L5-S1 issues from paddling

Chee-to

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Jan 11, 2002
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Why the hell would you kick anybody when you could just unleash the Knee of Death?
 

Chee-to

Michael Peterson status
Jan 11, 2002
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The stretching. Aside from zero medical evidence that shows static stretching as useful for warm up or injury prevention, it is actually increasing your chance of injury by doing it between sets.
The additional stretching after squat work sets was a goblet squat with relaxed pelvic floor.
 
Jul 27, 2014
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Hope you don't mind me hijacking this thread! I've been dealing with L4/L5 and L5/S1 issues for almost exactly a year now. I was in my car twisting to grab something from the back and it seemed to have been the straw that broke the camels back. Since then, I've been dealing with back pain and sciatic pain down to my right foot. I thought this would be something that would go away on it's own, but after 6 months I got an MRI. Results are 5mm disc herniation to the right at L4/L5 and 3mm to the left at L5/S1.

I'm in this thread because unfortunately paddling and sitting on my board really cause problems for me now. I've tried keep my back less arched (looking like a kook) and also I only sit off the side of my board in the water now but still, if I surf I pay for it for an average of 2 days later. I also cannot surf backside, as when I come off the top, the rotation of my body really bothers me.

On top of this, sitting for longer than 5 minutes is hard, and working (I work standing up and my work requires bending and twisting) bothers me.

At what point is an epidural or surgery to be considered? My doctor recommended epidural treatments after the MRI results initially but I rejected it. I've been doing PT since March twice a week. I sometimes have progress and sometimes get worse. Is this an issue that can resolve itself? Anyone else in the same boat?
 

VonMeister

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Generally disc herniations resolve themselves. There are more adults than not with disc herniations. By a large margin most are non symptomatic.

Your brain is creating a stress response to a benign neural input, which equals pain.

I'm betting the nonsense your PT has had you doing hasn't made any permanent changes and mostly is just movement that makes your back feel better for a period of time, then it's back to aching again. Even worse they may have given you a list of one or more syndromes you are suffering from to really underline that you are permanently broken. Things that include mobility, range of motion, psoas, and piriformis. Movement of your back does help and will make it feel better....for this to be permanent you need to make permanent changes.

Strength training, (I prefer the squat and the deadlift for efficiency and efficacy) does a few things. It strengthens the lower back in order to protect it from future injury. Muscle tissue and strength are your bodies primary defense against injury....like 99.999% of it. It forces you to move in a way that accesses 100% of the range of motion you require as a human under load. It also teaches you over time that you aren't broken and that picking up or moving heavy things not only is safe, injury shouldn't even be an afterthought.
 
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Bob Dobbalina

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Feb 23, 2016
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Hope you don't mind me hijacking this thread! I've been dealing with L4/L5 and L5/S1 issues for almost exactly a year now. I was in my car twisting to grab something from the back and it seemed to have been the straw that broke the camels back. Since then, I've been dealing with back pain and sciatic pain down to my right foot. I thought this would be something that would go away on it's own, but after 6 months I got an MRI. Results are 5mm disc herniation to the right at L4/L5 and 3mm to the left at L5/S1.

I'm in this thread because unfortunately paddling and sitting on my board really cause problems for me now. I've tried keep my back less arched (looking like a kook) and also I only sit off the side of my board in the water now but still, if I surf I pay for it for an average of 2 days later. I also cannot surf backside, as when I come off the top, the rotation of my body really bothers me.

On top of this, sitting for longer than 5 minutes is hard, and working (I work standing up and my work requires bending and twisting) bothers me.

At what point is an epidural or surgery to be considered? My doctor recommended epidural treatments after the MRI results initially but I rejected it. I've been doing PT since March twice a week. I sometimes have progress and sometimes get worse. Is this an issue that can resolve itself? Anyone else in the same boat?

Been in the boat. Working my way out of it.

My bulge was in the double digits and higher up before I started cortisone injections (helped a little, not nearly enough, but I'm considering it as an option if I still have the discomfort I'm holding on to by December), then had surgery in April. It changed my life.

