My Lower Back Injury, Progress & Rehab

Bigger Stronger Leaner Injuries and Rehab
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Hey guys,

I’m posting this thread to let others know about the injury that i suffered and my rehab/progress so others who suffer from the same condition can benefit from it. I am 26 yrs old, 6’4 tall, 100 kgs, Been lifting for the past 8 yrs and my training has been very powerlifting oriented for its entire course.

So, Back untill September i didn’t believe in deloading or wearing a belt for heavy lifts and that is when oneday i started feeling a pinching pain in my lowerback (left side) after a day of heavy back squats. I ignored it thinking it might be a pinched nerve but it didn’t go away and i ended up doing heavy deadlifts only to increase the pinching pain (which wasn’t still bothering me much).

So i keep going for 7 months, ignoring the pinching pain and in April 2014 a day after doing heavy back squats yet again my back finally gives inn and i am unable to sit down in any position the next day when i wake up. It felt like 2 bones in my back grinding against eachother whenever i’d attempt to sit. I finally give inn and decide to visit an Orthopedic doctor on 10th April 2014. I got on X-Ray and MRI done a day before visiting him and took them along.

He looks at it and tells me its a disc bulge (herniation) at L5/S1 and prescribes the following treatment :

1- 6 months off from gym & all sorts of weight training.
2- Ample bed rest
3- Wear a corset at all times (except eating & sleeping).
4- No twisting, lifting or bending.
5- Can go for Swimming if i want to but leaves it upto me.
6- Some medicines (NSAIDs and vitamins) probably. (For 6 weeks)
7- Perform William’s set of flexion exercises twice a day.

So, I decided to take his advice, for the first time in 8 yrs i take a long break from the gym & start wearing a corset. Up untill this point i still had no idea about what positions to avoid sitting inn. I kept doing bodyweight training at home and only DRIVING to work seemed to cause the pinching pain otherwise it slowly disappeared.

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2nd Update:

So, for from 10th April up untill 15th June my recovery is going great without any physical therapy or Chiro involved, Only self performed William’s flexion is what i was doing.

On 16th June, I got a digestion issue & had to be on the toilet seat for 8 times during that day (I used to sit in extreme flexion forward tilt on the seat up untill then). That leaves my body dehydrated and WHAM! the next day i face the most devastating pain i’ve faced in all my life, My back muscles SPASM for the first time and i ended up being unable to get on my feet, My back would stay in forced extension and i was unable to do literally anything for 3 days. That is when i started researching and reading about DISCS, DISC herniations, Injuries, Rehab, Pain, Spasms. Anything and everything related to Disc issues.

So after 3 days of misery and absolute bed rest the lock opens up slowly and i am back up on my feet by 20th June 2014. During this time and out of panic i located a CHIRO (first visit to any other person other than my Ortho) who told me performing WILLIAMS aggravated my disc problem since Williams tends to push the discs out further and he tells me about the MKENZIE method that it is supposed to push the discs back inn.

I decided not to go for Chiro treatment since he didnt sound too convincing but i researched on MKENZINE, Replaced WILLIAMS with MKENZIE set of exercies and found INSTANT relief. My lower back spasm went away slowly and i started feeling normal once again with the pinching pain in lower left also back to almost none.

Fast forward to 1st July 2014, By now i was alot more educated about what to do and what not, The sitting, standing and squatting positions to use and which ones to ignore. But on this day, Although i’m 90% pain free by now i start feeling heaviness and weakness in my right Quadricep above the knee. So this time i decide to see a SPORTS DOC who specializes in SPINES and has his set of physiotherapists at his clinic. He performs a thorough check up, Examines by posture, flexibility and range of motion, Looks at my MRI and X-RAY and then tells me that he rates my problem 3 on scale of 10 and that i should not have stopped my weight training back iN APRIL 2014 (My Ortho adviced me to stop). He tells me i should start physical therapy and i’ll see alot of improvement in weeks. (According to him the back spasm on 17th June was possibly a RELAPSE of the injury due to overexerted flexion on the toilet seat).

