Low Back Rehab Template

[Michael Ray]

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.

Hey, sorry to hear about your ongoing pain experience. It's difficult to give individual advice without a consultation with you. We'd be happy to remotely consult. It is unlikely we'd agree with the chiropractor's advice.

Deadlift - have you tried regressing to a deadlift less than the barbell weight? Perhaps a kettlebell deadlift?

[Michael Ray]

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?

Potentially but that may be complex. You'd probably benefit more from a consultation and regular programming from one of our coaches.

[DidNotDoTheProgram]

Deadlift - have you tried regressing to a deadlift less than the barbell weight? Perhaps a kettlebell deadlift?

Hey Michael, thankfully I didn't let myself get swayed too much by the chiropractor's opinion. Went to the gym yesterday and I was able to Deadlift with minimum pain. I was getting gassed out with just the barbell and a pair of 10kg bumper plates, but I can't complain. Almost teared up because I thought barbell DLs were still really far away haha.

I won't see that chiropractor again and I'll continue with the LBP template. Seems like I'm getting better, but If towards the end of it my symptoms are still fluctuating high I'll definitely look for a consult with you guys. Thanks a lot for your work on the template and all the free content available!

[Alexsauter]

I just posted recently, but I have had back pain for about 2 years now after stopping lifting heavy and doing PT and trying to leave it alone. It is only on the lower left side, and overall the pain increases with the more movement I do. Laying down is the most comfortable thing for me, sitting in a chair and standing make it worse as the day goes on. I have worked with a barbell medicine coach before, and I just wanted to try getting back into lifting because that is my goal, but every time I do a session it just increases my pain so much and I have to lay down and the next day it usually hurts more. It doesn't hurt at the moment because I am using like 15 lbs for goblet squats and KB deadlifts, but it's just the effects after that come. Like I just feel like the lifting adds on to the stress of daily activity that I have to do already like walking to class and stuff. Im sick of doing a session, then regretting it after or the next day because the pain increases quite a bit. Idk, I feel better when im not lifting because it doesn't cause much pain, but I want to be able to lift, but that makes the pain come back so I don't want to do it again. I just don't know if I can ever make my back better if I don't address the problem through lifting? Maybe I need to start at an entry point of loading/volume lower than what I did, because the first day of the template caused some pain, and then the next session I hadn't returned back to normal pain level, so I had to skip it.

[Michael Ray]

Hey Michael, thankfully I didn't let myself get swayed too much by the chiropractor's opinion. Went to the gym yesterday and I was able to Deadlift with minimum pain. I was getting gassed out with just the barbell and a pair of 10kg bumper plates, but I can't complain. Almost teared up because I thought barbell DLs were still really far away haha.

I won't see that chiropractor again and I'll continue with the LBP template. Seems like I'm getting better, but If towards the end of it my symptoms are still fluctuating high I'll definitely look for a consult with you guys. Thanks a lot for your work on the template and all the free content available!

I appreciate the reply. Let me know how things are going.

[Michael Ray]

I just posted recently, but I have had back pain for about 2 years now after stopping lifting heavy and doing PT and trying to leave it alone. It is only on the lower left side, and overall the pain increases with the more movement I do. Laying down is the most comfortable thing for me, sitting in a chair and standing make it worse as the day goes on. I have worked with a barbell medicine coach before, and I just wanted to try getting back into lifting because that is my goal, but every time I do a session it just increases my pain so much and I have to lay down and the next day it usually hurts more. It doesn't hurt at the moment because I am using like 15 lbs for goblet squats and KB deadlifts, but it's just the effects after that come. Like I just feel like the lifting adds on to the stress of daily activity that I have to do already like walking to class and stuff. Im sick of doing a session, then regretting it after or the next day because the pain increases quite a bit. Idk, I feel better when im not lifting because it doesn't cause much pain, but I want to be able to lift, but that makes the pain come back so I don't want to do it again. I just don't know if I can ever make my back better if I don't address the problem through lifting? Maybe I need to start at an entry point of loading/volume lower than what I did, because the first day of the template caused some pain, and then the next session I hadn't returned back to normal pain level, so I had to skip it.

Sorry to hear about your experience. I suggest getting a consult with us so we can talk through your experience and help find a path forward. We are happy to help.

[pekka.okuloff]

Hi.

