I feel a little better today as the NSAID’s and Soma are kicking in. Finding a comfortable sleeping position was difficult. The pain comes when bending or stretching at the low back and also quite a bit when lifting my left knee up i.e. when steeping up to get into my truck or to lift it and swing it to get out. No pain or discomfort when lifting the right knee. My daughter had to help me put my pants and socks on…I felt like an invalid.
Icing the area does help and just plain keeping moving is the best. Might be ready for some stretching in about 24 hours. Going down into a rock bottom squat position and rounding the back feels good and does release some tension.
The surgeon told my wife he took out less than 20%; from what I understand, that’s kind of the cut-off between “slightly increasd risk” and “greatly increased risk” or something like that.
So far the rehab has gone very well. I still have days where it’s a little more tender than others, but all-in-all I’m progressing pretty nicely. I told Eric last week I was already squatting 225 and pulling 275; by no means shattering records, but at least on the road to getting back at it full-steam ahead.
The 6-12 months for total recovery is what I had heard as well. After our discussion, I was amazed when you said you knew people who were back squatting in a week! As well, I talked to a very high caliber USAPL guy who did a meet 3 months post-op! Needless to say, these people are the exception versus the rule.
Thanks for the answer and I hope all is well!
Stay strong
MR
[quote]Dr. Ryan wrote:
Mike,
How much of the meniscus did you have removed?
As I’m sure you know, the area which is now not covered by the meniscus is going to be exposed to much greater loading forces. Hopefully, they only removed a small portion.
Some of the studies have shown persisting strength deficits at 8-12 weeks. Unfortunately, sometimes it may not feel normal during strenuous activity for 6-12 months. It usually depends on the degree of injury and any damage to any other structures.
Keep me posted on your progress, I was wondering how your rehab has been going.
About a month ago, I was doing full squats and injured my lower back. The pain was in my low back, but I did not have any pain shooting down my legs. I’ve had both a chiro and regular practitioner check me out, and neither thought it was necessary to take films. The chiro has been performing ART on my back and hips, because he believes (and I’m sure) that my tight hips flexors caused my injury during the full squats.
Currently I am feeling much better, but it just doesn’t seem to be back to 100%, and I want to know how long it might really take. I don’t feel any pain in normal sitting and standing positions. I only have pain, a slight pain, if I push my hips back and my stomach forward. I can do squats, also, and I’m very careful about my form. But I just am curious if I’ll ever get back to 100% and be able to go heavy again. Thanks.
I’ve just received a potential personal training client who has a pacemaker. He’s 42 years old, and is interested in resistance training, and is unsure of the proper route to take.
I’ve heard of warnings about repetitive movements with a pacemaker, what’s your recommendation? If he is capable of upper body resistance training, are there certain exercises to avoid?
During what part of the lift did you injure your back?
Based on the lift, plus the previous back loading during squats, a disc problem would be the most serious problem to rule out. Disc injuries come in many varieties, from very minor to incapacitatingly severe. From the sound of your symptoms, it doesn’t suggest any severe disc problem.
You would also want to rule out any muscle strain or ligament/joint sprain.
The doc should be able to perform a thorough exam and get an idea of what you have injured. A plain film x-ray probably won’t provide much info, but if the symptoms persist, an MRI would be the best choice.
Regardless of what is injured, the important thing is to understand the why’s and how’s of the back injury, in order to avoid future problems. Also, some acute treatment in conjunction with a lumbar training program should do the trick.
If you are interested in learning about low back problems and how to help prevent and treat them, I would suggest that you pick up a copy of Ultimate Back Fitness and Performance by Stuart McGill.
I don’t have much experience with pacemakers. What I would suggest is that you ask the client for his cardiologist’s name/number and ask him the same questions.
You would want to know if there is any kind of CV exercise limitations as well as any particular contraindicated movements/exercises.
Not only would this come off as professional to the client, but the Doc would most likely respect the fact that you made the effort and might possibly recommend you to other patients looking for a trainer.
I would want to rule out any patellofemoral tracking issues and assess the meniscus. There are several other issues related to plica, retinaculum, as well as the muscle s and joint capsule.
With a hx of subluxating patella, I would make sure to stretch the lateral knee structures and focus on some VMO quad exercises to strengthen the medial side.
Also, make sure that you stretch out the lower leg gastroc/soleus as well as the quads/hams. Insufficient flexibility in the ankles will effect squat mechanics.
