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Substitutions for a Dude with Hip Issues?

Hey all,

I have hip issues (labrum tear on both sides) that will require surgery late this fall. In the meantime, though, I’m gonna keep training, and I’m hoping to start up 5/3/1. However, my PT wants me to avoid BB movements for the lower body. I’m good to go with OHP and BP.

I was thinking of substituting Bulgarian SS and Single Leg DB DLs into the program. Does that make sense, or should I just avoid 5/3/1 and do something else? Thanks in advance!

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Get advice from your PT as to what you can do without making your problem worse, not from a bunch of random dudes on the internet.

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It wouldn’t hurt to get a second opinion.
But the last thing you want to do is to make matters worse.
Is it safe to assume you have had an MRI?

It is my understanding that an untreated labrum tear can hasten osteoarthritis. You sure don’t want that. I had both hips replaced at 65 years old. That was the end of supporting heavy weight with my legs. Doctor recommended holding no more than 100 lbs while standing. How would you like to top out at 100 lb squats?

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Yeah, I had one, followed by a cortisone shot, which didn’t alleviate the pain. Next step is surgery, unfortunately. It’s not unbearable at this point, and I can still train, but definitely gets uncomfortable especially when sleeping.

Damn, that is SO rough. What was the surgery and recovery like?

My sports med doctor said I’ll be at higher risk of arthritis because of the surgery, but I can’t live like this indefinitely. I often feel like an old man (I’m 29).

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Hip surgery is a very easy recovery if you get the anterior approach done. I had the left done and 8 weeks later had the right done. I was in the gym 4 days after surgery each time, but the trauma of surgery made me systemically weak as a kitten the first couple days. After four weeks I could put full weight on my hip.

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So what’s your training look like now, given that you can’t support above 100 lbs on your legs?

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I have found a few work arounds.

My leg training is much higher reps. My main thigh exercise is the leg press. The leg press I use is about at a 30 degree angle, which means the weight is half of what I put on the sled. I guess the weight of the sled (100lbs). I weigh 205lbs (about 120lbs not including legs), so I guess I can push around 220 lbs. If my guesses are correct I can load 340lbs of plates on the 100lb sled. I have two different leg press routines.

Monday (“heavy” day): I do 20 full range of motion reps over 2 minutes. Down in 5 seconds and back up in 1 sec, immediately followed by 20 normal speed reps (about 40 seconds). One set without the 20 reps at the end of the 2 minutes, and the second set to include the 20 extra reps.

Friday (light day): 2 sets of Dardin’s 30-10-30

All weighted calf work is done on the seated calf machine.

Also, I like shrugs, so I do them seated at the end of a bench, where I can use as much weight as I can shrug.

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He’s good with me doing isotonic movements for the lower body. Just wondering if it makes sense to plug these into 5/3/1 or if it doesn’t make sense with this program.

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I’ve had both hips replaced; there was no mention of any 100 lbs limit though. I’m still rebuilding after the second op, but I had the first one 6 years ago and easily went past 100 lbs squats with no issues.

Might be worth checking if your doc was over-cautious on that restriction - of course, mine could be under-cautious…

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I have always had a problem of self-analyzing permissible exercises. My philosophy has always been don’t do what hurts (the joint/attachment).

So I ask: What movements hurt?

That said, I don’t recommend this method to anyone. But that is how I determine what exercises I can do, and what exercises I should not do. (Not that I always follow my own advise.)

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My doctor said the fear was that excessive weight would squeeze the polyethylene (or whatever material it is) out from between the ball and socket.

After I went back for a follow-up after the first hip replacement, I told him it sure was nice the be deadlifting without any hip pain. First week back I was at 135lbs with no pain and the last week 185lbs went well too. He told me that was too much and gave me the 100lb limit.

Strange, he knew I lifted weights. I even showed him some of my contest pics. He wasn’t worried about me needing PT and let do my own. I suppose he thought he told me these artificial hips aren’t like my God given parts.

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That’s actually how I arrived at the movements I suggested. BB back squats and deadlifts (especially) hurt my hips, but for some reason single-leg exercises – like Bulgarian SS and Single Leg DB DLs – do not. This tells me those are probably OK. Maybe it’s because I have to load those much lighter and am also limited by ankle mobility.

If they don’t hurt, they might be OK, although I’m not a doctor, but it is similar to how I would work around an injury.
That said, I wouldn’t bother doing 531 percentages and all for small movements like split squats or 1 Leg DLs. They are great, and they can be pushed, but as Jim recommends in Forever, do a rep total per workout and push that as hard as you feel. If that’s your ‘main work’ maybe harder than others would. So say you do 50 or 100 total reps, you decide what of that is warm up, hard sets, etc.
Also, as mentioned above, leg press, or if you have access to it belt squat can be good substitutes for BB, and they are easier to do 531 with, or even Simplest Strength Template 531, provided they do not hurt you and your PT and/or doctor gives you green light.

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A hip replacement lasts 10-15yrs in the elderly - people who are generally less active. The more active you the lower the life expectancy. As a young person you do not want to go down the route of multiple replacements - risk of complications increases significantly and chronic pain issues can occur.

