When something hurts

Two years into training again, I tweaked my lower back deadlifting. Not catastrophically. Enough to make putting socks on awkward for a week. I did the thing every man my age does: I googled it for three days, ignored it for five, then made it worse trying to test whether it had got better.

Pain at 40+ is not pain at 25. The recovery curve is longer, the diagnostic noise is higher, and the cost of guessing wrong is six months out instead of six days. This module is the framework I wish I'd had two years ago.

The four questions to ask before doing anything

Whatever's hurting (knee, lower back, shoulder, hip, neck, ankle), the same four questions decide what to do next:

1. Did it come on suddenly or gradually?

Sudden, with a moment you can name (a pop, a tear, a fall, a specific lift): treat it as serious until cleared. Gradual, building over days or weeks: usually a load problem (too much, too fast, or wrong technique).

2. Is it sharp or dull?

Sharp pain, especially with a defined location (one spot, one tendon, one joint corner): doesn't deserve a "push through". Dull, diffuse pain, especially across a muscle group: usually responds to rest and reload.

3. Does it change with movement?

Pain that gets better as you warm up and worse when you stop: typically tendinopathy or stiffness. Manageable. Pain that gets worse with movement, or that wakes you up at night: don't ignore. Get a hands-on opinion.

4. Has it been there more than two weeks?

Two weeks is the line in the sand. If it's still there at day fifteen, you're past "it'll go away" and into "I need to know what this is".

Three "yeses" out of four (sudden, sharp, worse-with-movement, more than two weeks) and you're in the see-someone bucket. That's not weakness. That's mechanical sense.

When to push, when to deload, when to stop

Most men at 40+ binary-flip between "ignore it completely" and "stop everything for six weeks". Neither is right. There's a middle position called the deload, and it's usually what the body wants.

Push (keep training as planned): The pain is dull, diffuse, less than 3/10, doesn't sharpen during a working set, doesn't linger more than an hour after the session. This is normal training noise. Lift, eat, sleep, repeat.

Deload (drop volume, keep frequency): Pain is mild to moderate, present but not getting worse, somewhat localised. Cut your working weights by 30-40 percent. Cut sets by a third. Keep showing up to the gym. The session feels almost easy. Do that for one to two weeks. Then test.

Stop the offending movement (keep everything else): The pain is movement-specific (one lift triggers it, others don't). Stop that one. Train around it. Squat hurts? Deadlift, press, row, machines, accessories, conditioning. Don't blow up the whole program because one lift is angry.

Stop training entirely: Sharp, sudden, severe pain. Visible swelling. Loss of range. Numbness or tingling. Inability to bear weight. Pain that's worse at night. This is the small list. Outside of it, complete rest is rarely the answer.

The mistake most men make at 40+ is over-reading mild pain as "I need to stop everything", going to bed for ten days, losing the training habit, and never quite getting back. Deload. Don't deload-and-disappear.

Who to actually see, and in what order

When two weeks is up, or the pain qualifies for the see-someone bucket, the order matters. Going to the wrong specialist first wastes a month and a few hundred dollars.

Start with a physiotherapist, not a GP. Unless there's red-flag symptomology (numbness, fever, severe night pain, recent trauma), a good musculoskeletal physio can diagnose, treat, and refer for imaging if needed. Most physios will tell you in session one whether it's something they can fix or whether it needs imaging. They charge $90-$150 in Australia.

GP comes second, for the imaging referral. If your physio thinks an MRI or ultrasound is needed (especially for shoulders, knees and lumbar discs), the GP writes the referral. Without it, MRIs cost $300-$500 out of pocket. With it, the cost drops to $200-$300, sometimes less depending on the practice.

Specialists (orthopaedic surgeons, sports physicians, rheumatologists) come last, only after imaging. Going to a surgeon before imaging is going to a surgeon for nothing. Most won't see you without it.

A note on osteopaths and chiros: they help some men. They help fewer men than they claim to. Use them as adjuncts, not as your primary diagnostician. If a chiro is offering you a 24-session package on session one, find a different one.

What to do while you're recovering

The risk in any deload is losing the habit. The aim is the opposite: stay in the gym, just doing different things.

A worked example. Lower back issue (the most common 40+ complaint). One-week deload protocol I've used:

• Mon: Upper body pull (rows, pulldowns, face pulls). Core: dead bugs, side planks. No deadlift. No squat.
• Wed: Upper body push (bench, overhead press if comfortable, tricep work). Conditioning: Zone 2 walk or bike, 30-40 minutes.
• Fri: Light single-leg work (split squats unloaded, leg curls, calves). Carry work (farmer's walks, light). No bilateral lifting.
• Sat: Long walk (60-90 minutes). Mobility work. Sleep.

That's a real training week. It just doesn't load the back. Two weeks of that and most non-serious lower-back stuff settles. Then you reintroduce the offending lift at 50 percent and walk it back up.

Three things that make recovery slower than it needs to be

Drinking through it. Alcohol slows soft-tissue recovery measurably. If you're injured, that pint with the boys on Friday is real money out of your timeline. Skip it for two weeks.

Under-eating, under-sleeping. The body rebuilds on the same calories and the same sleep that built it in the first place. Cutting calories during an injury is the worst time to do it. Eat to maintain, not to lean.

Catastrophising. Most musculoskeletal stuff at 40+ resolves with rest, time, and load management. The lower back you tweaked deadlifting is almost certainly not the disc problem you're imagining at 2am. Get the diagnosis, follow the protocol, ignore the catastrophic narrative until the imaging actually says it.

The one rule that beats every other rule

Two weeks. If it isn't better in two weeks, see someone. Not the internet. A real human being whose job is the part of you that hurts.

Listen early. Train around it. Get the right person, not the closest person.

Further watching

• The 3 Best Exercises for Back Pain Relief — Stuart McGill (11:05)
• Squat Pain-Free! Fix Knee Pain When Squatting — Squat University (10:55)