Years of desk job and then hobbying by doing triathlons with aero position caused forward pelvic tilt and bulging discs. My quadratus lumborums were always acting similar to what your are describing. Has your PT pointed to what was likely cause for disc problems?

Stuart McGill (Canada) is good reference. I do his routine, modified sit-ups, birddog, side planks and has kept me in good stead. YouTube has plenty of free stuff. Guy foyer of ELDOA fame has reference material too.

McKenzie method always seemed to hurt my back more than help so I never stuck with it.

A good PT should prescribe a program, mobility and strength for you based on your specific problem.


But as I said it sounds like your Qls are working overtime (trigger points) right now, but that is not their permanent solution.

Kelly starrett has some free stuff on YouTube and his website mobilitywod.com has trial and options on subcriptions and I use it fairly regularly.

What has your PT suggested you do about it? Have you asked? There are several paths to try. The McKenzie series of movements were very helpful to me. David K

My PT was focused on relief. There was never a real discussion about lifestyle given when I arrived I could not stand up straight;)

When did the discs herniate initially? They don't stay in their initial state forever, the body reabsorbs most of the material and shrinks/dehydrates and then scars over the affected area.

There is the possibility that they aren't the source of your low back pain. Usually, discs are more sensitive to sitting than standing/walking. Leg pain?

I was helped immensely by a Chiropractor who had a specialty in ART (Active Release Technique).

I suggest you ask a few local crosfitters, swimners, runners, etc., and see what rehab specialist (PT, Chiropractor, etc) is mentioned by all. Good luck.

David K.

I'm in the same boat but I can't sit down, stand up and feel any sort of relief that lasts. I just went to urgent care this morning. I got a shot of toridol and have a pack of methylprednisolone. Yesterday I bent over to pick up a screwdriver and felt a zing of pain. It got worse through the day. I can at least walk around today but I can't fully straighten up and I think my torso is still at a slight angle.

I really need to find a PT or set of exercises too since this is no way to live. The problem I have with PT's is they start you out at the most basic level and expect you to take such baby steps. I'm an active fit person, there's no way I have the patience, time or money to see a PT for that many sessions to finally work my muscles and start rehabilitating my body.

Brother I hear you

Years of jumping out of airplanes into the night sky with a shit ton of equipment followed by yet more years of ruck marching with insane loads; capped off by sitting for hours and hours in body armor in a HMMWV. My back is totally jacked up.

I've found great relief in the short term with Motrin 800s (Ranger candy) and ice massages

Over the longer term two things:

1. Increase core strength thru proper ab work
2. Inversion therapy. I've bought a inversion table and use it regularly at home. They even have one here in gym for the special folks' compound where i'm currently working as the guys I support are just younger versions of me.

I did have a total rupture of L4/L5 and it was perfect pain. Pain like haiku is to poetry or expresso is to coffee. I had laminectomy at Walter Reed to 'fix' it. I did go on to jumping out of more perfectly good airplanes and doing Tri's (even did IMF in 14:46:xx) but surgery should be court of last resort. Avoid chiroquacks.

best of luck amigo

---

Steve

Sitting unsupported is nearly impossible

The first disc went skiing years ago. I twisted and I knew the second it happened.

I knew discs are reabsorbed but my understanding was the point where they protruded never heals and is always a source of weakness

Oxycontin. Isn't that the solution de jure nowadays?

I ruptured L4/L5 and bulged L2/L3 and L3/L4. Spent 16 weeks in PT. Like you said, they start very conservatively. I followed all of the baby steps and once they were outgrown started discussing more advanced options. My PT understood my pre-injury activity level, and I ultimately sent him the journal article linked below describing active recovery from such injuries. He really took an interest and worked in many of the conclusions into my PT plan; although he remains steadfastly anti-dead lift.

https://www.ncbi.nlm.nih.gov/...articles/PMC3812831/

I ruptured two discs at work many years ago and it left me unable to sit or move without a lot of pain. I'm talking the quivering jaw kind of pain, where it overwhelms every thought you have. I have been stabbed before, that pain was a minor complaint compared to the pain caused by disc materials pressing against my spinal cord.

My solution was chiropractic care, every other day for a while, then a couple of times per week, gradually resolving the pain until I could go back to work again after about a month. After 5-6 months my frequency lessened to about once per month and that is where I am now, two decades later.

I can run, bike, swim, and do nearly everything that anyone else can do, but when I run I can feel the bones in my back bouncing against each other. It forces me to run smoothly, which is a silver lining to the problem. I also take the usual joint support supplements and a COX 2 inhibitor I found from a natural source supplement.

