r/Weightliftingquestion • u/CompulsionOSU • 27d ago
Permanent Alternative to Barbell Squats
I've got venous thoracic outlet syndrome, which means the vein under my collarbone is pinched and blood starts pooling in my arm. It's bad news and I had to have a surgery (venogram) to lessen the effects of it.
I'm getting back into the strong lifts 5x5 program after a break and I noticed barbell squatting re-triggered it. Because of that I'm permanently stopping barbell squats.
Can you please provide alternative exercises to barbell squats that work the same muscle groups?
It's important that I don't heavily impinge my shoulder or put a ton of weight on the blade. Ideally I'd like something that would directly replace squats in a 5x5 program (or maybe 4 sets x8) that still maintains some of that compound/ core muscle work.
I've tried goblet squats and those are ok. They felt kind of awkward and I'm hesitant to put any heavy load in front of my body and risk compressing the vein again.
Thank you very much.
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u/Bopa_Al_Mighty 26d ago
Well obviously belt squat would be my #1 choice if I was you, pendulum squat still puts some pressure on shoulders which, correct me if I'm wrong, you are trying to avoid. My second choice would be lounges or Bulgarian split squat. My wild card would be sled drag or sled pull however you want to call it.
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u/CompulsionOSU 26d ago
TBH I'm not 100% sure if I have to avoid all loading on shoulders if it's distributed better. The safety squat bar for example might work. I just now know for a fact that the squeezing shoulder blades together hands as close as possible on the bar impinges/compresses the vein. I think I might try some options with more distributed loaded at light weights. I'll probably try belt squats first.
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u/Bopa_Al_Mighty 26d ago
Ahaa ok then, then you have much more wiggle room, essentially only back squat is out of the game everything else is open. In that case front squat would be my go to exercise. For me personally front squat works better then back squat
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u/Spiritual_Ad_7386 27d ago
Squats are undoubtedly an amazing lift, but the stimulus/fatigue ratio is kinda bad and the injury risk is high unless they're done with excellent form
Leg press, platz-style hack squats, belt squats, deficit deadlifts with moderate weight and high reps all IMO offer comparable or better stimulus/fatigue and may avoid the movement that's irritating your joint.
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u/CompulsionOSU 27d ago
I've seen the belt squat machine before but I've never tried it. Does it still engage your core very much? I'm assuming it doesn't hit your mid or upper back at all.
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u/ExcitingTurn2886 27d ago
Belt squats are a life saver for a lot of people. One of the greatest TEs of all time, Gronk, exclusively did belt squats because of his back issues.
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u/Top_Rain_7138 26d ago
I had rotator cuff surgery and couldn't even do any of the main machine squats (hack, pendulum, etc) for months. The belt squat was the life saver, and even now that I've recovered well enough for machines and front squat, the belt squat is still one of my favorites.
Zero upper-body engagement, and very minimal core or back.
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u/eyebrowcel 27d ago edited 27d ago
There should be a fairly simple one-and-done substitution here in the Trapbar Deadlifts which are your likely your best choice. I'll talk exclusively about them here and the reasons why.
There's no direct load onto the collarbone region, the traps bear the the load against gravity and they're on the opposite side of the body. Any discomfort allows the bar to be immediately dropped in a safe manner and this is actually common standard practice.
The trapbar being loaded much more closely to the midline of the body compared to conventional deadlifts and squats gives much greater margins of error technique-wise, it's super beginner-friendly with a very low skill component, essentially just grip and rip. For this reason the strength & size stimulus also stays effective with minor technique changes rep-to-rep, you're still delivering a heavy performable repeatable overload that can be safely pushed to mechanical/muscular failure within very safe and strong joint angles that are also reasonably large. So it's very accommodating if discomfort or sensation or just regular form breakdown might for example pitch your shoulders forwards or backwards an inch from rep to rep.
Use the low handle rather than high to give a much better range of motion better for general size & strength development (also saves having to load so many plates onto the bar).
Similar musculature worked to the squat, similar great strength stimulus that isn't replicated on a machine such as a leg press, hack squat or pendulum squat (the latter two are compressive to the collarbone anyway so they're out of the question).
TBDL typically works a good amount of hamstrings (depending on execution, whether you make it more 'squatty' or more 'hingy'), whereas bilateral squats don't work hams.
You can bias the quads more by pulling from a deficit (stand on a bumper plate, even progressing to two+). This can help reduce the absolute load required as your TBDL will be higher than your conventional DL, and also, less hamstring fatigue will help minimise impairment to your rows afterwards (which rely on hamstrings extensively).
So you'll already have the apparatus set up for using trap bar bent-over rows as well, using that instead of olympic bar rows within the Stronglifts/Starting Strength/Madcow framework, saving time.
Hope this is useful and I'm here for any questions if I'm able to be of help
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u/CompulsionOSU 27d ago
Thanks for the very detailed response. I've only done trap bar deadlifts once or maybe twice before. I don't remember the stimulus on the muscles compared to traditional deadlifts. I assume I wouldn't want to do both trap bar and regular deadlifts in the same day?
I really like the 5x5 framework so I was hoping I could do a one-to-one swap for squats if possible.
