Keep hurting my lower back and can’t train. Need tips n help.

Jan 16, 24 7:57

Post #1 of 23 (1609 views)

Would love any help or ideas on my back issues. It started a couple years ago. I couldn't stand up straight with lower back pain after just bending down and picking up a roll of paper towels. It lasted about a week. Didn't happen again for about 8 months. Im used to exercising long periods with no problems. Long trips on my bike etc. So after it happening more frequently I went and got an MRI and met with the back dr. They said it would happen more freuently and eventually I would need surgery to fix it. I was like WHAT???!!! Ive always taken care of myself. Been fit and exercised, lift weights but nothing too heavy to harm my back. 43 years old 6'4 and 195lbs. Went to physical therapy and have been doing the stretches everyday since but still my back keeps going out and I can't do things for a few weeks or longer. Sometimes I can hardly walk.
I don't want surgery anytime soon if possible. What else can I do? I stretch my hamstrings well, do cat and cow, dog birds etc and spend about 45 mins stretching but still getting hurt and happening more frequently. Here is a pic of one MRI pic showing discs and the interpretation. Any tips to keep this from happening would be helpful. PT said working my oblique abs would strengthen it and protect it but hasn't helped. I am not the type of person who is ok not being fully functional. Can't sit around. I need to run and bike. Thank you so much.

Main Impression and findings.
1. Disc protrusion at L5/S1 without nerve root compression.
2. Disc bulges L2-L4.

More detailed read but long.

However interval development of degenerative Modic type endplate changes seen at the inferior plate of L4 since MRI 2022. Broad-based disc bulge is seen at L2/L3 without nerve root compression. The effective AP canal diameter is 12 mm. Stable posterior disc annular tear. At L3/L4, broad-based disc bulge is seen without nerve root compression. The effective AP canal diameter is 13 mm. Stable posterior disc annular tear. At L4/L5, broad-based disc bulge is seen without nerve root compression. The effective AP canal diameter 17 mm. At L5/S1, broad-based disc protrusion is seen without nerve root compression. The effective AP canal diameters 16 mm.

Last edited by: SonnyCrockett: Jan 16, 24 7:58

Re: Keep hurting my lower back and can’t train. Need tips n help. [SonnyCrockett] [ In reply to ]

Jan 16, 24 8:31

Post #2 of 23 (1564 views)

Swimming would strengthen your lower back muscles and help support those disks. I fractured my L1 vertebra some years ago in a bike crash and recovered by doing lots of swimming. Flip turns hurt like hell in the beginning but gradually over 6 months the pain of flipping went away and no issues since then. It helped that I had been a swimmer for many years before this accident, and I'm guessing you don't swim much since you said that you "need to run and bike", but hey, it's never too late to start swimming. OTOH, you could be a burned out swimmer, in which case you know what you need to do. :)

"Anyone can be who they want to be IF they have the HUNGER and the DRIVE."

Re: Keep hurting my lower back and can’t train. Need tips n help. [SonnyCrockett] [ In reply to ]

Jan 16, 24 9:56

Post #3 of 23 (1496 views)

My wife has degenerative disks, essentially from skull to hips. She's had a couple of fusions in her cervical vertebrae, but has thus far avoided anything in the lumbar or thoracic region...though she effectively no longer has any appreciable disks in the lumbar joints.

You are probably right to avoid surgery for as long as possible, particularly any fusions, as long as you can find a way to manage it without. Its my understanding that fusions start a ticking clock which typically lead to more fusions as they result in your other remaining disks having to pick up the slack, and so it accelerates their deterioration. As long as the disks still "do something" something is better than nothing. However, THAT is a conversation you should have with your doctor about your spine. That's just the convo we have had about my wife with her dr.

I find the quality of the recommendations from your current PT to be suspect. Simply strengthening your obliques is unlikely to be sufficient. My wife has seen a PT for a few months a year to work on numerous exercises specific to her condition. It requires careful analysis of your weaknesses, and sensitivities to find what works to strengthen EVERYTHING up and down your spine without causing pinched nerves (which is usually the cause of an episode). Figuring that out is a lot of trial and error.

