The following is of course in no way medical advice it is merely the words of a weathered lifter with a fucked back. You should, of course, seek the opinion of a medical professional before doing anything you might regret.
Back pain is coming for you, if you lift or not you are statistically likely to get struck down with some form of back pathology or back pain in your life. I have dealt with back pain for pretty much all of my athletic life from about the age of 16 onwards I have suffered from back pain of some description or another it is far from debilitating (well it can be depending on how you snap it or flare it up) but it is severely annoying.
Some Studies
Study population – 439 13-year-old children – Findings – Signs of disc degeneration were noted in approximately 1/3 of the subjects. Link to study
Study population – 40-year-old men and women – Findings – Over 50% of subjects had abnormalities in their spine, 25-50% showed signs of protrusions and other degenerative issues. Link to study.
Study population – 98 people with no back pain – 64% of subjects had a disc abnormality and 38% had more than one abnormality. Link to study
Study population – 975 participants men and women – 71% of men and 77% of women presented disc degeneration.
As you can see above from a selection of studies (taken from the top results from google with the search term – “epidemiology mri back pain”) disc degeneration and spine abnormalities are by no means an uncommon thing in the human animal. Humans are poorly designed to stand upright we spent much more of our evolutionary past as quadrupeds and as such out, skeletal structures are actually pretty well adapted to be on all fours. Point being you can practice all the spinal health hygiene you want you are probably going to be dealing with some kind of chronic or acute back pain throughout your life.
Now add in heavy lifting into the equation and you are potentially accelerating your experience of lower back pain. There are plenty of studies and unscientific opinion to suggest that lifting weights is probably actually preventative or therapeutic for back pain but this is more than likely for people who think of lifting in the way they think of eating their greens it’s a healthy habit you do in moderation for the benefit of your health.
That’s fantastic if you have that approach to your life and lifting that’s great good for you and your healthy habits. I personally don’t practice moderation because fuck moderation, that’s why.
It happened you’ve snapped your shit up what do.
Some people will be reading this article out of curiosity but I’m not really talking to you however you might want to take some notes. Chances are if you have snapped your shit recently or even very recently snapped your shit you are looking for some guidance on what to do and thankfully you have landed on this website.
Below in order are your immediate duties of care or the things you should be doing to help get yourself back on the road to tin shifting.
- Settle down the acute symptoms. If you can’t walk around without a shit load of pain or tie your shoelaces without crying a single manly tear you should probably disregard heavy spinal loading (aka shifting tin) until you can pick up your dropped pencil from the floor without the aid of smelling salts. This basically involves active rest (note not passive rest i.e. lying on your ass this is literally the worst thing you can do) do what you can keep lifting but do things that don’t hurt your back, walk, swim, cycle and do your normal life. Hot baths, massage (self or someone else), gentle stretching and anti-inflammatory drugs can all help to ease and manage symptoms. Try as much as you can to get by without painkillers but for some back pain, you will need them just to function.
- Focus on the things you can do – for lifters one of the worst things about back pain or set back is that your not training and going forward. Use it as an opportunity to work on lifts like feet up bench press, bench row, pull-ups or lower body lift you can do without pain. Spend time getting better at the things you can do and focus your training time on this it can serve as an opportunity to strengthen weaknesses and not to stew on the lifts you can’t do.
- Troubleshoot what you can and can’t do – try a whole range of exercises you can or maybe can’t do spend maybe even a week fucking about in the gym and taking notes. Once you have a battery of lifts or activities you can do pain-free then you can move on to the next stage.
You’ve settled down the pain now your back in the gym what do?
Once you have a battery of exercises you can do pain-free then you can start a programme. I will suggest below a progression of programmes you can use to reintroduce yourself to full lifting I am going to assume it’s a pretty bad back spasm or strain that will take 6-8 weeks to get back to full training. It is perfectly possible to go through the above steps, settle down your acute symptoms and get into full lifting in a short time frame it could be one or two days or even one or two weeks.
If this isn’t the case, however, you’re going to need to put together a plan to bring yourself back up to speed. Some of the ideas ahead might seem overly conservative but you need to realise the following reality
“One overstep of the line, one rep too many or an exercise too early can set you back by weeks. You don’t have a definitive answer of what that step is or how it’s going to happen but it is a very real possibility and something you need to consider seriously.”
Start with pain-free training and begin to address your back pain or weakness with low-level exercises.
