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Thread: Probable Overuse Injury, Manifesting as Lumbar Strain

  1. #1
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    Default Probable Overuse Injury, Manifesting as Lumbar Strain

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    Hi all,

    Just wondered if anyone would be able to help diagnose a small issue, and what the best course of action might be from there.
    The short of it will be followed by a longer section on context, with extra (hopefully pertinent) information.
    Figures begin in lbs, but then end up kg just for accuracy's sake. Englishman living in Japan, current age 31, height 6'3", weight 104kg.

    The short of it: What is the best (and perhaps quickest) way to return to squatting and deadlifting following what feels like short-term overtraining, precipitated by over-eagerness (and sheer joy at lifting again) and likely inadequate recovery, but resulting in what feels like semi-severe lumbar strain?

    The long of it: Throughout 2020 I embraced Starting Strength and became an avid lifter, never missing a session throughout the year. By December I was squatting 435lbs for a set of five, and could deadlift around 350lbs for a set of five. Due to pulling my back deadlifting in September of 2019 (which did ultimately lead me to discover Starting Strength as I lay recovering, wondering what went wrong), my deadlift was always a bit on the light side, as overcoming the fear of something going wrong proved a big challenge at that point. Bench was 295lbs for a set of three, press at 185lbs for a set of five. All this is to say that I'd argue that my numbers were acceptable for the 9 months or so of solid time and effort I devoted into the program, and I'm fairly confident of my form, by and large. Please feel free to chide otherwise as necessary for my puny numbers, etc., should that appeal. The only downside is that I ballooned in weight from 115kg at the start to just shy of 140kg by the end of 2020. Eventually this, and other priorities creeping in, led to a small break from it all.

    Due to a number of stop-start efforts throughout the early part of 2021, I began to accrue small injuries here and there, and decided to hang up my lifting belt for a while. Cue back pain steadily increasing in the background over time, probably not helped by my rather sizeable mass by that point. Late April, I return to the gym keen to remedy my back, do a set of five for 40kg, 50kg, 60kg, and then at 70kg descend with as much control as a lead balloon sinking to the ground, and blow my back out again. Head home, lick wounds, but due to how much I'm carrying around the pain from this takes considerably longer to overcome than the first injury. Oh boy. Get an X-Ray though, and no particular issues outside of the fact that my back is in incredibly intense pain. Three weeks later, I'm back in at the bare barbell, and build up from scratch, very slowly adding weight. Terror reigns my mind as I lift, but I get back up to around 100kg for my squat and deadlift by August, then miss a week due to the death of a friend, and when I return decide that I feel such great confidence that day that I'll pull 100kg for three sets of five with the deadlift. Feel fine when I get home; do not feel fine when I wake up in the middle of the night to use the bathroom. No sir. Week of pain. Decide that it's time to lose weight instead.

    Spend a year cycling and eating better, get down to 102kg. Probably due to cycling so excessively, back pain begins to creep in semi-severely, at least to the point that there's almost constant mild discomfort. Am unable to sit down for prolonged periods of time without a niggling sense of pressure in my lumbar spine.

    August 29th, 2022, I say fuck it, time to rejoin the gym, and go back. Work up to squatting 60kg for a single set of five, and around 50kg with the deadlift. A bit sore when I get home, but the next day feel amazing, almost no pain in my back at all for the first time in maybe five months. Fuck yeah. Wednesday (August 31st) I go back, squat 65kg for three sets of five, bench 70kg for three sets of five, and deadlift 60kg for another single set of five. Sore after a few hours at home, but feel better the next day. Friday (September 2nd) squat 65kg again for three sets of five, bench 70kg for 3x5, deadlift 60. Sore again, but basically dissipates by the end of the following day.

    Monday (Sep 5th) rolls round: squat 70kg 3x5, press 60kg 3x5, deadlift 65kg 1x5. Feel great.
    Wednesday (Sep 7th): Squat 75kg 3x5, bench 80kg 3x5, deadlift 75kg 1x5. Feel great.
    Friday (Sep 9th): Squat 77.5kg 3x5, OHP 62.5kg 3x5, deadlift 80kg 1x5. Feel pretty good. Saturday evening, back pain begins, when I valsalva idly as I'm watering my garden, so to speak, I can feel pressure in my lower back. Throughout the two week process I've been feeling great, and so also neglected somewhat my caloric intake and general sleep, only getting around 6-7 hours a night.

