Lower Back Pain

Bigger Stronger Leaner Injuries and Rehab
1

Hey guys. Well is all started in May/June when I started running/jogging I felt a great deal of stress on my back when running.

Then july august came and towards august my back didnt feel very comfortable I stopped the weights too.
Its kinda weird to explain. Like its the bottom left of the back. hurts when i over arch and full twist to my right. Could be lumbar strain? I’m not sure really. 2 weeks ago doctor said it was a lumbar strain and gave me anti inflammatory pills.

I’ve been resting for 2 weeks and its not really getting any better. I swam a few times this week but thats about it.
Has anyone experienced this before? Am I allowed to do any exercises or should I still rest?
How long will it take to heal?

3

well i thought it was muscle sore cause i deadlifted and stuff. but i stopped jogging anyways.

SIJ dysfunction? whats that? is it serious? should i see a chiro or orthopedic?

5

Question for BBB,

I have had back issues off and on for a few years but generally a chiro session has got me back in the gym. What I have now is persistent numbness in right hip flexor/backside area, also manifesting slight numbness/tingling in right leg/foot.

I foam roll and use a tennis ball in the area daily. I am trying to stretch more. I have had one ART session to date too but that on its own has improved the situation. Any advice greatly appreciated.

JB

6

[quote]JamesBrawn007 wrote:
Question for BBB,

I have had back issues off and on for a few years but generally a chiro session has got me back in the gym. What I have now is persistent numbness in right hip flexor/backside area, also manifesting slight numbness/tingling in right leg/foot.

I foam roll and use a tennis ball in the area daily. I am trying to stretch more. I have had one ART session to date too but that on its own has improved the situation. Any advice greatly appreciated.

JB[/quote]

I know I’m not BBB, but here is my input:

Have you just done chiro manipulations or followed it up with proper activation, mobility, and movement work? What was the initial cause of the low back pain and what normally re-triggered each episode?

If you have radiating pain down into your foot, that is always a concern of disc/nerve root involvement. You may want to see an ortho to be evaluated for that and to rule out some disc/nerve root involvement.

Also, you say you are trying to stretch more. What are you stretching? Where do you feel your ROM limitations are? Have you had an movement analysis screening to determine your limitations? Or are you just stretching what feels “tight” to you? If you haven’t had a screening done, I’d recommend getting one done. Just because a muscle feels “tight” don’t always mean that it is the one that needs to be stretched.

7

[quote]bushidobadboy wrote:
Sacroiliac joint dysfunction.

If I thought you should see an ortho, I would have said “see a good ortho” now wouldn’t I, lol?

BBB[/quote]

lol funny but true. the thing is i just had an acl reconstruction last december so when i started running around may/june i thought it was because my lower back wasnt used to the form thats why the muscle sore.

anyways i went to the basketball court yesterday, made some shots and lay ups and hit a bit of my chest and triceps.

are there any exercises that i should stay away from other than the usual squats deadlifts?
cause i havent actually been back to the gym
should i try if i can run on flat surfaces?

8

[quote]LevelHeaded wrote:

[quote]JamesBrawn007 wrote:
Question for BBB,

I have had back issues off and on for a few years but generally a chiro session has got me back in the gym. What I have now is persistent numbness in right hip flexor/backside area, also manifesting slight numbness/tingling in right leg/foot.

I foam roll and use a tennis ball in the area daily. I am trying to stretch more. I have had one ART session to date too but that on its own has improved the situation. Any advice greatly appreciated.

JB[/quote]

I know I’m not BBB, but here is my input:

Have you just done chiro manipulations or followed it up with proper activation, mobility, and movement work? What was the initial cause of the low back pain and what normally re-triggered each episode?

If you have radiating pain down into your foot, that is always a concern of disc/nerve root involvement. You may want to see an ortho to be evaluated for that and to rule out some disc/nerve root involvement.

Also, you say you are trying to stretch more. What are you stretching? Where do you feel your ROM limitations are? Have you had an movement analysis screening to determine your limitations? Or are you just stretching what feels “tight” to you? If you haven’t had a screening done, I’d recommend getting one done. Just because a muscle feels “tight” don’t always mean that it is the one that needs to be stretched.[/quote]

It originally flared up while squatting and caused an apparent anterior pelviv tilt. While chiro appeared to correct this, I felt the underlying issue was never addressed and pain/discomfort would recur periodically (could be many months apart). I know posture is a factor with me, and I know I could have worked on flexibility more.
About 2 months ago my back flared up again after some rack pulls and deadlifts. Chiro sessions immediately helped but this time I was left with the numbness in glute and pins and needles feeling in my right foot. This has not happened before. Ironically, my lower back feels relatively strong.
I’m quite confused because I’m thinking a bulging disc must be responsible for the nerve damage - but I don’t have great lower back pain. I have only had 1 ART session to date but, as stated, there is no palpable difference.

