Hey man. 35, 6’2" 225 Intermediate. So, I have L5-S1 DDD, herniation, blah blah blah. Most of the time it hurts some, some of the time it hurts a lot, rarely does it not hurt at all. I’ve read/watched a lot of your pain science content, understand it, believe it…so, I don’t freak out when my back flares up, take some NSAIDS, and keep training. My question is specific to my performance when my back is acting up. When I am hurting a good bit, my strength on Squats and Deadlifts is often significantly compromised. That is, I could be feeling good one week, complete a top set, say, at 325 with no problem, and then the next time I go to squat and my back is hurting, the bar feels heavy as hell, 135 is taxing, and then I get buried on my warm-up set of 225. As in, literally cannot drive up out of the bottom. Same thing with my deadlifts…there are days that I can’t break half of the weight off the floor that I did for reps easily the last time I pulled. Any idea what could be going on here when this happens? Can inflammation in that area cause some sort of neurological deficiency that inhibits certain muscle groups from working the way that they should or something like that? It’s not like I would lose that much actual strength from one session to the next, ya know? Any insight would be appreciated. Thanks
Thanks for the post and I hope all is well. Sorry to hear you’ve been dealing with some back issues, but I would encourage you to separate knowledge of this pathology from symptoms, as it’s likely not causative given your symptoms.
That said, pain is a big input to force production, i.e. when pain is actively being sensed force production can be compromised big time. This is a neuropsychiatric phenomenon. Ideally, you wouldn’t think about it and ignore it as much as possible and thus it wouldn’t affect you as much.
That all being said, you might be getting a bit too much fatigue from your current training, which is producing recurrent pain. You might try squatting and pulling 1x/wk for a spell.
So pathology being the disc/potentially facet joint issues and my symptoms being pain and weakness? If that’s correct, then what would you suspect to be the cause of these symptoms, if not the given pathology? What I feel in my back certainly isn’t a muscle strain or the like.
That said, pain is a big input to force production, i.e. when pain is actively being sensed force production can be compromised big time. This is a neuropsychiatric phenomenon. Ideally, you wouldn’t think about it and ignore it as much as possible and thus it wouldn’t affect you as much.
Yeah, that makes total sense, and was my first inclination…essentially that I simply can’t lift as much because it really hurts when I try to.
That all being said, you might be getting a bit too much fatigue from your current training, which is producing recurrent pain. You might try squatting and pulling 1x/wk for a spell.
Dually noted, that has been my MO lately…to try to get enough work in that I stay just on this side of laid up for days.
Okay, okay. I get it now…and I didn’t even have to watch/read those (again). The cause of my symptoms being the thought/expectation that my back is going to hurt because of knowledge of the given pathology. If that really is the case, that is nuts. So, then, is it just as likely if Tylenol and NSAIDs bring relief, that it’s simply the reciprocal of this effect at work? I suspect that if pain is never only bio, psycho, or social, but always a mix, then the same would be true for its relief?
We aren’t suggesting that the sole cause of your symptoms is your thoughts/expectations. As you noted, it’s never only one of the three bio/psycho/social, and always has components coming from all of them. So, to the extent that you harbor fear of your back due to the knowledge of degenerative disk disease, it can make your symptoms worse and/or more persistent.
And correct, taking NSAIDs or Tylenol do not work solely via biological mechanisms. Every possible treatment or medicine is administered in a psychosocial context that influences its effects (you may be familiar with this, better known as the placebo effect). For example, receiving an IV pain medicine provides greater pain relief compared to an equivalent oral dose of the same medicine. SEEING the medicine get administered provides more relief compared to receiving the treatment without your knowledge. Etc.
As Jordan noted, you should probably focus less on the DDD diagnosis, and you may need some programming adjustments to better manage fatigue.