What would you recommend for phase 3, if I cant get to the gym 4 times a week?
Should I modify phase 3 for 3 days. Any suggestions on how?
Or should I move on to normal programming? (Beginner prescription propably)

I am currently on week 6 (did all 3 weeks of phase 1) and I have mostly no pain, but I do get a lot of tightness, that causes my back to crooked at
mornings. It gets better with the movement as the day goes by.

I'm 38 years, about 250 lbs and over 6' 2"

I lifted very actively during highschool, but gave it up when I started working. I've started again a few times, but never got past a few months before I've either injured myself or stopped for some other change in life.
I've had acute back issues several time after turning 25. I started lifting again last August. Started 2 times a week with golden six, and changed it to Beginner Prescription after a couple of months.
Hurt my back again second week in, after going on a trampoline in an indoor park with my kids.

[Michael Ray]

Hey! I think it'd be fine to either drop a day or move on to the beginner prescription if you are feeling good overall.

The main concept to keep in mind is adjusting loading as needed with RPE for each session. Let me know if you have any other questions.

[Peacecamper]

Hey, I'm interested in the low back rehab template, but I'm not 100 % sure yet if it's right for me.
I'm Gerrit, 32, from Germany and have some issues with lower back pain for a about two years now. It started around April 2020 when I hurt my lower back during a deadlift session. In hindsight my lower back was way too rounded and the day after the workout it hurt on a scale of maybe 4-5/10. When it didn't go away after a few days I went to see a doctor, who diagnosed a facett syndrom. I got a cortinson shot and the pain and the inflammation in the facets went away and everything was fine again.
Last year around the same time the same thing happend again. I didn't properly check up my form once more and had almost the same pain sensations, a little bit less than the year before though. So I though it was the same thing and the diagnosis was the same as well, but this time the cortison shot didn't really help. I went to see a physiotherapist and stopped working out for a couple of weeks. The pain went away, but once I started training again even with super light weights and under supervision of a trainer who corrected my squat and deadlift form, the pain came back after the workouts. Not very strong, it was usually more an annoyance than real pain, but something was clearly still amiss.
This went on the rest of 2021 and I went to see a different doctor a week ago. He analysed my spine, my running style and also measured my strength for specific muscle groups. The major things he found out and what causes the pain according to him:

My lower back muscles and also my hamstrings are both significantly weaker than my abs and quads. Additionally my left quad muscle is way stronger than the one of the right leg, but the right leg's hamstring is stronger than the left.
My lower spine is very flat, so the curvature of my lumbar is quite small.
I lack stability in my core, which can also be seen while runnning, where I stabilize myself by setting down my feet almost in the middle below my body and not below the hip sockets. I hope you understand what I mean, it's kinda to translate the German analysis into English if you're not used to the medical terms.

He said that the facet syndrome is most likely not my main problem, but the muscular disbalance and the flat lumbar spine.
He suggests to train the following muscles:

M. erector spinae
M. transversus abdominis
M. biceps femoris; M. semitendinosus
M. gluteus medius
M. gluteus maximus

Now to my question: With this medical history, is this template a good start for me? Or would it be sufficient to just lower the rpe on any existing program and maybe put some single leg exercises in to fix the differences between both legs? I own Thinner Leaner Stronger and Bigger Leaner Stronger by Mike Matthews, Jeff Nippard*s Fundamental Program and a couple of power building programs by Brendan Tietz. I started a few years back with Thinner Leaner Stronger with some success and switched to Brendan Tietz' programs thereafter. After a year the injury happened. I bought Jeff Nippard's program to find my way back into the gym and work on my basics again. I don't have any of your programs yet except the free version of the Bridge.

Also I think my breakdown in form and rounding of my lower pack is also caused by a lack of ankle and hip mobility. And while I absolutly want to work on this, would switching to sumo deadlift maybe a good idea to protect my lower back a little better? I also tend to have a rather wide squat stand with turned out feet. If I stand at shoulder width I can't reach any depth whatsoever.

Kind Regards and thank you in advance!
Gerrit

[Michael Ray]

Hey Gerrit,

Thanks for the backstory and sorry to hear about your low back pain situation. I think a consultation would be much more appropriate for your situation so we can talk through your history and figure out a path forward. If you are interested, please follow this link: https://www.barbellmedicine.com/shop...on-management/

[RRR]

Are there any general recommendations in regards to the timing of starting the rehab programs, specifically low back? Following a trip to snap city, is it recommended to get right into the programs possibly in the following days? Is it more symptom based?

