Powerlifting, Rehab, Uncategorized

How to return to training after a back injury – a case study – Step one getting back to training

My name is Marc and I have a back spasm.  The first important step to solving a problem or issue is to admit you have a problem or issue.

Week Commencing the 13-August-2018 I had my last heavy week of training coming into the ABS Pro Invitational in Dublin.  Training was going well and I was coming down the home straight.  Then Monday’s heavy squats occurred.

I worked up in singles up to what should have been a banker of a final heavy single of 310kg given that I had doubled 300kg the week prior and there was at least a rep in the tank.  But I bombed in/over psyched myself (insert excuse here) the long and short of it I fucked up my timing at the bottom and couldn’t stand up so I ditched the weight.

Which in itself maybe wasn’t a huge problem it’s not the first time I have ditched a back squat but it is the first time I have ditched 310kg in knee wraps.  Regardless I went on to do 270kg x 4 as a down set, sat down to the laptop for a bit of work and then stood up to take another rattle at 270kg, standing up told me that wasn’t a good idea.  So I stripped the bar and left it there.  Rest of Monday was pain-free.

Tuesday morning rolls around and it’s bench day.  Gotta do a video on squats for social media tho fam, so take the bar out and do a single rep with 20kg.  Something is rotten in the state of lumbar.  Instant regret shoots down my back and onto my face and I am in a hurt locker.  Put the bar back and then do some more warm-ups so can do empty bar squat demos.  Squatting is still sore but pain-free enough I can do reps with an empty bar to make a demonstration for a video

This was not a good idea .avi.  The next hours where a nice experience of gradually tightening up of the lower back followed by a lack of mobility.  Come Wednesday and getting out of bed is a solid 10/10 RPE with delightful pain running down my back.

Thus begins the tale of one snapped up balding, fat powerlifting coach’s journey to getting back to picking stuff up and putting stuff down without crying in pain or pissing myself.

Step one – get over yourself.

I was looking forward to the ABS comp I’m not even going to pretend like I am not fucking gutted I am not going but going to the competition and pretending like I don’t have an underlying problem would be a stupid decision.  It’s not the Olympics it’s just a fun competition.  So the first port of call was to think about the current situation and to make the right call for my training going forward as in for the next year.

Once I had decided on what was the best course of action (pulling out of the comp so I can make sure I get a good and complication free reintroduction) the next part of the process was trying to look at the bright side of the situation.

  • It’s a chance to let my shoulder calm the fuck down – I’ve been having recurring pain and issues in my left shoulder due to my pre-existing suspected labrum tear.  It has been groggy and annoyed for about 4 months now.  So this was a good opportunity to give it some respite.  I was able to perform pain-free pull-ups today for the first time in about 16-20 weeks so that is a huge step forward already.
  • Going to force me to take some time out of heavy lifting – you should really look at having about 4 weeks away from powerlifting training every year for most people this is normally taken up by holidays.  I am shit at taking holidays so this is a forced minimum of 2 weeks rest.
  • It’s a chance to get into a good work capacity block to set me up for some good training going forward.  Any excuse to take some time to work on the foundations of your training (work capacity/resilience/hypertrophy) is a good opportunity to set yourself up for better training cycles to come.

This stage is the most important as until you accept fate and are willing to do what needs to be done to the best standard it can be done you will be stuck in this stage.  I’ve had a few long-term injuries so I have some experience of this one so I know the best thing is to accept fate and get on with life.

This is hopefully just a 2-4 week sidetrack and not a long-term injury but only time will tell on that front.  As I progress we will see but I will make sure not to force myself into doing something I am not ready for as this will only lead to set backs.

Step two – let the pain resolve

Once you have committed to taking the necessary steps to try and come back from your set back or injury in the best manner available.  You need to then first of all research and then execute on the practical steps needed to make a good and full return.

Before you can go back to the training you need to achieve the following important landmarks.

  • Reduction or removal of general acute pain/symptoms around the affected area.  For me this means being able to move around day to day with minimal discomfort/pain in my back.  This was more or less achieved by yesterday (Sunday or 6 days post incident).
  • A pain-free range of movement specific to your training – you need to be able to move through the movements you are wanting to train unloaded with as close to no pain as possible.  In my case, these are bodyweight squats and hinging at the waist to pick something up from the floor.
  • You need to understand and practice good “spine hygiene” meaning you need to realise that everything you do in life has a chance to introduce you to load and injury.  The better you are at adopting optimal or good mechanics the better your back health will be and the longer your pain-free train life will be also.
  • Move within reason – walking, swimming and just generally moving around is good for your back and body the better you are at not being sedentary the better and quicker your recovery will be.

If you have a lapse or you flare up your injury or back pain then YOU MUST REGRESS to step one of this process, pushing through a sore/stiff back is not a good idea unless you have to.

Week commencing 27-August 2018 I managed to achieve pain-free bodyweight movement and lightly loaded movement (squat with 80kgx3 and RDL with 80kgx3).

I am also doing 1-2x swim sessions a week involving walking and light swimming in the water to unload the spine and encourage movement.  On top of this, I am trying to get in 10,000 steps a day as walking will help to train your quadratus lumborum which is very important for spine health and something we generally don’t train directly in the gym.

Step three – start to lay the foundations

Before you can start getting back into heavy weight training or performance training you need to develop good movement and the muscular endurance needed for your training routine.  This is going to vary from sport to sport or from person to person.  Since I am talking about myself I am going to be focusing on powerlifting training.

The following is my day to day maintenance routine I am using to help target muscular endurance and capacity in the low back, glutes, abdominals, abdominals and quads.

  • BW Squat – 3 sets 10

  • Bird Dog – 3 sets 2, 3, 4 (10 sec hold on each rep)

  • Hinge w broomstick – 3 sets 10

  • Banded Clam shells – 3 sets 10

These are done currently every day to help build up the important movements, coordination and muscular endurance around the muscles and movements that I use in my training on a session to session basis.

The exercises you choose will be based on the back pain/injury you have and the sport you are trying to get back to.  What you should be looking to develop with these exercises

  • Error-free movement – you want to train with low load and high volume the correct movements that you will be trying to utilise under high load or velocity in your sport to perform at a high level.  Doing a high volume of flawlessly executed reps of this every day will help to lay the base of your ability to load without pain going forward.
  • A stepping stone towards more intense training – whatever you are using to lay the foundation of your program or rehab program should also have a clear path from where you can progress them on to be performance training exercises further down the rehab process.
  • Develop muscular strength and eventually, endurance – this basic level of conditioning will allow you to better sustain and recover from more intense training.  One of the most common mechanisms for injury in sport is when a poorly conditioned athlete tries to train at volumes and intensities they haven’t done the physical preparation to sustain.  This is one of the main reasons exercise routines like CrossFit get such a bad reputation for injury.

Currently, I am on week 2 of reintroduction to training and am feeling tremendous benefit from the bodyweight movements in my day to day movement and ability to be pain-free.  It is also making rethink my approach to lower level conditioning for heavy lifting which I will maybe expand upon in later writing.

In the next part of this article series, I will cover how I reintroduce heavy lifting and ultimately get back to competition.

Cheers,
Marc

 

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