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 Post subject: my back pain journey
PostPosted: Sat Dec 08, 2012 6:27 am 
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so the good Doc has requested I talk a bit about my back pain journey. At first I was flattered that he would want to hear the story, but now I realise that his back has been hurting, so he had an ulterior motive all along... I'll try and keep this brief and concise.

The beginning

Back first started hurting in my teens. It went out in maths class once and I couldn't move. My mates thought it was hilarious but I was properly crippled! This was when I was 15. I have always had terrible posture, part of which I think is genetic (none of my family have good posture), but a childhood playing computer games instead of sports didn't help. From the age of 15 on, my back would hurt every day. Sometimes a lot, sometimes not much, but never was it pain free. I went to see three different physios on the NHS, all of which told me that I should rest. That was a big help.

Weightlifting

in my late teens I got into lifting weights, but only started to take it seriously 3 or 4 years ago. I thought I was making myself super strong and awesome, but I was, in fact, just building strength on top of dysfunction, which is bad. My deadlift was the most horrible, rounded back thing you could think of. I just assumed your back was supposed to hurt the day after deadlifts. Also, in my quest for an ATG squat, I was so paranoid about not hitting depth I would squat all the way down til my hamstrings hit my calves. This is far too low for my and would put me into a very rounded position, but I didn't realise that at the time.

The Fix

so last summer I think it was, after a particularly bad incident which left me crippled for about a week, I decided enough was enough. I went to see a much better physio, who told me that although my back was bad, it didn't have any lasting, irreversible damage (not herniated discs or anything). Turns out there's a tendon runs up your back, and mine was all inflamed and hurting. Basically what I needed to do was:

-release my piriformis
-strengthen my glutes
-strengthen my abs

so my hockey ball became my best friend, and I sat on that for ages every day. I also did supersets of bird dogs with hip thrusts, every day, multiple times a day. It helped a little, but I was still going into the weights room and hurting myself. I was getting frustrated, so I looked to what I was doing in the gym, instead of what I was doing at home.

KPj helped me out loads with this too. I went through to Kilmarnock to do some benching with him one day and he had a look at my mobility. He laughed at it, which I thought was very unprofessional. He also took one look at my front squat and told me I was squatting too low, and told me my dumbell rows were reinforcing bad posture. It was quite eye opening to say the least!

So, it turned out that a LOT of what I was doing in the gym was hurting me. I decided to:

-drop deadlifting completely. A controversial, and heart breaking decision at the time, but since doing this I have not had to miss a workout due to back pain.
-monitor my front squat depth. I use aerobics steps to make sure I squat below parallel, but not so low that my back rounds. 4 of the little plastic things that go inside an aerobic step is the perfect depth
-drop the weight on my rows and concentrate on good form (strength came back pretty quickly anyway)
-really concentrating on getting my glutes and core firing during warm ups. This was a really big deal. Times when my back was a little achey coming to the gym, a few sets of glute activation and bird dogs made me feel like a new man. Muy importante. This, along with dropping deads was probably the most important change in my routine.

these changes in the gym did loads more for me than all the bird dogs and stuff at home. Honestly, I think that those moves are better done as activation work as part of your warm up, than done at home to try and remedy back pain. Stretching my hips didn't seem to do anything either. I actually think stretching is a load of nonsense now, although I still stretch my hips prior to a lower body workout just in case.

In Summary

-stretching and core work in the house didn't do a damn thing
-if something hurts, don't do it
-find a way to do what you can as safely as you can
-get someone who knows what he's talking about to check your mobility and tell you what's contraindicated.

there you have it. Really, it's all my own fault for forcing myself to deadlift so much when my back clearly couldn't handle it. Since dropping the deadlift I've been able to train much more often and train my legs loads harder so it was actually the best decision I've ever made in my lifting life. I'm not anti-deadlift, however I do think you need to be honest about the type of training that suits your goals. If something you are doing makes it harder to hit your goals, you shouldn't be doing it. That, for me, was deadlifts.


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 Post subject: Re: my back pain journey
PostPosted: Sat Dec 08, 2012 7:23 am 
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i vote for sticky. best advice to handle back pain!

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 Post subject: Re: my back pain journey
PostPosted: Sat Dec 08, 2012 7:25 am 
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just one question: will you never be deadlifting again or are you thinking of doing it again, if you are some months/years without serious pain?

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 Post subject: Re: my back pain journey
PostPosted: Sat Dec 08, 2012 8:09 am 
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ephs wrote:
just one question: will you never be deadlifting again or are you thinking of doing it again, if you are some months/years without serious pain?


I've thought about it, but it's just not worth the risk.

Maybe if I get my hip/hamstring mobility to the point where I can pass the "straight leg raise" test (google it if you like) then I'll give it a go, but at the moment it's just too risky.


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 Post subject: Re: my back pain journey
PostPosted: Sat Dec 08, 2012 8:30 am 
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robertscott wrote:
ephs wrote:
just one question: will you never be deadlifting again or are you thinking of doing it again, if you are some months/years without serious pain?


I've thought about it, but it's just not worth the risk.

Maybe if I get my hip/hamstring mobility to the point where I can pass the "straight leg raise" test (google it if you like) then I'll give it a go, but at the moment it's just too risky.

to touch the ground while standing straight is also a similar test or not? i would also be very happy to pass some of these tests!