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3rd Update:

I start physical therapy with his therapist who mainly focuses on alot of HAMSTRING/GLUTE stretching + electronic stimulation and heat-pad

So i start feeling 90% again and alot better than before so thats when i started thinking, The sports doctor is right, I should never have stopped weight training as i was 90% pain free and spasm free till i was training regularly and heavy. Only the pinching pain on lower left side was an issue. I started feeling confident and decided to resume a BRISK WALK routine for a couple of weeks before i hit the gym again. After a couple of days of walking, With my body all warmed up i decide to LIFT UP my dog (An American Bully and weights about 40 kgs) and climb up the stairs to take him to his room upstairs. One has to remember that i had not been to the gym for almost 2.5 months up untill this point and i had never done any CORE training in my life, Only HEAVY WEIGHT split bodypart training with Abs at the most added to the training.

By now, From my own analysis, I think i had developed MUSCLE IMBALANCE in my back and legs due to non activity for 2.5 months (no walking either). So i climb the stairs and come back down and go to bed. The next day…WHAM! Im unable to get up on my feet again with extreme back spasm yet again + nerve pain in lower left + tired/heavy right leg again. For 3 days again im totally helpless and in agony and this is the first time in 8 yrs the pain finally breaks me as i feel paralyzed being unable to walk or get up yet again. So my father buys a Heatpad (i never believed in its effectiveness prior to this) and Ketaprofin Gel (NSAID for external application only). So after 3-4 sessions of heating 15-20 mins + Ketaprofin application twice a day i finally manage to get out of the back spasm and the lower left pinch moves to the right side of the back. Left pinch ends.

I decided to call up my gym folks and one of them refers me to a young but very accomplished Physiotherapist. (I also messaged Ronnie Coleman himself to get advice as he too suffered from many back disc herniations early on in his career yet manages to lift heavy up untill today, He was generous enough to reply back to my email and he tells me i should continue/resume training hard at the gym + get physiotherapy and deep tissue massage).

So 7th July onwards, I have been seeing this new Physio-Therapist who has been giving me Heat/Electric stimulation on the back + he has chalked out a stretching/exercise routine for my CORE. His main diagnosis is that I focused so much on the bigger/visible muscles and i totally ignored my CORE which is one of the primary reasons why my back gave inn and when i stopped training the muscle imbalances increased causing back spasms + morning stiffness which left me unable to movie. So now, I’m following his exercise plan and working hard towards building a strong core as the core will aid/help take stress off the spine + lots of Gute extensor/flexor + Hamstring work. I feel 80% recovered already from the last Spasm in the past 1 week that i have worked with him. My spasm is gone, the inflammation is gone, My core is starting to feel stronger, My back is not getting stiff in the morning and the right leg heaviness has gone down by 50 percent already. The pain is now reduced back to level of lower right pinch.

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What i have learnt in these 3 months of Rehab/Injury is and after visiting Orthopedic Surgeons, Physiotheraposts, Chiropractors and a Sports doctor:

1- Building a strong core is as necessary as building any other muscles in the body, Building a strong core is the fastest remedy to become pain free again and reduce stress off the spine if you dont want to go down the surgery route.

2- The medical community is still divided between Williams Flexion and Mkenzie extension exercises, Choose what relieves your pain, In my case it was Mkenzies.

3- With ample rest/Physiotherapy/Medication, Your disc herniation could and should get better in the timespan of 4-6 months. If not and when you have exhausted out all options of conservative treatment, only then should surgery be considered.

4- Wearing a Corset for the entire course of treatment is not a necessity, Wear it for the first 4-6 weeks till your pain level goes down.

5- Maintaining a SPINE NEUTRAL position takes the load off spine and is much better then keeping it in extension.

6- Heating/Heatpad is the best thing that humanity invented, When u have a back spasm or locked/Inflammed back, Heat your back 3-4 times a day for a couple of days and it works like magic.

