5 Considerations for Training with Back Pain
With Guest Blogger Chris Schnare
If there is one topic I know a LOT about, it is dealing with both the psychological as well as physiological adjustments that need to be made when recovering from and continuing to train with back pain. Back in 2016, at the end of what felt like a very solid training week, I noticed a slight discomfort in my lower back. Over the next 24 hours, the swelling, stiffness, and then incredibly debilitating pain, was to a degree that has changed my entire lifting career ever since.
My personal injury took my interest in back pain and treatment protocols to an entirely new level and lead me to study everything I could get my hands on. I got so deep into studying how to improve both myself as well as my clients, that I travelled from Eastern Canada to Costa Rica to spend 3 days working directly with Dr. McGill, Canada’s leading expert on spinal rehabilitation, to better secure my understanding of dealing with back-pained clients and high-performance athletes.
Below are 5 useful pointers and suggestions that I use to help my clients train with back pain. I encourage you to consider where you are currently at and address things accordingly.
- Find someone who can assess you and determine the cause of your pain
An often-overlooked aspect of recovering from injury is finding proper support. Not all clinicians and specialists are skilled equally at assessing all things. While each specialist is highly educated, they will all play unique roles in the therapy process. It is important to find the right person to help you assess your pain and create a treatment plan.
Most clinicians and therapists in general, if asked, will tell you what they love working on. So, it is a good idea to ask the question, “Do you know how to specifically assess back pain and design a treatment plan for me?”
This approach is great for 2 primary reasons:
- You as the pain sufferer are playing an active role in finding the best and most trusted person to help you.
- The clinician or therapist is working not only within their scope of practice, but also their specific area of interest and expertise.
This is win-win for all parties and, in my opinion, creates the greatest opportunity for success.
Finding the right person to help you is a great first step to help you continue to workout with back pain and to help you recover.
- Know when to check your ego
It may surprise you that this is number two, however it is the one that I struggle with the most. I am fortunate enough to have many highly motivated and competitive clients who would do almost anything to train at their normal capacity.
This is an awesome quality; however, it can also be the very thing that increases healing time. Highly motivated individuals are typically trying to do more, rather than less.
Training hard is awesome, and is necessary for improvement, but when you walk into the gym with a flare up or current back injury, it is important to trust the plan that is in place and know that your adherence to it will be the fastest road to recovery.
Time and time again, when my clients report flare ups to me, I hear one of the following things:
- I attempted a rep I shouldn’t have.
- The discomfort was there when I came in, but I didn’t want to mention it. I thought I could work through it.
- I felt pretty good after a few days off, so I tried to push it.
It may be difficult for you to lower your weight or avoid certain movements all together, or you may feel bored performing rehabilitation protocols. It can feel like years of hard work are wasting away, but it simply is not the case and you have to allow the tissue to heal.
Once healed, you can rebuild capacity and get back to normal, even if you must find a new normal for yourself based on the nature or degree of injury.
- Be open and prepared to change the plan on the spot (auto-regulate)
There is a basic saying that “all programs are written in pencil.” This means that at any given time, if you have planned a training or rehab session, it may need to be adjusted for variables you either did not account for or something may come along that throws a wrench in what seemed like a good plan.
Whether you are a trainer, a coach, or someone handling your own program, if you want to continue training with back pain, you must be ready to make the executive decision to change something that does not feel right.
Some examples here may be:
- Back squats replaced with dumbbell goblet squats to lower the shear forces and compression.
- Bi-lateral work such as a deadlift, substituted for unilateral work such as a reverse lunge.
- Dynamic exercises replaced with isometric exercises.
- Extending the eccentric component of a movement to increase movement control.
- More advanced core exercises replaced with lower load, spine sparing variations.
These are some major changes that can be adjusted on the fly. This list could be a very lengthy post in itself, so this is just to give you an idea and to open your mind to what may need to be done in order to keep moving forward.
- Do your homework
Chances are, you have been given some exercises by your coach or trainer. It is imperative that you do this work. In order to heal properly, you must play an active role in managing your own back pain. This may be done by performing specific exercises, movements, or movement patterns.
Another way that you can be an active participant in minimizing the pain that you are experiencing and encourage healing, is to use spine sparing strategies throughout your day. Some very simple adjustments can reserve a lot of capacity for more relevant and enjoyable tasks.
You must remove the pain triggers, postures, and positions that are causing your sensitivity and replace them with new habits. By increasing your awareness and knowledge of how you move during daily, mundane tasks like tying your shoe and picking up your child, you are becoming your own best source for pain relief.
- Educate yourself
Of course, even reading this blog post means that you are actively trying to learn, so high five for that right out of the gate!
It is important to find reliable sources that you trust, read their material, hire them for a short time to improve your lifting technique, get them to make you a program that suits your level, needs, and abilities, and then work hard to be proficient at it.
When a flare up or injury occurs, follow the steps above and be open minded and ready to learn from the experience, rather than getting down on yourself. I realize being positive and happy about a setback or injury seems like a silly recommendation, however it really is true.
I have a saying that I feel so accurately explains how you can shift your mindset from negative to positive:
“Injuries are education, so learn from them.”
The injury or pain is there, accept it, learn about it, and course correct as needed. Your recovery and training will be more enjoyable and you will come out better on the other end, ready to tackle the next training obstacle.