Joe’s Spine by Adam Skillin | January 18, 2018 When he was 16 years old, Joe Zirkle shattered his vertebra in a bad car accident. His most significant injury was a severe compression to the spine, known as a burst fracture, at L2. Repairing his spine required doctors to fuse 5 vertebrae together, from T12 through L4. Due to the titanium rods bolted to his spinal column, Joe lacks the ability to flex, extend, or twist a significant portion of his spine. For 9 years he experienced frequent bouts of intense back pain and spasms, typically following strenuous activity. Joe owns and runs a farm and nursery and volunteers as a firefighter. For him, strenuous activity is a daily necessity. He’s been set on finding a way to reduce the pain that has been an obstacle to his work and a damper on his quality of life. He pursued several different regimens of yoga, calisthenics, and mobility work, none of which significantly lessened the pain or improved his ability to work through it. Then in May 2017, Joe decided to try something new. Armed with a computer, a smartphone and tripod, a junky barbell, some old iron plates, and a gun-rack style squat rack, he signed up for Starting Strength Online Coaching (SSOC). Upon joining the SSOC community, Joe, a generally fit and active young man of 25, weighed about 155 pounds and stood 5’11” tall. He had done his research and came to SSOC fully aware that we’d suggest he gain bodyweight to facilitate his strength journey. But his commitment to getting stronger outweighed any hesitation he had about the process. The only time he missed workouts was when he was out all night on a fire call. And he made them up the next day, despite the lack of appropriate rest. He has never complained about the weight being too heavy or quit on a rep he could have finished. Being an extremely coachable client, Joe sailed smoothly through his Novice Linear Progression. His squats went from 135x5x3 lbs on Day 1 to 265x5x3, and he gained about 20 pounds of bodyweight. Then we had a minor hiccup. After Joe completed the 265x5x3 squat workout, he found that he had irritated something in his lower back. While it’s not uncommon for back tightness to present at some point during a lifter’s linear progression, it was necessary to proceed with caution in light of his medical history. When a lifter presents minor aches or pains that may have their source in training, we first eliminate the possibility that it is a technique issue. Joe’s lifts were all technically sound and this didn’t seem to be the problem. If you can eliminate form problems, often times the issue will heal on its own, even while you continue to add weight to the bar if the loading is appropriate. But for Joe, after giving the issue a chance to go away on its own while adding manageable weight to the bar, it became clear that we needed to discover and eliminate the source of the irritation. We knew that Joe’s deadlift was not causing pain, perhaps due to his inability to flex the portion of his spine that lifters so often have trouble holding in correct anatomical position. Since there were no form issues to be corrected on the squat, we had to look at changing the squat itself. The Starting Strength squat model, under ideal circumstances, places the bar just below the spines of the scapulae in the lowest secure position on the back, and requires a more horizontal back angle. This places more moment force on the back, which is what makes the back stronger. However, we weren’t really in “ideal circumstance” territory at the time. So, we decided to try a high-bar squat to keep him training and squatting and see if the pain dissipated. The high bar position is higher up on the back, on top of the traps, which results in a more vertical back angle, less moment force on the back and hip extensors, and more work required of the relatively smaller knee extensors. We reduced his squat weights as the high-bar squat utilizes less muscle mass. After 2 weeks of high-bar squatting, Joe switched himself back to low-bar squats. For him, the irritation in his back had become manageable. While I’d have preferred for him to wait a bit longer for a more certain conclusion, Joe is stubbornly resolute to get as strong as he can as efficiently as possible. Joe went back on his Linear Progression and continued adding 5 pounds to the bar every session. Soon we slowed this roll, adding weight only on Monday and Friday with a lighter squat day on Wednesday. He followed this program through with hardly a missed workout or a repeated attempt at a weight. In late October, 5 months after signing up with SSOC, at an adult male bodyweight of 200 pounds, Joe squatted a nearly perfect 355x5x3. Since then, Joe’s programming has moved on to different reps, sets, and relative intensity as training advancement demands, and he has just squatted a top single with four plates on the bar (405 lbs) for the first time in his life, as he continues to add weight to the bar twice a week. He has made necessary upgrades to his garage gym and found some larger clothes to cover his much larger frame. The strength he acquired has made him more capable in his work as a farmer and as a firefighter. But, most notably, Joe describes his episodes of back pain as “almost non-existent.” Joe’s story is largely unremarkable. He didn’t unlock some elite, unobtainable level of strength or come back from paralysis. But he significantly altered his physical circumstances for a better quality of life through the intelligent application of stress, recovery, and adaptation. And he did this despite the opinions of most people in the medical and fitness industries, who would have advised him not to put a heavy barbell on top of his fused spine. This model of applying controlled stimulus always works, even when you have to be a little bit creative. When we couldn’t follow the model to the T—when low-bar squatting wasn’t feasible. We did the next best thing for as short of time as possible and then returned to Starting Strength system’s criteria for exercise selection: using the most muscle mass to move the most weight on the bar over the longest effective range of motion. Joe does intend to compete at some point, but his motivation is intrinsic and not connected to the pursuit of national titles or other externalities. He’s an excellent testament to the value of commitment to linear progression programming and the simple reality that a stronger body results in a stronger quality of life.