Martin’s training has been going well in preparation for an upcoming powerlifting meet in a few weeks. On the 2nd of November, his training was moving along as per usual. The first two lifts of the day, the squat and bench press went without a hitch as per programmed. The last lift of that day, the deadlift, was at 210kgs for a set of 3 – it would be challenging but manageable.
His first two reps were tough doable. As he was pulling the bar up on the third rep, he felt his right thigh spasm and rip like a zipper. Suddenly, the muscle cramped up in pain. Martin dropped the barbell and grabbed his hamstring.
Then the pain intensified. An all-over ache, as if he had slammed his leg through a door. He decided to stop for the day. That night, the pain got even worse. It was sharp and felt like a knife through his thigh. He couldn’t find a sleeping position where his leg didn’t hurt.
But that wasn’t the only reason Martin couldn’t sleep. His meet was on the 28th of November, less than a month away. Did this injury mean he had to give up? Was all his preparation wasted?
Muscle strain or muscle tear?
When Martin instinctively reached for his hamstring after dropping the barbell, it was obvious that he had injured it. What wasn’t so obvious was what had happened – was it what we think of as a “pull” or “strain” or was it a tear?
Three days later at our next training session, the back of his hamstring showed bruising, indicating a muscle tear.
Muscle strains and tears can occasionally happen to lifters. Lifting weights in itself isn’t inherently dangerous or injurious. There are many reasons why lifters, new or experienced, can get injured. Watch Martin’s deadlift video again and pay attention to what happened on to the bar on the third rep. You’d notice that on the third rep, the bar drifted away and Martin was fighting hard to pull the bar back and up when his injury happened. While that may or may not have contributed to the injury, it’s impossible to confirm that his injury was a result of a technique error or he was tired that day or he wasn’t recovered from his previous training session. Sometimes, shit just happens, albeit rarely.
But an injury like this doesn’t have to force you to the sidelines.
Conventional wisdom says stop training and take it easy
If you see a doctor when you have an injury like this, it’s almost certain that you’ll be told to rest and take it easy.
For years, the standard treatment would be: 1. stop training, 2. take some painkillers, and 3. rest, rest, rest, until the injury is fully healed.
The problem is that letting the injury heal on its own leads to muscle fibres that don’t heal back properly as they should.
If you allow the muscle to rest and heal on its own, it’ll form scar tissue over the injured site. As a result, those muscle fibres can’t slide across each other like it normally would, inhibiting full function and is likely to get injured again in future.
Disclaimer: In the rare event that it’s a serious injury, like an avulsion or a complete tear, you need to get your ass to the hospital immediately. Serious injuries need surgical interventions.
The Starr Rehab Protocol: a stress/recovery/adaptation cycle
Instead of resting your muscle strain/tear, the best way we know to get your injury to heal up is to make it heal by rehabbing it.
Developed by the famous strength training coach Bill Starr (who also taught Mark Rippetoe, founder of the Starting Strength method), the rehab protocol focuses on high-rep work at light weights, using lifts that most directly stress the affected muscle e.g. the lift you were doing when you got injured.
By using the muscle instead of resting it, blood is pumped at a much higher rate through the injury site, which accelerates the healing process. The injured muscle responds to the stress of mechanical loading using its normal movement and contraction patterns and is forced to repair itself more completely and quickly than resting it. This prevents the scar tissue from forming in a way that inhibits the muscle fibres from sliding across each other smooth and make it more likely to injury the site again. As a result, the muscles heal properly and regain their function faster.
Important points to consider:
– Use perfect form.
– Light weights with high reps.
– Lift every day for two weeks.
– Increase the weights used daily. Reduce the number of reps if necessary.
– Don’t do other heavy work. This can interfere with the healing process.
It’s a fairly basic and straightaway process, but bear in mind that it’s going to be uncomfortable. But do it right, and you’ll be able to rehab your injury and get back to your training much faster than you ever thought possible.
Martin’s Rehab Workout—as it happened
The plan was simple. We would test the waters at the first session after his injury with very light weights, gradually increasing the weights. The moment he started to feel an increase in discomfort, that’s where we would stop for that day.
Initially, Martin felt frustrated at the low weights, because it seemed like he had lost all progress. But he trusted us to design a suitable rehab plan and knew that following a structured plan was the fastest path to a safe and full recovery.
