Back Rehab Question

[Ramstein II]

I wasnt sure where to post this thread. I guess this is kinda a training question. It looks like I have a lateral disc herniation at S1 L5. Its to my left side. McKenzie exercises have not worked at all for me. I hate the prospect of surgery or even corticosteroid injections at the site. I'm seeing an Orthopedic who I like and respect but feel like I'd be on the railroad to surgery if he had it his way. I'm willing to work around the pain for a long time to avoid having my back cut. Luckily I can train with certain modifications on leg day. I hurt while I walk and stand and feel fine sitting. I'm just looking for input here. Have any of you dealt with this type of problem? What exercises/rehab worked for you? Whats your opinion about current treatments for this? Any input would be appreciated.

By the way, Ive had pain from this for 3 mos. It seems to be getting better very slowly. Pain is in butt and outside of calf with a little tingling in foot.

 

[MikeHeavypecs]

I was very interested in reading your posting. I have the same disc herniation along with DDD (Degenerative Disc Disorder). I had the same symptoms many years ago that you mention. I found that I have been able to still build quite a bit of mass using a combination of machines and free weights (always a bench with a supporting back). Only a month ago, however, the tingling in my left foot went to complete loss of strength in half of my calf, making it impossible to stand on my toes on my left foot. My neurosurgeon said that this is the progression however I don't let it stop me in the gym. I, also, am putting off surgery for as long as possible......

Mike

 

[AnimalMass]

Reverse hyper. Reverse hyper. Reverse hyper. It was invented for that very purpose. It will provide traction fro you back while letting spinal fluid run in and help it recover. Most times it will eventually slide back in place. I'd try that for sure before having surgery.

Matt

 

[Mark-AUS]

AM - do you think that reverse-hypers may put undue stress on the injured disks/vertabrae?

To be very honest, I'm familiar with the reverse-hyper, but not in its effects on the spinal column. I'd appreciate any more depth you could go into on this topic.

Cheers.

 

[Ramstein II]

Thanks

I appreciate the responses. Im way off from surgery. Ill go a year at least before I even think about it. I just dont think a real deal herniated disc heals in 6 weeks. Im able to walk for an extended period now without limping. My butt just has a stabbing pain in it. So I know Im recoveringjust slowly. I dont believe the stats on recovery in 6 weeks. Maybe thats true for people with sore backs from muscle strains or even very mild disc herniations, but for a real deal far lateral disc herniation like this, I think Im looking at a year of recovery.

Im at a point in my recovery where I feel comfortable loading the back some with extension work. Ive been doing regular back extensions and a back extension machine. Im going to try the reverse hypers. I was doing them for a short while on a swiss ball, but it was too close to the ground. Unfortunately my gym and home gym dont have a reverse hyper station. I guess a good strong table or counter might work. Ive been fishing around the net and have found other bodybuilders whove recommended this exercise.

What has suffered the most is my leg day. Im stuck doing split leg squats with dumbells, leg press with only partial lock out, leg ext. and leg curl. Squats and Romanian DL are outat least for a very long time. To the bro above with DDD. Man, Im sorry to hear that. I know a woman with the same condition. Sounds like youre doing pretty well in the training department. Hang in there! To all those in painlater.

 

[MikeHeavypecs]

I'd like to try the reverse-hyperextenion. Can you explain how it is done?

Thx,

Mike

 

[MikeHeavypecs]

Ramstein,

Thanks. I try to do my best; I'm also a cowboy and like when I'm on my horse there is a cowboy saying "Cowboy Up" which means even in tremendous pain you get up and keep going. I try to apply that philosophy to the gym amd building mass (although I have to admit some days are more painful than others

Let me know how the reverse hypers work for you. I am going to try them..

Mike

I appreciate the responses. Im way off from surgery. Ill go a year at least before I even think about it. I just dont think a real deal herniated disc heals in 6 weeks. Im able to walk for an extended period now without limping. My butt just has a stabbing pain in it. So I know Im recoveringjust slowly. I dont believe the stats on recovery in 6 weeks. Maybe thats true for people with sore backs from muscle strains or even very mild disc herniations, but for a real deal far lateral disc herniation like this, I think Im looking at a year of recovery.

Im at a point in my recovery where I feel comfortable loading the back some with extension work. Ive been doing regular back extensions and a back extension machine. Im going to try the reverse hypers. I was doing them for a short while on a swiss ball, but it was too close to the ground. Unfortunately my gym and home gym dont have a reverse hyper station. I guess a good strong table or counter might work. Ive been fishing around the net and have found other bodybuilders whove recommended this exercise.

