Episode 40: Coffee, Deadlifts and Low Back Pain

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• Joe Gambino
• Joe LaVacca

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Summary
In this episode of the Beyond Pain podcast, hosts Joe Gambino and Joe LaVacca delve into the complexities of lower back pain, particularly in relation to deadlifting. They discuss common misconceptions surrounding back pain, the importance of understanding spine models, and share personal experiences with injury and recovery. The conversation emphasizes the significance of technique, individual differences in lifting, and the necessity of building a resilient spine through varied training methods. The episode concludes with a promise for future discussions on the topic.

Takeaways
Lower back pain is a common issue, affecting 90% of people at some point.

Misleading spine models can create unnecessary fear about back injuries.

Personal experiences with back pain can inform better training practices.

Technique in deadlifting varies based on individual experience and comfort.

Strength training is generally safe but carries some risk of injury.

Building a resilient spine requires training in various movements, not just stability.

Spinal segmentation is crucial for effective force transmission in the body.

Strengthening through flexion and extension can alleviate back pain.

Pain management should include understanding normal muscle soreness during lifting.

Future discussions will further explore deadlifting and performance perspectives.

Chapters

• 0:00 Introduction to Lower Back Pain and Deadlifting
• 3:05 Understanding Back Pain Models and Misconceptions
• 6:06 Personal Experiences with Back Pain and Recovery
• 8:53 The Importance of Technique and Individual Differences
• 11:54 Building a Resilient Spine through Training
• 15:06 Conclusion and Future Discussions

Transcript

Joe Gambino (00:00.642)
Welcome back into the Beyond Pain podcast. I am one of your hosts, Joe Gambino, and I am here with, I don't have a word for you because we just finished recording an episode. So we'll still keep you as Mr. Mexico. So back to back episodes. Well, thanks again for joining us for two episodes today, Joe boy, always from there. But you can find this podcast on Instagram, Beyond Pain podcast. You can also find it on YouTube, cupsofjoe underscore PT. And then you can reach out to either one of us on Instagram.

Joe LaVacca (00:09.462)
Yeah, I'm still in Mexico.

Joe LaVacca (00:14.934)
You

Joe LaVacca (00:18.958)
yeah.

Joe Gambino (00:30.23)
at Joe Gambino DPT for myself and at strength and motion underscore PT for Dr. Lavaca over there. And today we are talking about lower back pain and deadlifting. Maybe even blending that into just training in general, but we'll keep it there. Welcome back in Joe.

Joe LaVacca (00:49.814)
Good to be back. And in the intermission between episodes, I was again reminded of how poor I am at making coffee, how much I lack creativity, how many people do it better than I am. my wonderful friend, Melissa, is inside with making a honey cinnamon oat milk coffee. Just, you know, and it's the simplest thing, just watching her do it. I'm like, wow, I could easily do this.

And I don't because I didn't even know it existed. the more I travel, the more we have guests, the more I realize I'm not capitalizing on very simple things that would make my life more delicious and more splendid. So this is why I'm going to keep doing it, man. This is why I got to keep doing the pod, even though we're in Mexico right now, because I have to share this with people that there is hope. If you're like me, there is hope. Just keep searching.

Joe Gambino (01:44.398)
Well, Joe, I have good news for you. Really going to be helping you out here because I think I found our first coffee guest for the podcast. just have to schedule them out. So we'll be we'll be. Yes. So this is for you, You know, maybe for the listeners, if they're in your boat. But this I'm doing for you.

Joe LaVacca (01:55.926)
Ooh, this is very exciting.

Joe LaVacca (02:01.653)
I

That's going to be a three hour episode, easy.

Joe Gambino (02:07.31)
You're going to have your list of questions and then course list of questions.

Joe LaVacca (02:11.042)
yeah. Yeah. We're going to be on like a Tia Huberman levels after that one. It's going to be like three, three plus hours. You know, maybe it's part twos. Who knows?

