How to mitigate injuries when strength is going through the roof?

[hewrue]

I’ve been lifting for about 20 years. Started TRT with HCG about four months ago and I’m sitting around 1200 ng/dL and feeling great. I’ve always enjoyed lifting heavy and stick to 4 sets of 2-8 reps. However, I’m finding it difficult to stay healthy due to the additional strain on my joints and connective tissues. For example: I can hit 405 on bench for 5 reps, but my shoulder will be absolutely demolished for the next month and I won’t even touch flat bench until it’s feeling better (self-diagnosed as a rotator cuff issue.)

I’ve tried switching to a lighter weight, higher reps plan and I inevitably develop overuse injuries in the form of epicondylitis in the elbows, wrist pain, etc.

I workout because I enjoy it and I love to lift heavy, but I’m just having a difficult time self-regulating myself to avoid these nagging injuries. I just know that I want to go in the gym and lift as much weight as possible for as many reps as possible, embarrass the dude next to me filming himself struggling to bench 225 while walking around like he’s Ronnie Coleman, and leave without feeling like I ripped my shoulder in half. Am I just a complete psycho and I need to chill tf out? Do you guys have any training tips or techniques or he’ll, even just a different thought process that you could suggest? Thanks, homies.

 

[BurninSeagul]

I’ve been lifting for about 20 years. Started TRT with HCG about four months ago and I’m sitting around 1200 ng/dL and feeling great. I’ve always enjoyed lifting heavy and stick to 4 sets of 2-8 reps. However, I’m finding it difficult to stay healthy due to the additional strain on my joints and connective tissues. For example: I can hit 405 on bench for 5 reps, but my shoulder will be absolutely demolished for the next month and I won’t even touch flat bench until it’s feeling better (self-diagnosed as a rotator cuff issue.)

I’ve tried switching to a lighter weight, higher reps plan and I inevitably develop overuse injuries in the form of epicondylitis in the elbows, wrist pain, etc.

I workout because I enjoy it and I love to lift heavy, but I’m just having a difficult time self-regulating myself to avoid these nagging injuries. I just know that I want to go in the gym and lift as much weight as possible for as many reps as possible, embarrass the dude next to me filming himself struggling to bench 225 while walking around like he’s Ronnie Coleman, and leave without feeling like I ripped my shoulder in half. Am I just a complete psycho and I need to chill tf out? Do you guys have any training tips or techniques or he’ll, even just a different thought process that you could suggest? Thanks, homies.

It's great to hear that you've been committed to weightlifting for such a long time and that you're feeling the positive effects of TRT. Balancing heavy lifting with joint and connective tissue health can indeed be challenging. It's important to find a middle ground that allows you to enjoy lifting while minimizing the risk of injury.

One suggestion is to incorporate more variety into your training routine. Instead of focusing solely on heavy weights and low reps, consider incorporating different training methods such as periodization, where you alternate between phases of heavier lifting and lighter, higher-rep work. This approach can provide your joints and connective tissues with some relief while still challenging your muscles.

Another aspect to consider is proper warm-up and mobility exercises to prepare your joints and muscles for the heavy lifting. A dynamic warm-up routine and targeted stretches can help improve your range of motion and reduce the risk of injury.

Additionally, it may be beneficial to consult with a qualified strength and conditioning coach or a physical therapist who can assess your technique and suggest modifications or exercises to address any muscle imbalances or weaknesses that could be contributing to your injuries.

Remember, it's essential to listen to your body and prioritize long-term health over short-term gains. Pushing yourself is important, but not at the expense of your overall well-being.

 

[psauce]

Fucking collagen, man. It can really ruin our fun.

Your benching experience probably sounds familiar to a ton of people here. Taking time off after pain (outside of the usual soreness) is a must. There are a few supplement and programming tools that can help, also.

