When it comes to powerlifting injuries, one of the single biggest questions to ask is if it is volume or intensity induced. What that basically means is that if it is volume induced, at a certain volume level pain starts to increase. On the other hand if it is intensity induced, that means at a certain percentage of your 1RM pain starts to increase.
Volume induced injuries usually are overuse based injuries, such as tendinitis or other types of inflammation. What it boils down to is you are just doing too much of something, whether that is the total volume of a lift, volume of one specific movement pattern (Ex: only competition squatting, no variations), or possibly too much frequency with not enough time to recover between sessions. Volume induced injuries usually are minor at first, probably described as “discomfort” rather than pain, but when left untreated they build and build and build until they eventually start affecting your training.
Intensity induced injuries on the other hand usually are due to form breakdown. If at X% someone starts to feel pain, I can almost guarantee that is also the % that they start to alter their movement in a negative way. Unlike volume injuries, intensity based injuries are more acute and happen quickly, such as muscle strains or possibly even tears. While there is definitely overlap between these two, in my experience each injury definitely fits more into one than the other and we can adjust training based off that.
So how we do we know which it is? There isn’t a perfect answer for this, but usually three factors play into it:
What is causing pain?
Has this issue slowly built up over time?
When you warm up, does it feel okay until a certain weight?
“What is causing the pain” can many times dictate the answer right off the bat. If you know it is some type of tendinopathy, then we know it is probably volume induced. If it is a strained hamstring from a max attempt deadlift, we know it is probably intensity driven. The second question helps to determine if this is an overuse injury or an acute injury. If it has very slowly worsened each passing session, that follows the characteristics of an volume induced overuse injury. If you’ve had zero pain and then all of a sudden it’s now “7/10” on the pain scale, then that sounds more like an intensity induced acute injury. And lastly, if when warming up you do not experience any pain until a certain weight, that is leaning towards an intensity based injury.
So how do we treat this?
First let us understand that knowing if it is volume or intensity induced is not the end all be all. There are many more variables that go into play in determining a proper rehab protocol. But with the knowledge of knowing it is caused by volume or intensity, we can definitely make alterations to the training plan to adjust for this.
For volume induced injuries, your absolute best friend is data tracking. If you do not track volume, total sets, and just general training history it will make this much harder to know exactly what your tolerable volume limits were. If the injury is volume induced, as stated above, it means that you have done too much volume. So if we know a measured volume that you were able to sustain healthy training at, we know exactly where we need to be. A good recent example is my athlete Dan, who suffers from patellar tendinopathy that is definitely volume induced. Fortunately we track volume every block, and this past training block we specifically did a volume bump to see if he could tolerate it. Unfortunately he could not, but it was an easy fix as we know exactly where his tolerable levels of volume are from previous blocks where he was able to train pain free. We adjusted, and in a manner of one week he was already back to being pain free. They key comes down to reducing training volume. Usually at first I will drop volume more than needed though. If we continue at too high a volume the injury will get worse, but if we only drop to our normal tolerable volume most likely the injury will just maintain, neither improving nor worsening. So to initially to reduce inflammation, I will drop volume below their tolerable levels, allow them to recover, and once pain subsides then increase their volume back to the levels we know they can sustain.
As for the other side of things, with an intensity based injury the main fix is to adjust training loads to be below the threshold of whatever % causes pain. As mentioned before, intensity based injuries usually coincide with some type of form breakdown at that same %, so we will use that time at submaximal loads to specifically focus on fixing that improper movement pattern. Each session you can gradually increase loading, no more than 2.5-5% per session, and slowly work your way back up, always staying below that pain threshold. If you increase one session and pain is reintroduced, drop back down and stay under that threshold. Many times there will be “bad days”, so you need to autoregulate the training loads to account for that. To go along with reducing training loads, many times I use self limiting variations to accomplish this task. For example, we may still be able to keep relative intensity fairly high by doing a tempo pause squat variation that greatly reduces the loading demands, yet RPE wise can still push to higher levels. It is all dependant on the lifter, but the key here is staying below that pain threshold and working to improve movement.
For any injury there are always more variables that come into play than simply volume vs. intensity induced injuries, but this question is one that every lifter needs to ask themselves when experiencing pain. It is vital to know the route cause of the issue and address the training stress accordingly. Hopefully this helps better guide your rehab efforts, and any questions always feel free to reach out!