I had a bulge in your zone several years ago (and still do to some extent). I did not pursue surgery or injections then. I did chiro and trigger point massage to manage symptoms. It didn't "fix" anything, but it brought temporary relief just like the ice and heat did. I would use a lacrosse ball, a roller, a golf ball, a dog toy, or anything I could find that would shift some of the referred pain to my hips, glutes, and back. I slept on the floor. It took months for the pain to die down and I pretty much stopped all activity (especially surfing) other than walking. Sitting was terrible. I graded papers on my hands and knees. It took several months to start to recover. After that, I started training with a Sports Therapy guy. He gave me some strengthening exercises, some flexibility movements, and some massage work that helped move things along. THEN I hit the gym.

Give yourself time.
Rest.
Do what is comfortable and provides some symptomatic relief.
Nothing you do is going to back the bulge off other than providing some time for it to heal.
When you get to the end of your limits of pain tolerance, discuss options with a dr. again.
 
Jul 27, 2014
38
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8
Thanks for the responses guys.

I actually went through a few Physical Therapists before I found the one that I've been working with since March. He's actually a PT for some sports teams and works with the WSL also. He's been great as he knows what movements I need to do while surfing, so a lot of his workouts have been specific to the range of motion I need. He's also been having me do ELDOA's daily for traction, which do bring some relief.

I'm torn with the strength training. In February, my back only bothered me while working and I had very slight sciatic pain. The first PT I went to had me do BB squats and leg presses which definitely made my situation worse. The PT I'm going to now wants me to stay away from exercises that compress the spine at the moment.

Prior to my injury, I was on a standard gym routine (3 day split) for probably the last 21 years. I was a wrestler in HS and just kind of stuck with a similar weight training program. I've always done squats and deadlifts. This has been the longest that I haven't weight trained. Mainly because all gyms have been closed here in LA, and the PT has me doing more dynamic movements and less olympic style lifting.

I'm glad to hear that most disc herniations resolve themselves. My current PT actually said the same thing and definitely recommended against any kind of surgery. I guess I'm just a little frustrated after hitting the year mark that things haven't gotten 100% But I guess that's a part of getting old right?

My question is, if I do things that bring symptoms of pain on (like surfing). Is it making the situation worse? Or am I getting my body more accustomed to these situations?
 

VonMeister

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Thanks for the responses guys.

I actually went through a few Physical Therapists before I found the one that I've been working with since March. He's actually a PT for some sports teams and works with the WSL also. He's been great as he knows what movements I need to do while surfing, so a lot of his workouts have been specific to the range of motion I need. He's also been having me do ELDOA's daily for traction, which do bring some relief.

I'm torn with the strength training. In February, my back only bothered me while working and I had very slight sciatic pain. The first PT I went to had me do BB squats and leg presses which definitely made my situation worse. The PT I'm going to now wants me to stay away from exercises that compress the spine at the moment.

Prior to my injury, I was on a standard gym routine (3 day split) for probably the last 21 years. I was a wrestler in HS and just kind of stuck with a similar weight training program. I've always done squats and deadlifts. This has been the longest that I haven't weight trained. Mainly because all gyms have been closed here in LA, and the PT has me doing more dynamic movements and less olympic style lifting.

I'm glad to hear that most disc herniations resolve themselves. My current PT actually said the same thing and definitely recommended against any kind of surgery. I guess I'm just a little frustrated after hitting the year mark that things haven't gotten 100% But I guess that's a part of getting old right?

My question is, if I do things that bring symptoms of pain on (like surfing). Is it making the situation worse? Or am I getting my body more accustomed to these situations?
It depends. A small degree of discomfort is much different than pain. If surfing feels OK continue, but take it easy. If it is excruciating you should find some other activity that challenges the area without causing to much pain or making things worse. Find an activity that makes it feel better afterwards and do that...then add external resistance to that exercise in small increments. At some point the external resistance performed pain free is going to increase past what your normal activity and mean old mr gravity require.

Much of the pain you feel is your brain reading a neural input and providing a threat response. You've had an MRI so we know there is nothing abnormal going on with your back. Much of your recovery is going to be learning and believing that you aren't broken and aging naturally comes with some discomfort. Activities like surfing aren't going to make it worse so just do what you can do but more importantly understand that your back is 100% normal and there a over a billion people on earth like you but feel nothing.

Squats don't compress the spine....unless you're just a skeleton. At my Houston shop we started working with a PGA golfer in April who has been fighting back pain with immersion tables, stretches, yoga etc for years. We put him on a simple strength training program and got him out of the constant nagging pain in days and now he's pain free and climbing the money board.

