Repeated Lower Back Problemsand

[Rooble]

Good Morning Coaches,

Just to provide some context I've had lower back issues for a number of years, I hurt my back during a testing week about 6 weeks ago doing a 1RM deadlift, this was easily the most pain I've been in with my lower back issues for some time. Coach Joe posted some great advice in the group programming page and I've worked back up to nearly full strength. I had a great training day yesterday but unfortunately tweaked my back again doing deadlifts. This was nothing like as bad as the previous injury but a little frustrating none the less.

I know what to do to make this better and in a few weeks I'll be making progress, however I'd really like to change something to stop this happening quite so frequently so if you don't mind I thought I'd put some thoughts down and you could tell me if these sound reasonable and if possible you could add some further advice.

Firstly, is the idea that I won't hurt myself again flawed? Do I just need to accept that I'm probably going to hurt myself again at some point in the future? I definitely felt some very minor discomfort while deadlifting that made me think my back could 'go' yesterday, should I have paid more attention to the signs my body was giving me?

All my recent tweaks have come from deadlifts. I'm confident from the feedback I've had from coaches that form isn't an issue and I'm confident in my ability to determine the RPE to know that I don't frequently overshoot on this lift. The injuries have previously come at a point in training when the intensity is a little higher. I felt absolutely no discomfort training in the higher volume range previously in the training block, could there be any benefit to staying in the range for a period of time before ramping up the intensity? Just trying to apply some logic here but it's still pretty cold in the UK, could this be something as daft as when I work up to a top set of 5, all my warm ups are 5's so by the time I get to my working sets my lower back is more warmed up compared to working up to a top single where I will do something like 70kg - 5 100kg - 3 120kg -1 up to a top single.

Any help would be appreciated, I don't think this is serious enough to require rehab but I'd happily pay for a consult if this could be beneficial?

[Derek Miles]

I'm going to flesh out an idea here that I have said in various places, but likely bares some reinforcement. What you are experiencing is a pretty common phenomenon where an injury occurs, modifications are made, symptoms start to resolve, and as you are getting back to full training you experience a setback. We frequently talk about pain not equalling damage, but there are also instances where feeling good does not equal ready to go back to prior training and we need to be a little more mindful of some timelines. I would put this type of injury in that bucket as there was a direct mechanism of injury and we would likely call this a back strain and I'm going to use that vernacular for the rest of the post.

In general, strains feel better relatively quickly and if you keep moving normally activities around the house feel pretty good by 3-4 days. In the most physiological explanation, there is some muscle damage with a strain. Not necessarily a bad thing as we know how to build muscle back up. The issue is with something like a hamstring or quadriceps strain, we have really good ways of testing strength side to side and knowing when an athlete has at least addressed that deficit. We can't do that as easily with a back strain as it's just about impossible to isolate your left low back from your right and anyone who says they are isolating a specific muscle is lying. This would typically lead me to lean on time as a little bit more of a variable.....with a good rehab plan. To your point, and as a hypothetical example, let's say your injury dropped you to 80% strength on that side. So long as you are below 80%, things feel great you can train, hit volume, crush your enemies and hear the lamentations of their women. Once we start taking up intensity though, we get above that threshold. So, like a turkey around Thanksgiving, everything seems like it is great in life until it isn't. Higher volume, slow movements tend to be better in the initial phase and if I am to distill it down, you can almost treat these injuries like you need bodybuilding style programming for 6-8 weeks. They tend to benefit from isolation style movements like good mornings, GHD back extensions, reverse hypers all while controlling for momentum. Once strength is starting to improve on those metrics, you can start introducing some more speed to your lifts. Something to the tune of sets of 5 at <75% 1RM with and emphasis on speed off the ground. As this gets more comfortable, transition back to whatever program you are currently running.

For the first 2-3 weeks I tend to have athletes run the good mornings/GHD/reverse hypers in the "A" slot of the workouts 1) because it serves as a good warm up 2) it serves as a bit of a governor for weight selection with some pre-fatigue. If doing back extensions/reverse hypers I tend to program 2-3 sets with a weight where you can get 8-12 reps at 1RIR. Once you start getting above 12 reps, it's time to take the weight up. If you are concerned with losing gains, this is also and excellent time to get some supplemental work in with knee extensions and hamstring curls.

I would plan to run this format for 6-8 weeks prior to trying to hit some singles again. By then, I guarantee you will have seen some improvement in lower back strength and we are really just hedging our bets towards a more positive outcome with reduced risk. Never in the history of sports has someone said an athlete's back is too strong. Just means we need to find where that limit is.

Pretty sure I just cost myself at least a few consults here if people are searching the forum. Don't forget to tip your bartenders.

[Rooble]

First off, thank you for that incredibly detailed response. For what it's worth, people are attracted to BBM because you're all so helpful, if anything posts like that will get more consults.

Does the low back rehab template have similar programming as you have described?

[Derek Miles]

I'm glad to help. That was definitely a tongue in cheek comment on my part. I am working on updating the low back template as I am typing this and it will have programming broken out in how I described above. Even from your initial comment it sounds like you have a pretty good grasp on the issue and can likely get back to crushing it following what I typed above. We will try and have that updated template out as fast as I can edit it though.

Good luck