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Hello docs, I'd like to ask a question about the first 3 weeks RPE. It says 15 reps RPE 4 and I don't have a clue how to calculate this hahaha. Any insight.
Also, can I change the metric to kg?
Another thing to mention. I observed that the template follows the same principles with the article pain in training. I have some shoulder issues. Could the programming for bench and OP be beneficial for my situation?
Thanks!Comment
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Hey, thanks for the questions. Think of RPE 4 as ridiculously easy and not pushing into symptoms too much. Remember RPE includes difficulty, fatigue, and symptoms. In this context, symptoms may be the rate limiting factor and that's ok. I'm not sure on switching to kg, perhaps email support.
Shoulder issues - the template would lack specificity to your shoulder but you can try the recommendations in the pain in training article. We will also have a shoulder rehab template out soon.Comment
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Ok I see. But it also has RPE 5 and RPE 6. How does this compare with RPE 4?
Is there a way to calculate this?
The calculator on the template only goes to RPE 6.5 (lowest).
For example, we have 12 reps @ RPE 4, 12 reps @ RPE 5, 12 reps @ RPE 6. What's the difference between these sets?
Thanks!
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I wouldn't really worry about using the calculator in the beginning stages of the template. RPE is inclusive of load, fatigue/difficulty, and symptoms. Just go in each session and see what you can get done. It's fine to couple RPE with RIR in this scenario as well, so an RPE 4 would mean 6 reps in reserve. It's feasible weight will go up from an RPE 4 set to an RPE 6 but this shouldn't be expected every session or week. I don't think how much load can be lifted is a necessary focal point for the template but rather one factor in the process of finding tolerable training to complete while symptoms regress. Hope that helps.Last edited by Michael Ray; 06-14-2021, 08:31 PM.Comment
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Firstly hello - I was referred to this website from Reddit - had a lower back question and wondering the thoughts of you smart guys.
Herniated L5-S1 in September 2020 - I (39yr old Male -USA - retired athlete) was basically disabled and 6-8 weeks later I had surgery.
Went great, given the green light at month 3 to get on with my life
Went to the beach and overdid it at month 4 and since then I have had permanent numbness in the originally effected leg (going to the outer toes which feel so numb most of the time), and when I sit I now get pins and needles in my right foot (which prior to the re-injury I never had any issues with) so I cant sit in a chair- no more dates, no flights, no just chilling at the beach sitting down
Ended up having to change jobs to one where I can work from home at a stand up desk. Its been 6-7month since I reinjured myself and I would say I have gotten slightly worse but I do not have the sciatic pain which thank god I dont.
Had a second MRI and it shows a very slight herniation (nothing near like it was last time) to the side
Wondering what my options are - as a recently retired athlete I feel my 'Core" isnt weak and havent really found PT to helpful, I tried a personal PT session with David Goggians Stretch guy and he was super nice but that made everything worse haha
and now im dealing with a spasming back going on for 1 week.
If someone sees this and might be able to provide some insight and ideas thatyould be great, my next plan is to go the injection route and see what that does.
Thanks in advance to anyone who took the time to read and possibly respond
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Hey, sorry to hear about your situation. I think we can likely give insight and management recommendations but we need time and space to talk with you. We offer remote consultations. If you are interested, please complete our intake paperwork here: https://docs.google.com/forms/d/e/1F...ilUWA/viewform
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Hello, I am 33 Male, 6'4", 180lbs. For the last 4 years I have been training mostly for cycling and triathlon, with a decently heavy training load of anywhere from 6 to 15 hours per week, depending on the phase of training. This last year I started to have some lower back pain (mostly in the glutes and lower back) and I am hoping to focus on strength training for the next 4 months to improve my resiliency, endurance performance and body comp. The back pain is moderate, usually the worst just after waking up or in the evenings after training, but I can still run/bike/swim and preform body weight squats with no pain. (Though things like standing up after sitting, bending at the waist like a good morning, cause pain)
I am contemplating the endurance template or the back pain rehab template, but I am not sure which is the better fit. Before switching to cycling and triathlon, I did some powerlifting and at my peak could SBD ~350/225/360lbs, though I am obviously much much weaker now after having very minimal strength training for the last 4 years. I still think I have pretty decent technique and movement patterns.Last edited by Truant19; 09-07-2021, 04:21 PM.Comment
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Hey, thanks for the comments. Check out our article series by Dr. Miles regarding resistance training in endurance athletes: https://www.barbellmedicine.com/blog...d-injury-risk/
Regarding template - the low back pain template would likely be helpful with slowly reintroducing resistance training movements to your tolerance level.
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First two links are broken for me, as well as the YouTube reference on the first page of this thread. Anyone else have that issue?Comment
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Hello, I have a few questions regarding the Low Back Rehab Template.
Male
18 yo
185 lbs
6’1”
My back pain first arrived in the summer of 2020 while squatting and deadlifting. It started out feeling like severe DOMS. Over weeks and months, the pain kept getting worse and the soreness would hurt more and last longer. I had to lower the weight some to keep the pain down to a tolerable level. However, I was still pretty stubborn and tried to stay somewhat heavy. This caused the pain to keep getting worse and worse over time. I never had a moment where I “tweaked” my pain or anything like that; the process was gradual. I got down to very low weight while attempting my own rehab strategies, but none of them worked.
I was somewhat familiar with Barbell Medicine’s content about training, but not really the pain and rehab side. I started binge watching videos and reading articles and learned a lot about pain science. Even with this newfound knowledge, I still could not develop a successful strategy. I finally bought the Low Back Rehab Template in late July 2021. I started phase 1 using the default exercise for bench, PVC pipe hip hinge/RDLs for deadlifts, and BW squats. For reference, I have previously squatted 325 lbs and benched 270 lbs (didn’t really do BB deads as a football player, but I’ve cleaned 245 lbs and trap bar deadlifted 315 lbs). These numbers are from right around the time the pain started.
