Low back

Pain & Rehab Forum [Moderated]
1

Hey guys, I’ve read/watched almost all your content and really appreciate the info you guys provide. I’ll try to keep things as short as possible.

Incident: I’ve had minor back tweaks throughout the years, but a month ago in the middle of a rep I collapsed. That night I could barely walk and couldn’t even stand without pain. Strong pain.

Weeks 1: I did air deadlifts and squats through the pain. It progressed from bad pain all day and excruciating pain through the movements, to dull pain in the back throughout the day and a little pain through the movements. Your guys teachings really helped my mentality and I didn’t catastrophize.

Weeks 2: I started to do 135LB (~25% previous 1rm) deadlifts here and there with a bit of pain but doable. By the end of the week, pain while walking around mostly diminished and there was just uncomfortableness in the movements.

Week 3: Started great with no pain when upright, and just tightness in movements. I did PIN squats with a weight and range of motion that was just barely painful and that was fine, but after the 3rd set I could tell I went too hard too soon. My lower back was on fire from the last reps of the last set. The next day I was set back to beginning of week 2 with pain all day. So I kept moving around but took out all squats and just did deadlifts with the bar.

Weeks 4: The beginning of this week was basically how I started week 3. It took a week to get back to that state. No pain during normal day activities, tightness in doing movements, and pain when laying in the mornings. It’s the end of the week now and about a month in and I just did 135x12x3 yesterday and squats with the bar.

My primary concern is I don’t know if I need to stop doing things like deadlifts/squats until it “heals” a little more or if I’m on the right track. The reason for my hesitation is that every time after my gym session (3x a week) my low back is a little more inflamed and the next morning there is more pain that morning than the morning before (until finally the next morning it’s back to 2 mornings ago)". The difference between now and day 1 is AMAZING, but the last week or two has seen very little progress. I’ve never had a back pull this bad though, so I’m not sure if thats just part of the “game” even when doing everything “right”.

It feels like I might just be setting myself back judging off my sensations in the mornings post workouts and the lack of progress. But I’m not sure. I know this isn’t a consultation where you can tell me exactly what to do, but I would appreciate any feedback on whether im on the right track and keep slowly doing what I’m doing, or if I misunderstood principles and should lay off hitting the back directly until doing so doesn’t leave me inflamed after.

Thank you!

1 Like
2

The observation of persistently increased sensitivity through the rest of the day and into the next day after your session suggests that the “stress dose” you are using is a bit too high for you right now.

This may be related to the fact that you seem to have arbitrarily started at 135 lb (probably due to the convenience of using 1 plate, which is pretty common), and the way you have been attempting to progress from there. You don’t mention specifically how you’re programming added weight and/or sets here, but inappropriately large increments is probably the most common way people mess this process up.

Doing sets of 12-15 (often with tempo when things are really sensitive) is a fine place to start. We’ll often have people work up (using similar sets of 10-15) to one top set at a tolerable intensity, then repeat this with a 5-10% load increment about 48 hours later (i.e., non-consecutive training days). This process can get things de-sensitized and build up some positive momentum. As the sets get difficult to perform with heavier loads, you can drop the rep range, concentric tempo, and ultimately the eccentric tempo over time. When progress slows you can add one back-off set at a time (e.g., -20% from top set), monitoring symptoms, and continue progressing things stepwise from there back to normal activity.

Hope this makes sense.

1 Like
3

That does makes sense and I appreciate the time you took to respond.

I will start incorporating the top set idea instead of straight sets. Hopefully that is enough of a stress drop. 2 quick followups

  1. If both squats and deadlifts cause pain, should I do both every 48 hours and take that into account when thinking about how many sets to do. Or should I focus on one’s progression and add the other one in once I’m making good headway. Currently I’ve just been doing both, but alternating which one I do weight with and try to progress and which one I just use the bare bar to “grease the groove” with the motion.

  2. You mention the increased sensitivity for the rest of day and next day might indicate too much stress dose. Is increased sensitivity for just the rest of the night generally OK or should the aim be to not feel too much more sensitivity shortly after the workout.

1 Like
4

  1. Ideally you’d be able to tolerate doing both. If not, you could introduce some additional variation and perform different variations of the movements on different days. E.g. Day 1 SSB Squat + RDL, Day 2 Deadlift + Split Squat, Day 3 Low bar Squat + Lever Row

  2. If there’s some increased sensitivity shortly after the workout that doesn’t typically concern us unless it’s debilitating. If it persists into the next day, I’d dial things back.

1 Like