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Old 01-10-2011, 09:02 AM   #1
bamazav
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Default Training around lower back injuries

Let me start by stating that I am not a doctor. See your doctor for a professional assessment of any injury you may have.

In 1996 I moved an organ by myself and in the process diffused my L5-S1 disc. After months of pain treatments and misdiagnoses, I was finally forced to have a Discectomy and Lamonectomy. For the next 10+ years I did everything I could not to re-injure my back. In late 2007 my doctor gave me the choice of losing some weight or going on meds for high cholesterol. I decided to lose the weight and started my journey into weightlifting. I had already learned a lot about my body. This journey just built upon that basic knowledge I already had. I love to research and learn and have developed for me, a process to be able to train and take care of my back. I want to take a few minutes and share a bit of what I have learned.

Most of us do not even begin to realize how much we use our back until we are unable to use it. It is foundational for standing, sitting, lifting and turning. When you can not do any of those movements, you are literally stopped “dead in your tracks.” Now, my injury was different then most in that I didn't have one bulging area, but had squeezed the disc out all the way around. My symptoms came from the pressure outward pushing on my sciatic nerve. While your injury may be different, for sake of the discussion, I will focus on my type of injury, one that is exerting outward pressure, pushing on the nerves creating pain that is shooting down the left or right leg.

In a discussion, on training around back injuries, a few years back, Sports Performance Coach, Patrick Ward1 gave these helpful insights:
1. Don't do things that Hurt!
2. Take out flexion based exercises - crunches, bilateral deadlifts, bent over rows, exercises performed in a seated position (seated rows, seated pulldowns, etc) even if it doesn't really hurt.
3. Work on stability (core exercises)
1. When performing stability exercises, like planks, don't get over focused on 60 second holds. Instead, focus on shorter periods and doing reps. For instance 5 reps of 10 second holds. Over holding tends to lead toward bad form, be patient and build up.
4. For upper body pull movements get off the seated exercises. Instead, do things like standing 1-arm cable rows, half kneeling 1-arm cablerows, half kneeling 1-arm pulldowns, inverted rows
5. Train the legs with unilateral movements until your symptoms die down.
6. Work on Hip mobility
1. I would add Hamstring mobility also
7. Use the foam roller on your hips, glutes and hamstrings (my edit) to cleanup poor tissue quality and enhance mobility.
Having applied Ward's concepts to my training has helped greatly, but I do not stop there. You can squat and deadlift for reps, with weight, if you are careful and smart. For my back I also use
, inversions and reverse hyperextensions. These exercises have helped me squat and deadlift without pain or injury.

A brief Rabbit Trail:
To create your own McKenzie table, use two benches or a bench and a chair. Incline the bench slightly. Lay down on the bench, face down for a few moments. Adjust the angle as needed.

If you do not have an inversion table or boots, you can decline your bench as far as it will go, lay down on it for a few moments. A friend reports that he can usually feel his disc slip back into place after a few minutes of this type of inversion.

Here is a link to an easy to make reverse hyperextension
Just be careful not to over extend.
Rows tend to bother my back. If I do Pendlays with perfect form, I am usually okay, but if I round my back or pull up at all I find pain beginning. I have recently started using chest supported rows.
These provide core support and allow me the rowing movement without and pressure on the back.

For squatting you have to remove all pride. You will have to start light. I recommend starting with the dumbbells. I start my trainees with Goblet Squats.
These light weight squats teach and encourage proper form, while allowing you to squat with little to no back compression. When you have the form down, progress to bar only squats. Focus on form, not good form, great form. Each squat should be controlled and with great form. Slowly add weight. Don't allow pride or the guy waiting for the rack to force you to add weight too quickly, your back is more important than his curls. With patience and practice you can return to squats and even deadlifting by learning to care for your back.

While I am still growing in my weight training skills and numbers. I have been able to slowly work my way up to respectable weights for both squats and deadlifts with no further injury to my disc. The key is patience and always remembering Ward's #1. If it hurts don't do it. I would also add, don't push weight, push form. When form breaks down, stop. Do not try to “gut it out.” Stop, rerack, rest and try again later. If form goes, your back will soon follow. Take care of your back and enjoy lifting, you can do both!

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Last edited by bamazav; 01-10-2011 at 06:04 PM.
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