I’ll be here tonight and tomorrow, fire away.
hey Dr. Ryan, was wondering if you could give me some good ole internet diagnosis on some back pain I have been having;
I have been getting pain in my lower back just slightly off center right above my waist.
When I am walking around it doesnt bother me and once I am warmed up lifting I feel no pain (even when dling heavy). It gets pretty damn sore however on off days if I sit down for any length of time. No matter what type of chair it starts to hurt. I have no pain walking or bending forward at the waist.
The other way I can ‘activate’ the soreness is by tightly arching my back backwards while standing(sort of like a standing bridge). I would describe the pain as a dull one(not sharp) and not particularly localized.
foam rolling my lower back for a little while helps seems to take away the pain.
anyways, any info/advice you can give me is appreciated.
blam,
It doesn’t sound like a significant problem or I would expect you to have pain with lifting or bending.
It could be just some irritation to the myofascial structures in the area do to the strain of the workouts.
Getting some generalized ache with prolonged sitting isn’t uncommon for a couple days following a workout with squats or DL’s etc.
Try icing the low back after your workouts and then use a towel roll behind your lumbar curve when you sit. This should help. Below is how to use a towel roll:
Get on a roll- If your job or daily activities require you to sit for extended periods of time, using a lumbar roll will help to decrease the strain on the lumbar spine discs, joints and muscles. Sitting increases lumbar compression and without support, the lumbar lordosis flattens out and due to the viscoelastic qualities of these structures, tissue ?creep? occurs, which further increases the risk of developing low back pain. You can make your own roll by taking a towel, folding it in half lengthwise and rolling it up. Put some rubber bands around it to keep it rolled up. Sit all the way back in your chair and place the roll behind your lumbar lordotic curve. This works in the car and on airplanes as well as at your desk.
Let me know if you have any follow-up questions.
Keep me posted on your problem.
Take care,
Ryan
Dr. Ryan,
Got another question for you. I seem to have injured myself (again) somewhere along the way and my arms frequently go numb at night. The numbness is uncomfortable enough that it will wake me up and I have to move my arms briefly for it to go away. The numbness extends from my fingertips to my shoulders on both arms. My thumb & index finger are usually less numb than the rest of my fingers and arm. The position I’m sleeping in has no effect on the numbness.
I went to my HMO and I was subjected to the electric shock torture test for carpal tunnel syndrome and that was ruled out.
I’ve also noticed temporary numbness in my index, middle & ring fingers after deadlifting.
Got any suggestions?
Thank you for your time!
Hey Doc, how ya doin?
Just wanted to drop in and say that I have decided to go easy and slllllooooooooowwwwwwwwlllllllyyyy work into a rehab program. Currently I am only doing bridges and crunches along with stretching. I am working up to different bridges and bird dogs like those mentioned in GYBIG. I have ordered McGills book in order to educate myself, so in the future hopefully questions will be simple clarification or opinion. Thanks for all your help.
Kai Zen,
They need to evaluate you further. Somehow you are managing to get some sort of bilateral neurovascular compression.
It must be related to some kind of position. They need to evaluate for compression somewhere along the thoracic outlet (scalenes, clavicle and first rib, pec minor) versus central spinal canal compression.
I would think that any significant nerve problem would have showed up on the EMG/NCV test they did.
Deadlifts traction the nerves and place pressure throughout the thoracic outlet.
What position are you normally in when you wake up with the numbness/tingling?
Ryan
DA MAN,
With a disc problem, you need to be careful with crunches as they significantly increase intradiscal pressures and are a repetitive flexion exercise.
I usually have patients do a set of 10 press-ups prior to and following crunches. You may want to put a small towel roll under your lumbar curve when doing crunches to avoid some of the flexion loading.
McGill’s book is very good. You will learn a lot. You’ll probably know more than most doc’s after reading it.
Take care,
Ryan
Dr. Ryan,
I’ve had the numbness wake me up when I’m flat on my back and when I’m on either side. Both arms go numb at the same time when I’m sleeping and it’s never only the right or the left.
I’ll go back and see if Kaiser can do some more tests.
Thank you for your advice!
Dr Ryan
I didnt even think about the pressure. Thanks for the heads up and the tip.
[quote]Dr. Ryan wrote:
DA MAN,
With a disc problem, you need to be careful with crunches as they significantly increase intradiscal pressures and are a repetitive flexion exercise.
I usually have patients do a set of 10 press-ups prior to and following crunches. You may want to put a small towel roll under your lumbar curve when doing crunches to avoid some of the flexion loading.
McGill’s book is very good. You will learn a lot. You’ll probably know more than most doc’s after reading it.
Take care,
Ryan[/quote]
If you two are talking about a book that is good for helping rehab disc injuries, I would certainly like to read it. What’s it called?
Kai Zen,
When you are on your back, what position are your arms in and is your pillow thick or thin?
Laying on your sides can cause it due to the compression on the ‘down’ shoulder and in the ‘up’ arm if it flops forward across the body.
If you have your arms either laying across your chest/abs or over your head when laying on your back it can also produce symptoms.
The fact that it goes away with changing positions and moving your arms is a good sign. It would be a more serious problem if it was constant.
Do you have rounded shoulder posture?
