I'm going to start this article by stating that I am not a Doctor, nor am I a medical professional, so if you're experiencing consistent, excruciating or reoccurring back pain you should seek the advice of a qualified medical professional. On the other hand, I am a coach and an athlete who has sustained multiple back injuries over the course of my lifting career, and I've been successful in developing preventative measures for both myself, as well as the athletes that I coach so that the risk of injury may be lowered. The following is a detailed article on my personal experiences, recommendations and remedies for back pain.In the article, you will note how I mention hip and back pain together, as they typically correlate with each other. I've linked many posts, articles and videos by highly respected coaches in their particular field including Dr. Kelly Starrett, Eric Cressey, and Chris Duffin. I hope you find this article informative and possibly learn something that can help with your athletes training or your own training. Enjoy.If you're a committed lifter, which most of you who read this blog are, then you've probably run into hip pain, back pain or a combination of the two. These, along with shoulder/elbow pain, are the most common forms of pain you'll encounter as a lifter. More often than not, these pains are the side effects of constantly pushing yourself, training hard and coming close to/exceeding your Max Recoverable Volume (MRV). Now, this isn't a bad thing at all. In order to have a positive adaptation (in this case, getting stronger) you must consistently train harder and with a much higher workload. With this higher work load (in other words, training volume) you'll encounter certain "fatigue indicators" that can include hip and back pain.It's important to note that this isn't the only cause of hip/back pain. If you're an undertrained/beginner lifter and are constantly plagued by injuries or discomfort in the joints, then you need to look at your technique, as well as your recovery methods (sleep, nutrition, rest to name a few). But, for this article we will be primarily focused on intermediate-advanced level lifters who have their technique, nutrition and recovery pretty much dialed in.Also, it's very crucial to differentiate between what is an actual injury, or just a case of training-induced fatigue. Early on in my lifting career, I had multiple back injuries. These were definitely injuries, not just a tight lower back from doing volume Squats the day before. If you're an intermediate lifter with good technique and some training experience under your belt you've probably felt the lower back fatigue from hitting volume conventional Deadlifts or Low Bar Squats the day before. In these cases I'm sure you've thought to yourself, "Did I tweak something yesterday?". In most cases, the answer is 'No.' Lower Back fatigue is quite common and I've been asked before about lumbar disc herniations and pulled lower back muscles. Typically my response is, "If you herniate a disc you will definitely feel it." Although that's not sound medical advice, in this instance I'm speaking from experience, and saying it doesn't feel good is an understatement, but I digress. As an athlete or a coach, it's your job to understand the difference between training-induced fatigue and an injury (level of severity may differ). Although in some cases there's a fine line, and training induced fatigue can sometimes lead to injury down the road, it's still important to understand the particular case in question and remedy as required.
Activate Your Glutes!
I've heard many athletes and coaches talk about this one, and I've personally used it get become injury free for over a year.
I'm sure many of you are familiar with Silent Mike of Mark Bells Slingshot, Super Training Gym and the Power Cast. He's been plagued with lower back injuries on and off for most of his training career. Having a lower back injury can set your training back weeks, if not months and in a sport where getting stronger and prepping for an upcoming meet requires a lot of overall work, being put out for weeks at a time can set you back a ton. Mike has talked about how religiously activating and training your glutes every day can help prevent lower back injuries, while also increasing performance. The glutes are often an overlooked body part, as most of us consider the Squat to be our main glute developer, and although this is true In some regards, it's somewhat false in others. If you ask Bret Contreras he will tell you that the glutes require a significant amount of specific work in order to optimize performance. Although I agree with him in the case of training team sport athletes, I believe there is another way to be more sport-specific for Powerlifting as to not over fatigue an athlete by taking away from their recovery capacity.
Many Powerlifters advocate the barbell hip thrust and the glute bridge to help build their glutes, as well as develop lockout strength for their Deadlifts. This can be an excellent tool to use during a Hypertrophy Block to help potentiate future gains, but I believe that it strays too far away from the Principle of Specificity during General Strength and Peaking Blocks. If you're a committed advocate of the barbell hip thrust and it has shown consistent results for you, then by all means keep it in your program. But, for the vast majority of lifters there's a way to activate your glutes, and also maintain a level of sports-Specificity that will allow you to optimize performance and health.
Perform low-intensity glute activation exercises daily.