Good luck in dealing with your problem, and don't just drug it up because if you don't resolve the problem it will seriously mess with your mobility in the future. I know too many people from my old job that cannot turn their heads anymore and have to turn their whole body because so many of their vertebrae are now fused together due the damage that was never prevented.

 
FWIW, I find spending time stomach-down (kind of a supported plank) on a small swiss ball helps my spine relax. It opens up the vertebral spaces with zero strain.

I'm right there with you, too. Long story short - did a lot of damage to my body in the Marine Corps and just doing stupid stuff back in the days when I was indestructible. Herniated my L5/S1 in 1996 working as a roofer, subsequently herniated L5/S1 and L4/L5 again later in a MTB accident, herniated discs in the neck (probably headbanging), degenerative disc disease, etc. I have done stints with PT or chiropractic probably 20+ times in life. Throw in Lupus and Celiac, and my life is dictated by pain.

Dealing with pain is what got me interested in bike fitting, and drives much of my fitting philosophy to this day. I consider the bike fitting service closer to PT than what a bike shop typically offers. As some famous guy once said, "it's not about the bike."

I am FMS-certified (http://www.functionalmovement.com), and will say that if I don't practice what I preach and do my regular FMS stuff, it doesn't take long for things to get out of hand. It's all about having some regular maintenance to keep the body in balance. I see so much dysfunction in my customers. It's easy to skip the cross-training in order to keep up with the training schedule the coach prescribed, while trying to balance that with the rest of life. When someone says "I have a 4 hour ride scheduled this weekend", I'd rather see them do 3:30 and 15 minutes of functional work. They'll get more out of it.

The thing I like about FMS is that it is very specific to the individual. The FMS screen identifies your areas of dysfunction, and based on that, we can develop a workout regimen specific to you. For most folks, 10-12 minutes a day of foam rolling and a couple of other exercises is all it takes. Focus on restoring the body to a balanced state to reduce the chance of injury.

So, in your case, I would look for an FMS or SFMA person in your area and have them screen you. You might be surprised by what you find. You mention a "strength" program, but I would argue that you need a "functional" program. Not saying that your thinking is flawed, but the devil is in the details. You could be too strong in some areas, and strength training can exacerbate the issue.

On that note, the people who I screen who do the best have all been regular yoga practitioners.

---

Travis Rassat
Vector Cycle Works
Noblesville, IN
BikeFit Instructor | FMS | F.I.S.T. | IBFI
Toughman Triathlon Series Ambassador

This! And, it falls directly in line with what Tyrod said above about Stuart McGill and Kelly Starrett (sp?). Both Dr. McGill and Kelly ascribe to the FMS system. Two key words used by Travis here and he put quotes around them because they are so key......"strength, and functional"...once you get back on your feet through the FMS system you can then combine these two into a "Functional Strength" program which my recommendation would be the SFG Kettlebell program. However.....you must learn to hip hinge etc (which the FMS will teach you) before you enter into the simple SFG programing. Best of luck to you. I speak from experience here as 27 years as a police officer destroyed my back and prior to that, a HS football injury ruined my neck. The simple FMS and SFG stuff will put you back in the game though. Best of luck to you!

Tim

McGill does NOT subscribe to the FMS system. FMS and SFMA have been great disappointments in the research, neither have produced much in terms of results under research conditions.

Sorry to hear about the back. Don't know where you are, but look up and find a "Clinical Athlete" provider. ClinicalAthlete.com.

You can search for one by geographic location and one might be near you.

Good luck!

Yes.

The only things that ever truly worked were (1) increasing my activity level; (2) stretching, particularly quads, hips and hamstrings; and (3) core strengthening exercises.

As to the core strengthening, I highly recommend this book:

https://www.amazon.com/...idence/dp/1609611004

It's got a relatively simple core exercise program that helped set me straight. I've never been 100% since my lower back injury but I'm certainly greatly improved over where I was in my strength and flexibility.

---

War is god

I have read all the replies

I am away

I will be home Sunday but in the interim. All the responses have been helpful

The only one I can specifically address immediately is related to a brief experience with oxycodone. Not sure how it compares to contin but I was very ill. Had been rx'd vicodin which had done nothing and it was the most amazing drug experience of my life..........

Thanks and I will be back, just can't do a post by post right now

Rgds

Andrew

Stream of consciousness comments from someone w two herniated lumbar discs, and is a certified athletic trainer, CSCS,*D and exercise physiologist. Take it for what it is- free:), but feel free to pm if anything raises an interest/idea. The basic message is a) takes time, b) seek out experts who understand you are an n=1, not a "back pain rehab" protocol patient

1) most of us will have back pain at some point in our life...most of us have herniated discs (many w no side effects)...most of us will have the sx resolve....all that being said if you are on ST and in the middle of a ski trip then you are not "most of us". Your activity level/desire to move is the to the right of the bell curve. With this in mind think of yourself as an n=1, and look at all treatments/comments critically.