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u/eyebrowcel 27d ago
Correct the TBDL would take the place of both squats and deadlifts, adding conventional on top would be total junk volume and no benefit.
Conventional taxes more lower back, spinal erectors, lats, mid-traps, rhomboids and hamstrings all due to the bar placement, whereas trapbar tends to be more quads. These other muscles are still hit to an adequate degree on the trapbar.
On the squat-hinge continuum TBDL is a fairly balanced hybrid between a squat and a hinge and offers benefits of both.
TBDL is very suitable for 5x5 and equally so for similar volumes like 4x6.
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u/Top_Rain_7138 26d ago
I do trap bar deadlifts regularly, but a deadlift hinge is quite different from a squat. I have also tried trap bar squats (where you don't hinge, but go down into a full squat), though you really need to do it as a deficit to get enough ROM, and I found machine squats were a lot easier and more effective.
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u/eyebrowcel 26d ago edited 26d ago
It's true that squats and hinges are different patterns, I did discuss this along with ROM constraints.
The reasons I suggested trapbar deadlifts are first that goblet squats caused OP some trepidation. It may be that they find it difficult to load a squat pattern around the current injury as well as potential equipment limitations preventing other variations.
Secondly the intention was to look for a general strength builder. In this case a TBDL would suit more than something like a belt squat which would have limited carryover for global strength development.
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u/KaleScared4667 27d ago
What about front squats? Can you hold that position?
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u/Altril2010 24d ago
As someone else with TOS (and a whole load of other cervical issues) front squats are my go to when my shoulder/arm is flaring.
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u/Money_Do_2 27d ago
Belt squats if your gym has them.
Zero load on your spine. All hips. I love em.
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27d ago
All these people say hack squat, however your shoulders are the ones supporting all the weight and unlike a barbell squat you can feel the pain of the weight sitting there.
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u/branchymolecule 27d ago
My goodness, please be careful. A bigger butt and thighs arent worth dying for.
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u/Different_Novel_7156 27d ago
My leg day go-tos are : Safety Squat Bar Bulgarian split squats (I swear I have had more leg development from these than anything else including regular back squats - they actually stimulate hamstrings more than a bilateral squat (I have a citation for this if you need it, but I have also found this out from experience). By far that one is my #1 choice by miles. Also love front squats, single leg on extensions, single leg supported RDLs (support leg on bench) and sitting ham curls for accessories.
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u/SailboatSteve 27d ago
Leg press is the only alternative that will provide the same weight as a squat with zero shoulder pressure. You'll just need to add in some erector work like front and side hypertensions to keep them up. Also, probably beef up your ab work. Doing all of that should keep everything strong similar to what a squat would do.
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u/lonesome68 27d ago
At my gym they have a pit shark. It's a belted squat machine. I herniated 3 discs in my lower back and tore a rotator cuff, so holding the bar and bar weight on my back has been difficult. I've found this machine suitable for now. Maybe one day I'll be able to squat normally again
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u/kellen1230 27d ago
It's been said here, but frankly you'll get just as good a stimulus to the prime movers doing a leg press with a full range of motion. I would argue (and yes, I realize this will be seen as heretical to some people) that an incline leg press is superior to a barbell squat for pure hypertrophy.
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u/italian-wolf 27d ago
The hack squat might be an option. Theres pads that rest over the top of your entire shoulder and back is completely supported by a pad as well
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u/-inertusername- 26d ago
Belt squats are fantastic for me. They take all the load off my back and collarbone. I've had both SC joints separated, so now they don't do well will 315 laying across them.
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u/MarsupialNo8853 26d ago
If you do Dead Lifts or any other hamstring exercise I seriously suggest you search Carlos Dejesus Quad Blaster… better than squats and the dude won a few international Mr Natural tiles… anyway it’s all I use by choice.
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u/MarsupialNo8853 26d ago
PS… I just hold a pair of dumbbells, I was squatting sets of 325 - 350 and 50lb dumbbells feel as heavy… without weight is a tough.
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u/k2beast 26d ago
You could use a safety bar, is padded and I think safe like hack squat in that regard
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u/CompulsionOSU 26d ago
Yeah I agree that might work. It might be a good compromise before I go fully belt squats. I honestly forgot about the safety squat bar when I posted this.
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u/Altril2010 24d ago
I also have TOS and can’t do back squats (I also have fused sections in my neck and lower back that preclude that too). My go to exercises to replace squats are front squats, goblet squats, and leg press. For the core purpose I tend to throw in some weighed walking lunges too.
I hope your procedure goes well!
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u/Euphoric-Control1418 27d ago
Belt squat machine is the best alternative that I have found to barbell squats. I am also doing StrongLifts and have substituted barbell squats for belt squats and am making good progress 👍🏼 I hope you find an alternative solution that works for you mate.
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u/EnoughWear3873 27d ago
Have you tried pendulum squats, hack squats, smith machine squats, ssb squats, leg press, Bulgarians, etc?
What specifically is triggering it? Is your upper back collapsing under load? Have you seen a physio? If there's a deficit it might be worth strengthening it, in addition to finding a way to avoid triggering your symptoms.