I didn't watch your workouts so I can't comment on your form or how the previous exercises were performed....but some of the worst examples of the squat are performed in high school and college gyms and posted on instagram.

I would be reluctant to follow any advice on mobility therapy. Absent a severe neurological issue that prevents a muscle from contracting...or perhaps a broken bone getting in the way...your body has the mobility it needs. Taking an irritated or injured joint and manually pulling it into a subjective position of "enough" isn't safe or effective.
 
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Chocki

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It depends. A small degree of discomfort is much different than pain. If surfing feels OK continue, but take it easy. If it is excruciating you should find some other activity that challenges the area without causing to much pain or making things worse. Find an activity that makes it feel better afterwards and do that...then add external resistance to that exercise in small increments. At some point the external resistance performed pain free is going to increase past what your normal activity and mean old mr gravity require.

Much of the pain you feel is your brain reading a neural input and providing a threat response. You've had an MRI so we know there is nothing abnormal going on with your back. Much of your recovery is going to be learning and believing that you aren't broken and aging naturally comes with some discomfort. Activities like surfing aren't going to make it worse so just do what you can do but more importantly understand that your back is 100% normal and there a over a billion people on earth like you but feel nothing.

Squats don't compress the spine....unless you're just a skeleton. At my Houston shop we started working with a PGA golfer in April who has been fighting back pain with immersion tables, stretches, yoga etc for years. We put him on a simple strength training program and got him out of the constant nagging pain in days and now he's pain free and climbing the money board.

I didn't watch your workouts so I can't comment on your form or how the previous exercises were performed....but some of the worst examples of the squat are performed in high school and college gyms and posted on instagram.

I would be reluctant to follow any advice on mobility therapy. Absent a severe neurological issue that prevents a muscle from contracting...or perhaps a broken bone getting in the way...your body has the mobility it needs. Taking an irritated or injured joint and manually pulling it into a subjective position of "enough" isn't safe or effective.
World renowned strength-coach, Michael Boyle, who I thoroughly follow and study, refers to a barbell on your neck as a “torque-generator” that adds direct compression to your spine. Adding heavy load to the barbell, only increases the compression placed on the spine, not to mention the amount of shear and torque forces placed on the discs, the vertebrae, and the entire spinal column.”

Over time, if you continually barbell squat and compress, as well as torque on your spine, the greater the increase placed on the lower-back joints, which increases the chance of an overuse injury in the small structures of the lower back such as the discs. This doesn’t become a matter of if, but when.

When you start getting to heavy loading, the injury area is always the low-back. Your number one job as an athlete, as a strength-coach, as a trainer, etc., is to stay healthy. If we know the lower-back is the common area of injury with the squat, why wouldn’t we do all we can to protect that area? The spine is a very unforgiving body part. It has specific functions, and duties. We must learn to AT LEAST decrease the load, shear, compression, and torque placed on the spine to protect it.

Finally, I am NOT saying for everyone to completely stop barbell squatting. As you heard from my conversation with the man, I was hitting barbell front squats. I’m simply writing this to educate the reader on the topic, and suggest to barbell squat LESS. For me, I currently barbell squat every other week, if that often. In other words, if you don’t have a direct reason to barbell squat, take this information into consideration when designing your training schedule. Become “spine conscious” in your training and protect the health of your spine.





Personally I’m a big fan of Zercher squats and carries.

 
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VonMeister

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World renowned strength-coach, Michael Boyle, who I thoroughly follow and study, refers to a barbell on your neck as a “torque-generator” that adds direct compression to your spine. Adding heavy load to the barbell, only increases the compression placed on the spine, not to mention the amount of shear and torque forces placed on the discs, the vertebrae, and the entire spinal column.”

Over time, if you continually barbell squat and compress, as well as torque on your spine, the greater the increase placed on the lower-back joints, which increases the chance of an overuse injury in the small structures of the lower back such as the discs. This doesn’t become a matter of if, but when.

When you start getting to heavy loading, the injury area is always the low-back. Your number one job as an athlete, as a strength-coach, as a trainer, etc., is to stay healthy. If we know the lower-back is the common area of injury with the squat, why wouldn’t we do all we can to protect that area? The spine is a very unforgiving body part. It has specific functions, and duties. We must learn to AT LEAST decrease the load, shear, compression, and torque placed on the spine to protect it.

