Strained Pec from Low Bar Squat?

Medical Q&A [Moderated]
1

Hi Doctors:

I recently began experiencing pain from my upper chest (right under the collarbone) to my right shoulder, during and after my squats. I’m curious how you would recommend rehabbing it, since the pain was not the result of a concentric movement, so I can’t just squat at lower weights and titrate up as pain allows. My thought was to instead follow the Bill Starr protocol but with overhead presses, since that movement seems to most directly target the affected areas.

More details: I first noticed it three days ago, when I probably didn’t warm-up enough and was overly aggressive with getting the bar in a low position. (I was feeling like it had been riding high lately). The pain was tolerable though, so I finished my workout. Yesterday, the pain became progressively worse throughout the squats, to the point where I couldn’t lift my arm over my head after my first heavy workset. I decided to shut it down, and apply ice and rest that evening. Today I was sore, but better. Tonight I just did OHPs, 3x20 of the empty bar, as per the Starr protocol. I didn’t try any squats.

Some additional history: I am 40, and recently started the Bridge after the SSLP this year. In June or so I tweaked my right shoulder while stupidly grinding out that last rep on bench day. I happened to have a physical scheduled a couple of weeks later, and my doctor thought I sprained my AC joint and/or upper bicep tendon. I was pain free by September. And I don’t remember it ever bothering me during squats.

So, what should i do to rehab this? Do you agree with using the OHP? When should i re-introduce squats? Should I be trying a squat variant, like front or high bar squats, or just move my hands farther apart with low bar squats?

Thanks in advance, and thanks for all of the great content. Strength training has been a fun midlife crisis, and I’ve learned a lot from your articles and podcasts.

2

Chicago,

So, this doesn’t sound like you tore a muscle belly- so no need to do Starr Rehab Protocol. Similarly, it doesn’t sound like you acutely injured anything in your shoulder that’s specific enough to warrant time off. I’d just high bar or front squat (if you can’t high bar) for the time being, press as programmed, and don’t miss a squat session.

3

Thanks Doc. I was able to high bar squat, and complete the rest of my programming, with only minor discomfort. I guess I’m still learning how to recognize my aches and pains for what they are.

While I’m here, how about a podcast on sleep? How its important to recovery, how to deal with common sleep issues, etc.

4

Yea that’d be interesting, though if we told everyone they’d perform worse with less sleep we’d be doing a huge disservice to everyone via the nocebo effect so…

5

I think a podcast on sleep would be a great topic. I think the nocebo effect would come from not approaching the topic properly. Maybe just talking about the importance of recovery, sleep being a significant portion of that. You could talk about general good sleep habits. Some signs that you should talk to a doc about a health issue to be addressed. Effects of different habits on sleep, such as alcohol close to bed time, etc.