Physiotherapy that works for Barbell Athletes

Jordan Octeau

Physiotherapist

March 29, 2022

My Story

My name is Jordan Octeau and I am a Physiotherapist, Personal Trainer, Powerlifting Coach, and amateur powerlifter.

10 years ago, I was an everyday athlete just like you. I went to the gym regularly and got really interested in barbell sports. This came with all the classic aches and pains that come with these sports: shoulder pain, upper back aches, low back pain, knee pains, among others… I felt alone with these pains, and they were limiting my training. Every time I felt like I was getting further in my training, a new injury, ache or pain would hold me back. I didn’t know at the time that I was not alone in this, but I felt alone.

I saw many different professionals that were supposed to be able to help, but ultimately, they didn’t do much for me beyond temporary relief. Don’t get me wrong, these were good people trying their best, but ultimately, it didn’t work for me because they didn’t know how to help someone like me…someone like US. I realized part of the problem was many of them—as many people do—saw my sport as inherently injury-prone and excessive, when you and I both know that isn’t the case. I was told to “stop using so much weight” and “stop powerlifting for a year because nothing we’re trying is working”.

Over time, I decided I’d just figure it out myself. I became passionate about training, eventually becoming a personal trainer myself. Devoted to a helping others on their journey. Despite my sense of purpose, I also found myself on a self-fulfilling mission: curing my own pain. I took courses, went to conferences, and did tons of research. It was through my research and devotion to the mission that I ultimately decided to become a Physiotherapist. Fast forward 6 years, Masters Diploma from McGill University in hand, I felt equipped with the tools to not only help myself but help people just like you and I who DESERVE guidance and DESERVE to be pain free without having to spend time outside the gym.

Although this journey began as a self-fulfilling one, it has proven to be far greater and more beneficial than I could have ever imagined to not only myself, but to others just like me. My journey has evolved into our journey.  Some of you might be professional full-time athletes, but I know most of you have jobs, families, hobbies, and other interests. You don’t have 6 years to figure this out.

Injury Risk

Barbell sports are safe and extremely good for you. In fact, barbell sports have some of the lowest injury rates amongst all sports out there. To a lot of people, Soccer may seem much safer than Powerlifting or Olympic Lifting. Lo and behold, that is definitely not the case. In competitive male youth players, injury rates in soccer range from 9.5 to 48.7 injuries/1000h of practice (Owoeye et al., 2020). Olympic Weightlifting however has an injury rate of 2.4-3.3 injuries/1000h of practice, and Powerlifting 1.0-4.4 injuries/1000h of practice (Aasa et Al., 2020).

Does this mean soccer is dangerous?

No.

What I am trying to point out however, is that sports like Powerlifting and Olympic lifting get a bad rap because, to many people, the amount of weight being lifted seems so excessive that it MUST be dangerous. But people like you and I who go to the gym know that you don’t just show up on the first day and load up the bar until the plates are falling off, just like how your first ever soccer game wouldn’t be on a FIFA World Cup field.

In fact, resistance training in general is has shown a strongly positive correlation with injury risk reduction. Resistance training not only makes your muscles grow both in size and strength, but it also:

·  Strengthens your connective tissue

·  Increases the density of your bones

·  Reduces your lifetime incidence of almost all musculoskeletal aches and pains, notably low back pain

·  Increases your body’s capacity for work, leading to less risk of getting injured. For example, what seems more safe to you: Lifting a heavy couch with zero exercise experience, or lifting a couch when you can deadlift 300lbs? I think the answer is obvious!

Load Management

“Jordan, this is great and all, but I go to the gym on a regular basis and my shoulder hurts when I bench press, my back hurts when I deadlift, my bicep aches for a few hours after doing pullups or rock climbing, and my knee hurts when I squat”.

I hear you.