"Just do work on your obliques" is a very short hit, to me. I'd be looking for someone else.

Re: Keep hurting my lower back and can’t train. Need tips n help. [SonnyCrockett] [ In reply to ]

Jan 16, 24 10:59

Post #4 of 23 (1447 views)

Usual disclaimers regarding only knowing limited information about your history, not being a medical professional, etc.

However 2-3 Pilates classes a week for 2-3 months, preferably classical/romana style and then see how that's going. Avoid anything that is listed as 'dynamic' pilates. Generally you'll be working in a small group 4-5, and if you can make 1 class a week 1:1 and the other two group then you will get best value from time and $.

My comments are based on my personal experience (same issue as you, no surgery), that of my wife (who did have spinal surgery, but not fusion for same thing you have but with the nerve compression), and another close friend who again did have an operation but for slightly different issue.

Re: Keep hurting my lower back and can’t train. Need tips n help. [SonnyCrockett] [ In reply to ]

Jan 16, 24 11:09

Post #5 of 23 (1437 views)

No medical expertise here so disclaimer mode on! You x-ray is much better than mine :-)! I was getting in pretty bad shape a few years ago and then started doing a daily routine . . . I think someone here gave it to me. I alternate these video routines every other day:

https://www.youtube.com/...4BOTvaRaDjI&t=3s
https://www.youtube.com/watch?v=oVOnXIiPgM8

There are some instructional videos on how to properly do each on the positions. If you do the videos properly they are very hard. I started seeing/feeling results after about 6 weeks . . . I've been doing them consistently for over three years. These are not and complete cure, but I have done 4 IMs since I started this program with really no issues (other than getting slow). Wishing you the best.

David
* Ironman for Life! (Blog) * IM Everyday Hero Video * Daggett Shuler Law *
Disclaimer: I have personal and professional relationships with many athletes, vendors, and organizations in the triathlon world.

Last edited by: david: Jan 16, 24 11:11

Re: Keep hurting my lower back and can’t train. Need tips n help. [SonnyCrockett] [ In reply to ]

Jan 16, 24 11:57

Post #6 of 23 (1414 views)

Not a doctor, but did work for a company that makes spinal implants. Also someone in their 40's who deals with intermittent low back pain.

I would consider surgery only as a last resort.

Stretching hamstrings is ok, but I've found it sometimes makes things worse rather than better, at least in immediate term. Learning how to stretch my hip flexors and other front-of-body musculature was revelatory.

Doing squats with low weight a couple times a week helps.

Pilates helps too.

Re: Keep hurting my lower back and can’t train. Need tips n help. [david] [ In reply to ]

Jan 16, 24 13:02

Post #7 of 23 (1380 views)

david wrote:

No medical expertise here so disclaimer mode on! You x-ray is much better than mine :-)! I was getting in pretty bad shape a few years ago and then started doing a daily routine . . . I think someone here gave it to me. I alternate these video routines every other day:

https://www.youtube.com/...4BOTvaRaDjI&t=3s
https://www.youtube.com/watch?v=oVOnXIiPgM8

There are some instructional videos on how to properly do each on the positions. If you do the videos properly they are very hard. I started seeing/feeling results after about 6 weeks . . . I've been doing them consistently for over three years. These are not and complete cure, but I have done 4 IMs since I started this program with really no issues (other than getting slow). Wishing you the best.

Interesting, those exercises in the 12min videos are very very strongly correlated to the teaser, 100s, saw oblique roll back and mermaid of pilates. The key is the bit I bolded and where some instruction is really helpful. In my case some of the problems I've had is my body is compensating by using less ideal muscles to do movements, and so if allowed these get more overloaded. Proper tuition on the exercises is about focussign the right muscles to engage (and not engage) to then get them strong enough to work in a functional way as you run/cycle.

