Coach Britney Baker recently completed the Barbell Rehab Certification Course. We want to share her takeaways and reflections below!
The Barbell Rehab Method Certification is a one-of-a-kind continuing education event for BOTH fitness and healthcare professionals.
The Barbell Rehab teaches individuals to coach, modify, and maximize the barbell lifts for clients with pain or mobility limitations. The Barbell Rehab Method provides you with this systematic framework so you know EXACTLY what to do and in what order when someone has pain with a lift.
Barbell Rehab was created by Dr. Michael Mash, Physical Therapist and Barbell Coaching Expert to help fitness and rehab professionals improve their management of clients with pain or mobility limitations.
Barbell Rehab Method Seminar
The 4-step framework for training with pain
Step 1 - Optimize Form and Programming
Although form is just one aspect of the pain experience, if all you have to do is clean up your technique and make sure you have a flat back while deadlifting, then this would be an easy fix.
We can also adjust programming by dropping the weight down and adding a tempo, reduce the frequency of how many time per week you do the movement that gives you pain, or we can reduce the total number of reps and sets you complete to help alleviate the pain and keep you moving.
If this doesn’t help, then we move to step two.
Step 2 - Change Modifiable Factors
If changing your programming and your form doesn’t give you some relief, the next step we can take is to adjust your form to something more individualized for you.
This could be changing your grip width when pressing on bench or overhead movements, adding tempo, or changing the range of motion you go through with a landmine press. It could mean changing your stance width on deadlift or squat, how far out your toes are, the depth you go to on squat, the range of motion you go through on deadlift (ie instead of a full deadlift, maybe an RDL is more tolerable for you), or the position of the bar on back squat (high bar vs. low bar). In lunges, this could mean changing your shin angle, torso angle, your step length, and adding in a tempo.
If these don’t allow you to accomplish movements pain free, then we go to step three.
Step 3 - Substitute in a Tolerable Exercise
If we need to, we can also remove the lift that causes aggravation to the area, and sub out a tolerable lift that is the closest variation.
For example, if back squats are the issue, maybe we go to a front squat, a goblet squat, or a box squat. For bench press, this may mean switching to a DB Bench Press, DB floor press, or a push-up variation. If deadlifts cause you pain, this may mean we switch to a trap bar deadlift, an RDL, or even a glute bridge instead.
The main thing we’re looking to do here is to find an entry point to still accomplish the closest thing to the actual movement being performed. These are just a few examples of the many that are out there! Move on to step four from here.
Step 4 - Reintegrate and Rebuild
It’s important to consider if you really NEED to get back to a specific variation of a lift.
For example, if it’s required for your sport (ie, a powerlifter MUST be able to barbell bench press), then YES. You must be able to get back to that specific variation. If the pain isn’t interrupting your daily life and you enjoy the substituted exercise being used for your movement, then maybe it’s ok to stick with the substituted movement.
If you really WANT to get back to the movement, then the best way to know would be to test the movement at LIGHT loads about every two weeks. The goal would be to slowly add back more load over the course of days, weeks, or even months if that’s what your body requires of you.
Getting back to your original movements is likely not going to be linear, and it’s important to stay patient!
How Full is Your Cup? Recovery and pain
All things must be considered to train smart and LIFT FOREVER!
If you think about your work capacity like a cup, we have to think about what that cup is filled with outside of gym related topics. Maybe you have a stressful job, your nutrition could use some improvement, your husband/wife forgot to take out the trash, you sleep on average 4 hours per night, you’re stressed, anxious, etc. All these things add up and fill your cup to almost capacity, leaving little room for extra stress/load from a workout.
When that cup spills over, that’s when we’re most likely susceptible to injury. If our cup is already filled with other life stressors/factors, then it leaves little room to push yourself as much as you think you should.
If you’re dealing with several other life factors, that’s ok! It’s part of life. Just modify your workouts accordingly to meet your current needs and your season of life.
Tendons want Tempo -
Slow Down to Speed Up Progress
When dealing with tendinopathy, it’s important to be mindful of your load and capacity when the tendon or area is giving you trouble. One point that was made during the seminar is that our tendons want to be put on a tempo. Isometric work can also be a great starting point to help reduce pain early on (think plank hold, wall sits, etc.).
The first step when dealing with tendinopathy would be to modify your form and/or programming on your compound lifts to a more tolerable level. After the tendinopathy gets better, then we can add in tempo-based work and isolation work to help build up that tendon or joint’s ability to take on load again.
How We View pain - It is COMPLEX
In our culture, we often view pain as a bad thing. Specifically, here in the USA, we typically think that any kind of pain we have is automatically “bad” pain, and must be taken care of immediately.
Pain is really often an alarm that something might be wrong. It does not always equal damage. Our pain levels are also subjective, so what may feel like a 2/10 pain to one person, may feel like a 7/10 pain to another person. Our pain levels can also be affected by multiple factors that may or may not be modifiable (refer back to the cup theory :)).
You may also have an anatomical difference that requires a different toe angle on squats, or a slightly wider/narrower stance than others.
Pain is never a death sentence to making progress in training.
There are always steps that can be taken to stay on the path to your best self!