Accelerating Recovery from a Sports Injury: Case Study – The Lifter

Bill is a 52 year old man who has been lifting for the past 20 years. He was a serious powerlifter in his thirties, took to lifting just for health in his forties, and now that his three kids are finally in college decided a year ago to get back into lifting to push the numbers. Being no stranger to training, he followed a slow, consistent build up.

Two weeks ago he began the process of packing up to move into a new house. While lifting a heavy piece of furniture, he felt a “pop” in his back and immediate pain not just in his back, but down the backside of his left leg.

It seems like it might be a herniated disc. What is responsible? The recent ramp up of his program? A momentary loss of focus? Plain bad luck? We can never know exactly; what’s important is to face the situation we’re presented with.

Bill goes to see his physical therapist that helped him with his last back injury. He was screen for any red flag symptoms—changes to bowel, bladder, or sexual function, numbness of the perineum and groin, and weakness of the legs—that indicate a need for immediate medical attention. With these signs absent, there is a great chance he can make a full recovery through conservative rehab alone.

Bill has a 4x per week training structure. Two days are dedicated to upper body pushing and pulls, one day to the squat, and one day to the deadlift. Because he only deadlifts once a week, he has a built in week of rest before he trains again. The plan we came up with is to first modify his other days to prevent irritation.

Bill finds that benching doesn’t bother him much, nor do pull-ups or arm isolation work. However, overhead pressing and heavy rowing which are much more lower back intensive create irritation and we stop them. Traditional barbell squatting also heavily taxes the lower back, so it has to be modified. He does goblet squats with a very light kettle bell to keep up practice with the movement, then performs machine isolation exercises to hammer the legs without involving the lower back.

Outside of the gym he remains active through the day with frequent walks, gentle stretching, and nerve glide exercises to reduce his neurologic symptoms. He is fortunate to have supportive family and friends who help him finish with the house move!

When his deadlift day rolls around a week later, he finds his back is less irritated and the pain down the leg does not reach as far. Originally he was planning on doing 405lbs for three sets of six, but he modifies to 65lbs with some elevation so the starting position isn’t so low. Since the weight doesn’t bother him, he gets what he can out of the weight by doing very high reps and ends up performing three sets of 25 reps with short rest.

Now two weeks from the injury he is able to perform all of his upper body exercises except rows without a problem, and has built up to squatting and deadlifting 135lbs. He will continue building gradually, training hard what he can and backing off on what he can’t, until he is back to normal in several months. The key is that he doesn’t stop training, and that he listens to his body and builds back at the pace that works for him.

The take-away here is that even an injury such as a disc herniation can be managed without missing training as long as you are thoughtful in your planning and responsive to what your body tells you. Never ignore red flag symptoms, but also don’t fear back pain and stop all activity.