Dr. Ryan -Prime-Time-8/14-15

I’m ready for some questions.

Hi Dr. Ryan,

I tried posting this last night but wasn’t sure if you saw it. I related my experience with numbness in my arms when performing overhead squats (a new lift for me) in one of your Prime Time threads a few weeks back. You wanted me to update you, so I’d like to say the stretches you recommended (along with training various humeri rotations lightly on off days) has alleviated the problem. Thanks for your help!


I’m glad I could help.

Keep up the good work.

Be sure to get in touch with me should you have any other problems down the road.

Take care,


Doc, here’s a random question… in this wonderful deadlift thread
( http://www.t-nation.com/readTopic.do?id=753986&pageNo=1#754647 ), what’s likely to be the first injury this guy will have.

Feel free to speculate, this is just for fun.

Hi doc quick question about heel pain I wear orthotics but and Im fine as long as I am working out or just working for the most part but the pain after relaxing and getting back to moving at times is almost unbearable especially the day after squats
any suggestions
I stretch as often as possible to keep my calves from getting to tight

forgot to mention pain is in the rear of the heal not on the bottom


Damn that video is bad. I herniated a disc just watching it.

If he did that for a joke, then the joke is on him.

The lumbar flexion combined with the heavy loading is a recipe for disc injury. He could have easily torn ligaments or muscles as well. Then he goes and does several ballistic hyperextension moves that could have resulted in facet joint injury.

I sure hope he just did that once as a joke, if not he is setting himself up for a lifetime of low back pain.

Take care,



So is your pain around the Achille’s tendon insertion?

How long have you been having the problem? Was the onset related to any kind of change in your activities or workout program?

What kind of treatment/therapy have you had?

Take care,


Dr. Ryan, I realize both forms are safe when done properly but I was wondering what form of squats do you think puts the least structural stress(and hence chance of chronic injury) on the body over ones liftime of lifting:

The forms of squats being oly(high bar, med-close stance) and pling(low bar, wide stance).

this might be too vague to have a real answer; if so I apologize.
I’ve had muscular pain develop in the upper right part of my posterior (what I believe to be the gluteus medius) despite the fact I have been on hiatus from the gym during this time. Would this indicate some postural problem I should address, and what could be the possible cause? I know I am flat footed, would standing for prolonged periods normally cause this sort of pain?

Hey doc, can we expect an article from you? I know I’d read it

Bruised heel…
I pronate just a little?

Any insert orthotic recommendations?

-Get Lifted

Treatment etc…


I don’t know that there is black or white answer to that question.

From an injury prevention stand-point, the type of squat that would allow you to maintain the best form throughout the full range of motion would be best. However, it is important to change the exercises around to avoid developing a pattern overload.

The more exercises that you can perform utilizing proper form, the less likely you are to develop problems related to pattern overload and muscle imbalance.

The bigger issue is to choose appropriate loading parameters and program design.

Take care,


ongoimg for awhile flat footed as a duck heel pain is about a half to three quarters of an inch above the base of the heal

John Galt,

Well it definitely could be postural.

How about you give me a breakdown of your normal daily activites and the amount of time you spend doing them. That would help to figure out what may be contributing to the problem.

Is the gym layoff due to this problem or some injury.

Take care,



I’ve been threatening a low back article for awhile. I just have to sit down and type it up.



Get Lifted,

Well I would use one of those gel heel cups to help avoid irritating it anymore.

Follow the RICE protocol after practice.

As far as orthotics go, if it is only mild pronation an OTC arch support should work OK. SOFsole and Superfeet make some decent supports.

If you still have problems with planting/cutting you may want to ask your trainer if he thinks taping the arch and ankle would help to relieve any of the pain. The added support may help to prevent as much strain on the injured tissue. Since I haven’t examined you, its hard to tell if it would help or not. Could be worth a try.

What kind of treatment do you have access to?

Take care,


Electric stuff… Stemming(whatever that is) All that wierd stuff… Cryo cups, massages, ice bags of course… Whirl pools cold and warm… Heat packs… All the icy hot stuff… All kinds of tape… ummmm

That’s a lot of it.

-Get Lifted


Thanks for the help Doc… I’ll hit you up tomorrow when you are on.


Without examining you it is hard to say what is going on. Based on the area you are decribing, it could be some kind of insertional tendinopathy of the Achille’s tendon or some retrocalcaneal bursa irritation.

Flat feet could be a contributing factor. I would suggest that you try our some OTC arch supports to help relieve some of the strain on the area.

What do your daily activities consist of?

Sometimes, too much stretching could keep the area irritated.

Have you tried any NAID’s or ice massage of the area?

Do you do any calf exercises?

What kind of docs do you have access to?

Take care,


[quote]Dr. Ryan wrote:
John Galt,

Well it definitely could be postural.

How about you give me a breakdown of your normal daily activites and the amount of time you spend doing them. That would help to figure out what may be contributing to the problem.

Is the gym layoff due to this problem or some injury.

Take care,


I stopped going to the gym last week because I am ill, have a lot of homework, and am feeling very fatigued.

As far as my schedule, I’m a student. class is noon to 4 mwf, 830-3 tues+thursday. Tuesdays and thursdays I have all lab classes, which means I’m either standing around in the machine shop or chem lab until 3. This is generally when I notice the pain. When i’m not in class I’m sitting at my desk doing homework, eating, sleeping or some combination of the three. When I am feeling fine, I usually spend about an hour every other day in the gym, and if time allows I cycle/jog in between gym days for 20 mins (jog) to an hour (bike).