How soon to start rehab lifting after a lower back injury? How soon to start rehab lifting after a lower back injury?

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Thread: How soon to start rehab lifting after a lower back injury?

  1. #1
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    Default How soon to start rehab lifting after a lower back injury?

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    I'm a 52 year old, intermediate lifter. I was doing a back-off deadlift set yesterday and felt a sharp pain in my low back. I dropped the bar and started walking around, later performing some air deadlifts and squats, which seemed to help a little. I have full range of motion which is uncomfortable but doesn't cause additional pain, so I know I've got nothing to really worry about - just a significant low back tweak.

    After a difficult night’s sleep, I’m fairly uncomfortable no matter what, though movement (air squats & deadlifts), lacrosse ball rolling, and using a Tim-Tam (sort of like a a jigsaw with a golf-ball sized plastic end, if you’re not familiar with it) makes things feel a little bit better.

    Should I start on something like the Starr Protocol right away, or would it be better to avoid even an empty barbell for a day or two? I've heard arguments both ways, and was hoping to get some additional input from people who know what they're talking about. Thanks.

  2. #2
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    My general recommendation is this: if there are no symptoms that would be indicative of a significant pathology, nor a significant mechanism of injury, rehab should start almost immediately. Some information about what point in a deadlift or squat movement causes increased pain would be helpful for more specific recommendations, but, at that point, specific recommendations should come from a formal consultation.

  3. #3
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    Thanks for the reply. Air squats & air deadlifts don't hurt at any point in the range of motion - so I'm leaning toward starting some higher rep, very low weight squatting and pulling once I give things a day to calm down a bit.

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    Quote Originally Posted by Dr.B. View Post
    Thanks for the reply. Air squats & air deadlifts don't hurt at any point in the range of motion - so I'm leaning toward starting some higher rep, very low weight squatting and pulling once I give things a day to calm down a bit.
    Many people will disagree with me, but I have found that a higher load for very short sets is much better than high rep / low weight protocols for returning to training reducing reinjury rates.

  5. #5
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    Quote Originally Posted by Will Morris View Post
    Many people will disagree with me, but I have found that a higher load for very short sets is much better than high rep / low weight protocols for returning to training reducing reinjury rates.
    Interesting. I was planning to do something like the Starr Protocol, which as I'm sure you know is the opposite of that.

  6. #6
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    Quote Originally Posted by Will Morris View Post
    Many people will disagree with me, but I have found that a higher load for very short sets is much better than high rep / low weight protocols for returning to training reducing reinjury rates.
    Will,
    I tried your protocol and it worked BEAUTIFULLY. In my case I have used it so far for a hamstring belly injury and an adductor injury. Both times I used compression on the affected leg and did sets of doubles with a slower descent on squats and was very pleased with the results. Thx and highly recommend

  7. #7
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    Quote Originally Posted by Dr.B. View Post
    Interesting. I was planning to do something like the Starr Protocol, which as I'm sure you know is the opposite of that.
    Aside from any other considerations for or against, the Starr Protocol is not intended for back injuries or joint injuries, only for muscle tears. Sorta hijacking here, but it seems that no matter how many times Rip has explained this, people are continually trying apply it to situations where it is a terrible idea and not something ever recommended.

  8. #8
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    I've had a zillion back tweaks from squats/deadlifts and tried all sorts of treatments. What I find works quickly and reliably is just stretching the lower back. My operating theory is a typical tweak is just a muscle cramp.

  9. #9
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    Quote Originally Posted by Dr.B. View Post
    Interesting. I was planning to do something like the Starr Protocol, which as I'm sure you know is the opposite of that.
    I am quite familiar with the Starr Protocol. Starr was a brilliant man, and his idea of working a muscle belly tear almost immediately after injury is (still) revolutionary. The Starr Protocol has helped (probably) thousands of people return to training after muscle belly injuries. I cannot say this harshly enough, however, the Starr Protocol is NOT APPROPRIATE for joint, tendon, or back injuries. It is NOT APPROPRIATE for tendinitis, myalgia, arthritis, or other maladies. It is appropriate for muscle belly tears, and, honestly, I think we can do better even for those.

  10. #10
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    Muscle belly tears are a classic example of tissue damage and are rightfully called an injury. Back tweaks are not generally attributable to any specific tissue damage, and it may be inappropriate and misleading to use the term “injury” for them, and certainly the rehab should take a different approach.

    I would view nonspecific back pain and tweaks as a “functional” pain syndrome (as opposed to “structural”), and certainly the observed history and reported remedies are different from those seen in structural injuries. So even if we don’t (yet) know exactly what causes this type of pain, we do know some ways to address it. Interestingly, thinking of it and treating it as an “injury” appears to be counterproductive.

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