An article originally published on DeanSomerset.com but written by “the glute guy” Brett Contreras. I feel that this article illustrates my sentiments toward strength training and corrective exercise to a “T”. I hope y’all enjoy the read. – Nate
Today I’ve got a guest post from Bret Contreras on how he’s used strength to recover from a pretty significant back injury. Bret’s one of the top coaches in the world, consistently featured on all the top publications and websites, plus he’s in the final stages of a PhD in exercise science, which means the guy knows his stuff and is just a liiiiiiiiiiiitle obsessed with strength training.
When I was 16 years old, I got in a very bad car accident. It caused my low back to hurt for a solid year. Not only could I no longer play sports, I couldn’t even walk properly. My friends would make fun of my gait, comparing me to Al Bundy from Married With Children. An MRI showed signs of severe disc degeneration, and the doctor informed me that I had the worst spine he’d ever seen for such a young man. These were pretty scary words to hear back then. At the time, I didn’t think I’d ever be normal again, and I especially didn’t think I’d ever be strong or athletic.
Fast-forward 21 years later. Three weekends ago, I deadlifted 601 lbs at the 100% Raw Powerlifting Southwest Regional Meet. I’d been working at a 600-pound deadlift for six years (it took me two years to move from 585 lbs to 600 lbs). Perhaps of greater importance than the mammoth pull, however, is the fact that these days I rarely ever experience low back (or knee or shoulder for that matter) issues despite squatting and deadlifting heavy weights several days per week, 52-weeks out of the year, year in and year out.
At 37-years old and over two decades of lifting, my strength is at its peak and my joints are holding up just fine. In fact, I’ve never felt better. It wasn’t always this way. What finally got me out of low back pain was physical therapy. Back then, the standard advice was to stretch the hamstrings and strengthen the abs. I can envision the reader chuckling right now, but it did the trick. After a year of waddling around in pain, I started feeling better and better from daily hamstring stretches and crunches. It even motivated me to learn more exercises. First, I started employing additional upper body and calf exercises, and over time, I taught myself how to squat, deadlift, lunge, and back extension. Still, my back was very sketchy, and I can remember a time when deadlifts would leave my back excruciatingly sore for several days. Other lifts would often irritate my low back as well. This is very rarely the case now. In fact, the day following my 601 lb deadlift (keep in mind I squatted 3 heavy singles that day and deadlifted 3 heavy singles, missing a 611 lb grinder that I couldn’t quite lock out), I experienced no pain whatsoever.
So how did I do it? The truth is, I don’t know how I did it, it just happened over time. I can only guess as to which factors were contributors. While the pain experts would likely attribute most of my transformation to psychosocial factors, I personally believe that biomechanics plays a considerable role. If you haven’t taken the time to learn about the biopsychosocial model of pain in contrast to the postural-structural-biomechanical model, I recommend that you do some research. While nobody can say for certain how my back pain was solved, pain scientists and biomechanists would agree that the fix was brought about by some combination of biomechanical, psychological, and sociological factors. At any rate, below are some things that I feel have helped me improve as a lifter by decreasing stress on the body and increasing confidence.
Dramatically Increased Glute Strength
My glutes are strong as an ox. I think that this is a major factor in regards to my low back health. When I started prioritizing glute training, my body started to feel better. If you don’t train heavy, then you won’t quite understand how important the glutes are in terms of protecting the body. My form is not always perfect, but I always feel the glutes kicking in to do their job. The gluteus maximus is a giant muscle, and the larger it is, the greater its force and leverage potential. Your body is smart. If you have glutes, then you will naturally use them when you lift heavy, and using more glutes means relying less on other muscles and passive structures in the spine, such as ligaments and discs. It also means better force closure in the SI joint and more efficient transfer of forces between the upper and lower halves of the body. But glute strength alone isn’t sufficient. As I alluded to earlier, you have to move well, which brings me to my next point.
Improved Lumpopelvic Control
I know how to control my lumbopelvic hip complex when lifting. This took me years of practice. There was a time when I just lifted the load without paying any attention to what my back was doing. But these days, I’m highly aware of how the lumbar spine, pelvis, and hips interact, and I’m always considerate of my posture when under load. If you round too much at the lumbar spine, it’s going to take its toll over time – there’s no way around it. You have to learn to stabilize the lumbar spine and avoid going into extreme ranges of flexion while under heavy load. Failing to do so is recipe for disaster. If you hyperextend the lumbar spine, you might end up damaging the posterior elements over time. The neutral spinal position is always advised, and since the pelvis has influence over the spine, the muscles that produce anterior and posterior pelvic tilt must be strong, conditioned, and coordinated. This will help buttress and stabilize the spine during heavy lifting, so strong abs, strong glutes, strong erectors, and strong hip flexors are needed if you’re going to be lifting heavy weights.
