I’ve witnessed a number of clients tweak their backs over the years. There’s always a moment — after the initial shock and jolt of pain subside — when they look to me for answers. They want to know why it happened. What did they do wrong?
More often than not, my answer is, “I don’t know.”
My turn to suffer
Last week I experienced the mother of all back tweaks. Injuries always seem to happen around my birthday. I guess it’s the universe’s way of reminding me I’m getting older.
I’ve had plenty of tweaks in the past, but this one was different. It felt like someone had slid a kitchen knife into my spine. The pain was so intense I fell to the floor.
Over the next few days, it got progressively worse. Anytime I leaned forward, a sharp pain took my breath away. I couldn’t sleep, put my pants on, or tie my shoes. Getting out of bed or standing up from a chair became a prolonged contortionist act as I searched for any position that didn’t make me feel like I was about to pass out.
After a few days of rest, I decided it was time to start working the area. I’ve learned from previous injuries that movement helps things heal faster. Often with a few sets of moderately heavy deadlifts, the back pain goes away. But while I felt ok after my first workout, the pain came roaring back with even more intensity the next day. Stubbornly, I tried again and got the same result. Clearly, whatever was pissed off wanted to be left alone.
I hobbled around for a few more days and skipped my squat and deadlift workout for the first time in probably a decade. By the end of the week, I could sleep through the night and get out of bed without rolling to my knees.
Finally, a little more than a week after the injury occurred, I got under the barbell to squat. I could feel a twinge of pain with the empty bar, but it wasn’t bad. I continued working my way up in weight until I had 405 pounds on the bar. I did one rep and decided to take the win and rack it. Then, I moved on to the deadlift. The first set of 135x10 felt ok, so I continued, ending the session with a set of five reps at 405. Then I waited.
The next day I felt great — no pain at all. And I’m happy to report that last night I squatted and deadlifted within about five percent of my pre-injury weights. Crisis averted. I’m back, baby!
Mundane pain
What I haven’t mentioned is how I got hurt in the first place. It didn’t happen with 420 pounds on my back, nor did it occur trying to pick 475 pounds off the floor.
No, this devastating back tweak — by far the worst one I’ve ever had — happened standing up off the toilet.
Surprisingly, that’s not unusual. For as many back injuries as I’ve witnessed in the gym, I’ve seen or heard about far more that occurred during routine tasks of daily life, like moving a box, stepping off a curb, reaching for an object on a high shelf, or getting out of the car. Hell, my dad threw out his back while changing the bedsheets.
However, when injuries occur in the gym, the natural reaction is to blame the exercise, assume that lifting weights will hurt you, and stop training. Yet we don’t stop picking up boxes, making our beds, or using the bathroom, and we don’t assign blame to those tasks that are just as likely to trigger the same injuries.
You’ll probably tweak your back at some point. It may happen in the gym or at home, but it’s going to happen. And that leaves you with an important choice: Do you want to be strong and hurt or weak and hurt? Not training is rarely the right answer.
Rest, test, and assess
As my colleague Dr. Jonathan Sullivan says, “Aging is an extreme sport.” Shit happens. Things hurt, and more often than not, you don’t get to know why. What’s important is how you deal with it.
First, don’t catastrophize the situation. Yes, it’s painful, sometimes extremely so, but unless you’ve got a tingling sensation in your feet or a loss of bowel control, it’s probably not a big deal. Remind yourself that you’re not broken, and you will be fine in a week or two.
Second, manage the pain with lots of Tylenol and ibuprofen. Blunt the pain before it takes root. Hammer it hard with anti-inflammatories so you start to feel like your situation is improving. Optimism is a potent analgesic.
Finally, “rest, test, and assess.” Give yourself a few days to let the pain dull a bit. Then, go into the gym and test the area with light weights and high reps. For backs, some kind of deadlift variation is usually the best choice. Wear your belt for the entire workout to keep the area warm and provide extra support.
Then see how you feel. If the pain gets worse, stop. But if it feels better with motion and weight, keep going. Be conservative with your first workout and assess the injury the following day. If the pain intensifies after a workout, rest a few more days before testing it again. If it feels better, you can be more aggressive at the next session.
Try to get back to lifting heavy weights as quickly as possible, even if you only do one or two reps. Working at high intensities will prevent any further detraining. At the next workout, you can use the same weight and try to complete more reps.
If you follow this process, you’ll likely be back on track in two or three weeks, and the injury will just be one of many minor setbacks you’ve overcome throughout a long, productive training career.
Onward
I don’t know why I got hurt. What I do know is that I’m fine, and now it’s time to start pushing the rock back up the hill.
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