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 Post subject: Re: my back pain journey
PostPosted: Sat Dec 08, 2012 8:34 am 
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if you're interested then check out "Athletic Body In Balance" by Gray Cook, that'll tell you everything you need to know about movement screens.


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 Post subject: Re: my back pain journey
PostPosted: Sat Dec 08, 2012 8:16 pm 
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I was struck by your discovery that rows were doing you more harm than good. Question every assumption!


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 Post subject: Re: my back pain journey
PostPosted: Sun Dec 09, 2012 12:00 am 
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Thanks, Bob, for posting this. Yeah, I had an ulterior motive, the same motive that I'm on this forum at all--to learn from others. It's just that this topic is a little less abstract for me than some.

I'm not sure that it's deadlift or only deadlift that is the big culprit for me. I suspect that it may be multiple factors, which will make it harder to sort out. The fact that I feel worse when I get up in the morning makes me think that my bed is contributing. I sometimes feel worse after a heavy DL day, but not always. Same with squat--sometimes no problem, sometimes I get more sore, but usually only the next day. Only recently have I had any immediate increase in discomfort with DLing or squatting.

So I'm looking for others' ideas and thoughts about what I'm doing.

At the moment, I'm also eliminating DL. I will probably add it back in after a few weeks to see what happens. I've actually debated doing something like doing only one lift per workout to try to be more clear about what's bothering me. Maybe it'd be better to keep everything the same but just eliminate one lift at a time, I'm not sure.

I'm also getting serious about Athletic Body in Motion. I'll be doing the SMS later today, and then planning my routine for the near future.

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 Post subject: Re: my back pain journey
PostPosted: Sun Dec 09, 2012 2:56 am 
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Doc,

After you posted you DL form, did you change it?


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 Post subject: Re: my back pain journey
PostPosted: Sun Dec 09, 2012 4:22 am 
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KenDowns wrote:
I was struck by your discovery that rows were doing you more harm than good. Question every assumption!


ya, it's because my back was rounding over, so every rep was actually reinforcing the posture I wanted to correct!


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 Post subject: Re: my back pain journey
PostPosted: Sun Dec 09, 2012 4:24 am 
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Andy you should definitely get Athletic Body in Balance, otherwise everything you do'll just be guesswork.


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 Post subject: Re: my back pain journey
PostPosted: Sun Dec 09, 2012 2:12 pm 
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Have you considdered Good Mornings as an alternative to deadlifts? You may find you're less likely to round since the barbell is on your back instead of in front of you. Also, since you're not lifting a barbell off the floor, you can limit yourself to a ROM that allows you to maintain good posture.

Likewise, you could try performing Barbell Bent-over Rows at a 45-degree angle instead of Dumbbell Rows. The barbell never goes below your knees on this lift, so rounding shouldn't be a problem.

Note: For 45-degree Barbell Rows, I'd recommend lifting the barbell off a rack at the start of each set and putting it back when you're done, so you don't have to deadlift it.


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 Post subject: Re: my back pain journey
PostPosted: Sun Dec 09, 2012 5:46 pm 
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actually Matt yeah, I have been toying with the idea of adding good mornings for a while. I like the idea that it'll really keep my upper back from rounding as well as my lower back.

as for the barbell rows, they are actually almost as hard on my back as deadlifts. The angle your torso has to be at puts my back in the weakest position possible and it's murder


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 Post subject: Re: my back pain journey
PostPosted: Sun Dec 09, 2012 8:18 pm 
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Even rowing at a 45-degree angle (pulling to the waist)?


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 Post subject: Re: my back pain journey
PostPosted: Mon Dec 10, 2012 4:58 am 
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I think you will be able to deadlift eventually. But you need to clean up ASLR first, which will give you back your toe-touch.

You need to think of ASLR as if you would a bodyweight squat and BB squatting. The relationship is that significant. If you can't ASLR then you will not achieve a good posterior weight shift so heaving heavy things off the ground is always going to pull you forward into flexion because you can't efficiently pull the weight back into the body and do so primarily via hip extension.

I think this is why you are comfortable with a lot of turn out at your foot and a closer stance when squatting. Front squats are more quad dominant anyway so it's not a big issue.

I probably could of spent an hour just working on your ASLR. The PNF tricks started to give you the ROM so it is mostly a stability issue. I think achieving hip extension/glute activation with a "short foot" is what would be needed after regaining the ROM. Then doing some work on basic single leg deadlift movements and basic hip hinge drills.

(I know this is late, btw, but better late than never eh).

For an ASLR corrective when having your issue I really like bands. Loop a band around one foot but then raise both legs up to ~90degrees. Then you hold the leg with the band but lower the free leg slowly. The more you lower the more you feel the UP leg struggle. The band allows some wiggle room. Found a decent video of it.

http://www.youtube.com/watch?v=O0rgkr8piuU

An example of correcting that would be starting with the leg lowering, then do some glute bridging. However with your glute bridging I would regress to 2 feet at a time but with a band around your knees and concentrating on keeping the correct foot position. Then onto some Dowel-hip-hinging then a single leg DL movement.

I never got the chance to go into it much but when you're trying to find new ROM really focus on your breathing. When you feel you've hit your ROM limit, take a deep belly breath through the nose and exhale slowly whilst trying to move a little further. 2-3 good breaths normally makes a nice difference. This will seem like nonesense but it genuinely does work like magic. In fact I would bet your tspine extension/rotation would open right up with some good breathing drills before and during it.

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Thanks TimD


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