What to do:

Short term
1) relieve the pain and spasming.
1a) radiating pain is bad and one of the goals of PT/initial treatment is to centralize pain.
1b) it is hard to think clearly/rationally when there is a lot of pain, but the take home message it is can/will get better, and you can take specific steps to help this.

I think that most experts are trying to move away from heavy reliance on drugs- NSAIDS, muscle relaxants, etc. A good PT can help, but in most practices it is difficult for them to be able to spend enough time to really work one on one w you due to the need to see 20+ patients a day in many practices. They can almost certainly help, but the good ones also give you home exercise programs and remind you that the PT is a tool, but the exercises you do on your own are as important.

Short term if you can't get to PT think to past episodes and what exercises helped relieve sx. In my case it was extension exercises and working on hip ROM (but like you I am an n=1, so this may not work for everyone/I don't tell everyone to do it)

2) movement to begin to return to activity- under the supervision of a qualified professional who understands your limits and understands what your activity goals are and that you are an n=1.

3) find out what activity you can do to keep moving that doesn't exacerbate the sx. For me it was hilly walking. Running hurt, flat surfaces caused radiating pain and hilly walking was uncomfortable, but only in the back. W my knowledge base it made sense--it put me in extension and extension relieved my sx. This was invaluable for stress relief (and my dogs appreciated it too:)

For my n=1 (me) typical PT helped, but what put me over the edge was acupuncture. I was very skeptical, but by chance interviewed one for a podcast I do, gave it a try and am a convert. It is a tool, and it aided in pain relief/spasm relief which allowed me to do the PT. I also stopped drugs after 7 days and started using CBD cream and tinctures. I am fortunate enough to live near a compounding pharmacy, and I did a lot of research. I am not/was not a surgical candidate and in hindsight I wish I had also made the decision to see a physiatrist instead of an ortho. I've had the opportunity to interview for podcasts since August, and they are vastly underutilized in my opinion.

For the above w my insurance the ortho visit, MRI (significant radicular pain) and PT was covered. The CBD and acupuncture was/is out of pocket, but not outrageous in cost. After 8 weeks I would say I was 70% resolved and continuing to improve. Further improvement occurred as I increased activity, began to do more strenuous exercises specific to my problem.

Long Term
1) almost certainly you will have back pain again at some point. Almost certainly it will go away. It isn't something to worry about, but it is something to recognize and make sure you are taking steps to minimize it.

2) once you "finish" most PT you are now ready to begin strengthening. It is important to have someone to use as a teacher or a sounding board who knows what is going on. There may be additional "PT" or simple exercises that you need to still work on and/or you may have some exercises that are not good for you based on body.
For example for me- large pelvis, limited hip ROM congenitally in one hip means I am not well suited for some exercises- heavy squats for example.

Someone who is trained in the FMS has a tool that can be valuable, but it is a tool, and it is only as good as the ability to use the tool. Some PT's are excellent as are some personal trainers, ATC, chiropractors, etc.

Word of mouth is good and sometimes you luck into someone, or someone who knows someone. Again my podcast helped because I interviewed a DC, ATC who is brilliant and has helped w exercises (he was recommended by one of the physiatrists I interviewed).

3) begin to put together a toolbox of exercises that you do on a regular basis. I have an evernote note of work that has lists of exercises/tips for each that I make a regular part of my movement. I don't do them all everyday, but I do most of them on a fairly regular basis

4) consider regular consultations w the teacher/ sounding board for exercise technique feedback/movement feedback. I see the DC ATC every two weeks. I walk out every week feeling better and w more exercises or tips to add to the toolbox

5) it takes time- in my case my initial herniation was 15 years ago and until after the second one this past August I probably didn't maintain the level of back/hip fitness I needed if I wanted to be active. By all "normal measures" I was doing fine, but I'm an n=1 and what I want to do activity wise it was probably a matter of time.

Podcasts- in regards to what I mentioned above
FitLABPGH- http://www.fitlabpgh.blubrry.com
1) acupuncturist- episode 44-17 10-22-17
2) physiatrist- episode 50-17 12-10-17
3) DC ATC- episode 3-18 1-21-18

Moving2Live- http://www.moving2live.blubrry.com
physiatrist- I believe we talk a little bit about back injuries- probably in part 2. part 1- episode 9-18 2-28-18, part 2 episode 11-18, 3-14-18