I read from another part of this forum topic that it would be reasonable to repeat phase 1 or a week of it if I felt it was necessary… I’m on like week 8 lol. For the first few weeks, I realized just using bodyweight/PVC pipe did not exacerbate symptoms too much. I immediately started trying to add weight, which was a mistake. The weight has gone up and down throughout the past 8 weeks, and it seems that using no weight brings minimal symptoms, and using even a little weight (5-15 lbs) brings symptoms that last more than 24-48 hours. Based on this, week 6 and 7 have been using only bodyweight (except for bench). I read in the “Pain in Training: What do?” article that when symptoms are neither increasing nor decreasing, it may be useful to repeat sessions without increasing weight at all. I have started using this approach, as my symptoms mostly remain constant when I do not try to add weight (and I’m thinking this was the point of phase 1 the whole time lol). I will probably repeat the same week for another week or two in addition to weeks 6 and 7 (the same week repeated 3 or 4 times in total.) I have a few ideas of how to continue after that based on symptoms.
1. If symptoms decrease, I will move on to phase 2 and try to add weight VERY slowly.
2. If symptoms neither increase nor decrease, I am thinking of moving on to a “modified” phase 2, where I would just repeat week 4 over and over because I am not really comfortable going for 8s. Part of me is wanting to move to phase 2 simply as a means to bring in more variety. I feel I may be sensitive to doing SBD 3x week so I wanted to try phase 2 with very light weight as an alternative where I am doing SBD only 1x week.
3. If symptoms increase, I guess I would either continue phase 1 and decrease volume a little, or try week 4 on repeat with 10s or even 12s.
I am reluctant to stay in phase 1 for so long because I don’t want to keep trying something over and over when it is not working. At this point, I am basically relying on the fact that I seem to have found my “entry point” with bodyweight movements. I have had days/weeks when there was less pain than others, but I honestly cannot say that I have made any definite improvements since the pain began last year. It was just slowly getting worse and is now stagnant with the rehab template, but not improved. I can add some more context in another post if it would be helpful.
Overall, these are my questions:
1. Do my approaches seem reasonable? Are there some minor adjustments I should make based on what I’ve said, or maybe I need a new plan entirely?
2. Should I be trying to add weight at all during phase 1, or should I simply be repeating the same week to desensitize my body to the movements?
3. Is it common to see low back pain arise in the way mine did? It seems a lot of people on the forum with back pain experienced a “tweak” at some point in time but I did not. Also, does the presence (or lack thereof) of a tweak change the approach to rehab in any particular way?
Lastly, I’ll mention that I currently do not plan on getting a consultation. However, it is not completely off the table. If the pain does not get better through my own management with the template, my own research on pain and rehab science, and help from these forums, I will be getting professional help eventually.
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Sorry to jump on this but would say the low back template would be appropriate for someone who is recently experiencing “sciatica” like symptoms?
Over the past 5 months I developed some sciatica pain which seems to move from what I believe is my low back to the top of the hip and down one leg with numbness into the toes of that same leg. Don’t know if the low back template would cover this type of issue or if a consult wound be more appropriateComment
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Yes, the template can be helpful for aiding reengagement of activities (specifically resistance training) to tolerance. We are happy to consult with you. Usually in these scenarios we are monitoring to see if those neurological symptoms worsen over time (example loss of movement such as foot drop).Comment
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Barely started the first week (started with the knee pain template, but decided to switch as I think my pain is more back/sciatica related).
Deadlifts feel impossible to do now, I have a constant dull pain in my hamstring, but when trying to hinge for a deadlift the pain becomes sharp and I can't stand it. I can tolerate rack pulls only when above the knee, at which point the ROM is minimal, almost feels more like a glute exercise or something. Sumo used to be painless last week, but now it hurts too.
Something similar happens to the back extension exercises. When extending the legs, the pain just becomes too much. I was able to do some back extensions, but not all the prescribed reps or other exercises.
How should I proceed? Maybe repeat the first weeks until deadlifting becomes more tolerable? Are rack pulls a good way to transition to a pull from the floor without pain, or would you recommend something else? Funnily enough, high bar squats feel very good, I even feel like I can go deeper than before the injury.
EDIT: Went to a chiropractor and he acted in a very alarmistic way after doing some leg raise tests. Needless to say, I just got noceboed the fuck out of me. Told me to go back when I get some xrays because it looks like sciatica caused by protruding discs, and was scared to try any alignment without xrays to confirm. I told him I was doing some light work in the gym, and begged me to please not do any exercise at all, just rest.
I know BBM mantras but this is the first time a '""doctor"" acted in such an alarming way to me. Should I continue with the low back template or? Lol.Last edited by DidNotDoTheProgram; 11-09-2021, 06:48 AM.Comment
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Hi, I am 20 years old and have been suffering from left low back pain for about 2 years after I was lifting seriously but with bad form. Right after i stopped doing my back loading exercises I did a bunch of upper body stuff which made my shoulder start to act up and I kept pushing past the pain there as well. It has been about a year since the shoulder pain started. I have worked with a barbell medicine rehab coach before but stopped because I felt like I wasn’t making much progress. I have gotten MRI’s and nothing was shown on either the shoulder or back. My back feels worse then it did last year so I want to get back into lifting to maybe build back work capacity and get my back and shoulder better so I can actually lift. I was wondering if I could run the low back pain template and the shoulder rehab template at the same time?Comment
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