Thankfully, Martin’s injury wasn’t too severe so the deload in terms of weight when starting his rehab wasn’t too great, which was handy considering he had a powerlifting meet in a couple of weeks. Since he was able to start with almost 50% of the weight that he was using when he got injured, we dropped the reps from 20 to 5.
On days that he’s not in the gym (not shown), he did high rep bodyweight deadlifts for 25 reps per set, multiple times per day. It’s not ideal but he doesn’t have the time to make it to the gym daily for 2 weeks neither does he have weights at home.
Bear in mind that amount of weight you can start with on your first day of rehab may be greater or less, depending on the severity of your injury.
|3rd Nov||–||Deadlift – No weights used, the movement only.
25 reps per set, multiple times throughout the day.
|4th Nov||–||Deadlift – No weight used, the movement only.
25 reps per set, multiple times throughout the day.
|5th Nov||1||Deadlift with the empty bar, in sets of 20, adding 10-15 kgs per set.
|7th Nov||3||Deadlift 110 kg x 5|
|9th Nov||5||Deadlift 115 kg x 5|
|12th Nov||8||Deadlift 120 kg x 5|
|14th Nov||10||Deadlift 130 kg x 5|
|16th Nov||12||Deadlift 140 kg x 5|
|19th Nov||15||Deadlift 150 kg x 5|
|21st Nov||17||Deadlift 160 kg x 5|
|23rd Nov||19||Deadlift 165 kg x 5|
|26th Nov||22||Deadlift 167.5 kg x 5|
|28th Nov||24||Meet Day!|
Meet Day arrives
On Meet Day, Martin did his last deadlift warm up at a comfortable 160kgs.
This looked promising. By now, I was pretty sure that Martin’s hamstring was almost back to 100%. Still, better be safe than sorry.
So for his first attempt, we were conservative and opened his deadlift attempts with 165 kg – something he can very comfortably do and be sure to at least get a lift in for the deadlift.
He did that easily, so we decided to go a little more for his second attempt at 190 kg, which he did very easily.
At this point, he seemed very relaxed. In fact, based on how fast the bar moved, I suspected that he might even be able to achieve a mini personal record. Prior to his injury, Martin’s previous record for his deadlift was 215 kg.
Just to be sure, I checked in with him. He said his hamstring was feeling totally okay. Also, his form looked pretty much perfect. And even better, he seemed to be really enjoying himself.
I told him that I was pretty confident that he could hit a personal record that day. Did he want to give it a go?
Martin said yes, and so we loaded the bar up to 216 kg.
I held my breath as he got ready.
He set his feet in place and placed his hands on the bar, like he has done hundreds of times before. He took a big breath, set his back and started pulling.
As I watched him pull on the bar, I could feel my heart rate increasing. The bar kept moving up, slowly but surely, till he finally locked out 216 kg, a new lifetime personal record, with room to spare.
In Martin’s own words:
“At first, I was in denial and anger at my injury. The rehab process was difficult, but Shaun supported me and we didn’t give up. Actually, I recovered very fast, and I was grateful. I went into the competition without any expectations. And miraculously, I lifted more than ever before!”
Be smart when training through injury
The rehab protocol that we use works very well for muscle belly(strains or tears) or back injuries(associated with disc issues) but do note that it doesn’t respond well to everything. For example, connective tissue injuries do not respond well to this rehab – these issues require different approaches.
While we do our best to prevent injuries like this from occurring, stuff like this occurs occasionally. Injuries are, unfortunately, an unavoidable part of training. While it’s almost impossible to be 100% injury free if you’re physically active, you can and should take responsibility to rehab your injury when it happens.
You may not have an upcoming meet to prepare for, like Martin. You might be a lifter that got injured while training. And you’re probably quite worried, wondering when (or if) you’ll ever get back to normal, pain-free function.
The good thing about injuries that occur in the gym can almost always be healed in the gym as well. You need to make the injury heal with the appropriate rehab protocol, be patient and prepared for the discomfort of rehabbing the injured site.
Put in the effort to rehab your injury instead of letting it heal on its own and you’ll find that you’ll be able to get back to your pre-injury strength quicker than you thought possible while lowering the chance from the injury occurring again.