Joe Gambino (02:20.342)
Now just one long mega episode. That's what we'll do. And now you have to listen to it in bits and pieces to get all the goods out of it. But let's dive in. You know, we're talking about low back pain. We're talking about deadlifting today. Is there any specific place you want to start this con?

Joe LaVacca (02:28.726)
You

Joe LaVacca (02:37.876)
No, I think this is just, again, one of those common stories we hear so often with clients. And I think where a lot of it comes from are those poor models of the spine that clinicians still use, that squish out discs, that already have that like red gumdrop candy.

Joe Gambino (03:05.058)
Mm-hmm.

Joe LaVacca (03:05.814)
protruding from the side. Now I will say this, if you've ever seen those models at least the red gumdrop one was very stiff. It was real rigid so you were moving it around but the disc was hard and at least I'd always point out even when I would use those models was but you see like how tough the disc is and like every other section right that you know it's even harder than that it's like tire rubber you know.

It's not going to bend or break easily. It can adapt. And then there's these new models. I don't know if you've seen them, where all you have to do is just like squish and it almost becomes like a jelly doughnut. Everything just flies out, right? Everything just flies out easily and it builds this fear that, wow, look at that. My spine is so unstable. Look at that. All that fluid and juice and jelly.

Joe Gambino (03:48.504)
The jelly donut analogy, yep.

Joe LaVacca (04:03.53)
can just boom, go out at any moment in time. And these are the models now and they're meant with good intention. But I think the stories that are presented behind them are not helpful. So in turn, because 90 % of people will experience back pain at some point in their life, it is very common. It is easy to draw so many connections to it as to what causes it. Luckily, maybe we'll touch on a few of those things today.

But I would say without fail, almost everyone I've seen with low back pain comes in with a story on how deadlifts are going to be more damaging for their back. They've stopped doing it. Yep. And I was really interested in hearing where we were going to go with your story here. So why don't you share that? Because I think this is something that's common that we've heard, but this is actually something you've went through. So if you remind the listeners, what happened with the back pain? How long did you?

prevent yourself from lifting because now I see you working your way back up to PRs on Instagram and it's really fun to watch. So why you just share that.

Joe Gambino (05:11.886)
Yeah. So my, um, the main thing with my back when it went out, um, we can, you know, air quotes, cause that's a terrible term for, for me to use with it, but it's kind of exactly how it felt. You know, I was playing softballs my mid twenties at the point, and I just did one quick like turn to the left to catch a ball that hit the ground and took a spin in a direction that, um, I didn't expect it to, and put me on my knees. Like I literally had to roll the ball to the outfielder next week.

couldn't, it took me like five minutes to get off the field. It took me a while to, know, I think that initial flare up took maybe like six or nine months for me to like kind of really get over to like be able to like work out somewhat hard again. And then it's kind of limited me to a point where anytime I started to get back up, I think it touched on the podcast as well as like 275 was that number. Anytime I ramped up to 275, my back would start to hurt.

And I've had a couple of big flare ups since then. Um, one was when I first started working at perfect stride, um, and I had that big flare up that also took about six to nine months when I had that big, big flare up for me to like, get back to a point where I can even train again. Um, and it was always kind of like this like up and down cycle where. Anytime I felt better, I would just kind of go back and use my previous experience. My, my max at that time was like three 55, 275 was never that heavy, like not that heavy, but like.

Joe LaVacca (06:29.578)
We will see it's own view for 734.

Joe Gambino (06:32.526)
You know, I was able to do it. Right. So it was always my benchmark. Like, okay. 225 was good. 225 was good. That means I go to 250. 250 was good. That means the next time I go to 275 and then boom, my back would hurt. It was like this all over and over again. Right. So I needed to, you know, mainly the things that I changed was changing up the volume, um, building up more volume with lower weights over some time to make sure that my tissues actually adapt to that stuff. Um, and then a lot of it, and what I kind of want to talk about it as, as, um,

Joe LaVacca (06:35.19)
Yeah.