My poi not being critical of the video exercises, quite the opposite, I think I can see enough parallels to what I do to see that they are very effective. Just equally that I'd not start off doing them the way I know I need to based on the instructions in the video alone.

Re: Keep hurting my lower back and can’t train. Need tips n help. [david] [ In reply to ]

Jan 16, 24 15:49

Post #8 of 23 (1322 views)

david wrote:

No medical expertise here so disclaimer mode on! You x-ray is much better than mine :-)! I was getting in pretty bad shape a few years ago and then started doing a daily routine . . . I think someone here gave it to me. I alternate these video routines every other day:

https://www.youtube.com/...4BOTvaRaDjI&t=3s
https://www.youtube.com/watch?v=oVOnXIiPgM8

There are some instructional videos on how to properly do each on the positions. If you do the videos properly they are very hard. I started seeing/feeling results after about 6 weeks . . . I've been doing them consistently for over three years. These are not and complete cure, but I have done 4 IMs since I started this program with really no issues (other than getting slow). Wishing you the best.

i've posted these here a number of times. I had crippling disc pain and had basically given up on training. Foundation training saved my life (literally). I went from hardly being able to walk for almost a year to training again in very short order.

Re: Keep hurting my lower back and can’t train. Need tips n help. [SonnyCrockett] [ In reply to ]

Jan 16, 24 17:19

Post #9 of 23 (1296 views)

Back pain is highly individualized some people can have it and no MRI showcases anything, some could have none and their back is terrible on a MRI.

SCANS don't show pain.

There are a variety of exercise modalities that can help with symptoms and/or build capacity so the back can be stronger and or tolerate pain better.

IMO rather then just try and find a solution to back pain stop focusing solely on it and find an S&C coach and get stronger everywhere who knows it may be the solution.

Erin Carson would be a good option
Cait Alexander another

Andrew Garwood
http://www.2xu.com
http://www.newtonrunning.com
http://www.ascendsport.com.au

Re: Keep hurting my lower back and can’t train. Need tips n help. [garwood] [ In reply to ]

Jan 16, 24 18:18

Post #10 of 23 (1275 views)

garwood wrote:

Back pain is highly individualized some people can have it and no MRI showcases anything, some could have none and their back is terrible on a MRI.
SCANS don't show pain.
There are a variety of exercise modalities that can help with symptoms and/or build capacity so the back can be stronger and or tolerate pain better.
IMO rather then just try and find a solution to back pain stop focusing solely on it and find an S&C coach and get stronger everywhere who knows it may be the solution.
Erin Carson would be a good option
Cait Alexander another

Strength is one thing but for the lower back I would think that endurance plus strength is really required, since you are basically using your back at all times, including to some degree when sleeping. Swimming is the best way to build both strength and endurance at the same time. Further, if a person can learn to do flip turns, they are great for the back. Swimming is truly the best all-around exercise.

"Anyone can be who they want to be IF they have the HUNGER and the DRIVE."

Re: Keep hurting my lower back and can’t train. Need tips n help. [ericmulk] [ In reply to ]

Jan 16, 24 18:43

Post #11 of 23 (1268 views)

a guy i used to work for was just on the cusp of making what was then the world tour back in the 80s. took a belting from surfing and being a racquet sport player over the years and had back troubles. Said the only thing that kept his back good was swimming

Re: Keep hurting my lower back and can’t train. Need tips n help. [waverider101] [ In reply to ]

Jan 16, 24 18:51

Post #12 of 23 (1258 views)

waverider101 wrote:

a guy i used to work for was just on the cusp of making what was then the world tour back in the 80s. took a belting from surfing and being a racquet sport player over the years and had back troubles. Said the only thing that kept his back good was swimming

Cool, thanks for your support. Sometimes I feel like the only person on ST lauding the benefits of swimming. Apparently, most triathletes hate swimming and so never think of it in positive terms.

"Anyone can be who they want to be IF they have the HUNGER and the DRIVE."

