Ask Greg: Issue 106
Greg Everett

Troy Asks: I've been training for just over 3 years (took about 6 months off in there) and have a question about injuries. I'm currently training 4 days a week (most day include one exercise for Snatch, Clean, Pull and Squat) but find myself getting nagging injuries much more frequently than most other athletes (primarily calf and knee pain). I foam roll and warm up before every session, and stretch after. Just wondering if you've had any athletes that are prone to injuries and any advice you may have for preventing them? I feel that not being able to train injury free for long stretches is hindering my progress a fair bit.

I’m 25, about 5'10-11", 87-88kg, snatch 115, CJ 150, BS 200.

Thanks for your help.

Greg Says:
At only 25 years old, I wouldn’t expect you to be getting so beat up, especially training only 4 days per week. If you’re foam rolling, warming-up and stretching well as it sounds, it’s even stranger. First thing I would do is some additional work on the problem areas—calves, quads and hamstrings. Roll and stretch these areas even between sets during your workouts.

Next, I would suggest you find a way to do contrast hydrotheraphy as often as possible. Ideally this means alternating hot tub and cold plunges, but I realize that few people have access to this. There are facilities that offer the use of these things for around $20/hour, so look around in your area. It may be something you can do once weekly or twice monthly. Anything is better than nothing.

I’m also a fan of ice baths. Drop 20-40 lbs of ice in a bath tub of cold water and enjoy sitting in that for 10-15 minutes. Ice has gotten a bad rap lately, but andecdotally, this is very effective. Post workout or at the end of the day is the best time to do it. If you have a separate shower and bath tub at home, you can contrast by alternating ice bath and hot shower. Worst case, you can do contrast showers—not nearly as effective, but better than nothing. This stuff should help not just with inflammation, but more with improving blood flow and nutrient turnover to help recovery.

I would also look into your nutrition. Reduce pro-inflammatory foods and improve digestion. You can check out Functional Diagnostic Nutrition for some solid testing protocols and guidance there.

And of course, your sleep has to be in order. Do what you need to get 8-10 hours/night of the highest quality sleep possible. If and when possible, throw in a nap in the early afternoon—even if it’s 10 minutes of lying quietly somewhere and not worrying about work or the impending collapse of civilization.

Finally, you may try more frequent and dramatic modulation of training intensity and volume. For example, training hard for 2 weeks and backing off for 1, and having only 2 of your 4 weekly sessions being really high volume and intensity, with the other two being more moderate.

Kit Asks: Just wanted to start off by saying GREAT SITE and thanks for all the valuable information!! If we lived out there we would be clients for sure!

I don't know if this would help but here are some stats:

240 lbs
Max clean- 275 lbs
Max Snatch - 230 lbs
Front Squat - 365 lbs
Back Squat - 465 lbs

I wanted to ask if you or any lifters at your gym have experienced Patella Tendonitis, and if it's common among Olympic style Lifters? I am in week 5 of a 12 week (2 peak) program which has week 6 as 1 peak so were getting into heavy doubles and singles. At the beginning of the program, I would start getting some tightness and slight pain right above my patella towards the end of the workouts, in the auxiliary movement sets. I use the warm up from your site (great by the way) and also roll out on the form rollers to keep my quads warmed in.

This last week the pain comes on within the first few sets, it was starting to change my technique, so I shut it down. I have visited my local orthopedic doctor, and he eluded (not very definitively) to Patella Tendonitis. After some research, it looks to be where the pain is located and occurs while performing the explosive extension parts of the lift. His advice was to rest it... yeah I payed for that advice!

After some rest, 3-weeks or so, is there any specific types of mobility movements/ workout types or actions I should perform in a routine to help with this not coming back? I have attached a video of a warm up lift for your review. My coaches here have said they don't see any issues on the technique-end of the lifts that would contribute to this type of injury. Prior to the last few weeks, I've have never felt this type of pain. I have only been Olympic lifting for about 6 months now and really enjoy it so I don't want this to hinder my advancement, which is the main reason for reaching out to you guys.

Any advice would be much appreciated!

Greg Says: Very often this seems to come from tightness specifically in the rectus femoris (middle quad muscle that cross the knee and hip). Generally, it sounds like you’re on the right track with the foam rolling and warming up, but you may need to put more emphasis on this area. In addition to foam rolling all aspects of the quad (from VMO to ITB), get a lacrosse or softball and roll in the tender spot right above your knee (in all directions), along the ITB (you may find you have a particularly tight or sensitive spot about halfway up your thigh) and on the VMO. Sometimes tightness or adhesions in these areas prohibit normal patellar movement and cause pain.

Also, add what we at NorCal Strength & Conditioning used to refer to affectionately as the Death Stretch. I actually like doing this best on an incline bench (knee on seat, leg against back of bench), but you can do it on just about anything, such as a plyo box, flat bench, table, couch, etc. The idea is to stretch the quads at both the knee and the hip (really attacking that rectus femoris mentioned previously). Get into a lunge position with your back foot supported on some kind of platform (e.g. the top of a plyo box) and flex the knee while extending the hip. You can change the emphasis of the stretch to the hips by opening the knee joint more and extending the hip farther, or to the knee by closing the knee completely. Do both. You can also add rotation of the trunk to both sides.

You can also do the stretch by placing a pad on the floor next to a wall or post. Place the back knee on the pad and your foot/shin against the wall in a lunge position. I like this setup the lease because it puts pressure on the knee and unless you’re already pretty flexible, it’s difficult to get into a good position for an effective stretch.

Try using a heating pad on your knees pre-workout, and then some ice post-workout after you’ve hit everything with the foam roller and softball and stretched. See the previous question also regarding contrast—all of that should help you get it recovered and keep it healthy.

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