Joe LaVacca (06:50.634)
then it's just so true.

Joe Gambino (07:03.022)
Maybe how do we actually kind of like build up a more resilient spine, to speak. But it really just became, how do I like really strengthen through flexion, extension, side bending, rotation. So really like loading my spine and my hips. And just like really mobility was a, was was a major game changer for me, which looks a lot different for me now than it did in the past, so to speak. So yeah, my story was a little up and down and I'm finally at a point now.

Joe LaVacca (07:16.726)
I

Yeah.

Joe Gambino (07:32.366)
where dead lifting feels perfectly fine. Actually, like my back feels great. So I haven't really had any major issues with that. And yeah, I mean, we're back at 300, where we're getting close. So I think my goal by 40 is to just like, I think I'm just gonna try to PR on some stuff and really put a little focus on strength just for the fun of things, since things are feeling good now. And there's no real worry or concern about where my back's gonna be.

Joe LaVacca (07:47.938)
There you go.

Joe LaVacca (07:59.254)
Yeah, invest in it now man. That's what that's around heading to as we both go into our 40s together. The other other big thing here is you as you share your story and I think about other people that have come in is this idea that you know, there is a specific way to deadlift or a specific form or technique you should follow. And I think that there's there's caveats to that right? If you are a brand new lifter, novice in the gym,

then yeah, I'm probably going to drive mechanical lifting techniques efficiency with you a little bit more. If you are an experienced lifter and you've developed a strategy over time, I'm probably very rarely going to touch that because that has been ingrained in cycles and cycles and cycles. And for us to go backwards because you had maybe one bad lift or one bad pull.

and forgetting about the millions that were successful, again, doesn't seem kind of all that beneficial to me. So I think about it a lot with sports, right? Everything carries a risk. Nothing is risk free. While weightlifting is one of the safest, most practical things you can do from an injury standpoint, the longer you do it, the more likely you are going to have an injury. No, we'll put that in air quotes.

And I think on average, it's like if you, you know, strength train two to four times a week and you do so over the course of two years, you're going to probably fall into that bucket. And I can say that that probably jives, you know, where I'm like, you know, have to really modify something once a year, once every couple of years, even if it's just for a couple of weeks or a couple of months where it doesn't feel right to do what I used to do. Right. So I'll count that as an, as an injury for now. But, you know, the big thing there is.

If I go back to thinking about soccer, basketball, football, this, that, the other thing, I enjoy those things. I accept those risks. So it's the same thing with deadlifting. It's the same thing with every other, you know, squat or exercise we'll pick at the gym. Nothing is going to get us, you know, pain free 100 % of the time. So with that being the case, and I'm sure you've heard this, I'm sure you felt this too. When you feel the deadlift in your back, most of the time I go, yeah, no shit.

Joe Gambino (10:02.178)
Mm-hmm.

Joe LaVacca (10:22.388)
especially as it gets heavier and heavier, you're using your back muscles as part of the process to lift the weight off the floor. That would be like me saying, you my biceps hurt after bicep curls. So we have an expectation of bicep curls. We're sore, we're stiff afterwards, but yet we don't necessarily follow through with that with like low back pain, with low back exercises. We don't seek a pump. We don't seek fatigue. We don't seek soreness.

Joe Gambino (10:24.108)
Mm-hmm.

Joe Gambino (10:35.296)
Right.

Joe Gambino (10:45.358)
.

Joe LaVacca (10:48.18)
because for some reason we built this protection wall like, I shouldn't feel soreness or muscle, anything in these muscles, but I should feel soreness, hypertrophy, burning, aching, and every other muscle when I work out. Have you ever noticed that?

Joe Gambino (11:00.462)
I have, yes. There's definitely a way that we look very, very differently at things around our spine. you know, if you have pain, if you're, you've never really, you know, you're new at moving or lifting, you know, sure, you know, like good technique, things like that, those things are important. Not that they're not for more experienced lifters, but when you've loaded and you've hit maxes and you've, know, whenever you do something with max intent, you're likely going to break technique.