I always think/remember why am I training - the primary purpose for most of us is to be healthy, mobile and strong. Not wheelchair/bed bound or in pain. Most hip surgery procedures increase pelvic tilt and cause other musculoskeletal issues - that need specialist physio input to correct. For the elderly these do not form a big factor – as they are not doing intensive exercise and do not need such physio exercises. Doing squats, deadlift, single leg exercises can/will make these issues worse. Anything that loads pressure onto hips/lower back e.g. OHP wont be good.

You want to remain functional and pain free - that is fundamental goal that we should all follow! If you can’t train pain free or in a safe manner – its time to consider other options (e.g. non-weight exercises/yoga etc etc) to remain healthy.

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Totally hear you, man. That is a well-taken point. As much as I love lifting, I’m not opposed to alternatives. However, I think this may be a bit different because it’s a (relatively minor) repair of the labrum rather than a total replacement. My doc’s opinion was 1. try the cortisone shot, and if that doesn’t alleviate the pain 2. have the surgery. He typically works with very high-level athletes, people much more serious than myself, so I trust him. That said, he did not having the surgery will increase my odds of developing arthritis later in life.

The hip pain is causing an abundance of discomfort and, after a year of consistent PT, I don’t think it’ll go away even if I switch from resistance training to something like yoga.

Does that change your opinion at all? Or do you still think avoiding surgery is the best move?

Fascinating suggestion, man. I like that idea. I suppose the hurdle is knowing how to scale it – for example, I have DBs up to 40 in my home gym. Say I start out with 30 for BSS. Would you set a somewhat arbitrary rep total for the workout (e.g., 60), then shoot for 70 total next time, working up to 100, until moving up to 35?

That is a little past the basic 531 principle for assistance work but again if you treat it as main work it can work.

When doing single leg for assistance I usually just get the rep total for the day based on how I feel. If I’m still sore from the last squat session I might do the 50 with bodyweight only in as few sets as possible. If feeling good, I might grab some DBs or chains and after 1 set with BW I would do the rest of the sets with increasing weight until I hit it, or with the same weight with near max reps each set.

For main work, probably your approach would work better because it sets more goals and challenges, so psychologically it can be more stimulating as well. Depending on your approach, you can scale it that way, you can even add a 531ish twist to it, say one week you do 20s then 25s, then 30s the third week, and you kind of wave it like that in 3 week cycles, really just to make it more fun or interesting.

Going with your example, the way I can see that working is if you have limited number of sets, because if I have enough patience and energy, I can grab a pair of 80s or 100s (never actually went beyond 88lbs total weight on BSS) and BSS my way to 50, 1 rep per set. So say you have a rep goal of hitting in this case 100. Set a goal of doing it with X weight, in I don’t know, 5 sets. Then you have multi layer form of progression, you can reduce sets, increase weight, if you want you can reduce rest time, increase tempo, add pauses, a million ways to measure progress. Once you hit 100 per leg with X weight in your chosen number of sets, add weight, slow tempo, reduce sets, you get the idea. And on top of that you can still add some kind of a 531 twist I mentioned so you don’t max out every week.

If you are creative you can come up with all kinds of ways to make this work, and even fun. Not to mention if your injury recovers after surgery and you are able to squat again without causing yourself damage or pain, your weak side will be almost non existant.

Again, these are all just ideas and general suggestions, consult with your PT/doctor and listen to your body.

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I think you need to listen to your doctor. He’s a hip expert. I’m not a high-level athlete and I know my body will not recover as well as theirs. Most of us are not high level athletes. There are professional sports personalities who get discharged from hospital the same day as their procedure! And i’m sure they have teams to help them rehabilitate.

If I had pain in any of my joints and was told by my doc that stopping lifting heavy will make me better - that will be the end of my training days and I will avoid surgery. If on the other hand they said I need surgery to get better - then I will undertake surgery. You need to listen to your surgeon. Surgeons can’t replace cartilage that they out - they either shave off as little as possible or replace it with a prosthesis. So if had surgery I know that will never be the same physical specimen again as my good days…and I personally wouldn’t take the risk of further injury.

Bottom line is if lifting weights is causing damage to my body I will change sports. I train with the aim of remaining healthy and trying to get stronger. If I can’t achieve that - then what is the purpose of me training? I would do something else that allows to remain healthy…many options out there - golf, badminton, cycling.

On a second note I think original 531 published by Jim is the ultimate template for preventing injury. It has minimal sets and low reps. You lift heavy and go home. You build strength slowly and progress. It gives you longevity and the deload week gives ample time for recovery to your ligaments.

I’ve ran various templates for many years. Have put on strength year after year and size. Most people don’t even need the extra sets e.g. 5 x 10 etc lifting heavy puts on mass. You may not look like a body builder but you will be big. You can get defined doing other sports BJJ/MMA etc.
With 531 you can plan out your entire year.

I have had no injuries since starting 531 and put on solid mass over the years. As have my friends.

I think you are wrong. Hypertrophy occurs in 8-12 rep range. Lifting heavy does not make you bigger it only makes your strength increase. This is why @Jim_Wendler @dagill2 @hankthetank89 @T3hPwnisher . I’ve linked some of the guys above to correct me if I’m wrong.