7- It is an injury & not a lifelong condition, Dont make it one, Work aggressively on your Rehab, Find a good physiotherapist & focus on mental strength, Alot of the pain is connected to the mind, When u start telling yourself it aint as bad as u are making it out to be, You will notice a big difference immediately. Thats from my personal experience.

8- Last but not the least, Never lose hope & keep educating yourself. Bruce Lee overcame back issues, Ronnie Coleman had 4 herniations, Derek Poundstone had 2. All these men recovered & became stronger than before. Follow them & tell yourself you are no less :slight_smile:

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cool thread man, keep it up.

I’ve had back pain for pretty much my entire life (first time I was ever crippled with a spasm I was 15 in my math class!) and the doctors don’t know what the fuck is causing it. Had millions of different diagnoses over the years.

Been meaning to try those McKenzie postures for a while now. I do get a lot of relief if I do core activation work every day, but what I usually do is just do it until I’m pain free, then slack off a bit and get re-injured because of it!

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[quote]Yogi wrote:
cool thread man, keep it up.

I’ve had back pain for pretty much my entire life (first time I was ever crippled with a spasm I was 15 in my math class!) and the doctors don’t know what the fuck is causing it. Had millions of different diagnoses over the years.

Been meaning to try those McKenzie postures for a while now. I do get a lot of relief if I do core activation work every day, but what I usually do is just do it until I’m pain free, then slack off a bit and get re-injured because of it![/quote]

Thanks bro, Did u get a MRI done?
The medical world is still divided between Willaim’s and Mkenzie’s. Some say it is useless to perform Mkenzie’s unless you do William’s to open up/make up space for the disk to be pushed back with Mkenzie’s. My physio has got me doing a combo of both apart from the core-build up work. I believe once u build up your core (which is a 4-6 weeks process) you can cut down on the amount of core training u do to maintenance level. Like, my physio has me performing core everyday now but i will be bringing it down to twice a week or thrice a week MAX once i resume my gym training in September.

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Nope, harder than all hell to get one on the NHS (I’m Scottish).

I’ve never even heard of the Williams postures so I may try a combination of both and see how that works out. I’m just coming back from my latest back injury that had me doing no spinal loading for about 6 months! Last week I managed to front squat 40k! It’s not much, but it’s a start.

I’ve been doing a lot of the core activation stuff Chad Waterbury has written about lately and that’s made a REALLY big difference. These things in particular:

and

and

You could have a try of some of those and see how you feel.

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4th Update:

So…4th week into my rehab now, Lots of Core work & Ham/Glute stretches. I’ll cover some points quickly.

  1. My Back Spams have totally subsided. No spasms since my last update.
  2. My morning stiffness has totally subsided. No stiffness since my last update.
  3. My Leg heaviness on a scale of 10 has come down from 6 to 3 now since the last update.

I tested my back by going to a movie & a restaurant on the same day, That meant 3 hours of continuous sitting. I was able to do so without any discomfort, So the exercise regime is paying off. I’m into the 4th week now and 2 more weeks to go after which the physio will take a physical test to determine if i can resume weight-training or not. Most of my symptoms have subsided. The symptoms that now remain are minor right leg heaviness (burning foot) and a greatly reduced right lower back nerve pinch. From what it seems in these 4 weeks it feels i’ll be symptom free by the end of week 6 most probably.

The things that i’ve been doing since my last update are:

Heating my back thrice a day for 20 minutes each
applying ketaprofin gel once a day
2 corework sessions which include alot of glute/ham work, 25 mins each.

If anyone might be interested, I’ll write up my core routine here so other’s can take a note. It is this core routine that has healed my back within no time and i am now 90% pain free within 4 weeks of Re-hab.

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hey man I enjoyed reading ur rehab progress. I also have a bulging disc and if you could share your core work that would be great!!!

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I whole-heartedly support the McKenzie method for acute disc issues if it is posterior or posterior-lateral disc bulge (which majority of disc bulges are posterior or posterior-lateral). They are flexion-intolerant injuries, so I am uncertain of which medical professional are supportive of flexion based exercises for those types of injuries. If you are dealing with a facet/joint injury that has no posterior disc component, then yes, I agree with a flexion based approach.

