How pain science can change programming

Powerlifting is a sport that demands physical and mental resilience - the programming behind it has traditionally focused on strength, technique, and recovery. However, integrating pain science into powerlifting programming can revolutionize how we as coaches and athletes approach training, enhance performance, and mitigate the risk of injuries. In this blog, we'll cover the scientific principles of pain and explore how understanding pain can reshape powerlifting programming.

The Neurobiology of Pain:

Pain is a complex, multifaceted experience that extends beyond tissue damage. Pain is not a direct reflection of tissue damage; rather, it's a complex perception influenced by various factors. Neurobiological research has revealed that pain is a product of the brain's interpretation of sensory information. Incorporating this understanding into powerlifting programming involves recognizing that pain doesn't always correlate with tissue damage and that other factors, such as psychological and social elements, play a significant role.

Individualized Pain Responses:

Everybody has a unique pain threshold and response. Acknowledging this variability is crucial for tailoring powerlifting programming to individual needs due to the inherent diversity in how individuals perceive and respond to pain. People have different pain thresholds, meaning they experience and tolerate pain in distinct ways. Several factors contribute to this variability, including genetics, past experiences, and psychological factors such as current stress levels. By considering these factors, powerlifting programs can be customized to optimize performance while respecting an athlete's pain tolerance.

Central Sensitization:

Some athletes may experience central sensitization, a neurological phenomenon where the central nervous system becomes hypersensitive to stimuli, amplifying the perception of pain. This heightened sensitivity can impact how an athlete responds to training loads. Adjustments in programming, such as more gradual progressions or modified exercise selections, may be necessary to accommodate individuals with central sensitization.

Fear-Avoidance Model:

The fear-avoidance model emphasizes the psychological aspect of pain and its impact on movement. It was originally designed to identify and explain why chronic low back pain problems, and associated disability, develop in members of the population suffering from an onset of low back pain, but has since been applied to a selection of other chronic pain conditions. Fear of pain can lead to altered movement patterns and avoidance behaviors, ultimately affecting performance. Powerlifting programming informed by this model involves addressing psychological factors, promoting a positive mindset, and gradually exposing athletes to challenging movements to reduce fear and enhance overall performance, especially when considering injury.

Periodization Strategies:

Traditional periodization models in powerlifting typically revolve around manipulating training volume and intensity to achieve peak performance. However, incorporating insights from pain science introduces a more nuanced and individualized approach. Pain-sensitive periodization recognizes that athletes have varying pain thresholds and responses, and it involves tailoring training variables to accommodate these differences.

Here's a breakdown of how understanding pain science can inform the programming for powerlifting athletes:

1. Exercise Selection:

Context: Different exercises place varying demands on the body and can trigger different pain responses, especially considering the history of injury in an athlete.

Application: By considering an athlete's pain threshold, the programming can involve adjusting exercise selection. This might mean substituting certain movements that are better tolerated by the individual without compromising training goals.

2. Volume Adjustment:

Context: Pain perception can be influenced by the overall workload, and some athletes may respond differently to changes in training volume.

Application: Pain-sensitive periodization involves adjusting training volume based on an athlete's pain levels. This may include reducing or increasing the overall workload to keep it within a range that is well-tolerated by the individual, promoting adherence, and minimizing the risk of overtraining.

3. Strategic Deload Periods:

Context: Intense training phases can contribute to fatigue and potentially increase pain sensitivity.

Application: Pain-sensitive periodization incorporates strategically timed deload periods. These phases allow the athlete to recover both physically and mentally, managing pain levels and preventing the accumulation of stressors that could compromise long-term performance.

4. Individualized Progression:

Context: Athletes progress at different rates, and their pain thresholds can change over time.

Application: Understanding pain science allows for a more individualized progression plan. Coaches can monitor an athlete's response to training and make adjustments as needed, ensuring that the program aligns with their evolving pain thresholds.

5. Psychological Considerations:

Context: Psychological factors, such as fear and anxiety, can influence pain perception.

Application: A nuanced approach to pain-sensitive periodization takes into account the psychological aspects of pain. Creating a supportive training environment, addressing fears, and fostering a positive mindset can contribute to better pain management and overall well-being!

Integrating pain science into powerlifting programming goes beyond traditional volume and intensity manipulation. Pain-sensitive periodization acknowledges individual differences in pain responses, allowing for a more personalized and effective training approach that considers the athlete's well-being, adherence, and long-term success in the sport.

Mind-Muscle Connection:

Pain science emphasizes the interconnectedness of the mind and body. Techniques such as mindfulness, visualization, and biofeedback can be integrated into powerlifting programming to enhance the mind-muscle connection. These practices not only contribute to mental resilience but also influence a lifter's pain perception and response.

Load Management and Tissue Adaptation:

Understanding how tissues adapt to stress is crucial for effective powerlifting programming. Pain science highlights the importance of gradual load progression to allow tissues to adapt and reduce the risk of injury (Moseley and Butler, 2015). This approach involves meticulous attention to biomechanics, addressing movement imbalances, and implementing progressive overload strategies that prioritize not only strength gains but, crucially, the health and resilience of the tissues (Hodges and Tucker, 2011). Considering load management and tissue adaptation not only promotes optimal strength gains but prioritizes the health and resilience of the tissues, aligning with the evolving landscape of pain science research.

Rehabilitation and Prehabilitation:

Incorporating rehab and prehab exercises into powerlifting programming is crucial, especially when considering insights from pain science. Doing this involves targeted exercises designed to address movement deficiencies, enhance biomechanics, strengthen vulnerable areas, and promote neuroplasticity, contributing to both injury prevention and overall resilience. Furthermore, rehabilitation principles play a pivotal role in guiding the return-to-play process after an injury, ensuring a safe and effective comeback for powerlifting athletes. 

In conclusion, embracing the science of pain transforms powerlifting programming from a one-size-fits-all approach to a personalized, holistic system that considers the complexities of pain perception, individual differences, and the mind-body connection. The neurobiology of pain emphasizes the subjective nature of pain, individualizing responses, and recognizing the interconnectedness of the mind and body. It's not just about lifting heavy; it's about lifting smart, with a profound understanding of the science that underpins our experience of pain and movement. This tailored approach not only optimizes performance but also fosters a training environment that respects and supports the unique experiences of each athlete.

CITATIONS

Hodges, P.W. and Tucker, K., 2011. Moving differently in pain: a new theory to explain the adaptation to pain. Pain, 152(3), pp.S90-S98.

Lethem, J., Slade, P.D., Troup, J.D.G. and Bentley, G., 1983. Outline of a fear-avoidance model of exaggerated pain perception—I. Behaviour research and therapy, 21(4), pp.401-408.

Moseley, G.L. and Butler, D.S., 2015. Fifteen years of explaining pain: the past, present, and future. The Journal of Pain, 16(9), pp.807-813.

Myer, G. D., Kushner, A. M., Brent, J. L., Schoenfeld, B. J., Hugentobler, J., Lloyd, R. S., ... & Faigenbaum, A. D. (2014). The back squat: A proposed assessment of functional deficits and technical factors that limit performance. Strength & Conditioning Journal, 36(6), 4-27.