Training around lower back injuries

[bamazav]

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

McKenzie Stretches

McKenzie Stretches

, 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

Swiss Ball Reverse hyperextensions

Swiss Ball Reverse hyperextensions

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.

You Tube

You Tube

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.

You Tube

You Tube

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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1. IronMagazine Bodybuilding Forums - View Single Post - Training around a back injury

[BendtheBar]

Very helpful post.

I am going to move this to the general fitness forum and sticky it if that's ok?

[bamazav]

Originally Posted by BendtheBar

Very helpful post.

I am going to move this to the general fitness forum and sticky it if that's ok?

I had thought about posting it there, but then found your post from a few weeks back about back issues and decided I should post in the same thread.

[BendtheBar]

We generally don't police threads and where they appear, but with this being such a good reference thread for just about any fitness goal I though the general fitness section would be a great place for it. Either way is fine with me though.

[bamazav]

Bret Contreras has some interesting things to share about the back.

How Much are We Sitting and What are Some Physiological Concerns Associated With Too Much Sitting?
• A 2003 and 2004 U.S. Census showed that Americans spend an average of 56 hours per week sitting. This equates to half of one’s waking hours (8 hours per day). Another study showed that the British spend 15 hours per day sitting when totaling up the hours spent sitting at work, in transit, watching television, working on a computer, eating dinner, and reading. Finally, another study showed that Australians workers spend around 9.5 hours sitting. Researchers have dubbed this epidemic “The Sitting Disease.”
• When sitting, the large postural muscles of the back and legs are shut off which reduces fat-burning enzymes by 50%. Sitting also decreases the HDL:LDL cholesterol ratio, increases the risk of contracting diabetes by 7% for every 2 hours of sitting per day, increases the risk of heart disease, increases the incidents of depression, increases the risk of acquiring metabolic syndrome by 26% for every hour spent sitting irrespective of the quantity of moderate exercise performed (as shown by Australian researchers) and decreases lifespan (as shown by Canadian researchers involving a twelve-year, 17,000 person study as well as by Australian researchers involving a six-year, 8,800 person study). In addition, prolonged sitting increases incidences of discomfort (including back pain, muscle tenderness and aches, stiff necks, and numbness in the legs, chronic disorders, arthritis, inflamed tendons, chronic joint degeneration, impaired circulation, varicose veins, hypertension, obesity, cancer, high blood triglycerides, high blood sugar, osteoporosis, and herniated discs (Graf et al. 1993 and 1995, Grandjean 1987, Kelsey 1975).
• According to Missouri microbiologist Marc Hamilton, “If you’re standing around and puttering, you recruit specialized muscles designed for postural support that never tire. They’re unique in that the nervous system recruits them for low-intensity activity and they’re very rich in enzymes.” One enzyme, lipoprotein lipase, grabs fat and cholesterol from the blood, burning the fat into energy while shifting the cholesterol from LDL (the bad kind) to HDL (the healthy kind). When you sit, the muscles are relaxed, and enzyme activity drops by 90% to 95%, leaving fat to camp out in the bloodstream. Within a couple hours of sitting, healthy cholesterol plummets by 20%.”
• According to Galen Cranz, a professor at the University of California at Berkeley, “Short of sitting on a spike, you can’t do much worse than a standard office chair. The spine wasn’t meant to stay for long periods in a seated position. Generally speaking, the slight S-shape of the spine serves us well. “If you think about a heavy weight on a C or S, which is going to collapse more easily? The C,” she says. But when you sit, the lower lumbar curve collapses, turning the spine’s natural S-shape into a C, hampering the abdominal and back musculature that support the body. The body is left to slouch, and the lateral and oblique muscles grow weak and unable to support it.”
• Some researchers have created a new model or paradigm called “inactivity physiology”. It establishes that sitting and non-muscular activity may independently boost the risk of ill health, and that sedentary behavior is a separate class of behavior with specific consequences for ill health. These are different than those caused by taking too little exercise.

[bamazav]

You Tube

You Tube

[bamazav]

Treat Your Own Back

Treat Your Own Back

by Robin McKenzie

The originator of the McKenzie stretch and back treatments.

Low Back Disorders

Low Back Disorders

By Stuart McGill

All of his books on the back are supposed to be top notch.

[Spartigus]

Very good read!! I had a bad lower back from trying to deadlift too much with bad form back when I first started lifting. Good read mate!!!

[bamazav]

Scooby is a home trainer. He uses minimal equipment and has some neat ideas on his sight. Here is a video on back care.

YouTube - Back Pain, avoidance and rehab

YouTube - Back Pain, avoidance and rehab

[blackdove]

For a person who's had a round of injuries in the past, these exercises look really good. Thanx much.