How I Screwed Up My Back…..and What I Did About it


As anyone who reads this blog or knows me can attest, my back has been a mess in the past. But I guess that’s what happens when you dislocated your SI joint playing football, herniate three discs, and tear almost 2/3 of the quadratus lumborum muscle (Re: the big nasty that holds the place together) 10 years ago. It pretty much ruined any chance I had of going pro. But I’m not bitter.

Now I’d love to say this was a made-for-tv movie where Kurt Cameron played my life story of overcoming adversity to battle back from a devastating injury to return to glory, but let’s face facts: I still have pain on pretty much a daily basis, and will probably develop arthritis at an early age as a result of it. I’ve tried getting back into playing competitive sports, but every time I get into a game, there goes righty, giving way and making me spend the next few weeks trying to walk without looking like I’m 60 and in need of a walker.

Now hope is not all lost, people. I can still do a bunch of cool stuff and move well in certain directions. The ones I have the most trouble with is any type of explosive rotation work or change of direction movements, which basically make up the majority of any of the fun sports out there. It’s come to the point where I know what I have to do to make a flare-up get better, and also how to prevent them (Re: not be stupid), but every now and then I have to start at square one and build it back up after doing something I shouldn’t have done, or after sitting for too long without a rest break, etc, etc. So I’m going to go through some of the things I do to help my back get back in shape, as it took me a number of years to figure out what worked best for me, I thought it might help fast-track someone who is in the same boat.

Now before we start looking at the exercises and progressions I used, I have to say that the vast majority of back injuries are going to resolve themselves, and in the case of disc herniations, as long as there’s no extruded fragments in the central canal, the timeline is about 6 months. Ask anyone who has had this type of injury and see if the thought of spending the next 6 months in pain and limited mobility sounds appealing and they’ll most likely answer you with a swift kick to your left scrotum.

So there has to be something to do to speed up the process. After reading countless books on the topic, I came up with a sequence that seems to do the job pretty well for me, as well as for the few clients with acute and sub-acute disc herniations I’ve worked with.

Step One: McKenzie and Positioning

Depending on the spine, most disc herniations are posterior-lateral in nature, meaning the nucleus moves through the annulus rings towards the back and one side of the spinal cord. This will cause the disc that normally angulates to the front to now angulate to the back, changing the persons’ posture into more of a hunch or slouched over posture, complete with posterior pelvic tilt. One of the best ways to counteract this is with passive positioning into extension and allowing the muscular spasms to reduce guarding of the vertebrae and discs, and allow the nucleus a chance to recede back into the disc, therefore reducing pressure on the spine and lateral nerve roots.

By spending about 5 minutes at a shot in this position, it allowed the muscles to relax and the disc to move anteriorly as much as possible. From there, performing a kneeling cat-camel stretch to try to reposition the spine and pelvic was the only thing that would allow me to stand and walk during a work day until the pain reduced enough to start doing some form of active mobility and re-training of the abdominal muscles.

Step 2: Don’t Stretch the Tight Muscles

The first thing that tended to cramp up on me was my hamstrings and glutes. the Last thing I wanted to stretch out was my hamstrings and glutes. As I’ve discussed in a previous post, stretching these during back pain will essentially reduce the stabilizing effect of these muscles for the spine, and increase the risk of having the vertebrae buckle and become further injured.I had to try to get some level of stability into the spine and supporting muscles to take the pressure off the hamstrings and glutes to help them settle down, so I started working on core stability.

To regain some of the mobility of the hips and upper spine while protecting the low back, I started going through some mobility drills.

Step 3: Get Back Gradually

After a week or so of doing this daily, my back will normally feel good enough to start moving and lifting light weights, and eventually progress into heavier weights. I use a simple system of deciding whether I can move on to light weights or heavy weights. For light weights, If I can move through the full available range of motion, with or without pain, I start doing light weights. When I can move through the full available range of motion pain-free, and can do light weights with no loss of function the following day, I can start doing heavier weights.

My last major flare-up came last March, when I went to the NSCA conference in Las Vegas, and took a seminar with Todd Durkin, believed I was Superman, and went full speed into foot work drills. Of course, I tore up the carpet in that place, and I can assure you Todd never saw a 240 pound Canadian do a carioca like that. I was like freakin Fred Astaire wearing Under Armour in the absolute sexiest way possible!!!

