Never Ending Back, Hips, and Piriformis Trouble

Bigger Stronger Leaner Injuries and Rehab
1

Hello all,

I have been training for around 7 years. Mostly revolving around the Squat/bench/deadlift/press. I have always considered myself “injury prone” as at some point or another in training my back and/or hips flare up with some problems. I have since mpved away from the traditional lifts and mostly SSB or Front Squat. I use the trapbar for DLs etc…

Recently, to no surprise, I am back in the same boat. Taking this week off training to nurse a sore back and hips. Im becoming very frustrated. I feel like I put forth an effort to mobility/flexibility work. I do Limber 11 daily and try to stretch before bed.

I am to a point now where I want to try something more. I have always had the books Super Joints and Flexible Steel which both focus on mobility work and to some degree flexibility work. I always felt these were to in depth for me and didn’t want to commit but I am willing to try anything. Has anyone had any success with these books? Or anything else that had helped them? Its very disheartening to constantly be derailed by these pains. My family has a known history of back issues and I am really hoping to not be on that same path.

My plan is basicslly:

Morning mobility either from SJ or FS (pretty similar). Plan to do this everyday.

Follow that mobility work with this front split progression EASY FRONT SPLIT PROGRAM Part 1 – Flexible Steel

In the evenings I plan to follow this Four Knots program before bed Untying the 4 Knots: Jon Engum's 4 Weeks to Flexible Steel Program - Breaking Muscle

Is this too much? Anyone has other suggestions? I really like the “do this” approach which is why i gravitate towards a spelled-out program.

2

Are you doing any unilateral work like step-ups or one leg squats? Those have helped me more than any specific mobility work.
This way, mobility work is integrated into the workout itself rather than added in before.

3

Currently I am not. Would you suggest adding this work as assistance or sticking soley to unilateral leg work for a while?

4

Bighdx is not a doctor, but

Just 3 workouts I would suggest for varying levels of discomfort. Just realize that there are some days when your back is tight as hell that you need to work out for sure .

A. Back in spasm:

10 min walk on steep incline

Leg curls 4 x 15 reps

Hang off a hyperextension 3-4 minutes

Step-ups a. If you are slim and fit: EMOM 8 minutes 10 reps each leg

b. Big dude: EMOM 8 minutes 5 reps each leg

Body weight squat: 50-100 total reps superset with calf work

Some type pulldown 3 x 12 reps (for decompression)

Hang off a hyperextension 3-4 minutes

B. Not much pain, just tight:

10 minute walk on steep incline

Leg curls 4 x 10 reps

Front Squat:: Work up to one heavy set of 5, watch your form, brace your abs, maybe (6 total sets) supersetted with planks or ab wheel

Step ups 4 sets of 5 each leg, hold dumbbells for extra weight if needed.

Hyperextension: 3 easy sets, stopping in the last good rep superset with calf work

Some type of pulldown 3 x 12 reps (for decompression)

C. Good times

10 minutes walk on steep incline

Leg Curls (hard) 5 x 10 reps supersetted with ab wheel

Some type squat or block/rack pull, work up to one hard set, stopping on the last good rep (start really light, 8-10 sets including the warmup sets) I wouldn’t go below 5-6 reps in order to keep the load low.

Step ups or split squats 3 sets

Calf work

hyperextension 2-3 sets hanging for a minute at the end of each set

Pulldowns for decompression

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5

This is awesome. I dont have much equipment in my garage gym but i started doing single leg KB deadlifts and lunges with a weight vest to try to mimic some of those suggestions and so far so good. I feel sore in places i didnt know existed! (Good sore)

Thanks

6

I had absolutely debilitating back pain for years. The number one biggest thing that stopped it was strengthening my abs (particularly anything involving raising my legs) and more recently, strengthening my hip flexors.

Also, if you’re a sit-back-and-never-let-my-knees-go-over-my-toes squatter, that’ll make things worse for you as well.

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7

In addition to the advice from @flappinit I have noticed great progress from strengthening my glute medius muscles. Since routinely working on these, I have noticed less piriformis flare-ups and less overall lower back pain. Deadlifts and squats are improving as well.

I recently started doing SSB good mornings to pins set at my deadlift starting position height (thanks to Brian Alsruhe). I noticed improvement almost immediately.

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8

I had the same condition, thinking the piriformis was tight. Stretched more than a contortionist and specifically tried to strengthen glutes and abs for months.

Finally got an MRI, and had a herniated disc causing the pain.

Although mechanically that is probably the worst news, it’s better to know.

9

That is good to know. I got some xrays done but they didnt see anything. Perhaps I should ask fot the MRI to be sure.

10

They didnt catch mine on xray since it was soft tissue.

11

Do not get an MRI

Structural issues on an MRI are more likely to be asymptomatic, incidental findings than the actual cause of your pain. Depending on your age, disc bulges occur on 30-85% of people without pain, and at a higher rate in active populations.

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What this means is that getting an MRI and finding a “pathology” such as a disc bulge is not helpful, because there is a high likelihood the finding was always there, even when you were pain free. Clinically, we say that an MRI there was a poor predictive value for back pain findings such as a disc bulge.

As a result, people with back pain who pursue an MRI diagnosis typically find themselves chasing a “red herring” diagnosis. They therefore find themselves:

  • requiring more healthcare appointments
  • experiencing longer-lasting pain and disability
  • spending more money on healthcare
  • exhibiting more unhelpful beliefs about pain and a worse psychological state
  • more likely to receive treatments with placebo benefits

Please do not get an MRI. Save your money.

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