Adjusting Programming due to Injury

I wasn’t sure if this was a more appropriate question for the Pain/Rehab sub or the Training sub, so forgive me if I picked the wrong one. I have been experiencing some pain in my lumbar spine and I’m finally going to do something about it. It’s frustrating because I have my sights set on my first ever powerlifting meet in March, and had previously been making pretty good progress leading up to it, but now worry that this back pain is going to really mess this progress up.

Potentially helpful/relevant info:

26M - 6’1" - 212 lbs

Been messing around with weights off and on for about 8 years. Started actually strength training about 2 years ago, with a few non-injury related layoffs. Currently in week 2 of the 12-Week Strength template, after previously running 7-Week Hypertrophy (3-day version) and The Bridge 1.0. My training history has been, for the most part, injury free until recently.

Recent Pain:

I am experiencing some pain in my lower back of varying severity, more specifically the L4 - L5 region of my spine. This is the first time I have experienced lower back pain, in both my weight training and athletic history. The pain developed about 5 weeks ago and there was no specific event (like a pop or tear) that triggered it. I have been trying to ignore/fight through the pain, but have decided to take the issue more seriously after a particularly uncomfortable deadlift single of 385 @ 8 yesterday. The pain sensation is like a sharp tightness/stretching in that L4 - L5 area of my spine, if that means anything. At first, I felt the pain in both the bottom of the squat and the deadlift, but since cutting my squat depth by about an inch or so (still below parallel) I only really feel it in the deadlift.

I have diagnosed my pain per your recommendations in your recent podcast episode, as well as a video of Dr. Baraki that I found either on either the BBM YouTube channel or Alan Thrall’s. Thankfully, I am able to get through the full ROM of the deadlift pain free. It is only when I get to a certain load - somewhere around 315-345 - that I start to really feel the sharp tightness/stretching sensation. Given this, I should be able to continue to train the deadlift, as long as I am adjusting my load to something that allows me to get through the ROM pain free, correct?

Adjusting Programming:

Finally, my question: how should I go about adjusting the 12-Week Strength program around my back pain? As I mentioned before, I’m in week 2, so as far as competition lifts go, I’m working up to a heavy single, then getting some backoff sets in based off of a % drop from that single. Should I still work up to as heavy of a single as I can without pain, then do the prescribed backoff sets off of that at the prescribed %, or should I do something to add some more volume, like increase the number of backoff sets? For supplemental movements, such as the rack pull, should I take the same approach and adjust RPE based on pain, or do something to else?

TL;DR: how should I adjust the 12-Week Strength template so that I can train around my painful lower back while also minimizing a detraining effect?

Thank you,

Nate B.

Hey Nate,

Thanks for this. I think this is definitely consult territory and would encourage you to shoot us an email at info@barbellmedicine.com.

I don’t think the 12 Week Strength program is the appropriate training template to use in this situation if your back pain is worsening. That said, if you can pull for 2 weeks with a different ROM or lightened load and it goes away- then carry on. The volume may need to be adjusted, but a lot of this is wait and see you know?

Thanks for your response, Jordan.

I definitely have not given my back pain much of a chance to improve. I’ll give not being stubborn and dumb a try for a couple of weeks by going lighter on the pulls and see where I’m at. If I don’t feel any better after that, I’ll reach out to you all to discuss a consult.