Low Back Pain and Deadlifts/General Programming

Pain & Rehab Forum [Moderated]
1

Background
I had been having a very good run of training. My e1RMs were the best they’ve ever been: 180kg squat, 95kg bench and 180kg deadlift. Last Monday after my top single on squat was when the back pain had started. The pain seems to be around the tailbone area, and slighted situated on the left. Core/lowback exercises such as planks, side planks, sit ups, back extensions, supermans, cat to camels etc have gotten rid of about 95% of pain from my everyday life, however training still presents a few issues.

For benching there hasn’t been any issues. I don’t bench with a super exaggerated arch or anything like that, so programming is normal.
For squatting the pain is mostly from unracking and standing with the bar. The ROM itself isn’t too bad as long as absolute load is reduced. The issues seem to arise when going to 140kg and above I’ve been able to do mostly normal protocols with less weight (though until things go back to somewhat normal I’ve still replaced some squat variations with other exercises that have less spinal loading).
Deadlifts are the real issue though. My performance is way down; max is maybe 125kg and that’s a very painful 125kg. The problem is that reps seem to affect the pain more so than on squat. Basically more than just 1-2 reps even with just 60kg on the bar presents issues, and I don’t have access to lighter plates that are the same size so going lighter creates an very uncomfortable starting position. To add, the pain comes mainly from breaking off the floor, which is why a lower starting position is even worse.

  1. Could I use Good Mornings and RDLs for my main deadlift variations? They don’t have any issues with starting position so I can load them lighter than deadlifts, which I’ve found makes them workable
  2. If so, my general plan was something like this (pressing excluded)

Monday
Main Squat (High Bar) - top single and 3 sets of 5; progress weight as comfortable
Bench 1
Bench 2

Tuesday
Good Morning - same as squat on Monday
Bench 3
Leg Press - 3 sets of 15 @ 6,7 8; progress each session

Thursday
Second Squat (Split Squat) - 3 sets of 10 @ 6,7,8; progress each session
Bench 4
Bench 5

Friday
RDL - 3 sets of 15 @ 6,7,8; progress as comfortable
Bench 6
Row variation - 3 sets of 10 @ 6,7,8; progress each session

Does this look like something that would work?

  1. Beltless training is much more painful, even with reduced load. Should I drop the load even further and still go beltless or just keep the belt on for variations for now?
2

Hey @Dylan_Priest ,

Thanks for your questions. Lets dive into it: 1. Good mornings and RDLs are both good options when working around low back issues. RDLs in particular tend to be a little more tolerable to get into position and there is increased specificity to your main deadlift variation (assuming it’s conventional). If you have access to pins/bumper plates/blocks, you could also explore using a rack/block pull that places your starting position just above the point of discomfort. This variation would be a little more specific to getting you back to pulling from the floor with less symptoms, so may be worth exploring. I would recommend keeping the rep range relatively high (think 8-12 reps) with a relatively slow and controlled tempo (2s on the way up/2s on the way down for example). Instead of focusing solely on increasing load for this movement, you can also progress range of motion over time as symptoms calm down.
2. Overall your plan looks solid. My only critique would be the prescription for the high bar squats on Monday. Working up to a single and hitting sets of 5 may be pushing things a bit at this stage. If you don’t have a competition coming up, maybe think about increasing the rep range you’re working in and adding a tempo temporarily. For example, you could work up to a set of 8-10 @ RPE 8 with a 3-1-0 tempo (3s on the way down, 1s pause in the hole), followed by a few backoff sets. The idea is to reduce the absolute load while still getting some tolerable training done. Also, I would suggest a prescription similar to your RDLs when programming the good mornings. Outside of those suggestions, looks like a solid plan.
3. Wearing the belt should be fine, though I would still suggest reducing load through the use of higher rep ranges and addition of tempo as mentioned above. Hope that helps. If you haven’t already, I would recommend checking out the article Pain in Training: What do? for general guidance on programming. For individual guidance we would need a consultation with you, which we are happy to do remotely (see HERE).