What has suffered the most is my leg day. Im stuck doing split leg squats with dumbells, leg press with only partial lock out, leg ext. and leg curl. Squats and Romanian DL are outat least for a very long time. To the bro above with DDD. Man, Im sorry to hear that. I know a woman with the same condition. Sounds like youre doing pretty well in the training department. Hang in there! To all those in painlater.

 

[Freddy]

Call Louie Simmons. His number is on his website. He's destroyed his l4 and l5 vertibrea and has still come back to squat and pull ~800 at over 55 years old. The man knows how to rehab a back.

 

[AnimalMass]

Great idea Fred.

Matt

ps - Louie is great to talk to. He talks really fast though, so don't get lost.

 

[diesel85]

i can't see the explanation in this thread (on how to do the reverse hyper). i've got lower back pain, have thrown it out numerous times over the past 6 years, never been to a doc though, scared of what he might tell me. wanted to try and rehab it myself. thanks.

 

[Ramstein II]

Reverse Hyper

Reverse hypers=upperbody stays stationary and horizontal. legs move to work lower back. It's like doing regular back extensions, except your legs do the moving and the upperbody stays still. It's on the web. google it.

 

[smeyers]

There are a couple of different "things" that might be worth exploring depending on where you live...........I'll throw in some web sites,.......not to promote/advertise the material, but just to give you some where to start searching from.
1. Naprapathy,.......might be able to help, however, your most likely only going to find DN's(Doctors of Naprapathy), in Illinois or New Mexico,......a few others in other states........but sparse.

2. www.sciaticare.com I found this site when searching on the problems that I have with my lower back, the guy who created it supposidely healed his own spinal disc "injury" as well as sciatica.

3. The multifidus back solution byJim Johnson. I believe this book runs in the neighboorhood of 13-15 bucks. The one exercise that I got from the book has helped me a lot with my pain(I have an L5-S1 pars fracture, Grade 2 spondlylolesthesis, and hyperlaxity of the SI Joint/Pelivs).
The exercise is done on all four's on the ground, simultaneously and slowly lift the opposite arm and the opposite leg in tandom,(creating an unstable envirnoment), pausing for approx. two seconds at the top........the key to this is to engage the multifidi by deep breathing,(basically stomach vacums......ala old school bodybuilding). Make sure to really contract/hold your breath in at the top.
Also, another pointer with this exercise is to strive for endurance and not strength.

4. Check to see if any of your local chiropractors have a flexion/distraction table. You could google, "cox flexion-distraction" Make sure you discuss the severity level of your condition with your Dr. and Chiro if you were to attempt this.......it's not reccomended for severe cases.

5. www.backfitpro.com This is the website for Dr. Stuart McGill a prof. of spine biomechanics @ the Univ. of Waterloo in Ontario. He's books garner high praise from many professionals. I believe his e-mail is on the site as well. He responded to the e-mail I sent him, so it's worth a shot.

6. I'm not sure if your PT discussed this with you,(many PT clinics don't have the machines), but some people with herniated discs respond to Medx,......spine rehab machines, developed by Arthur Jone's Nautilus co. Another PT technique that your PT may/may not discussed with you that has helped with some people's pain relief with disc problems is McConnell taping.

7. Myofascial and soft tissue release type of techniques might help aide in providing symptomatic relief of.....tight psoas, hammies, low back, etc. I'd recomend looking into John Barne's myofascial release.....as it's quite gentle

Also, if for some reason surgery ends up to be an option down the line,..... I'm not sure if your doctor mentioned this, but artificial dics are now available here in the U.S. I believe,(not positive though), previous operations entailed drainage of the disc, or removal of the disc and thus fusion. www.getadr.com Usually rule of thumb is a waiting period of five years to see if the technology has a good track record.

Hope this helps a little, sorry for the length

 

[Ramstein II]

Thanks for the input. I have a new game plan. I was doing well, but I noticed that everytime I worked out with weights I would flare up for a day or two. I did DB bench press and was flared up for 3 days. Turns out that just the slinging of DBs to get into position is enough to aggrivate this.

I'm back on Naproxen and even prescription cortizone. This is a 2 week regimine. During this two weeks I'm only riding the life cyle for cardio to eliminate walking induced sciatica. Weights consist mainly of machines and cables for 2 weeks. The idea is to eliminate inflamation as much as possible short of an epidural steroid injection. ONce the inflamation is knocked down to as low as it can go with oral meds, I taper off and go natural. The hope is that this medicine induced elimination of inflamation will kick my body into the right direction of not "over reacting" to the herniation, thus giving the nerve more room to move and ease the sciatica.

If maximum inflamation reduction eliminates most sciatica (which it seems to doing), then I have a good shot at living with this herniation as long as I can modify my lifestyle enough to keep from getting inflamed again.