Finally, I am NOT saying for everyone to completely stop barbell squatting. As you heard from my conversation with the man, I was hitting barbell front squats. I’m simply writing this to educate the reader on the topic, and suggest to barbell squat LESS. For me, I currently barbell squat every other week, if that often. In other words, if you don’t have a direct reason to barbell squat, take this information into consideration when designing your training schedule. Become “spine conscious” in your training and protect the health of your spine.





Personally I’m a big fan of Zercher squats and carries.

Do you have a degree in YouTube?
 
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One-Off

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Thanks for the responses guys.

I actually went through a few Physical Therapists before I found the one that I've been working with since March. He's actually a PT for some sports teams and works with the WSL also. He's been great as he knows what movements I need to do while surfing, so a lot of his workouts have been specific to the range of motion I need. He's also been having me do ELDOA's daily for traction, which do bring some relief.

I'm torn with the strength training. In February, my back only bothered me while working and I had very slight sciatic pain. The first PT I went to had me do BB squats and leg presses which definitely made my situation worse. The PT I'm going to now wants me to stay away from exercises that compress the spine at the moment.

Prior to my injury, I was on a standard gym routine (3 day split) for probably the last 21 years. I was a wrestler in HS and just kind of stuck with a similar weight training program. I've always done squats and deadlifts. This has been the longest that I haven't weight trained. Mainly because all gyms have been closed here in LA, and the PT has me doing more dynamic movements and less olympic style lifting.

I'm glad to hear that most disc herniations resolve themselves. My current PT actually said the same thing and definitely recommended against any kind of surgery. I guess I'm just a little frustrated after hitting the year mark that things haven't gotten 100% But I guess that's a part of getting old right?

My question is, if I do things that bring symptoms of pain on (like surfing). Is it making the situation worse? Or am I getting my body more accustomed to these situations?
My 2 cents, having just gone through lower back "injury" and 6 months of rehab- listen to your PT. If it's making you feel better, great. If not, let him know. Add strength training INCREMENTALLY. During my PT I kept jumping the gun and doing too much and having what my PT called "setbacks." I'm finally back surfing almost 100%...just wish the surf would cooperate....
 

Chocki

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Saw barbell medicine post that earlier and meant to post it here too. I also forgot to see if I can view the full text at my work but I’m off until Tuesday so that‘ll have to wait.
Me after trying to read that article and any article on Barbell RX.
I know these words yet together they make no sense?
I thought we spoke English in this country?


VS

https://maxshank.com/mobility/avoid-this-mistake-when-dealing-with-an-injury/



This is Rob. Rob was 62 years old when he walked into my gym (referred from a member who had fixed their back pain). Rob hadn’t run for 15 years—he had chronic pain in most of his major joints, and his activity level was playing golf once per week. Fast forward to 6 months of diligent work at Ambition Athletics, and Rob and I were playing racquetball together once a week. He had actually regained the ability to run—even though it had been lost for over a decade. Rob is 67 now and we still play once a week to this very day, and he is one of my closest friends.
5 Minute Flow, Max Shank
 
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One-Off

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Related question. I've been doing a barbell day once a week, a planking day once a week (both these days end with 25 pull up and 70 pushups), a short run day and a long run day (plus surfing when there's surf, which has been very meager in my area). I have not increased the barbell weight in a couple months (nothing reasonably priced available in stores or online). So I upped the reps. Even at the same weight I'm having 2-3 days of DOMS afterwards (glutes and hamstrings). Is that normal? I thought my body should be adapted to the weight and I'm just doing maintenance.
 
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Chocki

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So I upped the reps.



 

Chocki

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Related question. I've been doing a barbell day once a week, a planking day once a week (both these days end with 25 pull up and 70 pushups), a short run day and a long run day (plus surfing when there's surf, which has been very meager in my area). I have not increased the barbell weight in a couple months (nothing reasonably priced available in stores or online). So I upped the reps. Even at the same weight I'm having 2-3 days of DOMS afterwards (glutes and hamstrings). Is that normal? I thought my body should be adapted to the weight and I'm just doing maintenance.