But then I felt the disc slip, and was on the shelf after 10 minutes.

Epic fail for me.

It took 2 months and a half-dozen chiropractor appointments and massage therapy sessions to get me to sit up and roll out of bed in the morning without shooting pain. I’ve never been one to complain about soreness or pain, and I think it drives Lindsay nuts some times, but there were definitely days that were close to unbearable.

That was in March. This was in November:

and this was December:

I decided to take some time off from heavy heavies for a few months to make sure I don’t over-stress the area, and will attack it again in March. My goal is over 400 pull from the floor, which in my mind will be a major victory over my injury in less than a year from the last big tweak.

Hopefully this helps one or two of you out there. This is one of the reasons I love working with injury rehabilitation clients, because I have an understanding of what they’re going through, how frustrating it is, and how amazing it can feel to get over an injury and start to “feel normal” or as normal as possible again. Let me know if you’ve overcome any serious injuries in the comments sections, and you might help to inspire someone else who is struggling with a similar injury and give them the motivation to keep on fighting.

About deansomerset

Certified Strength & Conditioning Specialist, Post-Rehab Specialist, personal trainer and probably the coolest guy my mom knows, I try to impart a little knowledge with a sense of humor to keep people reading. I've always thought if it's something that can grab your attention, you're gonna remember it tomorrow!!
This entry was posted in Uncategorized and tagged , . Bookmark the permalink.

21 Responses to How I Screwed Up My Back…..and What I Did About it

  1. Iceman says:

    Great post, the videos are very informative. I got a herniated disc in my back about 5 months ago and have been doing some of those stabilizing exercises, will start to incorporate the mobility ones now too, had somewhat forgotten about them in the process.

    Good point about stretching, or not stretching, the hamstrings. I always stretch them after a walk, I will have to quit doing that then. Read the same thing in an article by Mike Robertson last night too, so I’m guessing it’s the correct way to go.

    But the psychological factor is also a biggie, I’m terribly afraid of injuring my back again, so I’m only doing very light weights still. I had gotten my deadlift to 400lb, but I’m afraid to just touch a barbell now, but I will get over that eventually.

  2. Michael Wu says:

    Hey Dean, love the blog and even more the fact that you’re a fellow Canuck! Although since I’m from Quebec, I’m arguably not a Canadian according to some of my friends, but we’ll leave that for another discussion 😉

    I’d like to ask if this protocol could help in the case of sciatica caused by a hernia. I have a client of mine who has this issue, and though he’s being helped by a physio (who does seem to know what she’s doing), I want to have a better idea what I can do as his trainer.

    Thanks!

    Michael Wu

    • deansomerset says:

      Salut Michael!! Yes, we’ll consider Quebec part of Canada at least until the next referendum 😉
      This can be beneficial for sciatica, but follow the directive of the physio on whether you should use it with your specific client. Each person is different, and this is what worked well for me and a few of my clients where it was indicated. Without seeing your client and testing their movements, it’s hard to tell if this will be the best thing, but it’s worth a shot.

  3. Dean,

    I saw you mention that as long as you can get adequate ROM, you would use light weights regardless if pain was present or not. Do you recommend anyone using that same self-accessment system? I generally do the same, but pain has always been said to be an indicator or “not doing anything” with the “anything” usually being way too overrated?

    Also, have you heard of someone having lower back pain/hip pain only on the left side with accompanying pain/discomfort in the same left side’s knee and shoulder? Being that you are so awesome, I figured you may have some info!!!

    • deansomerset says:

      With a disc herniation, even breathing will be painful, so using pain as an all-or-nothing guide is sometimes useless. There will be pain with the movements, but the big difference will be whether it is a pain from stretching too far into a dangerous range versus the pain of simply moving. An example of light weights would be rack pulls instead of full range deadlifts, using just the weight of the bar and trying to re-establish hip mechanics here before progressing to full range, again with just the bar. Other examples would be body weight squats, slow lunges, pulldowns (not rowing, as the spine may not like having to stabilize against transverse forces), and supported pressing.

      I have herad of ipsilateral referring pain patterns from the low back, and it’s most common in people with sciatic compression (usually L4-S1 bulging) as well as thoracic compensation patterns left untouched. When the back goes, it takes everything with it.