You should start off with a frequency that is easy for you to make and probably less than you would normally do in the gym so if you are a normal gym goer and train 3-5x per week then you will want to start with a programme that has you training 2-3x per week. This programme will probably consist of a mixture of open chain/indirect spinal loading lower body exercises, seated or lying down upper body exercises and low-level core or rehabilitation exercises. Ideally, you will seek the help of a physio or rehab specialist at this stage to help to direct you in the correct direction the programme/suggestions below are based on generalities and won’t directly relate to your own situation.
Session 1
Feet up bench press – 3×10
Seated Shoulder Press – 3×10
Pulldown – 3×10
Seated Row – 3×10
Leg Ext/Leg Curl – 3×10
Plank – 3×30 sec
Glute Bridge – 3×30 secSession 2
Floor Press – 3×8
DB Incline Press – 3×8
Chin up – 3×8
DB Chest supported row – 3×8
Belt Squat or Leg Press – 3×8
Side Plank – 3×20 secBird-dog – 3×6
Session 3
Bench Press – 4×5
Seated Shoulder Press – 4×5
Pull up – 4×5
Bench row – 4×5
Leg Ext/Leg Curl – 4×8
Plank – 3×30 sec
Glute Bridge – 3×30 sec
The above is a very basic programme where you just use the weights you can handle based on the reps where naturally 3×10 will be a lesser weight than 4×5. Starting off light and adding weight week to week for a finite period as you back recovers (2-4 weeks depending on how badly your back has spasmed).
The important thing is the load what you can as best you can without regressing your back and it’s recovery, to look to strengthen up the muscles of the trunk and posterior chain without loading the spine or loading the spine in a way that doesn’t cause symptoms or issues. To take the opportunity to push your upper body size and strength and to maybe look at a higher frequency of upper body training than you may be used to doing.
Getting back into full training.
Once you have got to the point where you can squat bodyweight pain free or maybe done some light goblet squats without pain, lifted some light weights like a kettlebell from the floor without pain and are generally feeling healthy in day to day life and are training on a day to day basis with little to no issues or pain then it is probably time to start to get back into full training.
During this period of training, you are looking to take the patterns and ideas from the above period of training into their next logical progression and getting back into the tasks you want to pursue on a full-time basis in your training.
You can take two approaches with this kind of loading each has their positives and negatives.
- More frequent approach – 2-4x per week using the exercises you are trying to include into your programme. This will help you to tick off the acute loading of each load on for the exercise and will help you to get past the lighter training loads that you are doing to tick the box and see if you can do them. The drawback is there is the issue of chronic loading and building fatigue through the week, this is much less of an issue when dealing with loads of <60% but becomes a real concern when you get towards what might be considered training loads. This can also be a bad tactic with someone who has a long history of back pain or long-standing issues.
- Less frequent approach – 1-2x per week using the exercises you are trying to include in your programme. This will lead to a very slow return if you are going through tick box loads to check against acute loads to see what presents an issue. However, the more conservative approach isn’t necessarily a bad thing for those who have a long-standing history or particularly bad injury as it will allow for loading but makes overloading very difficult to achieve.
You can also try a mixture of the two approaches taking the more frequent approach when the loads are lower and then defaulting to a lower frequency when the loads start to come up to what you might consider a training load. I will lay out three examples of plans to bring someone back to squat and deadlift training after a 4+ week break from training
Stage 1 – Reintroduction of training in a pain-free range
The first stage or goal is to reintroduce the full movement or the movements you are trying to reintroduce in your training and have them as pain-free movement you should be looking at lighter weights and higher volumes of work. It is also probably or desirable that you start with a limited range of movement for the heavy bilateral exercises to minimise the scope for the lifter/athlete to compromise their spinal position or to flare up their back or go into spasm.
While they are moving through a limited range with heavier movements you might want to include full range of movement with exercises like – kettlebell goblet squat, kettlebell deadlift, single leg squat, pistol squat, leg extensions, leg curls, leg presses or belt squatting. Basically, the more muscular work you can get in while not directly loading the spine the better you are going to prepare the athlete for their transition into full training further down the line.
You should look to introduce range with exercises that have a smaller capacity for spinal compression or axial loading of the spine. Some good examples of that are front squat or high bar squat for squat reintroduction and trap bar deadlift for deadlift reintroduction. These variations that you are using to reintroduce range of motion back into the programme should have similar if not greater range than the meaningful task of lift you are trying to reintroduce.
