ 6 RPE, with no back-offs. If you wanted to see whether you tolerate additional stimulus, use other exercises – leg extensions, reverse lunges/split squats/step-ups, cossack squats/lateral lunges, etc. – but you don’t even “need” to do this for these “entry point-finding sessions”, it could just be work up to one set on the squat and move on, monitoring things for the next 24 hours before progressing further in load and/or volume.

1 Like
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Thanks for the response!

That is more or less the answer that I expected. Undershoot since the feedback is delayed.

Cheers