I can and will dive more into these subjects in future articles, but for now I want you to rest assured that what you are going through is Phymore common than you may think. I am here to listen to your personal struggle and create a plan with you so that we can get you pain free without having to spend time off training. Your goals are my focus. Whether it’s weight loss or gain related, bodybuilding, powerlifting, Olympic lifting, CrossFit, etc.

There are so many ways for us to go about it together, but I’ll give you a little peak behind the curtain of what my approach looks like.

One of the most important concepts we need to apply in your case is something called Load Management. In its essence, Load Management is a relatively simple concept, but applying it can be a lot more challenging in real life than on paper, which is where professional help comes into play.

To put it simply, load management is recognizing that the weight/volume/intensity/distance you are currently training at is causing you pain, and figuring out how much we need to modify it so that the alarm bells stop going off, without needing to stop training.

Load Management is based on the principle that sometimes pain can be caused in part by demanding more of your body than it wants to tolerate. Pain is an extremely complex area of study, but to simplify it for now, pain is an experience where your body senses a threat. Sometimes the threat is a real, physical and immediate one, like a broken bone, but often times the threat can be a lot more nebulous. Sometimes the threat is amplified by stress, lack of sleep, your preconceived notions and your previous experience with the threat. We will touch on these subjects in future articles, but in this one we will talk about the threat amplification factor that is “tissue load tolerance”.

As I mentioned above, our process may look something like this:

· For the last 3-4 weeks, you’ve noticed that your shoulder aches when you’ve been doing dumbbell shoulder press

· It hurts around a 3-4 on 10, nothing alarming but it’s definitely annoying you.

· You figured after a week or two it would go away, but it hasn’t, or it may have even gotten worse.

· You come see me and tell me this, and I ask (among many other pertinent questions) what kind of weight and volume have you been doing?

·  You tell me: I shoulder press 2x a week. I use 35lb dumbbells and generally do 4 sets of 10-12 reps.

· I then take you into the gym, and we test it out.

· You confirm, it still hurts when you lift it. The pain starts at the beginning and stays there throughout the set.

·  I take away the 35lb dumbbells and hand you 20lb dumbbells.

· Now you do the exercise and it hurts 1/10, definitely tolerable.

· We do a second set, and it still hurts at first, but by the end of the set you don’t feel any pain at all.

· I now help you create your “physio” program:

· You’re going to keep doing exactly what you’re doing, but you’re going to deload down to 20lbs on your shoulder press for this week. If this week goes well, next week we’ll up you to 25lbs, then 30, and before you know it, you’ll be lifting 35lbs again pain free.

Above was a relatively simple Load Management example, but it isn’t always that simple. Often times we need to manage repetitions, sometimes we need to change up your form to provide a different stimulus that isn’t perceived as a threat, sometimes we need to do some repetitive movements before the lift to calm things down, and that’s why seeing a professional like me is important, because I can help you figure out exactly what you need to do.

The Next Step

What I hope you take away from this, is that by seeing me, you absolutely can continue to train and get better at the same time. Sometimes it does involve taking a temporary step back while we let things calm down, but we can agree that deloading one exercise for a few weeks is barely a blip on the radar of your training history, versus not progressing for months or years because you’re limited by pain, or worse: giving up on your gym routine or gym-based sport all together because of pain and frustration.

If you feel that what I’ve said resonated with you, you owe it to yourself to book an appointment with a professional who’s been where you are, who understands your sport, your goals, and your needs on a personal level.

Let’s get you back in the gym.

References:

Aasa U, Svartholm I, Andersson F, Berglund L. Injuries among weightlifters and powerlifters: a systematic review. Br J Sports Med. 2017 Feb;51(4):211-219. doi: 10.1136/bjsports-2016-096037. Epub 2016 Oct 4. PMID: 27707741.

Owoeye, O. B., VanderWey, M. J., & Pike, I. (2020). Reducing injuries in soccer (football): An Umbrella Review of best evidence across the Epidemiological Framework for Prevention. Sports Medicine - Open, 6(1). https://doi.org/10.1186/s40798-020-00274-7