I'll do the heavy lifting

Powerlifters, Olympic lifters, body builders, CrossFitters, and casual gym goers: you have likely found yourself trying to lift with pain at some point in time. Examples are infinite but common culprits include back pain with deadlifts, shoulder pain with overhead press or bench press, and knee pain with squats or lunges. There’s nothing more frustrating than having an injury or pain set you back in your progress towards your fitness goals. Having to completely stop your workouts is not only unnecessary, it’s discouraged! So what can you do if you’re in pain with a lift yet encouraged to keep going?

Let’s start with the definition of “pain”. Pain is “an unpleasant sensory and emotional experience associated with or resembling that association with actual or potential tissue damage.” Did you catch that one? …actual OR potential damage to the tissue. Pain is incredibly complex with the influence of many factors, not just physical or mechanical. If you haven't slept well for the past week, for example, and suddenly have pain in your back while squatting, sleep deprivation may be something to consider before any other modifications. Get some sleep then reassess. More on pain in a future blog...however, if life is gravy and nothing abnormal has come up, let's look at your lifts and programming specifically.

Before you stop going to your CrossFit classes, drop out of the powerlifting competition, or avoid the gym altogether, try these four steps to reduce and eliminate pain during lifts. These steps should be followed in sequential order until the pain is resolved.

1. Re-examine form and programming. Form is how your body is positioned, coordination and quality of movement during the exercise. Form for each exercise will look different depending on your unique anatomy. We get into trouble with form when we force our body into a position that doesn’t work for us. For example, hip joint morphology can vary person-to-person. Some people may need a wider stance with toes out during squats and that’s okay. If you have a long femur, your torso will have a more forward lean during a squat versus someone with a shorter torso. That’s okay too. Forcing your body into a position that doesn’t work for you may cause pain. Most form variations within reason are okay and even necessary! On the other hand, programming includes the frequency (i.e., days per week) and volume (i.e., number of exercises, sets/reps) of exercises. Programming will vary depending on the individuals goals: a CrossFitter preparing for the Open will train differently than someone interested in general fitness. The thing to remember with programming is this: too much too soon and there's a good chance you’ll get injured. Making adjustments to form and programming can be the key to continuing to lift pain-free.

2. Make adjustments as needed. If form and programming is optimized yet pain persists, altering factors such as range, load, and intensity is next. Do you have pain in your knees only after 90 degrees during squats? Reducing your range temporarily while adding corrective exercises in the 90 to end-range may help reduce or eliminate pain and keep your lifting. Do you have back pain with deadlifts only over 175-lbs? Temporarily drop the weight to 165-lbs and slightly increase your volume. The key to remember: the modification doesn’t have to be permanent and will keep you lifting in the meantime while your body adapts to the new demands.

3. Switch out the aggravating exercise for a tolerable one. If all else fails, try a similar but different exercise. If you’re having pain with bench pressing, maybe try chest presses with dumb bells using a different shoulder angle, or even a push-up variation. You’ll continue training that particular muscle(s) but also give your body some time to heal, progressing as able.

4. Recover, reintegrate, and rebuild. Gradually and as tolerated, the exercise is reintegrated into your program and the load, frequency, intensity, and range built up to meet your specific goals.

You don’t have to stop your workouts and regress if you’re in pain. Start by making these adjustments and see if it helps. If not, time to call your physical therapist. Doctors of Physical Therapy are trained to evaluate and assess your condition to provide a diagnosis for your musculoskeletal impairment, a prognosis with a timeline, and a plan of care to get you to your goals.

Happy lifting!

Source:

1. Barbell Rehab Method course and course manual by Founder and Owner, Dr. Michael Mash.

2. Photo by Victor Freitas on Unsplash