You've already kind of built up those tissues right over time where it's going to be less likely to cause issue for that person than someone who's new who has zero experience with any of that stuff. Just, guess, a quick last point and just kind of go back to my story and where I kind of see a lot of people make mistakes as far as supplemental training, especially if they've had back injury, I want to kind of bring it back to pain is the focus is always on stability, stability, stability, like work.

Joe LaVacca (11:28.128)
Mm-hmm.

Joe Gambino (11:54.67)
from neutral trying to prevent flexion or extension or rotation or whatever it is. And that's kind of going back to like Stuart McGill on the big three. That's like everything that he's ever preached. And I'm not saying that we shouldn't be doing stuff like that, but it's missing half the picture as far as what our spines need to do to be resilient. So spinal segmentation is super important. That's exactly how our spines work to transmit force. If you're not.

able to segment your spine and moves in chunks, you have zero awareness of it. Chances are it's going to feel stiff. It's going to be achy, right? It's not going to be able to transmit force well. So spinal segmentation is a big one. Making sure we have full range of motion. Like, can you fully flex your spine? Can you fully extend it? Can you side bend? Can you rotate? And then once you have those things, can you actually produce force? You know, like, can you strengthen those tissues just like any other muscle? Doesn't necessarily have to be to the extent of like turning your bicep, but

Joe LaVacca (12:35.242)
Mm-hmm.

Joe Gambino (12:49.88)
You shouldn't be afraid to load those things. And I think once, you know, we do it's a, especially for me, like strengthening spine extension was like a massive game changer for, how things felt. There's actually a little, like the sensations when I did strengthen it first, it was like super fatiguing, super hard for me to do. Like now it's starting to get easier. but also feels different when I load those tissues. it's not painful. It's not like a traditional pump.

Joe LaVacca (13:00.96)
Holy.

Joe Gambino (13:17.942)
It's like an in-between uncomfortable kind of work out-y type of feeling. But at the end of it, like when I'm looking at how does an activity, how do I respond to something? It's not just during it, right? It's how I feel afterwards and over the next day or so, right? And if my back feels like better after I do those things, even if it felt like this weird uncomfortable sensation, then sure, I'm going to keep it in my program, right? It's not detrimental to me. And now I'm seeing more and more progress. Those things are getting easier.

It's allowing a lot of things to kind of branch out for where I am and how I'm feeling. So very, very clear. I probably should have been doing a whole lot more of that a whole lot sooner in a sense. But I was always so focused and back to our point from last episode, I always focused on flexion because flexion was always my problem. And I never was like, I need to work on a whole lot of like extension, extension, right? It was always flexion, flexion. now that I'm not that I'm not working on those things, but it was a whole lot more on it, on the extension. It's not that it made a difference for me.

Joe LaVacca (13:57.982)
Yeah, yeah. And for those listening.

Joe LaVacca (14:16.266)
Yeah, and if you're not following Joe on Instagram, please do so. I mean, it's really cool to watch Joe share his story, but then share his progress as well. And always try and train with our girl over there, which I love. So keep her in the gym, build good habits.

Joe Gambino (14:31.564)
That's the plan. got a little walking beams for her. So when she goes in there now, because she's older, I need to entertain her while we're in there. you know, we're still doing it.

Joe LaVacca (14:38.016)
Yeah. All right. Well, I think we have a lot more to say on this topic. So we'll continue our conversation in the future around this. But anything other closing remarks, quick takeaways for people?

Joe Gambino (14:52.206)
If I don't, think we'll elaborate on this, but we'll have your coach on the podcast to talk about deadlifting from a performance perspective, we'll let our little nuances about pain, but I think that will give a lot more context to the things that we've talked about today.

Joe LaVacca (15:06.08)
Sounds good, man. Looking forward to it. So Joe, thank you. Love you. Listeners, we love you. And don't forget to tune in next week for another exciting episode of the Beyond Pain podcast.