T Nation

Need Some Guidance!

This may end up being a decently long post - thank you to all those who take the time to read it!

A little about me:

I am 23 years old, just out of college, and heading to medical school next year. I have trained truly off and on since early high school, getting very into Olympic style lifting when I was 16-19, but fading away from that after some issues with one of my knees. Fast forward to today, and I am in no better shape than I was when I was 17, and am dealing with both a shoulder injury (DCO) and groin strain.

My strength levels are obviously quite down, and I haven’t effectively or intensely squatted or deadlifted in over 1.5 years. I started getting back to the gym about 2-3 months ago, and cut off some body fat that has built up during my hiatus, and am now questioning what to do next.

Given my injuries, I can’t fully squat or deadlift for the time-being, and have some inherent instability in my left scapula (due to the DCO), which I am working on. I really don’t have any interest in getting surgery for the DCO, and feel as if I can safely work with it (have been benching comfortably for 3 months) as long as I am proactive about upper back stability and strength.

From where I stand now (~190 lbs, ~16-18% BF with visible abs and V-cut, but some extra lower abdomen “padding”), my goal is to progressively lean gain from this point forward. I tend to put on belly fat quite easily, and prior attempts at “bulking” have certainly led to ## gains, but also excessive fat gain which at this point I am not looking to have to deal with (some fat gain is inevitable, though, I understand).

My questions:

  1. What would be a strong nutritional plan to follow moving forward? I was thinking along the lines of Shelby Starnes’ Lean Gains Principles, with carb cycling and a goal of ~2-3 lbs gained per month.

  2. What type of program would you suggest following at this point? I tend to like the idea of building dense muscle, using heavy sets, followed by accessory exercises at a mid to high rep range, but would love to hear some popular program ideas.

  3. Currently given my groin situation I have to avoid squatting and deadlifting, but am working on rehabbing it and strengthening my glutes to work them back into my routine. I’d love to hear some suggestions on what to do for leg development in the meantime, especially given the saddening amount of atrophy I’ve seen in my legs over the past year.

Thank you so much for all of your thoughts and advice, I have been lurking here for a long time and know that this community is well-versed in all things workout related!

Who told you you could not squat or deadlift? I mean really, deadlifting is just picking something off the floor, and you squat every time you sit on the toilet. I’d be willing to bet there was some variation of these lifts you could do without pain or further injury. It’s probably more than could be worked out over internet forums, but finding the right sports rehab trainer might be the best course of action for you. There are other things you could do to work your legs, but all come with their limitations and may or may not be better for your situation.

The best program for you is to start light with whatever you can do for now, and gradually work up your strength and endurance. You may not be able to squat 2X your body weight just yet, but starting with the bar is better than doing nothing.

Edit: I reread your post, and you did not say how old your groin strain was. If it is relatively recent, you definitely should rest/rehab before any stress is put on it. Use your judgement as to pain level when you rehab.

Thanks for the response, pcdude. I definitely agree that some iteration of deads / squats are probably possible, but I am going to take it very slow as I work back into them. At this point its what I would call an acute aggravation of a chronically occurring strain, as I’ve had the feeling before, but never this nagging.

As far as programming goes, I could use some help. Mentally I’m more happy with heavier lifting, and more frequent lifting, i.e. each bodypart 2x/week. Are there any tried and true programs out there that accomplish this that you guys know of? I would most likely work it into a M, T, Th, F split.

Leg press, rdl’s, leg extension, leg curls
all are likely easier on your groin. Maybe lunges, but those you’d have to try at.

For programs, a basic upper/lower split makes sense. However, outside of 5/3/1 I can’t think of any off the top of my head. And I know there are plenty out there, I just don’t have knowledge of any honestly.