Programming around Hormone-Induced Back Pain.

[Daltonar]

Hello all.

About 4 months ago I had a friend express a desire to get into strength training post bicep/shoulder surgery. (She ripped her bicep off of the bone and had to go through re-attachment. Not entirely sure what her shoulder surgery was for specifically).

I didn't let her start until she had
-Full ROM on the repaired shoulder.
-Clearance from her doctor.

I ran her through the standard NLP for three solid months, making adjustments as recommended in the gray book and she made some good progress.
Squat: 45lbs x 5 > 200lbs x 3
Press: Dowel Rod > 75lbs x 3 (Started artificially low considering repair).
Bench: 10lbs x 5 > 90lbs x 3 (Started artificially low considering repair).
Deadlift 65lbs x 5 > 230lbs x 3

>I never incorporated the power clean due to her age and the repair.
>Chins unfortunately are outside her current ability and I've not yet acquired the equipment to assist in developing them.

After her NLP workouts got really grindy, I ran her through a small reset and repeated the process. Eventually she stalled again and I switched her over to the women's version of the Texas method as outlined in Practical Programming. I was a bit nervous about it at first considering all of the nightmare stories you hear about the Texas method and the fact that she is 34 years old, but she is committed to training, loves to work hard, and the Vol/Lt/Int day setup works well with school starting back up (she can only commit to a long session once per week). For the first 3-4 weeks she seemed to really like the program and made another 15lb jump in her Squat/Deadlift for intensity day to get her numbers where they currently are (outlined above). Unfortunately, life seems to have occurred.

She and her husband are in the process of trying for a second child and after a few years with no luck, have resorted to calling in doctors for fertility tests/medications, etc. She recently started in on a new fertility medication that apparently has the lovely side effect of occasional debilitating back-pain, such that during her last session we had to abandon Squats and Deadlifts and stick to just pressing movements.

All of this being said, I want to keep her lifts moving upwards as long as possible. Her pressing movements are still moving so I'm not worried there. I'm just not sure if I can (or should) continue to expect improvement on the lower-body lifts with this new medication causing random bouts of acute back-pain.

Has anybody dealt with this sort of thing, either personally or with a trainee?
If so, what sort of workarounds/alternative movements did you implement?

[Mark Rippetoe]

She recently started in on a new fertility medication that apparently has the lovely side effect of occasional debilitating back-pain, such that during her last session we had to abandon Squats and Deadlifts and stick to just pressing movements.

You're going to have to explain this one.

[Daltonar]

You're going to have to explain this one.

I'd love to if I could. Also I'll issue a bit of a semantic correction: it might be more appropriate to call it a 'treatment' rather than medication. It is a pill she takes once monthly that increases ovulation.

She had some bloodwork done and I found out yesterday evening that she apparently ovulated for the first time in who knows how long (according to her she hadn't been before, at least not consistently and this treatment is just supposed to jump-start the system).

With that new information, I'm guessing it isn't necessarily the fertility treatment, but pain related to ovulation considering when/how it cropped up and how long it lasted.
The workout before the back pain popped up went fine, no pain of any sort during or after the workout. She said there was a bit of pain the day after that, with it becoming more severe the next day. A day after that (her next scheduled workout), all the pain was gone and she went through the entire thing without a problem.

The only thing that has changed is this new medication, and apparently that she ovulated.
At this point, I think it is just a waiting game to see if pain reoccurs during her next cycle.

[Mark Rippetoe]

With that new information, I'm guessing it isn't necessarily the fertility treatment, but pain related to ovulation considering when/how it cropped up and how long it lasted.

I think you have this figured out.

[Daltonar]

>Follow up, in case anybody in the future happens upon this thread that may be experiencing/witnessing a similar issue.

Trainee went through the treatment again this month. Bloodwork shows she again ovulated. This time the symptoms reoccurred, albeit at a lesser intensity. After a few days the back pain goes away.

[TommyGun]

My two cents and I am way under qualified, bu going through the fertility/ IVF stuff is grueling mentally and emotionally for the wife and husband.
It may be the most stress she has ever had in her entire life. This cannot be discounted and likely diminished her ability to train and recover.
Ive been through it (more specifically, why wife has). Does the cycle of back pain coincide with the doctor visits and/ or testing?