Low Back Pain - 'Real' injury?

I have a story on Low back pain that even with the benefit of all of your content (thank you by the way its been of great help) I am still at a bit of a loss for direction. Hopefully this can be helpful to others as well. I will try and be as incisive as possible.

Background information

Name: Carl
Age: 33
Experience: been lifting with the bridge or similar programming for about 1 year, 1RM for press, bench, squat, DL (180, 300, 410, 430)
Height: 6’1"
Weight: 205lbs.

I had never had any low back pain really ever with lifting or otherwise. I took a week off (first time in a couple of years) of lifting and when I came back and worked out I got really sore in my lower back, not upper body. I figured it was DOMS from taking time off, even though i had never experienced it. I tried to lift a little later that week but any weight on my back was too much. I tried again the next week and i was again way too sore. The 3rd week after a few days off, I was feeling good and was hoping to get back to normal I was doing pretty sets of 5x squat RPE 6-7. Bar speed was good it wasn’t too intense. On the way up on 3rd or 4th rep I had a tweak in the lower back. This was the first time the pain was definitely not just soreness, and the first time I have ever had a tweak. I tried some lighter weight and couldn’t manage. I finished my benching part of my lift and went home.

I was really sore and at this point started to really worry about the state of things. I went to a chiropractor (which I didn’t think was helping) and after another week finally came across all of your content about pain and psychosomatic pain model. This made a ton of sense and was a revelation! I had always skipped over the content about pain because it never really applied to me. I started to move more and do air squats which helped. I had a paradigm shift on how to treat the situation and my attitude, so all of that was good. In hindsight I don’t know if the pain I had at the beginning was really just soreness or if there was something more all the way back then up until the definite tweak.

Its been over a week since that change in approach, and while I feel better, I’m still only able to do very light weight with dead lift or squat without discomfort. Usually I am the type of person that just ignores pain, goes too hard, rubs some dirt on it etc. There are some things I realize I could have done differently like empty bar movements. However, I was still moving and on a couple of occasions I did play basketball. Basketball is an escape for me and I expected to warm up and not feel the pain or forget about it. It did though affect me significantly both before and after the tweak. I haven’t played since. I am still trying to reconcile the fact that my attitude and approach to all of this may have made things worse than they had to be with the fact that I seem to be still quite incapable of ‘getting back to normal’.

Is lifting 135 or less the path I should stay on even if its several weeks?
Should I be doing zero weight instead of light weight?
I will definitely put in a form check.

If you were previously training heavier without any issues, it sounds like you probably just pushed things too hard upon your return and the system is staying overly sensitive. You probably need a more substantial back-off and gradual re-introduction to training, both from a volume and intensity standpoint. I do recognize, however, that this much of a response after just 1 week off is unusual.

That sounds similar to what I am doing right? Or does back-off mean time with no training?

Also I didn’t go into as much detail about one occasion of playing basketball. I had about 3 days no lifting and the apparent soreness was less. I went and play basketball and afterward and the next day was the most sore i had been at any point. The fact that this wasn’t in response to lower back training changed my thinking away from what you seem to be suggesting. Or that is possible if its very sensitive?

Correct, I would NOT recommend time with no training.

And yes, it’s certainly possible if you’re currently as sensitive as you seem to be describing.

Thanks Austin, I am not trying to beat a dead horse here but I think a pretty good job of staying moving and training to whatever extent possible. Yesterday I did a few sets of empty bar squats and it was still pretty uncomfortable/painful at times. I figure that’s to be expected and shouldn’t necessarily mean stop, but at some point there probably is that point. This is tough to talk about from email I understand but is there any additional advice or guidance on how much pain or discomfort i should be training through and when not you could give for that?

Is there some amount of time where you would change the approach or is that irrelevant? I am going to keep training at whatever extent possible until i feel better correct?

I did a few sets of empty bar squats and it was still pretty uncomfortable/painful at times. I figure that’s to be expected and shouldn’t necessarily mean stop, but at some point there probably is that point. This is tough to talk about from email I understand but is there any additional advice or guidance on how much pain or discomfort i should be training through and when not you could give for that?

You had an acute back tweak. For many people who manage these “ideally”, they can be back to normal activity in a few days or less. But this isn’t the case for everyone, particularly those who have issues with fear, who end up in the office of a chiropractor or other medical professional, etc. Sometimes it can take a week or a few weeks to fully resolve. But the overwhelming majority of acute back pain gets better on its own.

You gave no indication of any so-called “red flag” signs associated with your back pain (i.e., leg weakness, incontinence, groin numbness, etc.), and you are generally able to function near-normally, with the exception of some persistent localized soreness / discomfort. In this situation, continued training is the recommendation. However, it may need substantial short-term modification - and this is OK. For example, you may tolerate a front squat and sumo deadlift/block pull or tempo work better than a low bar squat or conventional DL from the floor. I cannot “quantify” how much discomfort you “should” be in, or what specific exercises you should be doing – this is an individualized thing and requires some experimentation and patience.