    Plan to visit friends Sunday through Tuesday, and don't want to miss the Monday session, so decide to just push through and do a fourth set in the week. Sunday September 11th, I squat 80kg 3x5, bench 82.5kg 3x5, deadlift 85kg 1x5, and largely call it a day. Back begins to ache again. Stay in a tiny capsule hostel basically without AC, sleep like colossal shit on the Sunday night (maybe 4-5 hours of quality rest if that), but back feels better the following morning. Spend the day with friends, back begins to low-level but persistently ache several hours after waking. Sleep fairly badly the next night due to general discomfort at not being in my own bed, feel better when I wake up. Go swimming, yada yada, pain begins again around several hours after waking. Mild and endurable, but would rather it wasn't there. Return home.

    Wednesday (September 14th), return to the gym, squat 82.5kg for 3x5, press 62.5kg but can only manage four reps, do a walkaway set, deadlift 90kg. Back feels mildly sore again, but at least I'm sleeping more. Still probably not eating enough, though.

    Friday (September 16th), squat 85kg 3x5, bench 85kg 3x5, deadlift 92.5kg 1x5 during which I feel a very tiny tweak, which may even have been part of my imagination. Nonetheless, soreness fairly soon, bearable the next day but not great. Try to rest over the weekend, and get enough in, but there's a general soreness on my right side extending around my lower back come Monday.

    Monday (September 19th): work up to squatting 87.5kg 3x5, but all bar the first 2/3 warmup sets have some level of discomfort and pain. This may have been a sign. Almost wince as I put the 87.5kg on the shelf of my shoulders, but belt up, go very slow, and manage to do the three sets of five. Doesn't feel great at all. Press 60kg for three sets of five, but there's a definite pain in my back. Do some light powercleans (30kg), call it a day. Upon returning home, make the monumental error of going straight to bed. After an hour of reading and relaxing, I decide it's time to see where we're at, and attempt to stand up. Back has turned to pure rotten concrete, and is as stiff as a board. Oh boy.

    Take the week off (possibly an error?), attempt to go back on the Thursday but feel like I'm simply way too stiff still, end up actually returning on Sunday (the 25th). Work up to squatting one unbelted set of 60kg for five (being very cautious), no huge increase in pain between warmup sets, but there is a noticeable jump from 50kg to 60kg, hence my capping it there (had hoped to go to 70kg). Benched 80kg for 3x5, deadlifted 60kg for 1x5. Sore when I'm done, but spend the day moving around, and the aftermath is much more bearable. Sleep is stiff that night, as it largely has been since the 19th.

    Tuesday (27th) I squat 40kg for three sets of five, press 57.5kg for 3x5, deadlift 60kg for 1x5. Deadlifts seem to help, and back feels lighter, but my confidence is returning in such stride that with my final workset to go, I decide to spontaneously perform a parallel pull-up, and on the second rep feel something go in my back, and my upper buttocks seize up slightly. For fuck sake. Perform the final workset of deadlifts anyway, feel utterly deflated and frustrated at these injuries, spend the day walking around, eating ample protein and rice etc., go to sleep eventually that evening. Stiff and uncomfortable, but the next day isn't too bad. That being said, by the end of the Tuesday evening, I had been able to bend over and lay my hands flat on the floor with minimal (0.5 or 1/10 at most) pain, and move around basically unabated, with pain only returning at 2-3/10 levels upon sitting down for too long, and going to bed.