Focus on Free Weights
My training is centered on free weights. Trust me, I love using machines as much as the next guy – especially cable columns and Hammer Strength rowing machines. However, probably 95% of my training is dedicated to free weights. Getting free-weight strong will help you better tolerate machines, whereas relying solely upon machines can become problematic for many lifters. I’ll touch more on this later in the article.
Modulating Load and Effort
I know when to push the envelope, when to back off, and when to steer clear. In the past several years, I’ve had to back off of certain exercises that don’t suit me well. These days, I rarely perform dips, even though they used to be one of my favorite lifts. If I perform chins, they’re always done with a neutral grip, but I perform cable pulldowns more frequently than chins as my body tolerates them much better. This isn’t to say that you should make these same changes to your training, it means that you should listen to your body and make adjustments as time advances.
Moving on, I also perform plenty of submaximal work in my training these days, which is something I never used to do. For many years, I either maxed out or went to failure; there was no middle ground. However, I now regularly utilize lighter loads in my training, but I make the loads feel heavy by performing the movement either super-strict, with a pause, or with maximum acceleration. I’ll often stick to 60-80% of 1RM and just do 2-3 sets of 1-5 reps in one of these manners. Finally, if something feels off, I’m not too proud to go home and wait it out a couple of days until things feel right. The old Bret was too stubborn to do this.
If there’s one thing I’ve learned from various pain experts, it’s that there’s more to the pain picture than plain old biomechanics (posture, strong muscles, joint stability, movement patterns, etc.). There’s also a strong psychosocial component to pain. Every successful repetition reassures the brain that it’s safe to move in a particular manner. While most of us are aware that lifting weights is a neuromuscular phenomenon, we tend to focus on muscles and nerves and rarely think of graded exercise as brain therapy. Considering that the brain is the final authority on issuing a pain response, it makes sense to avoid painful movement and utilize a progressive approach with pain-free movements in training.
While this might seem like common sense, it is often adhered to in times of injury or more severe pain, but rarely during daily training or times of minor pain. I have made it a habit to avoid anything that feels off in training. If my shoulder feels off in the slightest degree when I bench or military press, I nix it for the day. If my back feels off in the slightest degree when I squat or deadlift, I nix it for the day. I try to find movements that don’t hurt, thereby effectively training around the issue. Within a couple days, things almost always clear up. I feel that this act stops pain from getting more serious by preventing over-sensitization of the tissues and preventing increased threat perception.
The final piece of the confidence puzzle involves simply knowing that other lifters have come back to set world records after debilitating back injuries. Injuries in the gym do not have to be death sentences. With good training, the body and brain can rebound and even reach new levels of strength and fitness. It all starts with believing.
The Perfect Control Subject
Now that I’ve listed some of the major factors that I feel helped me solve my low back problems, I’d like to mention that I have an identical twin brother. He loves to train out of a nearby condominium gym that contains machines and light dumbbells. For a couple of years, he relied upon the lying leg press machine and walking lunges for leg development, and machine bench, machine seated press, lat pulldowns, and seated rows for upper body development. Everything was fine at first, and then all of a sudden he started developing severe knee pain, presumably from the lack of glute and hamstring strength. Then he started developing severe shoulder pain, presumably from subpar mechanics and jarring forces brought about by machine-only training. Finally, he started developing low back and mid back pain, which I feel is highly related to insufficient glute strength. However, a prior rib injury and a prior roundback lifting injury were likely culprits as well. Needless to say, his body seems like it’s falling apart whereas mine seems to be thriving, despite the fact that we are the same age and share the same genetics. If my brother improves upon his training regimen by implementing the same methods that I have in my training, I feel that his issues will radically improve.
As I mentioned earlier, pain is very complex, and there’s plenty more to pain than biomechanics. But when you’re lifting weights, you need to be distributing stress as efficiently as possible. Using good form and developing strong core musculature go a long way in safeguarding the body from nagging injuries. As you can see, strength can be corrective. Strong muscles, strong mind, strong body.
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