Episode #5: Pain & Injuries In Barbell Training | Part 1 - What are Injuries & How Do They Happen?

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Pain & Injuries In Barbell Training | Part 1 - What are Injuries & How Do They Happen?

There are a few common problems in barbell training and powerlifting surrounding training injuries:

  1. Powerlifters stop barbell training altogether, do low load, non functional rehab exercises, mobility work, jump to injections, or surgery before ever trying to address the issues that led to the problem.

  2. Lifters stop barbell training until their pain goes away and then resume training without addressing the issue and their symptoms come right back.

  3. People believe they need to know what structure is injured in order to be treated or resume/continue training.

Why does this happen? 

Because of the narratives the medical and exercise worlds are telling us about barbell training when the majority of clinical practitioners and exercise specialists are not trained in barbell training techniques and powerlifting nor do they understand the mechanisms of injury in barbell training. They cannot effectively prescribe recommendations but confidently speak on these topics without being qualified. 

Because of this, we’re often told to not lift or that we should focus on non-barbell training exercise modalities to “rehabilitate” injuries. Then we return to barbell training without an introductory period or addressing the issues that led to the injury in the first place. 

In this episode of the Progressive Rehab & Strength Podcast, we’ll cover:

  1. What an injury is. [00:18:21]

  2. The difference between acute and chronic injuries and why it’s easier to wrap your head around the recovery time and process for acute injuries. [00:20:42] 

  3. What barbell training and powerlifting injuries are. [00:38:36]

  4. Injury Risk  and why injuries happen. [00:44:16]

  5. Why we use the term “injury risk reduction” vs “injury prevention.”  [00:52:07] 


Dr. Rori Alter, PT, PRSCC, SSC: [00:00:26] Welcome to Episode Five of the Progressive Rehab & Strength Podcast. I'm your host PRS clinical coach, Dr. Rori Alter, and I'm here with my lovely host Dr. Alyssa Haveson. And we are at a point in the Podcast where we feel that it's time to talk about injuries and how to address them. So we've spent the last few episodes really diving into the PRS Method. We've done an episode on barbell training, technique, and training motivation and really how PRS came to be, what our core values are, and what our core goals are that drive our decision-making progress from a rehab and barbell training perspective. So we feel that we're in a really good position, if you've listened to the first four episodes, to really get into the meat and potatoes and the heart of what we do here at PRS, which is injury rehabilitation for barbell strength and powerlifting athletes, in addition to coaching them with an injury risk reduction approach rather than an injury prevention approach. And just to kind of quickly get that injury prevention phrase out of your dictionary or toolbox or whatever, here at Progressive Rehab & Strength, we do not believe in injury prevention.

Dr. Rori Alter, PT, PRSCC, SSC: [00:02:01] You cannot prevent injuries. You can just reduce their risk of occurring. And once you have a very good understanding of how injuries develop, why they develop, and what the contributors to injuries are in any sport, but more specifically, barbell training, strength training, and powerlifting, you can then understand why we can't prevent injuries, but we can only reduce the risk for injury. So we're going to get straight to the point because we know that most of you are here because you want to be strong, and you've probably been injured because, as we said, you can't prevent them; you can only reduce their risk, or you don't want to get injured. So you might be a barbell training athlete, you might be a powerlifting coach or a barbell coach, or you might be a rehab clinician or a medical practitioner who participates in these barbell strength sports. And you have a strong interest in doing as much as you can to not get injured and to help yourself or your clients or athletes or patients through the injury rehabilitation process. So we're going to dedicate the next few episodes, episodes five, six, and seven of the Progressive Rehab & Strength Podcast to talking about mechanisms of injury in barbell strength and powerlifting, what pain actually means, and if it's safe to train with pain and injury, and then what to do when injuries arise and how to reduce gear risk for injury in barbell training and powerlifting.

Dr. Rori Alter, PT, PRSCC, SSC: [00:03:38] So before we get into today's episode, which is about the mechanisms of injury, I just want to remind you guys that if you're here and you are enjoying the podcast and you're enjoying what we do and would like to support us if you could give us five stars, or leave a nice review and subscribe to our podcast channel wherever you're listening to Podcast, that's very meaningful for us and helpful to us to keep this Podcast going and to keep putting out good information that's helping you. And if you have topics or questions that you're interested in that you'd like us to cover on this Podcast, please submit a podcast request form with your questions, and we will happily answer those on our Podcast or in our free Facebook group, the Secret Society of Barbell Mastery. So all those things are linked in the show notes, but give us a review. Leave us five stars or a nice little review to help keep us motivated to keep this Podcast alive.

Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:04:36] So Rori, before we start to talk about the mechanisms of injury and what injury really means, and how to continue training with an injury, why are we talking about this? Why is it so important to talk about it and to understand injuries in barbell strength sports?

Dr. Rori Alter, PT, PRSCC, SSC: [00:04:54] So first of all, obviously, this is a really great question. We wouldn't be here if that wasn't a great question. First and foremost, like I already said, injuries are not preventable. We can just reduce their risk. So no matter if you dot all your I's and cross all your T's and you're following the perfect program, you're going to at some point experience an injury; you're going to experience it as a lifter. If you're a coach, your athletes are going to get injured. If you are obviously a physical therapist or chiropractor or doctor, you're going to be having those injured lifters come to you. Now because injuries are going to happen, one of the biggest things that we see, and oftentimes we're kind of like the second or third clinician or coach that people come to after they've been experiencing injuries for a really long time, is that people lose motivation to train when they're injured, and they stop training altogether. Even if those injuries aren't affecting the rest of their body and they're able to train, let's say they hurt their knee, and they're still able to train their bench press or their pull-ups and their chin-ups and their overhead press. They stop training when they get injured, or they do insignificant low-load non-functional rehab exercises, or they focus on mobility work, or they're quick to jump to injections or surgery even before trying to address the actual issue that led to them experiencing the injury or the pain.

Dr. Rori Alter, PT, PRSCC, SSC: [00:06:25] So when we're experiencing training injuries, it's not that we need to do 8 million other things to address the pain of the dysfunction. It's like what's going on in the training that we can address to figure out why the injury happened and reduce its risk for the future. But also, instead of stopping training altogether, how can we use training to rehabilitate and keep us not losing progress on all the other lifts during that process? So we see people stop training the painful lift altogether. We see people incorporate non-training-specific rehab, and we see people really lose motivation to train and focus on singular elements of injuries when injuries are actually really multifactorial, and you can't address an asymmetry or just the asymmetry or if there if asymmetry is and that's a whole other podcast that we can have a conversation about. It's not fair to the lifter to only focus on a "weak muscle individually" or asymmetry or a leg length discrepancy or whatever.

Dr. Rori Alter, PT, PRSCC, SSC: [00:07:39] Because chances are if you're identifying those things, they already existed anyway before the injury, and you've had those things for a really long time. So it's not those things that necessarily lead to the injury. Injuries in barbell training and general injuries in life are multifactorial. So we see that people are really focusing on identifying the tissue that's injured or damaged, the one muscle or one joint or one thing that's contributing to the injury or the pain or the experience of pain. And people stop training because of that. And then when they do resume training, they're not really reintegrating to training appropriately. So that is why this pain and injury topic is so important to us. Obviously, it's what we do. It's our bread and butter here at PRS, but we just feel that the majority of people focus too much on wanting to know what structure is injured, stopping training altogether, or focusing on non-sports-specific rehab. So Alyssa, can you talk a little bit about why we run into these problems that I was just talking about when we have barbell athletes or powerlifters who are injured?