Rosemary is a woman in her 60s. April 2011 she fell over with sciatic pain down both legs and was stuck in bed hopped up on morphine. The MRI report reads in part,
"The L4/L5 disc is degenerate with quite extensive annular disc bulging. L5/S1 disc also shows degenerative features with diffuse annular disc bulging at this level. There is considerable oedema and swelling of the left L5 nerve root immediately beyond the left of the exist foramen where the nerve is compressed by laterally situated disc material. There is also quite marked compression of the L5 nerve root more superiorrly in the lateral recess due to the supra-adjacent L4/L5 disc pathology.
[...] There is moderate severity degenerative change in the mid and lower lumbar facet joints bilaterally. This is associated with some minor oedema involving the L4/5 facet joints and also at the L3/4 facet joints."
She also has osteoarthritis in her spine. Recommended was laminectomy and nerve root injection - basically shave off some of the bulging disc and numb or kill off the painful nerve.
Partly on the advice of her physiotherapist daughter who's worked in a surgical spinal rehab unit, Rosemary rejected this, and decided to work out instead. Essentially she swam for six months, this being a non-load-bearing way to strengthen muscles. After that she got a gym routine from me, I got her doing cable rows and the like, again strengthening things without bearing a big load through the spine.
April 2012 she started personal training with me. At the time PPST3e was not published, and I was the only one of the 15 trainers at my gym who coached barbell lifts at all, so I had to experiment and improvise. The way I see it, muscles seize up because they're trying to hold the joint together - strengthen the muscles, and they won't have to seize up. She trained with me once a week, then repeated workouts on her own twice more during the week.
Like most women in their 60s, she was not strong enough to squat or press the 20kg empty bar. At the time we didn't have bumper plates and I wanted to reduce the range of motion anyway, so deadlifts were also out.
We began with unweighted goblet squats, planks, kettlebell deadlifts and the like. My theory was: the movement is more important than the load, build good movement and the load will come.
2012 May in her 7th week she did rack pulls with 35kg; the ideas was to reduce the range of motion to make it easier to keep the lower back in extension and thus safe. On being confronted with her first 20kg warmup set, she said, "this won't hurt my back, will it?" I explained that the work we'd done so far meant it wouldn't. I had her do rack pulls for 5 reps x 3 sets, and added 2.5kg each week. Some weeks she couldn't do it, so we just did 3s, then tried again the next week.
2012 June in her 12th week she did her first barbell squats, 20kg for 3 reps x 5 sets. I chose a progression of 3 reps in one session, 4 reps in the next, 5 reps in the next, add 2.5kg and back to 3 reps.
2012 September she was up to squatting 32.5kg 5x4 and pulling 70kg in the rack, so in the following session I had her max her squat and try weights from the floor. She squatted 45kg and pulled 60 for an easy single, then 65, then 70.
I said, "Rosemary, I think we can safely say that your rehab is over. If you can regularly and reliably deadlift your bodyweight, that's probably as much as you need to do to keep your back safe. You could go further, maybe do 80, 90, who knows. But just for health, you could stop PT now and just maintain."
"No, I want to see how far I can go."
I went and bought her some weightlifting shoes.
Progress of course has not been linear since then. People go on holidays and detrain, and detraining is more profound for older people than younger, you need a bigger deload after illness or holiday. Nonetheless she's made progress, and has competed in powerlifting meets since then. Here she is in March this year, almost 3 years after her initial MRI report, and almost 2 years after starting training with me. At 6kg she went 70/25/90 for 185, with a 4th record attempt at deadlift of 95.
Personal training clients typically don't go well with traditional peaking cycles since they can't make every session, and can only train for 30-60' each time. So we need a fairly robust routine that can handle that. Nowadays I'll take people through their linear progression, and once it starts getting hard I change them to 6 week programmes of "4 steps back, 5 forward," where the "step" is 2.5 or 5kg.
For example if a person was up to work sets of 105 in squat, they would deload to 85 in the first week, adding 5kg a week until 110 in the last week. So they're adding 2.5 or 5kg to their work weights every 6 weeks.
Now preparing for Nationals in June, she'd been up to squat work weights of 60kg and managed 70kg on her third attempt. First six weeks she worked to work weights of 62.5, this current six weeks it'll be up to 65. I hope that since work weights of 60 got her 70 on the day, 65kg 5x3 should get her 75. Likewise deadlift was at 80kg 5x1 and she could do 95, so 85kg 5x1 should get her 100. She'll be 66 years old by then.
Already she's set national records. It's true that her class was blank. You could say, haha, no competition - or you could say she has done something nobody else has done before. It's exciting training her, because we honestly have no idea how far she can go, we have no examples to follow.
She says she's in constant pain - DOMS! No sciatica. She's not had a further MRI. As a high school teacher, she frightens her students by threatening to throw troublemakers out the window. Thus her nickname on the vid.
Starting Strength and its variants are something to try before trying surgery. Without the SS books and DVD, and in particular without the SS seminar I attended last year, I could not have helped her achieve these results. I've no doubt that an actual SS coach could have done better for her. Nonetheless she's done well and is happy with her results. With her consistent hard work and positive attitude she is an excellent example to everyone else in the barbell team at my gym.