Supplement wise, adding in some glucosamine/chondroitin/MSM can't hurt. When you reach a point, like with your bench, where you think you may have aggravated tissue, both TB-500 and BPC-157 are effective for speeding repair, particularly with respect to collagen synthesis. I've had the best success with BPC-157, but they are both generally recognized as effective. (If you use both, don't use them at the same moment... spread them apart throughout the day, because some of their effect is redundant.) Your tendons will supercompensate, just like muscles, but they do it on a very different time table. Those compounds just speed it up.

In terms of programming, I think when you get to the bigger numbers, you need to add in some variety to make sure that you're adapting holistically. (I had to wipe myself off because that word is so fucking douchey.) What I mean is, if you're really pushing 1RM or generally slow, big lifts really hard, you will respond essentially to that stimulus and that stimulus alone. That is fine right up until it isn't, and the rest of your physiology hasn't caught up. It's one reason the Westside guys -- who really only cared about 1RMs in three movements -- did such varied (and, at times, bizarre-seeming) work. Hit the hypertrophy work, and do some work where you can move the bar really fast. Also, to the extent you do accessories, think of it more like preventative PT than anything else. Especially as it pertains to the shoulder... strong rotator cuff muscles and balanced deltoid development can prevent a ton from going bad, but it tends to go bad very abruptly and severely when it does.

If you have a nagging injury, a physical therapist is the first go-to. If you lift at a serious gym, get a recommendation. You can also call an orthopedic surgeon's office and ask who they refer to for your specific anatomy concerns.

And really, program your lifts and don't ego lift. That's where it all goes to shit.

 

[hewrue]

It's great to hear that you've been committed to weightlifting for such a long time and that you're feeling the positive effects of TRT. Balancing heavy lifting with joint and connective tissue health can indeed be challenging. It's important to find a middle ground that allows you to enjoy lifting while minimizing the risk of injury.

One suggestion is to incorporate more variety into your training routine. Instead of focusing solely on heavy weights and low reps, consider incorporating different training methods such as periodization, where you alternate between phases of heavier lifting and lighter, higher-rep work. This approach can provide your joints and connective tissues with some relief while still challenging your muscles.

Another aspect to consider is proper warm-up and mobility exercises to prepare your joints and muscles for the heavy lifting. A dynamic warm-up routine and targeted stretches can help improve your range of motion and reduce the risk of injury.

Additionally, it may be beneficial to consult with a qualified strength and conditioning coach or a physical therapist who can assess your technique and suggest modifications or exercises to address any muscle imbalances or weaknesses that could be contributing to your injuries.

Remember, it's essential to listen to your body and prioritize long-term health over short-term gains. Pushing yourself is important, but not at the expense of your overall well-being.

Thanks, man. I appreciate the thorough reply and I definitely needed to be reminded of that last paragraph.

I’ve been perusing through Rebuilding Milo and The Squat Bible by Aaron Horschig (Squat University) and attempting to incorporate his body part specific warmups each time that I train and I have noticed some improvement in mobility, which should lead to safer lifting.

I also plan to start utilizing periodization, as you suggested, naturally beginning with a deload as I attempt to sort out a more structured phase-style programming that will work best for me.

Again, thanks.

 

[hewrue]

Fucking collagen, man. It can really ruin our fun.

Your benching experience probably sounds familiar to a ton of people here. Taking time off after pain (outside of the usual soreness) is a must. There are a few supplement and programming tools that can help, also.

Supplement wise, adding in some glucosamine/chondroitin/MSM can't hurt. When you reach a point, like with your bench, where you think you may have aggravated tissue, both TB-500 and BPC-157 are effective for speeding repair, particularly with respect to collagen synthesis. I've had the best success with BPC-157, but they are both generally recognized as effective. (If you use both, don't use them at the same moment... spread them apart throughout the day, because some of their effect is redundant.) Your tendons will supercompensate, just like muscles, but they do it on a very different time table. Those compounds just speed it up.