When you do introduce your meaningful task of full lift then it should be done on a pain-free basis the loading should be done at a pace and with volumes that don’t flare up your back. Some pain/stiffness can be acceptable but that depends very much on how far along you are in the return process and how bad the original back injury was/how long and illustrious your previous back injuries were.
Stage 2 – Reintroduction to full training
When it comes to the second stage of reintroducing yourself to training after a back injury or a long lay off then you are looking to get back up to two things
- Train using similar or slightly higher volumes of training than you would use when you are fully fit or when you are looking to get stronger. It is important that this is volume (i.e. number of reps in the week) and not intensity (weight on the bar) or volume load (total KG lifted in the week i.e. intensity x reps) as these are likely to result in overload when applied to tissues that aren’t fully healed or conditioned for training.
- You should be using the same frequency and week structure you are intending to use in the next phase of training or in your training going forward. This is to expose yourself to the pattern of loading your tissues will be undergoing during the week to allow them to adapt and acclimatise to your training pattern. It will also allow you to flag up any likely issues going forward.
You should be starting to get into training with intent and experiencing less pain and discomfort from your training as the block goes on. Any issues flagged up such as back seizures or pain developing should be noted and treated with whatever means you have. You should try and work through lower levels of discomfort but if it starts to become recurring and more debilitating in nature then you may need to go back a few steps in your reintroduction process.
At the end of this period of training, you should be feeling more confident about your abilities to train under a full programme and begin to be able to think about loading towards heavier intensities or performing heavier working sets and being to try and being the process of producing overload and getting stronger.
Stage 3 – Return to pull training
Your first full block of training you might want to include one heavy or overload session in the week and operate a lower load/volume based session. This could be a good time to try some of the dynamic effort methods or speed work advocated by templates such as the original 4-day westside template or other more recent additions such as Brandon Lilly’s cube method.
You will probably want to stay away from any kind of acute overload based approaches these are programmes based on placing a high amount of loading into one workout examples of which are
- Rep outs / AMRAP (as many reps as possible) approaches an example of which would be 5/3/1 or some elements of the juggernaut template.
- Max effort days in the westside template or other similar programmes.
- Pyramid schemes some of which can be found in some of Boris Shikeo’s programmes.
- Cluster sets, drop sets or any form of spinal loading taking towards failure.
The reason being by doing any form of acute loading or using methods that are designed to bring you towards concentric failure either through volume, intensity of effort or lifting towards 100% of max you are increasing dramatically the chances of you flaring up or overloading any underlying issues that may be still present in your back.
If you follow a more traditional or the more common kind of powerlifting specific templates that have been popularised by the work of people like Mike Teschner then you might want to look into progressing on with the work of the previous block following a progressive ramp in volume load and intensity over 3 week waves and then providing a deload of 50-60% volume every 4th week to ensure you are deloading your spine and the tissue surrounding it.
Once your back into training, what are some other training variables you should consider?
- You should be looking how to move in the most protective manner you can around your spine you should be looking to learn how to brace correctly and to adopt as close to an optimal or safe technique as you can manage.
- If you haven’t hired a coach before now would be a good time to find someone reputable in your area to help you direct your training. Whilst online coaching can be very effective and is a really good option if you don’t have anyone with the necessary skill set available in your area it’s probably a good option. However, if you have a good coach in a travelable distance you might want to consider hiring their services.
- You should be looking to give yourself the best opportunity possible to perform or to be able to train in a productive manner as such stretching, mobility, warming up and soft tissue work are all management strategies you should be looking to explore and include in your training process. On their own none of these things is a silver bullet but when used properly they can increase your proficiency in training and your healthy training life.
- Take notes of when you are reactive refer to your training Diary and see what exercises you were doing, the volume you were using, intensities you were using. Also, take note of the training week the way in which it is spread and where the points of loading are. You should be able to come up with a structure that works for your body and recovery ability through a trial and error process.
- You should be looking at additional conditioning you can do for your trunk these should be done in a way that adds to what you are doing. For example, some glute and spinal stability work might be best done in a warm-up or done in post-session. You should try and develop a better understanding of how the spine works and ways of developing it for performance whilst you don’t have to be an expert in the field the more you understand the better you will be able to define what you need to do or help guide yourself in the correct direction.
This article is here to give you ideas and guidelines and is in the way here to replace the input of a professional. But hopefully, it can help to get you thinking about structures, progressions and where to go post back snap.
Marc