When the initial, acute symptoms begin to settle, I progress to “core”/lumbar exercises that re-enforace a neutral spine. PRI exercises have been an amazing at facilitating proper neutral lumbar positioning (the 90/90 PRI exercise video above is a great example of the exercise and there are many others).

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I herniated a disc back in February of 2013, didn’t take rehab seriously enough…and then reherniated it in August. I couldn’t use my legs for 2 days after I reinjured it.

A year later, I am stronger than I have ever been.

I attribute this to multiple things:

1.) Core work. I started by doing bodyweight planks for 3 sets of as long as I could possibly hold them (at least 60 seconds). I eventually upped this to 3 sets of 2 minutes. Then I started adding weight. Now I switch between weighted planks and ab wheel rollouts EVERY time I lift. At first it seems like you are doing too much for your abs, but as long as you sleep enough and eat enough your body will adapt and you will get stronger.
2.) Hamstring flexibility: A lifetime of sitting has led to tight hips and hamstrings. Do these: https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcQ3h1tOHS8LpN3EYrlSpdXAHAA2Rn60tcetHztbZWY_rxFb19L4JALWBmpd every time after you work out. Think about flexing the leg you are stretching and pushing your other leg into the ground.
3.) Attention to form. When I reinjured myself I took 2 weeks off from the gym. Then I began squatting for 15 reps every time I worked out, focusing on keeping my core tight and not letting back round. I started with the bar and added 2.5lbs to either side of the bar every time I came in. I eventually worked my way back up to around 185lbs, and then began to slowly up the weight back to my max.

Best of luck to you, and I hope you have a speedy recovery. Planks are your best friend.

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also interested in the core routine slimshady

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Hey there, Glad to hear you’re recovering well. It’s a time consuming, and bumpy road to functionality and i’m sure you will continue to encounter dark times where you will feel hopeless. That being said, stay open minded and positive, and learn as much as you can on rehab and recovery for the injury.

I’ve been lurking on T-Nation for about two years but finally decided to join on account of my own recovery from a disk injury (L5-S1), my own recovery thread coming soon. As for my experience with rehabbing, I also sing the praises of the Mckenzie method, as I was able to bring down the original pain and inflammation level with the help of the McKenzie exercises. That being said, it was not a cure, but it certainly does help.

I may have missed the answer to this somewhere, but have you had an MRI yet? If not, I highly recommend it. Not only will it give you some peace, but it will help whatever professionals you are working with. I only recently have been able to return to 90% pre-injury pain/function level since I had an MRI and started Cortisone/Ozone Therapy. It may be something you might want to look in to.

Blessings,
Jon

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Give reverse hypers a try

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[quote]Nharnia wrote:
hey man I enjoyed reading ur rehab progress. I also have a bulging disc and if you could share your core work that would be great!!![/quote]

Sorry i haven’t been visiting T-Nation lately, Will post my routine in a day hopefully.

[quote]outlaws wrote:
Give reverse hypers a try[/quote]

I tried that during the acute phase but extending the back was making matters worse, believe it will be much more effective now that i am well through the acute phase.

[quote]StructureInChaos wrote:
I herniated a disc back in February of 2013, didn’t take rehab seriously enough…and then reherniated it in August. I couldn’t use my legs for 2 days after I reinjured it.

A year later, I am stronger than I have ever been.

