RPE scale and other programming questions - low back pain

Almost posted this in the training place but idk.

Over the past ~6 months, I’ve injured my low back doing the deadlift 4-5 times. Thanks to you guys I’m pretty okay at not catastrophizing and keep training. The pain isn’t bad at all after a few days each time, but it’s affected my deadlift in a huge way and I’m not sure how to train my deadlift anymore, which makes me sad because deadlift is bae. My working sets used to always be above 225lbs with an all-time 1 rep PR of 300lbs. I think the initial injury happened after not lifting for maybe a month and then going back to the weight I left off at, which looking back was probably a bad idea. At the time it didn’t seem like a bad idea because the weight was moving and I was completing my reps.

I’m able to train the deadlift without exacerbating the problem, up to a point. My problem is I have no idea where that point is, and it’s been super frustrating each time I injure the area again. Most recently I pulled 225lbs for an easy single which I’d rate around an RPE 7, but after I put the weight down it became apparent that it caused pain again and a few minutes later I was suffering through RDLs with just the bar to try to work the pain out some. The week after I did deadlifts at 95lbs which seemed okay, then I bumped it up to 115lbs the following week. After going through this over and over and over I feel very wary of increasing the weight and there is some anxiety surrounding deadlifts at all now. The other injuries have generally happened in the 135lb - 180lb range when lifting 4s or 5s, though I’ve also been able to train in that range without injury for most sessions.

Meanwhile, I’ve started running the powerlifting 2 template for everything that is not a deadlift and have started to hit squat and bench PRs. When squatting I have close to zero pain, though there is always sensation in the area even when just sitting or standing. I did purchase the low back pain rehab template but notice it uses RPE in its implementation. How does one figure out their RPE for these lifts when it feels like the body could easily handle more weight, but the lifts then result in severe pain lasting a couple of days? Deadlifting 135lbs for 4 reps would feel like an RPE < 1 if 1 means I could get 9 more reps, but if I work up to actual RPE ~7 I feel certain I’d injure myself again eventually.

Should I even be using the low back pain template if I basically have zero pain when keeping deadlifts light af? How can I determine where to start the deadlift weight, when to increase weight, and at what rate to increase the weight? Would it be reasonable to drop the weight down super low and basically run through a linear progression again, increasing the weight each week? That’s what I feel inclined to do, as I can’t seem to figure out how to use RPE here.

Anyway thanks you guys are cool.

@faerie Hey, sorry to hear about your low back pain situation. Sounds like you have the right mindset with attempting to continue to train but need a bit more guidance on a tolerable game plan for your situation. I’d likely recommend getting a consult with us to help guide this path for you. The low back pain template is a great option for your situation and perhaps just a single consult to provide guidance may be beneficial for your situation and how to move forward.

In regards to your questions:

  1. How does one figure out their RPE for these lifts when it feels like the body could easily handle more weight, but the lifts then result in severe pain lasting a couple of days? - The example you use is coupling RPE and RIR. You can think of using RPE as all inclusive of fatigue, difficulty, and symptoms - rather than how many more reps could I complete. Hopefully that’s helpful. My usual caveat here is you are not training for performance but rather trying to build back to baseline, once you can make the switch in mindset you’ll find yourself less and less worried about “What if this isn’t enough weight?” Regardless of symptoms, it is important to remember RPE isn’t a perfect metric but rather is dynamic based on a multitude of individual and life factors.

  2. How can I determine where to start the deadlift weight, when to increase weight, and at what rate to increase the weight? - Have you checked out the template? There are educational materials in a pdf and the template will guide you through the process by imposing changes in volume and intensity.

  3. Would it be reasonable to drop the weight down super low and basically run through a linear progression again, increasing the weight each week? That’s what I feel inclined to do, as I can’t seem to figure out how to use RPE here. - Sure but you should still use some subjective metric to help guide the path rather than just “add fahve.” I think it would be helpful to talk to one of our team members to work through this with you. Often the expectation is pain free but instead it should be how much work can I get done with tolerable symptoms (not left feeling debilitated afterwards = unable to go do other life activities).

You can schedule a consult here - Pain & Rehab Consultation