I can provide more background info too, I was just limited in how much to post at one time. This is a long one!
I was running the 12 week strength program (3 days instead of 4 to see how I adjust to the loading - since last time I ran it I had likely been inappropriate loading and had to manage some minor shoulder tendinopathy).
Things were going well, and I was on the last training day of a deload week (week 6) doing some paused squats. I had a great morning of sitting on my ass playing video games for hours and made my way to the gym. Like always, I was warming up with just the empty barbell for the first few sets (usually around 5), then I do 1 plate, 1 and a quarter, 2 plates, etc. all for the same rep ranges as prescribed. I had noticed that things felt a bit odd in my low back but the bar was moving well and the RPE was trending fine. Get to my top set 1@8 pause squat - 315 lb, a weight I handled with no problem before numerous times and the previous warmup single at 300 moved fine. Get to the bottom of the pause, feel a slight pop. Audibly, say “cool” instead of freaking out since I have read about tweaks such as this so many times but have not really experienced it in such a way. Decide to still complete the rep rather than bailing, rerack the weight, and find myself having to slowly lower myself to the ground in a somewhat seated and lying position.
I am thinking to myself well this is interesting, probably just a minor setback but we will re-evaluate in a few minutes. Guy working on out near me asks if I am alright and if I need help, I told him i’m fine just may have tweaked my back a little but should be okay. A minute later or so I get myself up to a leaning position against the rack, seated, then move to a seated position on the pull up foot-step thing, where I tend to rest between sets.
Knowing not to catastrophize, I know that this is just a minor setback in the long term of things and I should be back to normal anywhere from 1-8 weeks or longer. No big deal, just do what you can. So about 20 minutes have gone by and I move to try to bench just the bar first. Still a lot of pain and discomfort in my low back but other than that bench moves fine. Then try to deadlift and squat just bodyweight, cannot really do that pain free and if i do I do it so out of line of my normal movement pattern it looks like someone’s first day learning to squat ever.
Thats a bummer, but we will keep re-evaluating over time. I condinue the rest of my day, all with some pain but managable. By this point things have really started to stiffen up and I notice that it’s more on the left side. A day or so later I notice it is not really in the low back, but instead in the left hip. I cannot really bend over, putting socks and shoes on hurts a lot, but other than that I can still walk around and I’ll stay active. If i had to guess, i strained or tweaked something in the left hip, perhaps the psoas major based off sensation - though that is not very reliable of an indicator. However, I knew this does not really matter as much what happened, and focused on the prognosis of things being fine in time and just doing what I can versus dwelling on what I cannot do.
Still hurts a few days later and I can only comfortably do bodyweight lunges for lower body movements, but still able to bench almost the same, just keep feet up or use no leg drive at all. See my doctor, he asks some questions and checks with leg raises and some resistance to determine that it likely is just a strain and that he does not think there’s damage such as a muscle tear. Sweet. He said to just be careful loading it, that he does prefer if I did isolation movements like machines but it is my judgement based how i feel. I say to myself cool, he doesn’t even lift, so i’ll just get to squatting the bar and deadlifting the bar and work my way up.
A week or so later I am squatting and deadlifting the bar, though the range of motion isn’t quite full - squats have to be a little high to avoid debilitating pain but other than that its very minor and manageable pain as I expected. Deadlifts I switch to light rack pulls just above shins for the same reason.
It is worth noting too that for about 6-7 months I have also had what I figured was non-specific pain on the side of my left shin/ankle - mostly noticed and irritated after using the stationary bike on GPP days. Still had full range of motion. Figured this was not an issue as I was able to work on my feet all day and load it normally (squats and deadlifts) pain free.
Driving and sitting is still a pain, I occasionally get light pins and needles in the bottom of my foot, and it hurts my hip/glute (around glute med) bending my neck/head straight down (pretty easy to avoid doing that though) and my hurts when I brace for a lift. Interestingly, extending the right leg also hurts the left hip/glute. But I am still able to load it relatively pain free so onwards and upwards. The problem is more in daily tasks than in training.