I attribute this to multiple things:

1.) Core work. I started by doing bodyweight planks for 3 sets of as long as I could possibly hold them (at least 60 seconds). I eventually upped this to 3 sets of 2 minutes. Then I started adding weight. Now I switch between weighted planks and ab wheel rollouts EVERY time I lift. At first it seems like you are doing too much for your abs, but as long as you sleep enough and eat enough your body will adapt and you will get stronger.
2.) Hamstring flexibility: A lifetime of sitting has led to tight hips and hamstrings. Do these: https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcQ3h1tOHS8LpN3EYrlSpdXAHAA2Rn60tcetHztbZWY_rxFb19L4JALWBmpd every time after you work out. Think about flexing the leg you are stretching and pushing your other leg into the ground.
3.) Attention to form. When I reinjured myself I took 2 weeks off from the gym. Then I began squatting for 15 reps every time I worked out, focusing on keeping my core tight and not letting back round. I started with the bar and added 2.5lbs to either side of the bar every time I came in. I eventually worked my way back up to around 185lbs, and then began to slowly up the weight back to my max.

Best of luck to you, and I hope you have a speedy recovery. Planks are your best friend.[/quote]

I agree with most of the stuff you mentioned, I also attribute my disc hernation to tight hamstrings, Prior to this condition i never gave a rats a** about what tight hamstrings are and what harm could it do to my body. Poor shitty Deadlift form is what broke the camel’s back in my case. Now that i’ve been cleared to resume training, I will give Deads a skip altogather. The risk is not worth it. Squats is a different story, I’ve been adviced by my Physio to start with Bodyweight squats and go very slow while progressing onto weights. Whats your take on Back Squats post injury? From all the folks i’ve talked to, Guys like Derek Poundstone & Jay Cutler, They all recommend switching to Front squats as they dont compress the spine as much back squats.

[quote]StructureInChaos wrote:
I herniated a disc back in February of 2013, didn’t take rehab seriously enough…and then reherniated it in August. I couldn’t use my legs for 2 days after I reinjured it.

A year later, I am stronger than I have ever been.

I attribute this to multiple things:

1.) Core work. I started by doing bodyweight planks for 3 sets of as long as I could possibly hold them (at least 60 seconds). I eventually upped this to 3 sets of 2 minutes. Then I started adding weight. Now I switch between weighted planks and ab wheel rollouts EVERY time I lift. At first it seems like you are doing too much for your abs, but as long as you sleep enough and eat enough your body will adapt and you will get stronger.
2.) Hamstring flexibility: A lifetime of sitting has led to tight hips and hamstrings. Do these: https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcQ3h1tOHS8LpN3EYrlSpdXAHAA2Rn60tcetHztbZWY_rxFb19L4JALWBmpd every time after you work out. Think about flexing the leg you are stretching and pushing your other leg into the ground.
3.) Attention to form. When I reinjured myself I took 2 weeks off from the gym. Then I began squatting for 15 reps every time I worked out, focusing on keeping my core tight and not letting back round. I started with the bar and added 2.5lbs to either side of the bar every time I came in. I eventually worked my way back up to around 185lbs, and then began to slowly up the weight back to my max.

Best of luck to you, and I hope you have a speedy recovery. Planks are your best friend.[/quote]

Hey Jon, I did happen to post the results of my MRI in one of my earlier posts, It came out as a L5/S1 disc prolapse & my team (Ortho & Physio) prescribed their treatment accordingly. 10th week into Rehab now and i am 90% symptom free. Will be posting an update today.

An MRI is usually considered valid for 6 months, I had mine in May that is before all the rehab work & recovery process. I will be getting another one by the end of this year to check the progress. I would like to know what symptoms are you left with now if any and howmuch does that affect your everyday routine?

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5th Update:

Guys, 10th week into my rehab & recovery now. Post 6 weeks my Physio told me i need not visit every alternate day & i should continue the rehab program at home. I am 90% symptom and pain free now by the end of 10 weeks and most of the stuff that used to remind me about the injury is now doable without any pain. That being said, As the pain & stiffness level goes down i’ve started slacking off which i shouldn’t.

Quick summary:

  1. 90% pain & symptom free by 10th week. Only certain extension movements give me some specific point pinch, Burning foot & Leg heaviness has dropped down to 1 on a scale of 10.