I think it would be a good idea to see a good sports med chiro or PT that could assess not only the knee, but also assess your form on the squat to see if there are any issues that could be contributing to the problem.
I would also suggest trying to squat deep with a light weight vs a little heavier weight and see if there is a difference in the knee symptoms.
Since it has been a long standing symptom, with no significant change and it does not cause any pain or restrict your activities or movement, I wouldn’t be too concerned.
It may be related to patellar tracking. Often times the lateral structures will be tight relative to the strength or opposing forces on the medial side. Doing some stretching and self-foam roll treatment of the ITB/TFL can loosen up the lateral structures. Doing VMO quad exercises can help to strengthen the medial side.
If you are concerned, a sports med chiro/PT.ortho could eval the knee and rule out any sign. underlying problem.
Sounds like it is going as good as expected. Definitely keep the ice going for the next couple days.
In order to give you some idea of what stretches to perform or avoid, I need to know how your symptoms change with movements. Bend forward, backward, side-to-side and twist side-to-side. Try to note how the pain responds, and if all movements hurt, which ones are worst/best etc.
Next, bend forward 5-10 times and see if the pain gets better/worse with reps. Then bend backwards 5-10 times and moinitor changes.
Let me know the results, and I’ll give you some suggestions.
Try searching the cool tips archives for my Get on a Roll tip. You can use the towel roll to support your lumbar curve when you sit.
Damn man, that pic looks like it hurts. I would suggest that next time you try being the guy on top
[/quote]
The move wasn’t executed right which is why I felt no pain until my tendons popped. However, should it ever happen again I plan to be on the other end of things ;]
[quote]
Did you have an MRI done on the shoulder? [/quote]
No, I was just examined by the therapist. He decided I had suffered tendon damage on the front of my shoulder and the inside of my forearm (medial epicondyle). The movement that it was injured with is basically putting your hand at shoulder level, palm facing out with your elbow bent and then forcing the elbow to come forwards and up. (This may be a better picture of it http://bjj.org/techniques/bjjfighter/gi/side/americana/tnday40063.jpg )
I have the same problems while squatting with lots of volume. I have found that I can support pretty much any weight with the squat, but having my arm in that position for a prolonged period hurts as it requires me to apply force in the exact manner in which my arm was hurt. So the discomfort only comes in movements when my shoulder is stretched maximally.
[quote]
Have you continued with the RH program that you did in PT?[/quote]
Honestly I have only done it on and off. I still do external rotations with a band every once in a while and always make sure to warm up my rotator cuffs and shoulders using cuban snatches with 5lb plates and lots of light shoulder pressing before trying any benching or heavy shoulder presses. It is strange in that from a certain ROM my shoulder is just as strong as it ever was (I can put up good numbers with a 3 board press) but when my shoulder is stretched, and particularly with the bench press, my strength is way down and the discomfort is very high. So I’m basically looking for a way to regain the strength in that specific area in my ROM.
I would expect that you will be able to return to lifting heavy.
I would suggest that you get the book Ultimate Back Fitness and Performance by Stuart McGill. It will provide you with a great education about back injuries as well as giving you a road map for RH and injury avoidance.
In order to give you some idea of what stretches to perform or avoid, I need to know how your symptoms change with movements. Bend forward, backward, side-to-side and twist side-to-side. Try to note how the pain responds, and if all movements hurt, which ones are worst/best etc.
Next, bend forward 5-10 times and see if the pain gets better/worse with reps. Then bend backwards 5-10 times and moinitor changes.[/quote]
Dr. Ryan,
Let me begin by say that I really appreciate you taking your valuable time out to help me.
bending forward- moderate pain left side only- gets better with reps
bending backward- no pain, just a general lack of flexibilty
side bend left - moderate pain left side
side bend right- moderate pain left side
twist left-moderate pain left side
twist right- little to no pain
Still hurts when I raise my left knee up. Primarily in the low back but it radiates out to the hip bones at the top and back side.
yo i need help dr. ryan i am 18 and i want to have the perfect body. i work out hard, i eat alot, i just want to get my arms bigger and my chest and back quicker i am like 176 pounds i use to be like 189 but had fat i dieted for a while workout running i just want to know how can i get bigger quicker…
Thanks for taking the time to reply!. To be honest I couldnt give you a point in the lift when I injured my back as I didnt start feeling the pain until a few minutes after the lift. Over the last several days the pain seems to be receding though I am not putting it under any load for a while yet. I will definately be looking into that book you recommended. Thanks again, I greatly apprecieate it!