In terms of programming, I think when you get to the bigger numbers, you need to add in some variety to make sure that you're adapting holistically. (I had to wipe myself off because that word is so fucking douchey.) What I mean is, if you're really pushing 1RM or generally slow, big lifts really hard, you will respond essentially to that stimulus and that stimulus alone. That is fine right up until it isn't, and the rest of your physiology hasn't caught up. It's one reason the Westside guys -- who really only cared about 1RMs in three movements -- did such varied (and, at times, bizarre-seeming) work. Hit the hypertrophy work, and do some work where you can move the bar really fast. Also, to the extent you do accessories, think of it more like preventative PT than anything else. Especially as it pertains to the shoulder... strong rotator cuff muscles and balanced deltoid development can prevent a ton from going bad, but it tends to go bad very abruptly and severely when it does.

If you have a nagging injury, a physical therapist is the first go-to. If you lift at a serious gym, get a recommendation. You can also call an orthopedic surgeon's office and ask who they refer to for your specific anatomy concerns.

And really, program your lifts and don't ego lift. That's where it all goes to shit.

Appreciate the advice, truly. I didn’t expect to receive a comprehensive response, much less two. And I certainly feel humbled to be reminded that as knowledgeable as I believe myself to be in terms of strength training, there’s always a ton of room for growth and learning.

I’ve been interested in using peptides to support the poorly-perfused tissues in conjunction with dynamic and well-rounded warmups for quite some time as I’ve read promising results from many. I’ll continue to do some research on proper dosing techniques and whatnot as I’m fairly unfamiliar with compounds outside of the basic AASs.

As I replied to @BurninSeagul, I plan to begin a deload phase and incorporate more stringent programming as opposed to my usual “leg day, warmup, heavy af squats, some accessory work, out” type of “plan”. I certainly need to be reminded to vary my lifting and it absolutely makes sense that muscles and connective tissue don’t necessarily develop at the same rate. I also spoke to a good friend of mine who suggested added in tempo lifts with slow eccentric portions and isometric holds as well. It’s not something I’m familiar with but I look forward to incorporating it during this deload period.

Luckily for me, I worked in healthcare for a number of years and have contacts in the ortho and PT side of the house, so I’ll be cashing in on those connections soon. Knowledge is power. Thanks again!

 

[JDLift]

Do some slingshot work or similar tool, it'll help the shoulder. If I am feeling banged up I will just do 1-3 weeks of overload with a band then go back to my normal shit. Alternatively if you want a totally new venture in life you could jump into equipped lifting. It gets a bad rep from tiktok generation kiddies but those dudes are moving absolutely retarded weights. From what I've seen the equipment makes formerly injured dudes able to work in big weights without pains at all even when they handle several hundred over their raw max so that may be worth looking into.

Also worth mentioning is your form might suck from a safety perspective. I have gotten hurt on maxes a few times when shit goes out the window and I just try to get the lift without dying but if you are getting hurt on ~80-85% then you may wanna examine your positioning. Over the years shit slowly gets out of whack just like a car, and you need to tune things up a bit. Check out your internal/external rotation, your arch, your scapula retraction or lack of, your tuck vs flare at the elbows, wrist position, where the weight 'sits' in your hand, and grip width. Over time I have had to change my form many times, going from pinky on the ring to full-time close grip and then back outward and now I press ring finger on the rings. I've had to adjust my tucking vs flaring a lot, my setup, the position I set my back on the bench (flat vs on my traps vs on my mid back), where I place the bar in my hands (wrist cocked back vs knuckles to the ceiling, sitting in the palm vs sitting into the thumb) and probably a dozen other small dumb things but it got me to 'Elite' powerlifter status after ~13 years so it was worth it I guess. This lift is the most technical and fickle of the main compounds, just give it some time and try different shit for a few weeks and see how it feels then try other new shit etc etc until you find what works painlessly.