  2. I started swimming from the 7th week up untill the 10th week to get my body back into the groove before i start lifting weights. Its a great way to recondition your body and stamina before resuming your training. Swimming aggravated the symptoms in the first 2 days (as my Physio told me it would so not to worry) but relieved all of the symptoms within 6-7 days and took my progress towards the 90% pain free mark.

  3. I am now probably taking my last Anti-inflammatory drug VOLTRAL which was prescribed by my Ortho.

  4. I can now go to movies, Sit at work, Drive without feeling any pain. I absolutely credit the CORE/GLUTE program with my rehab & progress. When the injury happened, Initially i thought i would never be able to walk normally, My physio kept telling me “You follow these exercises for 6 weeks and by the end of 6th week you’ll be laughing at these idiotic thoughts that go through your mind right now”. His words came true, I was indeed laughing at how afraid i was when the injury hit me. I feel blessed to have gotten my life back after these 10 weeks.

  5. Maintaining & practicing a NEUTRAL SPINE position is what will make sure an injury relapse doesn’t happen. Practice doing it for 2 weeks everywhere forcefully…Home, work, movies, restaurants, Everywhere. By 3rd week your body/sub-conscious mind will start adapting to the neutral spine position itself without having to be reminded to sit that way.

  6. Never let hopelessness hinder your progress and aims. My thread is primarily for you people who are going through a similar phase in life. Read from where i started and where i stand today. With dedication, You can fight off any hurdles in life. Surgery should absolutely be the last option in my opinion.

I am going to resume my Weight-training from October (after a layoff of 6 months). My next updates will be primarily focused on my gym progress and my back’s response to my training.

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Care to give some details on the core/glute program? Thanks for sharing and awesome recovery so far

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Could you share your core/glute program?

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Sorry for the long delay. The Core/Glute strengthening program that aided my recovery is as follows:

(I am dividing it in 3 sections, I did it twice a day for 6 weeks and then once a day for 4 more weeks, Now after i’ve resumed my gym training i do this workout thrice a week).

1- Bridges (3 sets of 60 seconds each)
2- Planks (3 sets of 60 seconds each)
3- Stomach Vacuums (5 sets of 20 seconds each)
4- Lying Supermans ( 3 sets of 20 reps each) (Frontal raise only)

5- Lying Leg Curls ( 3 sets of 20 reps each)
6- Quadruped Hip Extension (3 of 15 reps each) (Pelvis resting on the floor, No elbow lift)
7- Prone Hip Extension (3 sets of 15 reps) (Leg straight out without any bend at the knee)
8- Lying Side Leg Raise ( 3 sets of 20) (head resting on the folded elbow).

Third section (Stretching)

9- William’s Flexion Single knee to chest (about 4-5 sets with 15 seconds of knee pause at the chest.

This program was given to me by my physiotherapist. Point to be noted, I bought & wore ankle weights (4 kgs) after the first week to further strengthen my core/back/gute muscles.

At the end of each workout after William’s flexion. He would have me do lying leg raise VERY slowly just to improve and bring back the ROM that i had lost because of the injured disc. At first it hurt, As many people with disc herniations cannot lift their single leg beyond 45 degrees. Eventually after 6 weeks i regained the 90 degree ROM.

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Update:

So i finally resumed weight training last week after a 6 month layoff. Have started real light about 20% of my 1 RM. Still testing the waters, Back has started feeling good, It looks like my remaining 10 percent symptoms will subside as i get into the groove. I only have a slightly heavy right leg now, Which is 1 on a scale of 10.

I’ve been doing circuit training for now, Just avoiding big compound lifts like Deads, Squats & Overhead press, Will go slow for 2 months and then incorporate Front squats, Leg presses and MODERATE heavy stuff in my routine. No super heavy stuff on the cards for atleast 6 more months as i dont want to mess up my back again. Pretty happy to be able to perform atleast 25 of the 30 exercises i used to do.

I did notice my disc getting irritated while brisk walking on the inclined-treadmill so i will be avoiding that completely & will switch to cycling or open-air track walking. Anything that slightly irritates the disc should be completely thrown out of your workout untill you’ve healed completely.