From Excruciating Back Pain to Deadlifting in 6 Weeks

Setbacks happen to all of us, and I’d be lying if I said I had never experienced one. To accompany our previous blog post, Setbacks Aren’t Stopping Us, I’m going to discuss when I experienced a lower back injury, and what I did to preserve and overcome it.

What was the lower back injury?

Let’s take it back to December 2015. I had been lifting for a number of years at this point, and tweaked my lower back in training. An MRI confirmed that my L4/L5 and S1 intervertebral discs were protruding (or more commonly referred to as “disc bulging”). I experienced an immediate physiological response – I felt some “pops” in my lower back and was unable to move. I was in excruciating pain, but I was about to learn the truth about pain and rehabilitation.

You might be thinking, “how on earth did you do that?!” Unfortunately, diagnosing pain is not that simple and is often multifactorial in nature. Pain is also influenced by a number of biopsychosocial factors, which is the interconnection between biology, psychology and socio-environmental factors. I could not change that I injured my lower back, but I could adapt and recover from it.

At the time, I was being coached online by Dr. Jordan Feigenbaum from Barbell Medicine. Immediately following the injury, I took a few days rest from training. With Jordan’s encouragement I was back into training the following week – with some adjustments, of course.

As this was my first serious injury, I proceeded with caution. Scrolling back to 2015 on my Instagram account gives us a recount of the events unfolding in real-time, emotions and all. Throughout this blog, I will share relevant posts from when the injury occurred, the adjustments that were made, and the outcome.

The date that Rachael injured her lower back – 19 December 2015
An MRI on Rachael's lower back

19 December 2016: this was the exact moment that I injured myself. Zoom in to check out my facial expression and me clenching onto my lower back.

24 December 2015: receiving my MRI results on Christmas Eve. Obviously it was an appropriate time to ask Santa for a new back. Merry bloody Christmas!

What did we change?

After taking a few rest days and loading up on ibuprofen, I was back in the gym the following week.

We made some modifications to my training program through exercise selection, intensity (both internal and external), and training volume. It also made sense to set some new goals.

We first looked at exercise selection. We had to find an entry point with exercises that I felt comfortable performing and that either improved or stabilised my symptoms.

To start, we made the following changes:

  1. Back squats to front squats
  2. Deadlifts to Romanian deadlifts
  3. Bench press with feet on the bench.

We made these adjustments because I found them to be less stressful on my lower back. The movements I was avoiding are not inherently bad, but we needed to dissociate the pain experience from training.

Once we had found an entry point in terms of exercise selection, we modified the internal and external intensity. These factors influence how “hard” we could train. We decreased the internal intensity (RPE or Rate of Perceived Exertion) down from a RPE 8-9 to an RPE 5-6. With reducing the RPE, the external intensity (load or weight on the barbell) naturally decreased as well.

Next, we modified the volume by increasing the number of reps per set. We started as light as an empty bar with the aim of increasing the load overtime providing that my symptoms did not worsen.

We also shifted goals. Being a powerlifter, I am always pushing to increase my powerlifting total. Rather than focusing on getting stronger in the squat, bench press and deadlift, I changed goals to improve in other areas. I chose to focus on exercises like front squats and chin-ups. These exercises not only felt comfortable, but also helped me to continue training in a way that I was accustomed to, and enjoyed.

Training adjustments

4 January 2016: making some training modifications by bench pressing with my feet up to reduce lumbar extension.

9 January 2016: putting extra effort into my cardio sessions. Here I was doing a HIIT session with the prowler.

What didn’t we change?

Whilst there were a significant number of changes that were made to my approach to training and program, much else remained the same.

I did not stop training. In fact, I still continued to train 4 days per week, along with cardio 2 days per week. I also included different types of exercise, like yoga. Modifications were required as an early intervention, however I returned to “normal” training about 2 months after the injury.

I did not catastrophise the situation. I remained optimistic and was certain that I was would return to a full recovery. Our mindset can have a significant effect on our physical well-being. It’s imperative to maintain a positive outlook to improve our rehabilitation. Importantly, my coach at the time (who’s also a medical doctor) provided positive reassurance. This reassurance has been shown to improve outcomes [1].

I did not make any changes to my diet. My goal at the time was to maintain my body weight. I did not eat less to account for the lower volume or intensity in training. Contrary to that, I also did not eat more to boost recovery. I was already consuming a sufficient amount of calories that met my energy requirements.

