I have a (minor) disc bulge at L5-S1 for about two years now. I’m trying all kinds of rehab exercises but I’m really not getting anywhere.
The only thing that helps (and I’m doing that on a daily basis) are back extensions on a swiss ball (10 reps and a 30sec hold) and wrestler’s bridges. But are these safe to do with a back condition like this? I also tried to add lots of core exercises (side brigdes, birddogs) but those seemed to aggravate the bulge. Wtf?
And I tried foam rolling too but my condition also got worse from this. So the main things you read to treat a bulging disc work the other way round for me! Very weird. I did roll the gluteus and the hip flexors. At the end my back became inflamed and I had to take anti-inflammatory pills. How the hell is all this shit possible?
I don’t know what to do anymore. Anyone with similar experiences?
Without a physical examination, it would be difficult to prescribe the best exercise movements for a disc bulge type condition. There are many factors that come in to play.
That being said, the back extension movement you described is quite commonly used in the rehabilitation of discogenic back pain (the back extensions). There are a series of exercises you may find useful grouped under the name “Mackenzie exercises” if you google it. Some of those movements may irritate the bulge, depending on its location (is the bulge lateral, posterolateral etc?). So with a disc bulge, avoid any movements that increase the pain and work towards those movements that alleviate the pain. For example, if you find that bringing your knees to your chest makes it worse, stop.
Based on what you have stated, it would seem like you have a flexion intolerance. How aggressively are you doing the core exercises? Is there one side bridge that causes more aggravation than the other? Is there one side of the birddog that increases pain? Or do the movements in general increase discomfort? Have you modified any of those exercises-short lever side planks (on your knees or hips vs. your ankles), birddogs with only your hands or only your legs moving? Are you overdoing the core exercises? Are you overdoing the abdominal training-crunches, sit-ups or any other forward flexed positions? Too much rehab can irritate a disc as well, so make sure that you allow sufficient recovery between rehab bouts.
How is your hip flexibility? Can you extend at the hip fully? flex fully? Loss of these movements can cause compensatory movement at the lumbar spine. Make sure your hips are mobile and your torso is stable. A good resource for back injury rehabilitation is Dr. Stuart McGill.
Thanks for the reply. The core exercises actually feel good, but it’s the day after I’m feeling irritation. I don’t think I was overdoing these … Did those exercises once during the day for about 20 minutes.
My hip flexibility is fairly good (according to my chiro). I googled those mckinzie exercises. I’ll try those out when I’m feeling a bit better.
There’s one thing I do find weird though: my chiro gave me an exercise to do in the morning when I wake up. Lay on my back and pull my knees to my chest to stretch the region out a bit. It tried it, it always hurts and the week following that morning I had a very painful lower back. This shit sucks.
Anyway, Thanks for the help, I appreciate it a lot.
Based on a couple of items you stated (decreased pain with back extensions, pain with knee to chest), I would seriously consider removing the knee to chest movement, especially in the morning when your discs are typically at their most hydrated. I would also add standing extensions (hands on hips, bend backward with no pain) as needed as a portable form of the swiss ball extensions.
After waking up in the morning, really try to avoid any forward flexion for at least an hour or so (e.g. watch your position when shaving or brushing your teeth, standing in the shower, sitting on the toilet etc). That forward lumbar spine flexion puts posterior pressure on the fluid-like portion of the disc, which in turn, would exacerbate the bulge irritation.
With regard to the core exercises, try breaking it down in to two sets of 10 mins or even try them every other day instead of daily. The main goal of those exercises should be muscular endurance, as it is that quality that is tied to better long term back pain prognoses.