Back pain, how to rehab?

Pain & Rehab Forum [Moderated]
1

Last Friday I tweaked my back during deadlifts, so I thought it might be smart to get some insight on how to proceed.

I´m 32 years old, 1.8 m tall and 98 kg. I have been lifting with barbells for about 12 years, could be longer. Since then I´ve had recurring episodes of back tweaks.
followed by back pain. These have varied in severity from pretty mild, to pretty severe (unable to sit or walk for more than 5 minutes without pretty severe pain, took a few months to get back to normal)
Unfortunately, these episodes have hampered my progress, and prevented me from getting actually strong. My best squat (high bar) was 175 kg 5 and best deadlift 1854
this was a few years ago. I would say on average I’ve had one or two tweaks every year.

My strategy untill now was to take one or two weeks off from training after a tweak. Usually the worst pain had subsided and I would ease back into training.

Friday I deadlifted. 152,5*5@6,5 157,5@7,5-8 were the first two sets. These were harder than expected. I adjusted my planned weight for the third set to 160.
The fourth rep was about rpe 8. I felt a mild ache, and decided not to push through, expecting that might lead to problems. Was the last set anyway. (low stress week)

Finished training, back felt okay, very mild ache. Same evening, bit more stiffness, also during bending over. Next morning, pretty stiff, difficulty bending over.
Moved and walked a lot that day. Sunday a bit better. After reading some articles on the site. I assume nothing is really wrong.

Just got back from training, was supposed to do squats. empy bar, okay, 45 kg5, okay. 65 kg4, mild ache during reps 2-4, .754 aching was a bit more, but manageable.
854, starting to become a bit painfull. 90*4 pain started to become uncomfortable. Did a few sets with empty bar which also hurt a bit.

So right now my back hurts more than before. I wonder how I should proceed next, since I think I pushed it too far today. How should I manage training load and pain?
Should I work up to a weight that just produces a mild ache and gets better during the sets?

I’m also thinking about maybe giving sumo a try, since this seems to be a recurring problem, despite not even pulling at high rpe’s (9-10).

What are your thoughts? Thanks in advance.

2

Hi Dutch sorry to hear about your pain but hopefully I can lend some words that will help. First I actually had a similar situation this past summer with pulling from the floor. There was a period of time where it was very uncomfortable and painful to pull from the floor which was making training very unproductive. I was hyper vigilant and focused on my low back when ever I trained and I was getting very upset. After a couple of weeks of this unproductive training I switched things up. On the days that I pulled I found a height in the rack that I could pull from that gave me no issue (just below the knee for me) and I used this as my main pull. After about two weeks of this I lowered the rack position to about mid shin and pulled from there with no pain. Then finally after another 2 weeks I tried pulling from the floor and found that pain and discomfort was almost entirely gone. Now two months later I am pulling from the floor with no pain at all and training is going great.
Some key points that I have learned from the bbm crew and have used for myself are not to catastrophize things and movement can be a great medicine. It seems as though you are being highly focused on your back pain like I was but this may just intensify the pain.
So overall my advice, and I know I’m not one of the docs, would be to find a weight or height that you can pull with that produces minimal to no pain and tirtrate to affect. As for your mentality try not to catastrophize the pain and know that you are in control and that you are not broken, but a strong person that can do amazing things.
Hope this helps and I wish you the best with your training!!

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Nick, thanks for your reply.

I tried out your suggestion today. I decided to do rack pulls. I could not pull from below the knee without pain but above the knee was okay. ROM was very short but
got to start somewhere. I added a little weight each set until I hit 125kg*5 and decided to stop before it started to become painfull. Did some light leg presses afterwards
with reduced ROM and these were okay also. Even though it wasn’t a real training I still felt like I did something productive.

The catastrophizing part I’ve picked up on since I’m on this forum. I tell myself that my back just hurts but isn’t really injured and that the pain will go away.

Just got to build up from here. Fortunately I can still do the most Important lift, the bench press.

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Hey Dutch glad to hear that you got back to training. Just wanted to say not to diminish the work you do even though it may be light it was still real training. The movement that you do that is light may not feel affective but as you continue to move it will help you realize that your not damaged and will help boost your confidence in training. Keep crushing it and keep that confidence up!!