Hello Swole Woman!
I want to get into serious strength training but I’m terrified of hurting myself more than I already have.
For background, I’ve had chronic issues with low back pain and shin splints. I’ve been to physical therapy at least 4 times since I was a teen and have done massage therapy and acupuncture. I’d really like to get more serious about lifting but right now, especially since I’m improvising with what I’ve got at home, it seems like I’m in a constant cycle of getting pumped on lifting heavier weights and then tweaking my back, which forces me to back off.
My goal now is to get strong enough in my core that I could try more serious lifting when I can get back into a gym. I’d love some specific advice on how to progressively develop my core strength.
Currently, I’m trying to work out 3 days a week. I created a list of ~15 different core exercises I could do that includes hips, glutes, abs and quads. (I can send the list if that’s helpful) For each workout, I pick five exercises and do sets of 3, with about 7-10 reps. But for core work in particular, I’m not really sure how to increase the strength over time.
You know I love a fridge magnet aphorism, so let’s cue one up: being an athlete is not never getting injured, but learning to manage your injuries. This is not a terribly visible part of sports, but pain and injury management–not cures–areis an absolutely enormous part of it. Most athletes you see on any field or court are just a jumble of physical ailments, kept at a low-enough simmer to allow them to play. Similar is true of most people who have been strength training a long time; if you are able to, say, squat 600 pounds and have never endured some sort of acute or developing chronic pain, you are an incredibly rare person.
Sometime pain comes from doing something wrong, unintentionally or intentionally; sometimes it comes from the way bodies are built or how they change over time. Pain is not an indictment of any given person. It’s important to know this because it should inform our overall approach and understanding of how we manage or mitigate pain.
Okay–first of all, I think you need to ease up on self-prescribed core exercises. I’m deeply sick of “working your core” as the supposed solution to all problems. Cores, and particularly core “strength” or “endurance,” is neither as simple nor as universally good as everyone seems to think. Not all core exercises are made equal, and a core exercise is not a core exercise just by virtue of doing it; the way many “core” movements are structured, your lower back can actually take over and take on too much or all of the stress. That may be good for you overall, because maybe your lower back actually does need to be stronger; or it might be bad for it because you’re not actually strengthening your core to take pressure off your back, you’re just doing more lower back work. There is no real way of knowing the difference without the substantial involvement of a knowledgeable doctor, one who will actually ask you, for instance, where you feel different movements, make sure your form is correct, and make sure that you are using the right muscles.
Perhaps your PTs prescribed this approach, in which case, I guess listen to them and not me. Except that I must point out that even with apparently lots of core work, you’re still having back pain issues. If a PT’s advice or prescription didn’t help you, and they especially didn’t help you after you flagged the ways in which you are still having pain, you should feel empowered to seek a second opinion.
I want to put a word in here for two other professionals whose guidance have helped me: sports medicine doctors, and actual strength training coaches.
Everyone is familiar with the exchange where you say, “doc, it hurts when I do this,” and the doctor says, “stop doing that”—a joke format, but also a real thing that doctors mysteriously do a bunch of times each day. No shade to doctors; I believe that many are excited and thrilled about the beautiful complexity of the human body, and are just fatigued from trying to explain it to people who don’t care. But if you are a person who does care, a sports medicine doctor might be a better match for your growth-mindset attitude to your body. A sports medicine doctor, in contrast to a regular PCP, is focused on helping people continue to move despite their aches and pains. You don’t have to be a world class athlete to go to a doctor like this, and I have found them to be, on average, more solutions-oriented than the average PCP. Their job is not just to solve your pain and problems, but to help you continue to move. A regular doctor, in my opinion, should also be focused on this. But often they are not.
NEXT: while a strength training coach is, and I cannot stress this enough, not any kind of medical professional, few people know more about learning to work through injuries with the goal of strength training than an experienced strength training coach. While they might not be able to literally fix you, they will be able to a) understand what strength training means to you, and why you are moved to do it even though right now it hurts, and b) point you in the direction of the resources that will allow you to get through this phase and learn to manage your injuries, if not outright cure them. That could be particular movements, other PTs who are more experienced with your particular issue, or lots of other stuff.
You might assume a strength training coach isn’t really focused on injuries, and that you shouldn’t go to them before you successfully complete physical therapy and are in perfect condition. Absolutely nothing could be further from the truth! There’s nothing a strength training coach will understand better than “wanting to lift despite being injured.”
I think also, on a softer note, a strength training coach may be able to give you a more holistic understanding of your body and the role of “your core” and your lower back in how you move. I highly recommend reading this old Daniel Duane story, which is in large part about the strength training gym Mountain Athlete and the coach who ran it, who died with several students in deep emotional gratitude to him for how he repaired their actual injuries and relationships with their bodies. This story also presents strong case that, even if you have low back pain but weren’t looking to start whole body strength training, it might help in ways you don’t even realize (yes, in part by working your core, but also much more than that).
Finding a coach can be a little tricky, I admit. But if you’re in an area that’s not exactly densely populated with powerlifting gyms, there are plenty who offer their services online (in-person sessions will undoubtedly be better, but, pandemic and all, sometimes we have to take what we can get). I’d strongly suggest checking out the coaches of strong people you follow, and perhaps see if those coaches are part of a bigger staff, or if there are other coaches those coaches talk about. There’s no foolproof strategy, but just like with working out, don’t set the bar too high.
I’m proud of you for wanting to push through (though, as always, be gentle). There are people and a community who will understand your commitment to the swole way of life; it might just take a bit of legwork to find them.
Disclaimer: Casey Johnston is not a doctor, nutritionist, dietitian, personal trainer, physiotherapist, psychotherapist, doctor, or lawyer; she is simply someone who has done a lot of, and read a lot about, lifting weights.