About 2 weeks now and I am back at one plate (135) for 8 reps, tempo.
About 3 weeks and I am up to 205 - this is going great.
Now a month later and I go to 225 a bit less tempod - slower progress is still progress.
About a week after that, so around week 5 of my little rehab, things regress. I thought perhaps I loaded too much too fast and restrained things in a way (if i even did in the first place) - just dial it back and continue. Also since I have benefits through work, I checked to see what my physiotherapist that I used a year or two ago would think on anything else I can be doing do assist in helping. Naturally being a skeptical person, I took what she said with a grain of salt because frankly some of it sounds like pseudoscience bullshit or anecdotal at best.
- She said it is likely multi-factorial, that I strained hip flexors and I have “neural tension” in my sciatic nerve and its not gliding properly - and its possible i may have sprained my ankle months ago (the pain i described earlier) since my ankle is way “looser” that the other and the tendons seem “looser” too. She told me to do some neural mobilization exercises (basically dynamic stretching/movement) before doing my normal workouts, and to try to even out my weight when standing long periods since one hips higher than the other (I assumed its been like this since probably birth and has not been an issue - squat moves well and does not seem wonky). That I also may have small tears in the tendons in both the hip and shin/ankle.
- I looked into neural flossing and neural tension and the literature seems to be mostly anecdotal and there is a lot more we do not know to be able to conclude benefits of such movements. But I decided I had the time so I will humour this idea and do them. Doing those versus doing something like a leg press seemed to be the same result in terms of sensation - first being harder and getting easier and easier. Id actually argue that the leg press or squat felt better afterwards so I stopped with those mobility movements after about a week. This brings us closer to now. The last 1-2 weeks have been almost as bad as the first week. It seems that pain I mentioned in my shin and ankle earlier has worsened, which is frustrating as I’m on my feet all the time, majority of it at a desk standing or having to bend down a lot). I can still load the squat and the range of motion is fine (just a tad high but manageable for now, the issue comes several hours after training things seem to feel worse. I also have been taking one Advil each morning to help as mornings the pain is quite debilitating and I do not know why. I try to instead focus on the prognosis - it is just frustrating levels of pain at times.
I was able to touch the floor bent over before all this, now I can still barely bend over and reach my knees. Daily tasks such as standing at work start out pretty hard (mornings seem to be more difficult, same with late evenings). At times, it is quite debilitating and I have noticed no progress over the last few weeks - this week somehow feeling worse than the week before.
So, what this all is boiling down to is I am basically frustrated. I thought I had the right ideas, mindsets, practices and expectations (trying to embrace the process) but then there are setbacks like this that have little to no explanation. I know that the prognosis is great and that it is only a matter of time until things are back to how they were prior.
The best analogy I can think of is I am going down what I know is the right road, and thought I had the correct expectations in how long it would take, but it feels like i’ve been going down it for so long and expected to be further by now. So it is just frustrating and this pain is debilitating at times, bringing a slight feeling of being lost down said road.
So my questions are: where should I go from here? Continue pushing forward, trying to mitigate the pain with exercise and NSAIDs? My doctor wants me to see a specialist, since he thinks it is more likely tendons and ligaments vs just being muscle. I know in time it will be pain free. I am aware too that part of my frustration is hoping to be able to be recovered enough to train for (a few weeks) and then run the spartan race without re-injuring. Is it possible some people are prone to tendinopathy issues than others - or am I perhaps just loading incorrectly (or both, realistically)? Of all things I actually had thought most of this time I had loading on the more conservative side, so I am not sure.
TLDR: I am trained, I thought I had the right ideas and practices, still hurts and sometimes getting worse and it is frustrating - now what? Basically, how to keep embracing the process when things seem to take a dive again.