Lifter Case Study: Thien
I haven’t done a lifter case study in a while, and with the recent success in @liftintin’s training, one is due. And really this case study encapsulates multiple athletes I coach, as I have seen an increasingly interesting trend in just how little workload some people need to do on squat and deadlift. As I have mentioned in other posts and videos, I define “injury prone” as someone who is an outlier from the normal workload most people of similar demographics respond to. The more “injury prone” you are, the more of an outlier you likely are. Which in sense means no one is actually injury prone per se, more so their individual response is enough of a deviance away from the norm that they many times they never venture enough to the left side of the bell curve to find their individual workload.
As of right now, I have 5 lifters, including Thien, that came to me deemed “injury prone” who are doing great on 5 or less sets of squats per week and 5 or less sets of deadlift per week. 4 of those being 83kg or lower weight class lifters where the norm indicates this workload is significantly less than the average lifter would respond to.
Thien in particular has had chronic knee pain for I believe almost 4-5 years now, and a little under 3 years with me. He never really did a crazy high workload though. He typically did 2 day a week frequency in squat and deadlift, with somewhere around 8-10 sets on squat and 5-7 sets on deadlift. Which in reality for a 69kg lifter is pretty low in the first place. Thien saw multiple PTs in regards to technique and movement to not much avail, and we experimented with many different setups of training to load management with small amounts of success, but no consistency. And what really helped us figure out what would work is the benefit of me just being able to coaching a wide variety of athletes. I started to see similar trends in other lifters such as @thekilopractor, @drewthompson21, @jumbojoel_, and @paytonpowerandperformance. As I saw success with one, I could see the crossover in application to others and start to individualize each approach. All 5 lifters have similarities in their programming in the sense of low workload, but how that is distributed and set up is completely different for each.
As a baseline, a general template I could lay out for all of these lifters is they responded great to ascending set work, with no more than 3 sets on any given day. Some of these lifters are only squatting or deadlifting once a week. Some do more comp specificity than others, some do less. Some respond to higher rep work and some to lower rep work. But the overriding similarity was the ascending set model with very low set count daily.
For Thien, as can be seen on the anti-reel slide (CLICK HERE), has a 2 day frequency for both lifts. For deadlift, we know he responded very well to high rep work. But he also detrained skill wise from singles and low rep work if we had too much of a prolonged absence from it. So on his primary deadlift day, he simply has a top single which he will put to notable RPEs by the end of the block, followed by a high rep back off set. On his secondary deadlift day, he actually has an ascending RPE model where he does a low rep set that is heavier in absolute load, but lower in RPE, before doing a higher exertion high rep set for his top set on the day. From this he was able to get the skill practice and intensity requirements from the low rep sets, but also able to fill the volume gaps by doing high rep work that could be the equivalent total reps of doing multiple sets of low to mid range rep work.
Squat though was his nemesis, but there was definitely a correlation between total workload in squat and deadlift. We had tried low workload on squat to no avail prior, but that was also during times of higher workload deadlifting. The key will all of these cases I am referring too is the total workload from squat and deadlift combined being low, as they do have notable transfer in fatigue for most lifters. For squat there were 3 main things we did that really brought this model together for Thien. First, as can be seen all work is ascending. I think the utility for the ascending set approach is simply the warmup and neurological affect on pain that prior sets can have. You will see many times a lifter complain that a top set has a small amount of pain, but then by their final back off set it has gone away. This might be contributed to the weight being lighter, but I would bet if you put them into an ascending set approach they would then see a similar affect where by the top set they are feeling near 100%. Second, we had to control the rate of descent. One thing we had learned prior is that if we self limited the eccentric to concentric reversal through tempos or pauses, Thien would typically be able to manage through small amounts of pain. But once we brought back normal competition squatting, within a couple weeks it would return. So simply put we left this as standard now that at all times he has a more controlled descent. And then lastly, seemingly accessory work through things like leg press, belt squat, or unilateral work wasn’t tolerable, but we needed to fill volume gaps in some way. The issue with regular squatting is Thien was sensitive to deviations in center of mass. So to be able to manage some higher rep work while making it very easy to maintain his center of massive and provide more stability, we did high rep back off sets of Hatfield squat proceeding his ascending set Safety Bar work.
All of this combined has equated to Thien being pain free for the first time in years for multiple blocks on end, and once again hitting PRs on his squat. It’s far reach from the norm of what most people would do, but when I look at my clientele as a whole, this is becoming a pretty frequent setup I am seeing. Much of this is just reiterating what I have said in many posts in the past, but just follow the data and know that it can be shocking sometimes how far someone can deviate from the norm of what you’d expect their response and workload to be.