We believe that my herniation is irreducible through extension or other exercise. It is likely the "worst" kind--a sequestered herniation where the nucleus has pushed completely through the outer wall. The ironic good news about this is that the worst herniations (sequestered) are also the most likely kind for the body to resorb and shrink through an immune response.

So, I'm very optimistic about this new approach. As long as I can get un-inflamed and stay there I can hopefully boost the immune system and let it disolve the disc material over the next year.

Kinda weird to be doing machines and cables. I feel like a girly-man. Honestly though, its kinda a nice break from the iron for a little while. I doubt I'll be lifting DB for a year though. I'll be back on stable free weight movements, such as BP in 2-4 weeks.

I would advise anybody who is strong and advanced to be careful with dumbbell stuff. I discovered that moving 100+ lbs DBs around is quite dangerous if you have any pre-existing back problems.

BTW, I am currently researching how diet affects inflamation and immune response. Inflamation is a double edged sword. On one hand it signals an immune response, but too much inflamation too long leads to all kinds of problems and pain. I'm researching the categories of prostaglandins, how to manipulate diet to raise some prostaglandins and lower others. I intend to post my results here.

Sorry for the long post. Sometimes putting in writing what my plan is helps me legitimize it and keep to it. This board keeps us all inspired.

 

[smeyers]

Ouch, a sequestered herniation, that definatly thows out previous suggestions. Looks like you're on the right path with the diet,........sounds like your reading the anti-inflammatory diet. As far as the diet route is concerned, if you have any in depth questions I'd shoot em to Dr. Andrew Weil, or Thomas Incledon. I'm not sure if Tom would have specific knowledge on this issue per say,(and not trying to flame his site or anything), but from my personal experiences from talking to him in length, at several different fitness seminars, I've been extremely impressed with him.

Also for future or current pain management, microcurrent therapy and/or cold laser therapy might be worth checking into.

With the dumbells,......after everything gets straightened out,.......check out power hooks or dumbell trays,(for power racks). These two devices would eliminate getting the DB's into position for every set,.......thus it might be feasable to have a training partner get them in position for the first set, and take em down after your last set. IMO the hooks, although more portable, aren't as functional when the weights start to exceed 105-110lbs. They start digging into the palms of your hands pretty good, also the length of the dumbells starts to become an issue.

I'm sure your doc has already mentioned this to you, but just in case he/she didn't,.........make sure to ask him/her if your condition could in any way develop into cauda equina syndrome,....symptoms that might signal CES. Although rare, true CES,(similar, but not true CES, symptoms have been reported through botched surgies), can come into play by herniated discs encroaching on nerve bundles in the spinal canal,.....the cuada equina is the main bundle.

Good luck with your rehab.

 

[J DUB]

3. The multifidus back solution byJim Johnson. I believe this book runs in the neighboorhood of 13-15 bucks. The one exercise that I got from the book has helped me a lot with my pain(I have an L5-S1 pars fracture, Grade 2 spondlylolesthesis, and hyperlaxity of the SI Joint/Pelivs).
The exercise is done on all four's on the ground, simultaneously and slowly lift the opposite arm and the opposite leg in tandom,(creating an unstable envirnoment), pausing for approx. two seconds at the top........the key to this is to engage the multifidi by deep breathing,(basically stomach vacums......ala old school bodybuilding). Make sure to really contract/hold your breath in at the top.
Also, another pointer with this exercise is to strive for endurance and not strength.

The exercise you are describing on all fours is commonly called the quadriped. Another way to do it is with the stomach on a physioball, thus creating a more unstable environment, but make sure you are keeping yourself very stable on the ball . Like you said, the hold at the top is important. You can also do a poor man's version of a reverse hyper on a physioball...just lay on the ball on your stomach, hold onto something with your hands and raise your legs. I am not so sure I buy into the whole multifidus theory as it has certainly not been proven, but doing this is better than nothing so long as it is pain free.



5. www.backfitpro.com This is the website for Dr. Stuart McGill a prof. of spine biomechanics @ the Univ. of Waterloo in Ontario. He's books garner high praise from many professionals. I believe his e-mail is on the site as well. He responded to the e-mail I sent him, so it's worth a shot.

McGill is very well known for back rehab. Although a lot of his work was done on workers and not athletes, it could still have some value for you. Definitely give him a shot.


7. Myofascial and soft tissue release type of techniques might help aide in providing symptomatic relief of.....tight psoas, hammies, low back, etc. I'd recomend looking into John Barne's myofascial release.....as it's quite gentle

John Barnes is a a weird guy and has some "out there" theories, but I can tell you that the foam rolling is pretty good for the IT band at least.