Re: Keep hurting my lower back and can’t train. Need tips n help. [ericmulk] [ In reply to ]

Jan 16, 24 19:32

Post #13 of 23 (1238 views)

I’ve got friends who are just recreationally active and have disc troubles. Their PTs had them doing exercises to fire their glutes up and activate those muscles. Worked for them

I find this hilarious - probably get my account deleted if I write what a red neck would say about working your but more

Re: Keep hurting my lower back and can’t train. Need tips n help. [Geek_fit] [ In reply to ]

Jan 17, 24 5:09

Post #14 of 23 (1165 views)

Yes! I couldn't recall who it was that pointed me in the direction of Foundation Training. I assume it was a you and I owe you a big Thank you! Do you still do this every day? Any other tips, advice, or resources for me? Thank you again!

David
* Ironman for Life! (Blog) * IM Everyday Hero Video * Daggett Shuler Law *
Disclaimer: I have personal and professional relationships with many athletes, vendors, and organizations in the triathlon world.

Re: Keep hurting my lower back and can’t train. Need tips n help. [ericmulk] [ In reply to ]

Jan 17, 24 7:35

Post #15 of 23 (1127 views)

ericmulk wrote:

waverider101 wrote:

a guy i used to work for was just on the cusp of making what was then the world tour back in the 80s. took a belting from surfing and being a racquet sport player over the years and had back troubles. Said the only thing that kept his back good was swimming

Cool, thanks for your support. Sometimes I feel like the only person on ST lauding the benefits of swimming. Apparently, most triathletes hate swimming and so never think of it in positive terms.

Jack Lalanne said that as humans continue to live longer and longer swimming will be seen as the most essential form of exercise. It's the only sport you can do until you die. I'm sure I'll be an active swimmer the year I die. So basically what I am saying Eric is we've figured out the secret to life. That's a decent consolation prize for people not understanding why we do it.

Re: Keep hurting my lower back and can’t train. Need tips n help. [david] [ In reply to ]

Jan 17, 24 7:43

Post #16 of 23 (1120 views)

I do the full workout 2-3x a week. But I do the decompressive breathing every morning and a good founder stretch.

Only other thing I can really think of is to strengthen your hips so your back isn't compensating. I do "7 way hips" a few times a week as part of a general strength program. My coach turned me on to that and it seems to help quite a bit.

Re: Keep hurting my lower back and can’t train. Need tips n help. [ajthomas] [ In reply to ]

Jan 17, 24 14:47

Post #17 of 23 (1059 views)

ajthomas wrote:

ericmulk wrote:

waverider101 wrote:

a guy i used to work for was just on the cusp of making what was then the world tour back in the 80s. took a belting from surfing and being a racquet sport player over the years and had back troubles. Said the only thing that kept his back good was swimming

Cool, thanks for your support. Sometimes I feel like the only person on ST lauding the benefits of swimming. Apparently, most triathletes hate swimming and so never think of it in positive terms.

Jack Lalanne said that as humans continue to live longer and longer swimming will be seen as the most essential form of exercise. It's the only sport you can do until you die. I'm sure I'll be an active swimmer the year I die. So basically what I am saying Eric is we've figured out the secret to life. That's a decent consolation prize for people not understanding why we do it.

Ditto, I'm pretty sure I too will be an active swimmer the year I die and hopefully up until the day I pass on, maybe even during a Masters meet. That happened at the short course nationals a few years back; a 76 yr old guy passed out on the back to breast transition in the 400 IM, sank to the bottom and had to be dragged out. Died on way to hospital. Wife was vacating separately and was quoted as saying he died doing what he loved doing. Guy was good too, he was leading his AG when he passed out, and had won the 2 IM earlier in the meet, with a 3rd in the 100 IM. IMO, this is the way to go out. :)

I've posted this before and a lot of STers did not agree but hey, it's a free country, at least so far.

"Anyone can be who they want to be IF they have the HUNGER and the DRIVE."