This seems like the most obvious one; work on activating your glutes, then they'll work better. Simple enough, right? Well, many people become complacent, rush through their workouts or just completely skip the warm-up/activation portion of their training. The biggest thing I can say is this; once you've had a true lower back injury, then you'll begin to understand the importance of warm-up and activation work. But instead of learning by experience, try and take the steps early on to prevent such an occurrence. By taking 10-15 minutes before your training session to perform Bodyweight glute bridges, lunges, squats and a variety of other drills can go a long way towards optimizing performance and limiting the risk of injury.
Below I'll link some of my favorite videos for overall glute activation and methods for "opening up the hips" (which is also key to back health, as Dr. Kelly Starrett will go over in a few of his videos). In my opinion, people like Dr. Kelly Starrett, Chris Duffin and Eric Cressey (just to name a few) are the biggest authorities in the field of sports performance and longevity. This sport is a marathon, not a sprint, so being healthy as long as possible is one of the big keys to success.
Sit less, move more.
There's an excellent quote that states, "the one hour of you doing something right in the gym can be undone by doing it wrong for the other 23 hours in the day". This applies perfectly to glute activation (and overall mobility), especially for those who are students or have jobs where they are constantly sitting all day. Constantly sitting can cause your hamstrings, and hip flexors to tighten, in turn causing your glutes to get tight and become "deactivated". The simplest recommendation is to move more, sit less and perform a few mobility exercises everyday.
"How Chronic, Prolonged Sitting Impacts Your Body - and What to Do About it" by Eric Cressey
One of the best quotes I ever heard was, "do something every day that will get you closer to your goals", and as simple as it may seem, doing these little things will lead to big steps in the right direction.
This may be the most overlooked aspect of consistent, reoccurring lower back and hip pain. If your training is too difficult (consistently exceeding your Max Recoverable Volume), or you're one of those people who don't believe in taking rest days, then you can alleviate a lot of pain/fatigue by simply taking a step back and evaluating your plan.
Although a successful training plan is highly dependent upon fatigue and fatigue accumulation, there is a difference between the "right fatigue" and the "wrong fatigue". Without going deep into a separate article I'll attempt to keep this brief.
In order to force a positive adaptation in your training you must accumulate an appropriate amount of fatigue over a given time period. In most cases this will be over the course of 4 weeks, where training will consistently get more and more difficult, accumulating fatigue and eventually reaching the point of a Deload Week (or a temporary reduction in training volume). It's important that you accumulate this type of fatigue over the course of 4-6 weeks (depending upon phase), rather than 1-2 weeks. If you're constantly in a fatigued state, you cannot perform optimally or train with enough intensity/volume to improve. Also, if you constantly need a Deload Week every 2 weeks, then you're missing out on serious strength adaptations and potential to perfect your technique through long term, consistent practice.
To conclude this last point, it's important to note that balancing the fitness-fatigue relationship is crucial for making progress. Being in a fatigued state for too long can result in injury, but not accumulating enough fatigue can result in a plateau in progress.
If you're interested in learning more or want an in depth look at what goes into the Principle of Overload, Stimulus Recovery Adaptation (SRA) or Fatigue Management then I will link a few videos at the bottom from Chad Wesley Smith of Juggernaut Training Systems.
This article barely scratched the surface of back pain and how to prevent/minimize its effects. As a coach or an athlete it's your job to take the appropriate preventative measures to ensure the lowest likelihood possible of an injury occurring. Now, it's a general understanding amongst high-level strength athletes that not all injuries are preventable; eventually you're going to run into them, but the severity can differ. No athlete goes their entire career without sustaining some sort of injury, whether it's training-induced or unrelated, so it's your job to be as diligent as possible to prevent the big ones that can set your training back weeks or even months.
Before I wrap this article up I must stress that if you go through training constantly worried about sustaining an injury, then your training will most definitely suffer. You need to find a happy balance between injury prevention and training hard to induce the desired results. I posted this quote on the Nova Strength Instagram page on Tuesday, but I'll say it again here because I think it paints a perfect picture;
"Remember- train like an animal, think like a human." - Mike Tuchscherer of Reactive Training Systems (RTS)
What he means by that is simple- it's important to train hard, because that's what stimulates a desired adaptation. But it's also important to understand that training is a long term process and there are multiple factors to consider when talking about an athletes progression; In this case it's injury prevention. If you're constantly injured then it's almost impossible to make consistent, sustainable progress (not to mention the havoc that injuries can play on the mind). Don't let the fear of injuries stop you from making gains, but also respect what the weights are capable of doing to your body.
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