      • Thanks! I get the pain reference. With the ipsilateral referring pain, how can one go about addressing the sciatic compression? ART was already done, but some movement re-education seems to be the only thing that will help!

      • deansomerset says:

        Hip mobility, spinal stability, and deep core activation patterns to relieve the pressure on the nerve, then work on re-training basic movement patterns to not stretch the hamstrings and piriformis while performing an anterior tilt.

  4. Jim says:

    As you know I have had experience in this too. And I remember you telling me when I first trained with you these exercises and they are the bees knees of back care. One thing I have found though, and apparently a lot of sub-continental Indian and Asian fighters use it, is the good old cat stretch.. if you watch a cat, stretch like it. That has helped pretty much anytime I have needed a good disc seperator stretch.

    Also, in response to Drive, I generally will workout when sore, but pay VERY KEEN attention to my body. Anyone who has had some severe medical condition or another will generally have a more attuned sense of their body. They know that they can work through pain, because if you don’t you end up on the couch longer. I don’t know if Dean will support this, but I found that if the pain stays the same or a few percent more, after you have worked out, then you have not done anything to jeopardize the area. And believe me, with scoliosis, you don’t want to be jeopardizing anything.

    Again Dean, thanks for an awesome article.

  5. steve grier says:

    Good morning, I am that person you do not want to be, I made it to 68 before my spinal problems started. I have always been an athlete, weights, surfing, skiing, running, etc, etc. I was diagnosed many years ago with a degenerative disk problem in my lower back that pretty much stopped my competitive running, at the time I was told surgery was not necessary, was taught how to lift properly, stenching and all the above. I was ok until four years ago when I started having trouble walking, much neck and back pain, Then it all started, many doctors, tests, bottom line, surgery to the upper spine with instrumentation, one year later surgery to the lower back with rods, screws and a cage around the spine. I am still having trouble walking, my strength level has been reduced considerably, my activity is almost nil. I still manage to get to the gym two to three days per week, I do some yoga every day and about 15 to 20 minuets a day on the treadmill, other than that the golden years have been tarnished. So my young and strong friend, watch your back. Steve Grier

    • deansomerset says:

      Steve, wow, sorry to hear that. Hopefully since you built up such a high level of fitness prior to all the surgeries, you’ll be able to bounce back relatively well and be able to start doing more without pain. I’ve worked with a number of DDD and spinal surgery clients, and it is a long haul, but in the end, the procedures you’ve had sound routine for your conditions, and the outcomes are usually very good within a year or two without complications.

      Hope all goes well.

  6. Andrew Kirby says:

    I have Sciatica and I will definitly be using the excersise’s in the stability and mobility vids

  7. Tristan Sharp says:

    This post was a great inspiration as I am now dealing with a flare up. Do you believe there is any good in static stretching or should one just focus on joint range of movement and mobility drill. How would you shut down tight hip flexors causing anterior pelvic tilt with out stretching them?

    • deansomerset says:

      Hi Tristan. Read the article linked to in the post for whether to stretch or not stretch a tight muscle. Static stretching has a role, but it has to be used in the right situation of stiffness, not when the muscle is tight because it’s trying to provide stability for an unstable region (like the spine). Stretching tight hip flexors may be counterintuitive since they are trying to hold the lumbar spine together since the core muscles aren’t able to do their thing. Once stability is able to be provided by the core muscles, the hip flexors will release on their own without needing stretching.
      I think I just blew your mind there. Sorry about that 🙂

      • Tristan Sharp says:

        When my glutes and hips began to tighten after some interval training on the arc trainer this morning I performed a sequence of core stability exercises later in the day and it noticeably lessened. It looks like I will be focusing on mobility drills and stability exercise from now on. On a side note how would you address hip flexors that are fibrotic due to scar tissue and adhesion’s? Would manual therapy and static stretching then have a role to play? I am asking this because this is a problem that both me and my brother both have. Our right hip flexors will never release and act normal like our left ones.

