Pain
I was in the middle of a set of 265 lb deadlifts one Friday night when I heard/felt/experienced a snapping feeling in my lower back. I don’t remember the exact sensation–my memory is mostly of the state change from “heavy but fine” to “oh my god something is wrong”.
My next memory is immediately lying down on the floor in pain. My spine was fine, but I had no idea how I was going to convince my body to suffer through the one block home. In fact, I had no idea how I was even going to stand up. Then I started thinking about how even if I got home it would be hard to sleep through the pain, which would suck. And I was supposed to be Alex’s second at a mudruckers race on Saturday, and how was that going to go? And of course, how long was it going to take to get back to lifting anything at all? Think of the lost gains!!
As it turns out, this kind of thinking is not helpful when you are in pain.
The next thing that happened is that Josh, the gym owner, came over. He was totally composed, checked in with me to see that there was no serious injury, and then started me on what turned out to be a transformational journey.
First, he had me start to move, very slowly, in the direction of standing up. When I say “in the direction of” what I mean is that he took the movement of standing up, broke it down into the smallest reasonable quanta possible, and had me try the very first one. Imagine: tense your leg, as though you’re about to pull it toward you, but don’t actually move it.
It turned out that this didn’t hurt–at least, not any more than I already hurt. So we did that a few times, building some confidence that some movement wasn’t scary to do (in the sense that it wouldn’t generate more pain).
Then Josh had me move on the next quantum of movement–pulling my legs toward my body. Having gone through the first step of the process, I already felt more confident. We did the same thing of repeating the movement, but this time moving my legs a little further, with the guardrail that if it ever felt threatening or started to hurt more, I should pause there, let my body notice the pain, and then relax back to the original position and repeat.
What this did was make my pain response notice that nothing (newly) bad was happening. Each time I was able to move my legs a little further.
We repeated this process for each successive stage until, after maybe 15 or 20 minutes, I was able to move to a sitting position.
Then we did the same thing again–exact same process–to get me to be able to stand up, and then to start walking.
By this point, I was pretty confident I could make it home. The walking also helped with the pain quite a lot–my muscles had originally tightened up in response to the shock of the initial tweak, and walking helped them to loosen up. It also increased my sense of agency, which also seemed to reduce the pain.
After I’d walked around a bit, Josh had me start doing air squats and air deadlifts (i.e. with no weight). I ended the night doing sets of RDLs and squats with the 45 lb bar. This was a revelation to me, since about an hour earlier I’d expected to spend the next week lying in bed. Instead, I spent the next week slowly adding more weight to the bar. Within a few weeks, I was back up to deadlifting heavy weights.
Then I tweaked my back again.
This was incredibly frustrating, but I also had a better sense for how to respond, and the process worked even better the second time. I did slow down the ramp back to heavier weights to give myself a bit more confidence that I’d be fully healed before lifting again.
I remember the first time I did 265lbs again–it was kind of scary. It also went fine, and after a few more weeks of adding weight to the bar, I’d mostly stopped thinking about it.
Over the course of my training, I’ve had a few other tweaks to various body parts, and each time a similar structured recovery process has worked wonderfully.
I’ve also got a better sense for when I’m at risk of a tweak, so I’m much better at managing load and stress to avoid issues. But life is a stochastic process in which we control only a handful of variables, and sometimes things happen. One of the variables I can control is how I think about the sensation of pain in reaction to those sometimes things.
This experience isn’t some novel insight into pain–it’s really just one example of the biopsychosocial model of pain.
Biologically, something had happened, but my initial catastrophization reaction had caused it to feel much worse than it really was. Having Josh walk me through how to handle it meant that the social experience was helping it feel better (rather than worse, as would have been the case if he’d been freaking out), and going through a structured process reduced my fear and catastrophization as I saw that I had more agency than I’d realized in how the pain felt.
This model doesn’t solve the problem of pain–and of course my original tweak still hurt for days, but the amount of hurt and the impact it had on my activity was much reduced.
If you are interested in how to manage pain during training, Austin Baraki at Barbell Medicine has written a good post, though my experience has been that it’s much easier to apply these techniques with the help of a coach than to do it myself.