I have a question regarding the low back pain template and my rehab in general if anyone can help!
About me: I’m a 21-year-old female and have been training using Barbell medicine 12wk strength templates and Powerbuilding templates since Februrary 2019 (I love them btw!). My main goal is to increase the big 3 and my lifts pre-injury were 125, 70, 150. My goal now is to manage my pain enough to be able to get back to them numbers and hopefully exceed them.
I injured my back on the 26th of August, I’ve had tweaks before but they usually went away after a day or so but this one has been much more painful and long-lasting and why I’m calling it an injury. The pain is located on the right hand side where my low back meets my glute. It hurts most doing deadlifts, picking up any weight from the floor and right when hitting depth in squats, but it also hurts doing rear-delt flyes and bent over rows. It also hurts to put socks on in the morning and lifting my left leg up to my chest if that matters
For the first 2 weeks, I did light squats and tempo squats ( no more than 40kg), deadlifts and RDL’s with just the bar, as well as benching as normal and normal upper bodybuilding that doesn’t aggravate it. None of these seemed to make the pain any better, but they didn’t make it any worse either. I started the low back template on the 7th of September and since I had already been keeping active I went straight to Phase 2 (Maybe I shouldn’t have). Anyway, I’m trying to be patient with it and trying not to put too much load on it but my question is how do I know what is too much? I’m having difficulty gauging RPE and when I should stop because I know I can tolerate more pain in theory but I don’t know how much I should tolerate. For example today, I worked up to 50kg for a set of 8 reps on low bar squats, which should’ve been @7, I know I could’ve done more weight and had more than 3 reps left in the tank strength-wise but I’m not sure how far I should push the pain. It’s not pleasant but it’s certainly not intolerable either. Should I be tracking how I feel directly after the sets, or the next morning?
Is it just a waiting game for the injury to get better? I’ve been following BBM and have read all the articles on pain management and I suppose I’m just trying to ‘embrace the process’ but it’s harder than I thought and I’m itching to get under some heavy weights again.
Hey @Aoife_Ni_Chearbhaill - sorry to hear about the recent low back pain experience. Thanks for trusting us and purchasing the low back template.
You have the right mindset with embracing the process and often these situations take longer than we’d expect/like. When discussing tolerable symptoms I usually have the person include their symptomatic experience with their fatigue experience (meaning as a part of their RPE rating). With this in mind our symptomatic experience may limit our top end weight selections and that’s perfectly ok given our current goal isn’t chasing numbers for performance. Given you began having symptoms the end of August, you are about 3 weeks into the process and symptoms appear to have stabilized - which is great and considered a “win”. Most folks in these scenarios notice improvement in their symptoms in the weeks following initial onset so you will more than likely continue to improve. However, keep adjusting training as needed and allowing RPE to guide the path. In regards to knowing if you’ve done “too much” there isn’t a correct answer here. Symptoms will inevitably ebb and flow throughout this process (see photo) and ultimately what matters is how you respond on the days you are more symptomatic and less symptomatic. With that said, I usually tell folks if they noticed significant increase in severity of symptoms during or after training then they should continue to adjust future sessions via RPE however if that continuously happens after several sessions/week then programming likely needs to be adjusted to be more accommodating to your experience. The usual thought here is if you have a more symptomatic day then we want to immediately think we’ve “made matters worse” or “done something wrong” and we can’t really say that typically nor should we immediately jump to making dosage of activity changes for a single session spike in symptoms. Having an auto-regulatory tool in place to adjust training and reframe your goals to working through this experience while being patient goes a long ways to keeping you active to tolerance while symptoms improve over time.