      • deansomerset says:

        Without knowing all the facts, I’ll tentatively say that yes, manual therapy will help out, but static stretching won’t provide much benefit if there are adhesions present. Once they’re broken down, static stretching will be good, but until then I prefer to use more active flexibility and mobility drills.
        My first question is why is the right one scarred and the left one not? Is there a leg length discrepancy (right leg longer than the left)? If so, you can stretch all you want and it won’t do a thing for it, until you balance the leg length out. Barring this, try to find someone in your area who is bang on with posture assessment and can tell you if it is from a compensation in another part of the body.

  8. Kelsey says:

    Hello Dean!

    Thank for such an informative (and entertaining) blog! I really enjoy reading your stuff. I have disc bulges/herniations all through my lumbar spine (with dehydration collapsing one of them) as well as torn labrums in both hips. I still back squat (to a box to control depth) though front squat leaves me in tears (havn’t figured that one out yet). I deadlift with a trap bar. My QL was WAY overactive and I have to agressively roll it prior to each work out to keep it in line. Any thoughts about stretching/not stretching it or at least balancing out it’s hyperactivity with the muscles that are supposed to be working? When it’s tight that’s when I have pretty intense local pain deep in my spine. I’m assuming it’s pulling and squishing something that doesn’t like to be squished.

    Thank you again for a great blog!

    • deansomerset says:

      Hi Kelsey. Tough call on this one. What is your posture like? Are you slightly slouched, or can you maintain a fully upright posture? As discs degenerate and collapse the natural tendency is to push the body into spinal flexion, which will make the QL fire up even more to hold you in place. Barring that, it is more than likely a compensatory action to hold your spine in place since the joints are compromised. A front squat puts weight in the front of the body, relying on the QL to keep you from falling forward even more, which would explain the pain with this movement.

      If the discs are collapsing, tryo working on spinal stability before trying stretching, as the tight muscles are tight to hold the spine together. If you’re performing a lot of bilateral exercises, there is no reason to have only one side of your back sore versus the other unless your technique is way off and your twisting and leaning. If only one side is tight compared to the other, it’s acting as a stabilizer. Stretching it will only destabilize further, but if you need to roll it to relieve pain, by all means do. Just try to do some stability work as much as possible instead of stretching, and you should see an improvement.

      • Kelsey says:

        Thank you for the advice! My posture isn’t great. Even when I stand up straight, which I try to remember to do, my low back is in prominent lordosis. (former gymnast). I can’t even flatten my lower back into neutral if I tried. Cat and camel stretches hurt in both positions. The only thing that helps is feet propped up whilst being flat on my back. Will doing stabilizer drills help train the other muscles to fire and take the pressure off the QL?

        I’ve only just added bilateral lifts about two months ago after roughly a year of rest/rehab/unilateral lifts. I’ve been pleased for the most part with my progress (in the spirit of cockiness: I’m a 130lb female who squats 200, deadlifts 215, and glute bridges 275×8) . I’ll try stabilizer drills for a while and see if it helps. Thank you again!

        Kelsey

  9. Andrew says:

    Hey dean I can’t get enough of these blog posts. Keep them coming. You and Tony G are going to take over the world. I am an exercise physiologist in Australia (you will be happy to know I’m a Canadian citizen). And I train some similar clients to you (mainly workers comp related). your posts, videos and advice has been so insightful especially with one client in particular with chronic low back pain (QL related) His physio and I were discussing today exactly what you have blogged about. So THANKYOU so much. Keep them coming. We really appreciate it. I love great knowledge bombs.
    Looking forward everyday to the posts.
    Thanks again.
    Andrew
    P.s. Your segment in muscle imbalances revealed was the best! SNAP!

    • deansomerset says:

      Hey Andrew. Glad to see you’re picking this up all the way down under, and yes, my segment was definitely the best 🙂
      It’s always neat to see some of the things I’m trying out with respect to injury post-rehab and imbalance correction are some of the similar things being practiced by other rehab professionals in different parts of the world. It gives me hope that I might know what I’m doing!!

      Thanks again

  10. Andrew says:

    No dean, it gives me hope that I know what I am doing! Haha. I’m really intrigued in the spinal hinge, tightness posts. My client has extremely tight hip flexors, left low back pain, hip external rotations deficits. His physio and myself had a good discussion on trying to build his core stability first and then working on his hip mobility like what you discussed. I think he is lower back is crippling on his hip flexors to have some stability.
    Thanks for all your help.
    Andrew

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s