I chose not to visit the myriad of specialists (such as physiotherapists and chiropractors) that come to mind when you experience pain. Instead, I rehabbed my lower back through strength training. In some instances it can be necessary to consult a health professional for guidance and support. In my case, I felt confident in my body and abilities to recover with my coach’s guidance and support.

22 February 2016: back to squatting 90kg for 4 reps with a barbell on my back, pain free. This was a milestone for me.

28 February 2016: dabbling in different types of exercise (like yoga) to keep myself moving and occupied.

What was the outcome of the lower back injury?

6 weeks after injuring my L4/L5, I was back squatting with a barbell on my back and deadlifting from the floor – pain free. This entire process taught me that the human body is incredibly adaptable and resilient.

Early on, my Radiologist and GP said things like “you’ll never deadlift again” and “it’ll be years before you’ll pick up another barbell”. Whilst I respect their authority in their respective fields, they were not well-versed in the current research that supports strength training to rehabilitate pain and injury. I honestly believe that without training and a positive mindset, my recovery time would have been much longer.

In the two posts below, you’ll see me deadlifting 60kg from the floor 6 weeks after the injury. The following post is a video of me squatting 110kg for a personal best 3 months after the injury.

I hope this blog gives you some insight into pain and rehabilitation, and what we can do with our training to help facilitate recovery. If you’re currently experiencing pain and need some guidance, we’d love to help. Contact us to arrange a consultation.

18 December 2016: a throwback post of me deadlifting from the floor 6 weeks after the injury (sometime in January 2016).

28 March 2016: a video of me squatting 110kg for a personal best 3 months after the injury. I couldn’t believe it!

References

  1. https://pubmed.ncbi.nlm.nih.gov/24218376/

Setbacks Aren’t Stopping Us

We love training. We also want to keep training productively for years to come. It’s obvious enough that without challenge there’s no change. Setbacks do happen however. So what can you do when despite putting in your best efforts, nothing seems to budge?

This is where troubleshooting your training can give you insight into what might be holding you back. Setbacks aren’t stopping us, and they don’t need to stop you either. Today we’ll discuss five key areas to troubleshoot. We hope in doing so you will get the most out of your efforts. The five key areas are as follows:

  1. Recovery
  2. Nutrition
  3. Programming
  4. Pain
  5. Motivation

We will cover each area to varying degrees. Ideally you can take way from this article practical strategies to implement. This month we’ve also made sure our companion article covers the same topic but shares a unique and personal perspective. Make sure you give that a read too!

Recovery

What do we mean by the term “recovery”?

Well let’s talk about another word first, “hormesis” [1]. In biology hormesis is defined as an adaptive response of cells and organisms to a moderate (usually intermittent) stress. Examples include things you may already be doing like exercise and dietary energy restriction.

People thrive on exposure to occasional stress. In the process of restoring balance after an appropriately stressful event, our bodies respond by growing, repairing and importantly adapting. Through adapting we become more tolerant to stress, stronger, and more resilient. Essentially hormesis is the positive response to stressors by your body and mind, when using the appropriate dose.

Programming and nutrition are built-in into the broader concept of recovery. I will address these other points later. Here I’m going to focus on low-hanging fruit here. Many people get caught in the weeds about what the best way to “recover” is and hyper-fixate on things like specific breathing strategies, massage tools, ice baths and more. There’s two things you can do today to improve your recovery: improve your sleep quality and practise stress management.

  1. Sleep quality: simply aim for consistent 7 to 8 hours each night with a routine bedtime.
  2. Stress management: whether it’s walking, meditation or reading a book in a quiet space – find some ways to downshift and unwind after a busy or stressful time.

Nutrition

Nutrition for the purposes of building muscle and maintaining a high training quality is simple. Although we can unpack which nutrition strategies are best, there’s only a few things people need to focus on. They are sufficient energy and protein intake. Expanding on energy intake, resistance training is anaerobic so carbohydrate intake matters too. We need sufficient protein intake to support both recovery and muscle building. We need sufficient energy to support training and the energy-rich process of muscle building overall. Below is a summary of some simple targets:

  1. Protein: 1.6g-3.1 grams per kilogram of body weight – somewhere in the middle of this range is the sweet spot for most people [2, 3].
  2. Carbohydrates: 2-3g per kilogram of body weight [4].
  3. Energy: 25-40 calories per kilogram of body weight.