    Thursday (yesterday) I simply repeat the same set, with the exception of an 82.5kg bench for 3x5, to see whether the pain lessens or gets worse. My spine itself seems fine, actually, but that same niggling spot mildly off-centre since Tuesday of my upper buttocks/lower lumbar region feels even tighter afterwards. Again, am able to lay hands flat on ground with basically no pain after moving around most of the day. Throughout the whole week, I've woken up feeling very stiff, and today (Friday) is no exception, but after moving around it does slowly get easier. Tidy my apartment, go to work, have maybe 2 or 3/10 discomfort throughout the day, but can get through it all. Veeeery mild occasional sciatica down my right leg (back in September 2019 - December 2019 I had fairly severe sciatica which went away with deadlifting, so I'm no stranger to it, and this doesn't feel quite that bad).

    So there's my life story, and I'm sure I owe anyone who's made it this far a very expensive drink in return someday.

    To get back, then, to the initial question, and to let any poor soul who's still reading this return eventually to their wife and family:
    - Did I do too much too soon? Going from not squatting and deadlifting at all to 87.5kg/92.5kg in three weeks/around 18 days, respectively, seems a bit on the overeager side.
    - Does the Starr rehab protocol apply here to what might be an overuse injury? Can this be conducted whilst still benching and deadlifting, if I choose to use squatting as the primary lift for it, say?
    - In a separate thread ("What would you consider an injury that calls for not lifting for a while"), Rippetoe states with "an overuse injury that cannot be warmed up enough to train through. These things you train around, meaning you train everything else that can be trained while leaving the injury alone, so that the system receives stress but the affected tissue does not." Would it be advisable then to simply not squat or deadlift at all, but continue benching and pressing for a week or two until my back begins to feel better?
    - I'm due to return to the UK at the end of October for two and a half weeks for a funeral, so I'm curious if it would be a good idea during that period to simply lay off everything and return to lifting once I'm back here in Tokyo, hopefully on the mend. Does this sound advisable?
    - In terms of sending in a squat form video, I attempted to record one the other day but was told that at my current gym I'm not allowed to. I know. I will clandestinely shoot one anyway as soon as I have a willing accomplice able to help out with this, but for now please forgive me for being unable to send that in. Whilst I am fairly confident in my ability to squat and deadlift (especially given the near instant relief I felt at first upon returning at the end of August), it is of course still possible that unseen issues are holding me back.

    I'll leave it there, but thank you enormously everyone who's read this far for being part of such an excellent, considerate, and dedicated community. I love lifting, and am simply keen to return to the fray as soon as I'm able to, so any advice at all to help me get a general lay of the land here would be incredibly well received.

    All the very best,
    Leo

  2. #2
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    I'm not going to read this. Anybody else?

  3. #3
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    Hi Mark,

    Thanks for the reply in any case.

    To be more succinct about it (context still above, if you're in need of a novel)

    What is the best (and perhaps quickest) way to return to squatting and deadlifting following what feels like short-term overtraining, precipitated by over-eagerness (and sheer joy at lifting again) and likely inadequate recovery, but resulting in what feels like semi-severe lumbar strain?

    Additional secondary questions, for which I will be most indebted to anyone able to help:

    - Did I do too much too soon? Going from not squatting and deadlifting at all to 87.5kg/92.5kg in three weeks/around 18 days, respectively, seems a bit on the overeager side.
    - Does the Starr rehab protocol apply here to what might be an overuse injury? Can this be conducted whilst still benching and deadlifting, if I choose to use squatting as the primary lift for it, say?
    - In a separate thread ("What would you consider an injury that calls for not lifting for a while"), Rippetoe states with "an overuse injury that cannot be warmed up enough to train through. These things you train around, meaning you train everything else that can be trained while leaving the injury alone, so that the system receives stress but the affected tissue does not." Would it be advisable then to simply not squat or deadlift at all, but continue benching and pressing for a week or two until my back begins to feel better?
    - I'm due to return to the UK at the end of October for two and a half weeks for a funeral, so I'm curious if it would be a good idea during that period to simply lay off everything and return to lifting once I'm back here in Tokyo, hopefully on the mend. Does this sound advisable?
    - In terms of sending in a squat form video, I attempted to record one the other day but was told that at my current gym I'm not allowed to. I know. I will clandestinely shoot one anyway as soon as I have a willing accomplice able to help out with this, but for now please forgive me for being unable to send that in. Whilst I am fairly confident in my ability to squat and deadlift (especially given the near instant relief I felt at first upon returning at the end of August), it is of course still possible that unseen issues are holding me back.