When sleeping on your side, try placing a pillow snugly behind your back and then lean back against it. This should rotate the shoulders slightly to remove pressure from the ‘down’ shoulder, while shifting the upper shoulder back slightly so that the arm will have a tendency to rest at your side as opposed to rolling forward. Some people may need to hug around a pillow to prevent the arm from falling across the body.
Also, place a pillow between your legs when you sleep on your sides to keep your pelvis from torquing.
Keep me posted.
Take care,
Ryan
Massif,
Stuart McGill has a couple different books related to low back pain/injuries: Low Back Disorders and Ultimate Back Fitness and Performance.
Ryan
Let’s get this party started.
Dr Ryan I believe Iinjected into a nerve in my front left side delt…I saw a slight muscle jump when I inserted the pin But being a novice I thought it wasnt anything major…I finished the injection (1 cc of fena )and within minutes my fingers went numb…Ive had pain in my bicep and my outer pec all where they connect to the delt in that area…Its been 2 weeks and it seems to be getting better…
For the first week I was in extreme pain and there was alot of fatigue and soreness…I could barely rotate my shoulder. I went from doing a 70lb flye to not even being able to do a 20 lb one due to the pain…I used an inch long pin, someone suggested I might have hit a tendon…But i think it was the nerve…How long will this take to heal?..It still gets fatigued and there is slight pain in the area should I work through it…I took of the past week and a half… I did pushups today and its way better but still weak and not 100%…
There was no swelling or lumps or bruising but if i flex the area hard there is still some slight pain…Ive been getting alot of different opinions… Thank YOU
ALso let me specifie the fingers that went numb were the pointer middle and thumb…
Dr. Ryan,
Recently for the past six months I have been plagued with various injuries. A hamstring strain that won’t go away, a rhomboid/mid trap strain that won’t go away, a possible biceps tendon tear, and now a possible subscapularis tear/strain.
Because of my injuries, I have started to become curious (and afraid of) about the abilities of athletes to recovery from real serious injuries. More specifically, from complete muscle tears and partial muscle tears. In your experience have you seen athletes completely recover from these types of injuries, and return to their sport with the same (or better) fitness levels prior to the injury?
In general, what are the average recovery time frames from full or partial muscle tears?
Thanks.
Shinebox
Paranoid strength,
Well, sounds like you’ve been having fun.
I doubt if you actually injected it into a nerve. You may have nicked it initially inserting the needle. I would think the pain would have been too intense as you were doing it to continue the injection if it was in the nerve. More than likely, you injected it right next to the median nerve and either the bolus put mechanical pressure on it or the substance created a chemical irritation of the nerve. Healing would depend on how long the chemical irritant remains around the nerve and the degree of inflammation or irritation of the nerve.
From what you have said, it sounds like it is healing. I wouldn’t think that working out would cause further damage, just be cautious and avoid any movement/exercise that recreates or exacerbates the numbness.
Keep me posted on your progress. If it stops improving or gets worse, you may want to have your doc check it out. They could do a EMG/NCV test to check for any nerve damage.
Take care,
Ryan
Hi, Dr. Ryan, I have a brief question for you. I was deadlifting earlier this evening and during my 1st set as i went to lower the weight i started to feel this burning in my lower stomach. I think it was the oblique, but it was close to where the oblique meets the abdomen, so i’m not sure. It was also just above my waist. I just chose to not lower the bar quite as slowly (still lowered with control though) and finished my deadlifting routine. I felt a milder version during the 2nd set, and an even milder version during the 3rd set, and after that, I didn’t feel it again for the rest of my routine (i did 10 sets). I felt that area on both sides of my body and nothing felt different between them. So, my question is, what was the deal there?
[quote]Dr. Ryan wrote:
Paranoid strength,
Well, sounds like you’ve been having fun.
I doubt if you actually injected it into a nerve. You may have nicked it initially inserting the needle. I would think the pain would have been too intense as you were doing it to continue the injection if it was in the nerve. More than likely, you injected it right next to the median nerve and either the bolus put mechanical pressure on it or the substance created a chemical irritation of the nerve. Healing would depend on how long the chemical irritant remains around the nerve and the degree of inflammation or irritation of the nerve.
From what you have said, it sounds like it is healing. I wouldn’t think that working out would cause further damage, just be cautious and avoid any movement/exercise that recreates or exacerbates the numbness.
Keep me posted on your progress. If it stops improving or gets worse, you may want to have your doc check it out. They could do a EMG/NCV test to check for any nerve damage.
Take care,
Ryan[/quote]
THank you very much. You’ve helped mentally relax me alot…Just out of curiosity if there was nerve damage that showed up on an EMG from this or anything else that there is nothing that can even be done… I was under the impression that if there is nerve damge that you cant regenerate? I ask because I was in a car accident several years ago ad went through the gammit of test MRI EMG and there was nerve damage found on my left side and the only thing recommened was physical thereapy which I thought was aw aste because they were basically the same movements I do in the gym only they use much lighter weights? So I just deal with the slight weakness and fatigue on that side.
I’m sorry, I just thought of another question, lol. I go to karate classes once a week and sometimes, when practicing the crescent kick (pick bent knee up, extend it out and then retract, and while doing so, move foot in an arc motion), i’ve felt this sudden numbness in the hamstring of my kicking leg, and its only when i do this kick, and its only happened on my left leg, not my right. Any idea what’s happening? (it doesn’t happen often, just frequently enough i figured it’d be a good idea to look into it). Thanks Dr. Ryan.