9

[quote]JamesBrawn007 wrote:

It originally flared up while squatting and caused an apparent anterior pelviv tilt. While chiro appeared to correct this, I felt the underlying issue was never addressed and pain/discomfort would recur periodically (could be many months apart). I know posture is a factor with me, and I know I could have worked on flexibility more.

About 2 months ago my back flared up again after some rack pulls and deadlifts. Chiro sessions immediately helped but this time I was left with the numbness in glute and pins and needles feeling in my right foot. This has not happened before. Ironically, my lower back feels relatively strong.
I’m quite confused because I’m thinking a bulging disc must be responsible for the nerve damage - but I don’t have great lower back pain. I have only had 1 ART session to date but, as stated, there is no palpable difference.
[/quote]

I don’t see the squatting causing the anterior pelvic tilt, unless you strained your low back and caused spasming of the QL and lumbar erectors. But more than likely, you had the anterior pelvic tilt prior to the injury.

If flexibility and mobility are issues for you, which you stated, I would recommend backing off heavy deadlifts, squats, etc until that mobility deficit is restored to normal, especially with your history of injury.

I’m not surprised that your low back feels relatively strong, as those with strong low backs normally are the ones with hurt low backs. Generally, those with strong low backs have developed them due to over compensating with low back muscle activation due to inhibited hip extensors (glutes, hamstrings, etc).

Over time, this will wear down on the low back and cause the chronic issues. Also, with a disc issue, you won’t always have low back pain. You can just have the radiating pain down the leg.

My recommendations - go see an ortho to rule out disc involvement, begin a mobility program focusing on hip flexor/quad flexibility and all around hip mobility (IR, ER, Abduction, Adduction, etc), and start some corrective/preventative exercises (lumbar stability, glute activation, etc).

10

[quote]LevelHeaded wrote:

[quote]JamesBrawn007 wrote:

It originally flared up while squatting and caused an apparent anterior pelviv tilt. While chiro appeared to correct this, I felt the underlying issue was never addressed and pain/discomfort would recur periodically (could be many months apart). I know posture is a factor with me, and I know I could have worked on flexibility more.

About 2 months ago my back flared up again after some rack pulls and deadlifts. Chiro sessions immediately helped but this time I was left with the numbness in glute and pins and needles feeling in my right foot. This has not happened before. Ironically, my lower back feels relatively strong.
I’m quite confused because I’m thinking a bulging disc must be responsible for the nerve damage - but I don’t have great lower back pain. I have only had 1 ART session to date but, as stated, there is no palpable difference.
[/quote]

I don’t see the squatting causing the anterior pelvic tilt, unless you strained your low back and caused spasming of the QL and lumbar erectors. But more than likely, you had the anterior pelvic tilt prior to the injury.

If flexibility and mobility are issues for you, which you stated, I would recommend backing off heavy deadlifts, squats, etc until that mobility deficit is restored to normal, especially with your history of injury.

I’m not surprised that your low back feels relatively strong, as those with strong low backs normally are the ones with hurt low backs. Generally, those with strong low backs have developed them due to over compensating with low back muscle activation due to inhibited hip extensors (glutes, hamstrings, etc).

Over time, this will wear down on the low back and cause the chronic issues. Also, with a disc issue, you won’t always have low back pain. You can just have the radiating pain down the leg.

My recommendations - go see an ortho to rule out disc involvement, begin a mobility program focusing on hip flexor/quad flexibility and all around hip mobility (IR, ER, Abduction, Adduction, etc), and start some corrective/preventative exercises (lumbar stability, glute activation, etc).[/quote]

Sounds about right. Cheers for the recommendations, I am going to do that. The miserable factor is I enjoy leg training, e.g. squats, etc, most so that is a bit of a shitter. However, I think I will keep the goblet squat there just now and see what happens.

Thanks

JB

12

[quote]bushidobadboy wrote:

[quote]JamesBrawn007 wrote:
Question for BBB,

I have had back issues off and on for a few years but generally a chiro session has got me back in the gym. What I have now is persistent numbness in right hip flexor/backside area, also manifesting slight numbness/tingling in right leg/foot.

I foam roll and use a tennis ball in the area daily. I am trying to stretch more. I have had one ART session to date too but that on its own has improved the situation. Any advice greatly appreciated.

JB[/quote]

Firstly, you don’t have radiating pain as levelheaded mis-read. That would be a bit of a warning sign. What you do have is nubness/tingling, which siggests minor nerve compression, WITHOUT nerve sheath inflammation, since it is only and inflammed nerve sheath that radiates pain.

So this suggests to me that the nerve is being compressed by soft tissues rather than hard, since hard tissue (bone) would be far more damaging to the sheath.