[John1975]

Hi guys. Just a quick one. I've had LBP on going for a few years now. Not continously but flare ups every now and then in the last year or so I seem to be more prone to these flare ups and my training has suffered as such. I've altered my training by lowering RPE on DL & Squats (where I normally tweek) I've switched from conventional DL to sumo and Switched from LBBS to HBBS with some success. My set to set and singles strength has dropped a bit but I expected that. About a month a go I hurt my Low back pretty bad high squatting (3 days unable to move and on some strong pain medication) . I recovered quite quickly after that, day 5 I was running and day 7 I started the lowback pain template... It was all going well until today.. I was on week 6 day 3 I deadlifted (conventional with belt) 8@4 112.5 kg 8@5 117.5kg no problems then 8@6 122.5kg was going OK then half way through I felt the tweek again similar to the last one I stopped what I was doing so as not to aggrivate it any further (I didn't do this last time and it was unbearable the next 3 days). My plan is to rest it until the pain is manageable and then get back into the training albeit very conservatively but my question is how can I make any progression if I can't even get through the LBP rehabilitation template... Stop deadlifting / squatting full range for a while and or reduce the intensity and volume right back and grade it back in according to tolerance?
Sorry for the essay but I know you guys like context

[StefanGureng]

Minor lower back pain - how to use the template.

I'm doing hypertrophy training 6 days a week for a couple of years now but can't progress my lifts to adding any weights to squats and deadlifts. (When I try my on and off mild lower back pain starts to radiate shooting pain down my leg or legs. My idea was to buy the template and replace my leg days with the the low back pain template. However, when I read the document I get a big confused to if this is such a good idea? Any thoughts?

Also thanks for all the free podcasts and videos on lower back pain that you have published. I have definitely learned a lot!

Stats: 43 years old, 95 kg. 1 rep max, Bench: 110 kg, squat 80 kg, deadlift dont know but typical set is (40 kg x 10).

[hassanizhar]

Low back pain is a common condition that can have various causes, such as muscle strain, herniated discs, or spinal stenosis. Most cases of low back pain improve within a few weeks with conservative management, such as rest, pain relief medication, and physical therapy.

It's important to avoid bed rest and stay active as much as possible, as prolonged inactivity can lead to muscle weakness and further pain. Gentle exercise, such as walking, swimming, or yoga, can help alleviate pain and improve flexibility and strength.

If the pain persists or is severe, or if there are other concerning symptoms, such as numbness, tingling, or weakness in the legs, it's important to seek medical attention. In some cases, imaging or other diagnostic tests may be necessary to rule out underlying conditions that require specific treatment.

The low back template appears to be based on evidence-based management strategies for low back pain and aims to provide education and reassurance to individuals with non-specific low back pain.

[Allen Fleck]

Posting this here as I got no response from starting my own thread

Hello. I just purchased the low back pain template and am a bit confused on the 3-0-0 tempo. Does this mean 3 seconds on the eccentric phase 0 seconds at the bottom and 0 seconds for concentric?

Also, for the Rehab Exercise 1 (flexion) the exact same list of exercises are listed for Rehab Exercise 2 (Extension). Which exercises are for flexion and which are for extension? They can't both be the same can they? For reference I have template version 2.1

Also, I see no mention in my template of the Sphinx and Cobra exercises mentioned by earlier posters of this thread. Have those been removed from the current template?

[Pirzat]

Hello, I'm Pirzat(29). First of all, English is not my mother tongue, so I'm sorry for the mistakes. So I want to use template, but I need to know that it will be appropriate for me. Firstly, I have structural spinal problems. I have a Schuermanns dissease patient, but my scoliosis is very light and my kyphosis and lordozum do not prevent me from making compaund lifts, provided that I have to pay attention to my form. It took me a lot of time to learn the right forms due to my back problems, I had a lumbar hernia in this process and it recurred a few times. But each time, I was able to get rid of the symptoms by using some spinal decompression and some programs spesific to hernia which includes core work a lot. After these, I did ss for about a few months consistantly, but I had to take a break because I changed the city because of my work. After this break when i start lifting again it reoccured while i was deadlifting and this time a few days later i start to feel a lot of numbness at my left leg. I havent felt any pain, but I had a lot of numbness. It's been a year and I've stopped exercising altogether. Although I am almost fully functional and symptomfree in my daily life now, when I move to the bottom of the hinge position with an empty bar, I start to feel that numbness again. In addition, I feel this symptom when I carry around 20 kg while standing. I want to start the barbell training again and I thought this template could be a good start. But I still want to know in this situation is it really ok for me. I would be grateful if you reply. thanks.