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11/21/2005 - Kris
Rehab Q: Two years ago (Dec 2003) I sustained a good morning injury (felt like something "rolled down" the middle of the low back, slight bruising, impossible to sit for the next few days). I continued benching while treating the injury with RICE, painkillers and very light accessory work. 3 months later, a chiro adjusted me after sub-max squats caused the left side of my back to stiffen up. I also treated myself for gluteal trigger points.

In May 2004, I got my first full-blown lumbago (severely drooping right shoulder) after light squatting. Got muscle relaxants and painkillers. A back specialist put me on the McKenzie extension protocol, neural mobilization and a core training program (swiss balls, balance boards). He told me the right side of my lower back was not fully contracting. After 3 months of religious rehab work, I got another bout of lumbago after light box squats (okd by therapist); continued the same treatment.

In March 2005, 15 months after the initial injury, I was finally doing regular ME squat/dead work. Everything was fine until I got another case of lumbago in August 2005 after decline benching. The back specialist could find nothing structurally or neurologically wrong with my back. Apparently, the lumbago is triggered by compression of the spine which causes the nucleus to spill over and irritate the nerve roots. Am now focusing on strengthening my midsection (reverse hypers, side bends, abs...), while carefully regulating heavier SQ/DL work. Sleeping and sitting long hours can also trigger a mild case of lumbago (always tilted to the right). The recurrent pain is not too bad, but zero SQ/DL progress over the last two years is no fun. Giving up is not an option.

I would HIGHLY appreciate any suggestions. Am also curious whether this is a common injury scenario in powerlifting. I lift raw but could reluctantly consider equipment if that could help keep me under the bar. I live in Europe and am 30 years old. Thanks for your time!

If you get a tilt to the right you present as a lateral shift. You need to perform lateral procedures before you do extension procedures per McKenzie

The sitting for prolonged periods of time may be a sustained flexion load. Produces posterior and lateral disc migration.


Did you notice it always takes three months for you to get better. This is how long it takes people to get better if they do nothing at all.

If you're not getting worse with activity( lifting) but are getting worse with inactivity(sleep and sitting) then try to fix these postures.

You have a poor internal mechanism( weak annulus) With bad postures this will get loaded and weakened and more likely to injury with minor tasks.

Ironically the spine is quite resistent to herniation with compression. Brinkmen(research) cut a disc trying to create a herniation with compression loads... it could not happen however as soon as flexion was introduced the disc herniated.

You must remember that reverse hypers are a crushing compression force with a flexion component.

Can you currently squat?
Can you currently deadlift from a high pin position?

Why do you think you are weak in "core"?
The combination of heavy compression and heavy core training may be too much...

You may try to re-estblish squatting with minimal assistance training(core training)

If squatting is out of the question, then try single leg exercises. I have found these to be tolerated by individuals who can not tolerate heavy squatting.




,
Michael Hope


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