Weightlifting & Spine: Red Flags, Pain Management, and Safe Progression

By Dr. Sidharth J Unnithan, Consultant – Sports Medicine, Aster Medcity, Kochi

Spine Day is an excellent reminder of the vital role our back and neck play in every aspect of life, especially in high-intensity sports like weightlifting and powerlifting. For those who regularly push their limits with heavy weights, certain spinal issues are more common.

Understanding Common Spinal Injuries

Back Sprain or Strain are the most frequent injuries. A sprain involves the ligaments (the strong bands that connect bones), while a strain is an injury to the muscle or tendon. Disc Prolapses is more serious injury which occurs when a disc’s inner, gel-like center pushes through the tough outer ring, potentially irritating nearby nerves.

The Red Flags of Injury Prevention

The most critical factor in preventing back and neck injuries has nothing to do with training equipment, whereas it has everything to do with attitude. The biggest mistake a lifter can make is attempting a weight beyond their current capacity. Before ego lifting know your level and increase the load gradually. Using protective gear such as proper shoes and a lifting belt is helpful.

Immediate Pain Management: Heat, Ice, or Rest?

When pain strikes, the immediate action should be determined by the type of pain. If a muscle pull has occurred, a heat pack should be applied because heat helps to relax the muscle that is in spasm. However, if a strain occurred while lifting, or swelling or bruising, ice is required to reduce inflammation and swelling. When the muscle is tight, apply heat. In both cases, rest is essential, regardless of whether you use ice or heat, as continuing to train on an injury will almost certainly make it worse.

Knowing When to Stop and Seek Help

Pain is subjective, but using a scoring system can help a lifter make smart, objective decisions about their training. A scoring system like the Visual Analogue Scale (VAS), where 0 means no pain and 10 is extreme pain: pain at 1/10 is considered mild and may be acceptable to continue, but if the pain reaches 5/10 or higher, it is a clear sign that the load is too much, and the lifter should immediately reduce the weight or stop the exercise.

Additionally, a lifter should seek medical attention if the pain increases from one set to the next (for example, mild in set 1, but moderate in set 2), if the pain is so severe that they cannot perform daily activities or it makes it hard to sleep, or if the pain and associated symptoms, such as swelling, do not disappear completely after a couple of days of rest.

Differentiating a Minor Strain from a Serious Injury

A lifter can often self-assess the severity of an injury in the first few days: if the injury is a minor muscle strain, the pain will start reducing immediately when the lifter is at rest and should disappear completely within one to two days. Conversely, a serious injury is indicated by pain that is much more severe, accompanied by noticeable swelling, or if the individual is unable to perform normal activities. In these more serious cases the pain might be severe enough to interrupt sleep, professional medical attention is required.

Preventive Practices for a Healthy Spine

Incorporating specific exercises and habits into your routine is the best long-term defense against injury:

• Proper warm-ups to prepare the muscles for the heavy work.

• Always start heavy weightlifting sessions with smaller weights.

• Include some form of mobility and strengthening exercises in their routine.

• Make sure to do post-stretches.

• A deep tissue massage once a month can help relieve stiffness and is an excellent injury prevention tool.

• Holistic Health: A proper diet, adequate sleep, and rest are equally important