The above targets are a range and do not take into account individual factors or goals. For instance, the energy needs for a 70kg female versus a 90kg male are likely to be vastly different. If you need help determining what targets you should be aiming for, feel free to contact us for advice.

Programming

This can be summed up with the following sentence: Don’t do too much too soon, after doing too little for too long. In particular however we encourage clients to build traction on a program gradually. Even when all else is equal, when individuals push exercises to an excessively high intensity (read: RPE 9 always), blindly focussing on adding weight or reps, fatigue creeps in. Good quality programming should minimise overuse and maximise fitness while minimising fatigue [5, 6]. It will involve the following:

  1. A variety of exercises, rep ranges and loading zones
  2. Gradual exposure to higher volumes and intensities
  3. Autoregulation
  4. Not consistently going to failure.

Lastly, we encourage individuals to be active outside of their strength training program. Doing so will yield a myriad of benefits such as improved stamina, helping maintain a healthy bodyweight and stress relief. These factors will ensure your resistance training is more productive.

Pain

Pain is never pleasant. We don’t wish anyone to be in it. Additionally, pain is a complex mechanism designed to protect your body. If you have the time, I recommend you watch this 15 minute Ted Talk here. What we can do with your training however is modify the stimulus. This might mean changing the range of motion, load, volume, tempo or exercise all together. Importantly, we don’t stop training. The benefits of exercise always outweigh the exceedingly rare negative experiences. On top of that, resistance exercise is incredibly safe [7, 8]. We cannot cover the topic of pain here exhaustively nor do it justice. Instead, remember that your body is designed to adapt and our goal is to help you always work from the correct entry point.

Motivation

We can’t stress this enough – seeing results come from seeing things through. Behind any successful program is compliance. So, the important question to ask is, what makes someone compliant? Motivation alone isn’t enough. Riding the high of good-feels can only take you so far. Thankfully, we can look into more practical ways to help everyone stay the course [9, 10]. They include:

  1. Understanding the consequences of doing nothing
  2. Trusting that training will be effective for reaching your goals
  3. Maintaining a positive attitude towards training
  4. Having a positive trainer/client relationship
  5. Practising good communication
  6. Comprehending health literacy
  7. Adequate knowledge and putting that knowledge into action
  8. Accessibility to tools such as your training program and fitness tracker.

Although we said motivation isn’t enough. It’s still important to know your “why”. Moreover, training should be working towards that “why”. This is why we value things like feedback forms and check-ins, allowing for programs to evolve over time to be best suited and catered towards an individual. A participant’s active role and desire is incredibly important when fostering compliance.

Tackling your setbacks once and for all

Training setbacks don’t need to stop you from making progress. Instead they can be fantastic learning experiences. By reflecting on and developing new strategies, you can always be equipped to make long term progress. We hope today that you have a better grasp of the concepts of recovery, nutrition, programming, pain and motivation. If you have any other questions, reach out to the Ivy Training team today.

References

  1. nihms39393.pdf
  2. International society of sports nutrition position stand: nutrient timing | Journal of the International Society of Sports Nutrition | Full Text (biomedcentral.com)
  3. International society of sports nutrition position stand: diets and body composition | Journal of the International Society of Sports Nutrition | Full Text (biomedcentral.com)
  4. Nutrients | Free Full-Text | The Effect of Carbohydrate Intake on Strength and Resistance Training Performance: A Systematic Review | HTML (mdpi.com)
  5. Effects of Resistance Training Performed to Failure or Not to Failure on Muscle Strength, Hypertrophy, and Power Output: A Systematic Review With Meta-Analysis – PubMed (nih.gov)
  6. Effects of Resistance Training to Muscle Failure on Acute Fatigue: A Systematic Review and Meta-Analysis – PubMed (nih.gov)
  7. Injuries among weightlifters and powerlifters: a systematic review – PubMed (nih.gov)
  8. (PDF) Injuries in strength training: review and practical application (researchgate.net)
  9. Key Factors Associated with Adherence to Physical Exercise in Patients with Chronic Diseases and Older Adults: An Umbrella Review – PubMed (nih.gov)
  10. Factors affecting therapeutic compliance: A review from the patient’s perspective – PMC (nih.gov)