    Amply thankful regards,
    Leo

  4. #4
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    Quote Originally Posted by Mark Rippetoe View Post
    I'm not going to read this. Anybody else?
    I tried.

    Lots of references to non-specific pain, stiffness, and pressure in the low back. Several mentions of apprehension and fear approaching the lifts.

    Biggest thing that stood out in the early part of the post was a 435x5 squat versus a 350x5 deadlift. I'd say we need to see a squat video at the very least.

    To the OP, it sounds like you're dealing with back tweaks. Usually these are a result of the neuromusculoskeletal system trying to *avoid* injury rather than an acute injury themselves. This happens at a subconscious level, but I'd encourage you to think about how your conscious thoughts as you approach training are reinforcing that mechanism.

    Grant Broggi wrote a nice blog post on the subject. Lifting and Back Pain - The Strength Co.

  5. #5
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    Hi Matt,

    Thanks for taking the time to reply, and sharing that article by Grant Broggi. The basic takeaway of pain being a response to changing environments (and thus to not fear it quite so much) is one I'll definitely keep thinking about.

    Currently, in this specific case, there's a distinct pain roughly where I'd say my gluteus medius (guessing a bit here) connects with my lower lumbar spine, specifically on my right side. Air deadlifts, squats, and a light walk didn't lessen the soreness this morning, so I'm going to give it another two days, then see from there. The plan is to hopefully knock out some warmup sets with the squat and deadlift, and do my full workload of presses for the day between these.

    Quick one on the squat/deadlift point: given that the NLP recommends squatting and deadlifting three times a week, but then eventually narrowing the deadlifts down to every other session, and then eventually one out of every four sessions (DL > chins > PC > chins > DL is my understanding), wouldn't it be natural for the squat to remain somewhat above it? Just curious on where my misunderstanding is here.

    Best regards as always, and thanks again,
    Leo

  6. #6
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    Less Dostoevsky, more Hemingway, please.

    But, briefly: Starr protocol is for muscle belly tears. I don't believe that's what you're dealing with. Overuse injuries are dealt with by temporarily reducing loading and volume.

    I also think you're not managing your recovery well. At least I think I caught that somewhere around chapter 3.

    On the squat/deadlift question, no. Typically the deadlift starts heavier and takes larger jumps in the beginning and thus stays ahead of the squat through the end of NLP in spite of the lower frequency. This has been discussed elsewhere.

  7. #7
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    Hi Matt,

    Thanks for taking the time to respond again.

    In all likelihood, you're quite right and I'm not managing my recovery as well as I could be. All the same, I'm trying to learn what I can and can't do, and to act accordingly from there. Thanks for the input you've offered there, and for additionally clarifying my confusion surrounding deadlifting and squatting numbers.

    Best regards, and may you find great joy in lifting spectacular quantities of heavy objects,
    Leo

  8. #8
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    starting strength coach development program
    Quote Originally Posted by McCawidule View Post
    Hi Matt,

    Thanks for taking the time to respond again.

    In all likelihood, you're quite right and I'm not managing my recovery as well as I could be. All the same, I'm trying to learn what I can and can't do, and to act accordingly from there. Thanks for the input you've offered there, and for additionally clarifying my confusion surrounding deadlifting and squatting numbers.

    Best regards, and may you find great joy in lifting spectacular quantities of heavy objects,
    Leo
    You're welcome, and good luck. Also, keep in mind that not only are you detrained, you're at a much lighter bodyweight than you were when you started NLP the first time, not to mention where you ended it. Your mechanics, recovery capacity, and overall strength will be impacted accordingly. Something to consider would be to limit your squat jumps to 2.5kg per workout, and deadlift once a week while pushing that up by 5kg for a while. This should give you some relief while allowing you to get your back stronger, which you need, based on your previous numbers. And figure out how to manage your recovery. You have a lot less room for error at 104kg than you did at 140kg.

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