Re: Keep hurting my lower back and can’t train. Need tips n help. [ericmulk] [ In reply to ]

Jan 17, 24 15:12

Post #18 of 23 (1053 views)

far out - got goose bumps reading that. that guy was going full maximum as the back to breast turn during a 4IM race is a very very challenging part of the event as any swimmer knows.

Re: Keep hurting my lower back and can’t train. Need tips n help. [waverider101] [ In reply to ]

Jan 17, 24 15:19

Post #19 of 23 (1047 views)

waverider101 wrote:

far out - got goose bumps reading that. that guy was going full maximum as the back to breast turn during a 4IM race is a very very challenging part of the event as any swimmer knows.

You nailed it, the back to breast is challenging even in a 2 or 1 IM, since you're already breathing hard from the fly and back legs, and then you have hold your breath to get your max underwater distance on the breast pullout. IMs of any distance are hard. :)

"Anyone can be who they want to be IF they have the HUNGER and the DRIVE."

Re: Keep hurting my lower back and can’t train. Need tips n help. [SonnyCrockett] [ In reply to ]

Jan 17, 24 16:14

Post #20 of 23 (1029 views)

Have you checked to see if you have a pelvic tilt? 48yo, 6’1 195-205 depending on time of year.
Saw my unit trainer when I was in the Army years ago from chronic back pain.
MRI said similar things, with narrowing etc. Figured it was wear and tear from jumping, body armor, mission kit, and stuff like that.
She noticed I had an imbalanced pelvis causing a slight right shoulder drop, curve in back, left knee rotating inwards and slight left arch drop.
She gave me some band work to do and some SI joint exercises.
Now, 17yrs later mostly pain free, MRI hasn’t gotten any worse, spine is straight, some light degenerative discs but all much more manageable.
Something to check out. It even helped my Achilles tendonitis.

Re: Keep hurting my lower back and can’t train. Need tips n help. [SonnyCrockett] [ In reply to ]

Jan 19, 24 5:29

Post #21 of 23 (940 views)

More information needed. Generally don't treat an image, but symptoms that can be correlated to positioning. You are stretching, what else are you doing? What did the MD say? What is your PT saying is the issue. Are you working on strengthening, posture, hip muscles? What is the training of your PT? Spine specialist?

Re: Keep hurting my lower back and can’t train. Need tips n help. [SonnyCrockett] [ In reply to ]

Jan 19, 24 6:05

Post #22 of 23 (927 views)

A few generalities I've noticed as I've aged into my 50s and dealt with neck, back, hip, knee, and foot problems.
1. Don't underestimate the benefits of walking. I used to think walking was for old and unathletic people. It's not a cure-all, but it is a big help for me. Esp on trails or gravel roads where the terrain is more variable. All those little microbalance adjustments add up. Walking is now the basis of my exercise plan.

2. Running and cycling are quite 2-dimensional. You don't have to drop them, but incorporate more 3-D activities that exercise and stretch the whole body in all ranges of motion.

3. Let go of aspirations of racing and comparing with your past prime and others' performances. Focus on staying active with well rounded activities that work for your own well-being. If your progress gets you back into racing shape, fine, but don't make that your priority.

4. If you have a desk job, be aware of your posture and how long you sit at your desk. Proactively schedule breaks to move around.

5. My problems appeared to be caused by both lack of strength (or maybe asymmetric strength) and inflexibility. I was in great shape for running and cycling, but other muscle groups were being ignored. PT is good, but I think there is no substitute for having a well-rounded set of activities that improve both strength and flexibility.

Re: Keep hurting my lower back and can’t train. Need tips n help. [SonnyCrockett] [ In reply to ]

Jan 19, 24 9:32

Post #23 of 23 (890 views)

One of the more common mistakes folks make when rehabbing is "stretching" too much and not dosing the strength part well... Obviously I don't know all the details of your case, but you may be falling in that category.

CB
Physical Therapist/Endurance Coach
http://www.cadencept.net

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