Lower Back Rehab Program Critique / Lower Back Rehab Help!!

Pain & Rehab Forum [Moderated]
1

Hi Derek and Michael!

I’ve written a lower back rehab program template for myself and I wanted to see if you guys think that my programming choices were reasonable, great or straight up horrible. I’ll put the template at the bottom of this post, but FIRST, some Context!

The backstory:

So, back in July of 2018 (~7 months ago), I had the most long-lasting back tweak ever from squatting. I hoped it would recover in between 1-7 days but it didn’t. It gradually got better VERY SLOWLY and reached its best around early November 2018 (4 months later). I was still training BUT with reduced weight and volume. Around that time, I wanted to try and “make up for lost time” by jacking up the volume but keeping the average intensity still lower than what I was able to hit before the initial tweak in July. My lower back pain at this time was around a 2 out of 10 on average. I ended up re-tweaking it in mid-November.

I can’t say what the cause was, but my gut tells me it had to do with introducing too much volume too soon and not tracking session RPE. I was tracking set RPEs though and I thought that as long as I wasn’t hitting RPE 8-10 consistently on the squat and deadlift, I’d be able to tolerate all the volume and it wouldn’t set back my lower back recovery. I was wrong. I jacked the volume up because I wanted to GET BACK TO HITTING PR’S!!

So again, I started the process over of lighter weights/reduced volume and this time, I ended up re-tweaking it for the 3rd time again on Dec 31 2018 (3 days ago). Leading up to the 3rd tweak, I was very conservative about re-introducing volume and I’d say average lower back pain was around 4-5 out of 10 when squatting/deadlifting and just an achy 2 out of 10 when I was going about my daily life.

Current mental state:

I’m trying to stay positive and re-assure myself that everything is going to be ok, but sometimes I can’t help but get frustrated because it’s been a good 7 months since I’ve been able to get even close to my old maxes on squat or deadlift, let alone hit PRs on them!

I’ve been watching/listening to Barbell Medicine’s content regarding pain and rehab and I think doing that, has helped re-wire my mindset regarding pain and helped reduce fear and as such, each re-tweak after the initial tweak has been easier and faster to recover from. That being said, I can’t help but think that I’m doing something wrong and feel frustrated and sad when my goal is to be as competitive of a powerlifter as I can be and having these setbacks is not helping me get to that goal. I have a meet in about 4 weeks and it would be nice if I could even just match my previous bests, but I’m currently doubting myself and my ability to perform.

It’s a tough pill to swallow, but I think I’m gonna have to just hit easy peezy singles at the meet and focus more of my efforts on rehabbing my lower back for the next 8 weeks or so. I think I need to just throw the idea of hitting PRs on squats and deadlifts out the window for now. although it’s extremely tough for me to do.

The Program/Template:

Monday:
Comp Squat Single @6
Comp Squat 3 sets of 8 @ 60% of e1RM of Single

Comp Deadlift 5 Singles @<6 EMOM

Wednesday:
Comp Squat 2 sets of 8 @ Monday sets of 8

Friday:
Comp Squat Single @6
Comp Squat 2 sets of 8 @ 60% of e1RM of Single

Comp Deadlift 1 set of 5 @ Monday Weight - 5-10%

Progression Scheme:

Squat - Add 2% for 4 weeks on backoff sets of 8. So it’d be 60/62/64/66. After 4 weeks, reset and start at 62% and repeat. So it would be 62/64/66/68.

Deadlift - This will be almost like a linear progression where I’d +5lbs every week until singles start getting to around RPE 7-8 and then we would reset 10%

Program Notes:

  1. The point of the singles is just to practice them for my meet.
  2. I plan on NOT increasing sets x reps at all for AT LEAST the first 4 weeks. Probably 8 weeks.
  3. Deadlifts seem to only hurt my back the most at a higher weight, when done for reps. As such, that is why the EMOM Singles are there on Monday (along with being there for Singles Practice) and 1 set of 5 on Friday just to help de-condition the fear of doing nothing but singles. Anyways, I hope this is enough info for an answer! I know it was a bit long, but I wanted to try and balance both being detailed and concise as possible.

Thanks again, Docs!

2

Hey I just wanted to reply and let you know things should improve over time with a good protocol. Personally I have two (what I consider) major experiences with non-specific LBP. The second time I was a good bit smarter about it and once it had subsided well enough that I could squat to depth with little pain, I very slowly increased weight on the bar. I started squatting with an empty bar 3x/week, increasing 10lb each week.

Prior to the “injury” I had signed up for a SS meet that happened after I’d begun squatting and deadlifting again, but had not fully recovered. I did a single attempt on both squat and deadlift with a weight I knew I could hit easily with no pain - 225lb, and instead spent my mental focus on my three press attempts.

A year later (and one or two bouts of not training…sigh lol), I did another SS comp. I squatted and deadlifted 350lb, both of which I had never lifted greater than 315lb prior to the Friday before the meet.

More recently I just completed the 4 day hypertrophy template which prescribes a total of seven squat and deadlift work sets EACH at its volume peak. I felt no pain at all. Well, if you don’t count the mental anguish. Lol.

Anyway, I guess this is just a long winded way of saying hang in there. Try not to let it get you down!