 

[FrancoC]

If you’re getting your shoulder issues only from barbell bench, I’d suggest doing dumbbells instead. I haven’t done barbell flat in decades because of that same problem. With dumbbells I’m able to keep my elbows pushed in more so it’s not putting that unnecessary strain on the joint.

 

[hewrue]

Do some slingshot work or similar tool, it'll help the shoulder. If I am feeling banged up I will just do 1-3 weeks of overload with a band then go back to my normal shit. Alternatively if you want a totally new venture in life you could jump into equipped lifting. It gets a bad rep from tiktok generation kiddies but those dudes are moving absolutely retarded weights. From what I've seen the equipment makes formerly injured dudes able to work in big weights without pains at all even when they handle several hundred over their raw max so that may be worth looking into.

Also worth mentioning is your form might suck from a safety perspective. I have gotten hurt on maxes a few times when shit goes out the window and I just try to get the lift without dying but if you are getting hurt on ~80-85% then you may wanna examine your positioning. Over the years shit slowly gets out of whack just like a car, and you need to tune things up a bit. Check out your internal/external rotation, your arch, your scapula retraction or lack of, your tuck vs flare at the elbows, wrist position, where the weight 'sits' in your hand, and grip width. Over time I have had to change my form many times, going from pinky on the ring to full-time close grip and then back outward and now I press ring finger on the rings. I've had to adjust my tucking vs flaring a lot, my setup, the position I set my back on the bench (flat vs on my traps vs on my mid back), where I place the bar in my hands (wrist cocked back vs knuckles to the ceiling, sitting in the palm vs sitting into the thumb) and probably a dozen other small dumb things but it got me to 'Elite' powerlifter status after ~13 years so it was worth it I guess. This lift is the most technical and fickle of the main compounds, just give it some time and try different shit for a few weeks and see how it feels then try other new shit etc etc until you find what works painlessly.

I’ve seen Mark Bell advertise the Slingshot but never really investigated it much further than that and didn’t understand the mechanics behind it’s utility. I went ahead and ordered one from ol’ Bezos so I can give it a “shot” (practice my dad jokes since me and the old lady are trying to do the parent things).

I’ll have to change up my hand and elbow positioning as well and just generally get back to the basics on my mechanics. On my third deployment, I was a medic on a surgical team and we were seeing a huge number of patients. A few months in, I went from dropping 14g IVs on everyone to missing every single IV for like 30 patients in a row. I was incredible frustrated and I just went to my ER Nurse and asked him to teach me how to do an IV like I was a first year med student. He was like WTF? why? I just told him that I must have developed a bad habit somewhere and I couldn’t figured it out. So I just relearned on a couple dudes on my team with 22g catheters and I was back in business. It’s wild how we can slowly and subconsciously pick up bad habits. So I’ll definitely give myself a good reteach/relearn and see how it goes.

 

[hewrue]

If you’re getting your shoulder issues only from barbell bench, I’d suggest doing dumbbells instead. I haven’t done barbell flat in decades because of that same problem. With dumbbells I’m able to keep my elbows pushed in more so it’s not putting that unnecessary strain on the joint.

I was given this advice awhile back and here’s how it has gone since then: 1) Hurt shoulder on BB bench. 2) Rest and heal. 3) Feeling alright so I jump on DB bench. 4) Feels good but my gym only runs up to 100’s and I wanna hit low reps so I go back to BB bench. 5) Back to step 1 lmao.

With this upcoming deload and changing up my programming, I’ll definitely be incorporating DBs more as I agree with you: much less shoulder issue with the DBs. On a positive note, whenever I’m hitting DBs with elbows tucked for a few weeks, my triceps absolutely blow up and my XL shirt sleeves act like tourniquets on my arms. So that’s a plus haha.

 

[Colette]

Shoulders are so often a limiting factor. Evolution favored mobility over stability when inventing the rotator cuff. Are you on hgh? It can help repair damaged tissue. But if the shoulder is truly thrashed, an MRI, PT, and, sorry to say, a Deload might be required. But I have seen remarkable shoulder healing with hgh alone. Just make sure you do a lot of stretching and warm ups.