So, soft tissues (muscle, tendon, possibly ligament) are compressing the nerve, and it is happening to two different nerves IMo, due to the two discrete sensory areas. I would postulate that your lower limb numbness it likely to be compression of the common fibular nerve as it winds around the head of the fibular. Cause is likely to be a tight ITB on the side, since the ITB inserts chiefly on the fibular head.

Glute/hipflexor numbness could be caused by the tight hip flexor, since some nerves pierce the muscle and/or run between the psoas major and minor.

The glute numness is probably related to the above, but may be caused by a tight prififormis muscle compounding the issue, as it may be compounding the lower leg numbness further down by compressing the sciatic nerve.

That is my e-opinion.

BBB[/quote]

Great advise from BBB. And you were correct, I completely misread the symptoms as radiating pain, rather than just numbness, so my apologies for that.

I personally think it would still be beneficial to see an ortho regarding this, mainly due to the fact that this is now a chronic, low back, nerve entrapment issue. I’m not a very big pharmaceutical person, but in severe cases, a quick dose of a prednisone pack or something similar can help start the recovery in conjunction with proper soft tissue manipulation, mobility, and muscle activation work. If you are more of a homeopathic mindframe, arnica is a great topical (not oral), all-natural anti-inflammatory.

Not to hijack the thread, but BBB, what have your experiences been with clients who have that “tight feeling” symptom running down their leg due to nerve entrapment? More of a disc pathology or just soft tissue entrapment of the nerve? From my experiences, there have been some with disc pathologies occurring at the same time, but I wasn’t completely sold that the disc issue was the cause of their symptoms. Just wondering your opinion. Thanks for all of your contributions!

13

[quote]lol funny but true. the thing is i just had an acl reconstruction last december so when i started running around may/june i thought it was because my lower back wasnt used to the form thats why the muscle sore.

anyways i went to the basketball court yesterday, made some shots and lay ups and hit a bit of my chest and triceps.

are there any exercises that i should stay away from other than the usual squats deadlifts?
cause i havent actually been back to the gym
should i try if i can run on flat surfaces? [/quote]

lol not to break you guys up and be rude but i do need some more opinion bout my matter.
would sufficient rest ensure healing on its own? if so, how long?

14

Zlyc,

You already got a great opinion. I think BBB already gave you a great recommendation, go see a chiro. It will be the first step towards re-setting proper positioning to your SI joint and will help relieve the added tension and likely spasm in your low back. Another person you could go see would be somebody with a functional movement analysis background to determine what imbalances you have and that can set you up with proper exercises to correct those imbalances.

Will resting make your back feel better? Probably. Will it fix the problem? Probably not. You already saw a doctor and they did the typical “anti-inflammatory” and rest route. Obviously that didn’t work. You also say you are just coming back from ACLR. Did you go through a proper rehab? Regain proper ROM in all of your joints?

Exercises to avoid? Anything that makes your back hurt. Simple as that. If running bothers your back, stop running. If deadlifts re-aggravate your back, stop deadlifts. Pretty simple stuff. Am I saying to never return to running, deadlifting, or anything else that hurts? No, absolutely not. But you have to fix the underlying cause before returning to exercises/activities that are causing pain. Again, a chiro, especially once familiarize with sports medicine will be best able to evaluate you and get things going.

15

[quote]LevelHeaded wrote:
Zlyc,

You already got a great opinion. I think BBB already gave you a great recommendation, go see a chiro. It will be the first step towards re-setting proper positioning to your SI joint and will help relieve the added tension and likely spasm in your low back. Another person you could go see would be somebody with a functional movement analysis background to determine what imbalances you have and that can set you up with proper exercises to correct those imbalances.

Will resting make your back feel better? Probably. Will it fix the problem? Probably not. You already saw a doctor and they did the typical “anti-inflammatory” and rest route. Obviously that didn’t work. You also say you are just coming back from ACLR. Did you go through a proper rehab? Regain proper ROM in all of your joints?

Exercises to avoid? Anything that makes your back hurt. Simple as that. If running bothers your back, stop running. If deadlifts re-aggravate your back, stop deadlifts. Pretty simple stuff. Am I saying to never return to running, deadlifting, or anything else that hurts? No, absolutely not. But you have to fix the underlying cause before returning to exercises/activities that are causing pain. Again, a chiro, especially once familiarize with sports medicine will be best able to evaluate you and get things going.[/quote]

well yeah knee is dead stable according to my knee doctor. Ive got almost full ROM, bout 1-2 degree off. well the thing is i saw a general doctor and he gave me the typical anti inflammatory so i havent seen the ortho.

where do i find someone with a functional movement analysis background?
if resting won’t fix the problem then what will?