 

[FrancoC]

Shoulders are so often a limiting factor. Evolution favored mobility over stability when inventing the rotator cuff. Are you on hgh? It can help repair damaged tissue. But if the shoulder is truly thrashed, an MRI, PT, and, sorry to say, a Deload might be required. But I have seen remarkable shoulder healing with hgh alone. Just make sure you do a lot of stretching and warm ups.

Any specific dosing protocols?

 

[hewrue]

Shoulders are so often a limiting factor. Evolution favored mobility over stability when inventing the rotator cuff. Are you on hgh? It can help repair damaged tissue. But if the shoulder is truly thrashed, an MRI, PT, and, sorry to say, a Deload might be required. But I have seen remarkable shoulder healing with hgh alone. Just make sure you do a lot of stretching and warm ups.

I couldn’t agree more. Haven’t started HGH but have certainly been interested in it for a while. Based on my moderate PT knowledge, I don’t suspect any serious injury but a deload is definitely much needed.

I haven’t done much research on HGH protocol. I understand that it’s most beneficial when run for longer lengths than AAS, but how long? Or is it a compound that people generally stay on indefinitely?

 

[Colette]

Protocols vary with goals but, yes, anything less than 3 months isn't very useful. Very low doses of .5 - 1 iu are run indefinitely for anti aging. In some countries, wellness clinics prescribed it for that. Larger doses of 4 or more ius are run for shorter periods for healing and recrecovery. I run something in the middle...2.5 iu's per day about 7 months out of the year for anti aging, joint support, lifting recovery and a cranky shoulder. My 31 yo son is running 4 ius per day, split into 2 doses while recovering from a sprained ankle. He'll cycle for 4 months. That's what I did following a bad bike wreck. Healed quickly. Side effects were peripheral swelling , stiff joints, and some tingling sensation in hands. But at 2.5 ius I have none of that. Downside of the higher dose is that it's best to split the dose so you're pinning 2× day.
Good luck with that shoulder.

 

[Gbunk]

You could always try switching exercises to machine or smith and see if that helps with the joints. Sorry if I repeated anyone else.

 

[psauce]

If you’re getting your shoulder issues only from barbell bench, I’d suggest doing dumbbells instead. I haven’t done barbell flat in decades because of that same problem. With dumbbells I’m able to keep my elbows pushed in more so it’s not putting that unnecessary strain on the joint.

I strongly agree on this one. I've got two shoulder replacements now, and learned a ton about shoulder anatomy in the process of surgery research and rehab. My PT was an active powerlifter himself, and he was insanely helpful. In any event, flat barbell bench just ain't for some people. Neither are dips -- those are even more extreme in terms of the stresses on the joint in certain positions.

If you don't pay the bills because of your barbell flat bench, and it regularly causes pain, don't approach 1R, don't go to failure with heavy weight, change the angle, use a machine, or grab the dumbbells. Otherwise, hit me up for great shoulder replacement rehab tips because I've lived it twice.

 

[AlphaAnabolic]

Rotate your main lifts. Close grip press , competition width press, pin press at varying heights, floor press with barbell or db, incline , seated shoulder press , standing shoulder press , DB’s. Some goes for squat and deads rotate back squat , front squat, good mornings , rdl, deficit convetional , deficit and normal height sumo. Auto regulate by doing 1 max set of 6-10 reps on a max weight as opposed to doing heavy 2s,3s,5s. Some weeks use bands and take a deload. Lots of rear delt , upper back work before bench or shoulder pressing. Pull aparts with a band. Rope face pull. Seated cable row keeping elbows high. Blast those rear delts befor pressing. Matt wenning has a series called Wenning warmups where he goes over different ways to warm up and prevent injury before lifts. A little deca for joint lubrication.