16

[quote]Zlyc wrote:

well yeah knee is dead stable according to my knee doctor. Ive got almost full ROM, bout 1-2 degree off. well the thing is i saw a general doctor and he gave me the typical anti inflammatory so i havent seen the ortho.

where do i find someone with a functional movement analysis background?
if resting won’t fix the problem then what will?[/quote]

Good to hear the knee was stable, but I was more interested in hip and ankle ROM. Knee ROM is always a focus, but a lot of practitioners neglect to measure the hip and ankle. If those two joints are immobile, then you are likely to have low back pain/injuries. I am assuming that you are referring to 1-2 degrees off of knee flexion/extension.

Where to find somebody with a function movement analysis? See if you can find a Z-health practitioner local to you. Ask around. Post your location and see if anybody on here can refer you.

If resting won’t fix the problem then what will? I’m just going to cut and paste from one of my previous responses: “But you have to fix the underlying cause before returning to exercises/activities that are causing pain. Again, a chiro, especially once familiarize with sports medicine will be best able to evaluate you and get things going.” In addition to that you can check out a z-health practitioner or other movement analysis practitioner to find out what the exact causes are and they should be able to lead you in the right direction.

Gotta be proactive about this if you want results.

17

[quote]LevelHeaded wrote:

[quote]Zlyc wrote:

well yeah knee is dead stable according to my knee doctor. Ive got almost full ROM, bout 1-2 degree off. well the thing is i saw a general doctor and he gave me the typical anti inflammatory so i havent seen the ortho.

where do i find someone with a functional movement analysis background?
if resting won’t fix the problem then what will?[/quote]

Good to hear the knee was stable, but I was more interested in hip and ankle ROM. Knee ROM is always a focus, but a lot of practitioners neglect to measure the hip and ankle. If those two joints are immobile, then you are likely to have low back pain/injuries. I am assuming that you are referring to 1-2 degrees off of knee flexion/extension.

Where to find somebody with a function movement analysis? See if you can find a Z-health practitioner local to you. Ask around. Post your location and see if anybody on here can refer you.

If resting won’t fix the problem then what will? I’m just going to cut and paste from one of my previous responses: “But you have to fix the underlying cause before returning to exercises/activities that are causing pain. Again, a chiro, especially once familiarize with sports medicine will be best able to evaluate you and get things going.” In addition to that you can check out a z-health practitioner or other movement analysis practitioner to find out what the exact causes are and they should be able to lead you in the right direction.

Gotta be proactive about this if you want results.[/quote]

yeah 1-2 degree referring to knee flexion. how do i test for knee and ankle rom?

no z health practitioner around me… lousy country. its so cool that your countries are so advance. people injured here wont even get medical attention. messed up.

i recall the last time i squatted made it feel bad. probably like 3-4 weeks ago or so. i might have jerked upwards on my last rep. would that mean anything?

18

[quote]Zlyc wrote:

[quote]LevelHeaded wrote:

[quote]Zlyc wrote:

well yeah knee is dead stable according to my knee doctor. Ive got almost full ROM, bout 1-2 degree off. well the thing is i saw a general doctor and he gave me the typical anti inflammatory so i havent seen the ortho.

where do i find someone with a functional movement analysis background?
if resting won’t fix the problem then what will?[/quote]

Good to hear the knee was stable, but I was more interested in hip and ankle ROM. Knee ROM is always a focus, but a lot of practitioners neglect to measure the hip and ankle. If those two joints are immobile, then you are likely to have low back pain/injuries. I am assuming that you are referring to 1-2 degrees off of knee flexion/extension.

Where to find somebody with a function movement analysis? See if you can find a Z-health practitioner local to you. Ask around. Post your location and see if anybody on here can refer you.

If resting won’t fix the problem then what will? I’m just going to cut and paste from one of my previous responses: “But you have to fix the underlying cause before returning to exercises/activities that are causing pain. Again, a chiro, especially once familiarize with sports medicine will be best able to evaluate you and get things going.” In addition to that you can check out a z-health practitioner or other movement analysis practitioner to find out what the exact causes are and they should be able to lead you in the right direction.

Gotta be proactive about this if you want results.[/quote]

yeah 1-2 degree referring to knee flexion. how do i test for knee and ankle rom?

no z health practitioner around me… lousy country. its so cool that your countries are so advance. people injured here wont even get medical attention. messed up.

i recall the last time i squatted made it feel bad. probably like 3-4 weeks ago or so. i might have jerked upwards on my last rep. would that mean anything?[/quote]

Hi

most of the folks i see internationally are via skype and web cam for z-health related mobilty work.

pm me if you’re interested…

Just by way of context, here’s an overview about z-health

and here’s why a movement assessment can be a Good Thing

mc

dr mc schraefel, cscs
zhealth movement performance specialist (RIST9S) and current z-health master trainer intern.
rkc ii, ck-fms, ikff ckt