Annular tear?

[wk105]

Hi Rip,

I saw an osteopath today after a recent SI joint pain flare up, and he said to stop squatting and deadlifting because he thinks I've got an annular tear. He recommended core work and smith machine squats.

Sorry for the lengthy injury history, but it's probably important:

26/11/13
Back tweak while squatting. Lost tightness at the bottom. Felt something wrong instantly – ligament at the back of the hip? No numbness, tingling, or pain down either leg.

Squatted 440x5 on 1/12/13 without pain.

13/12/13
Flare up after squatting 465x5. No pain during the workout. Extremely tight in the morning. Struggling to put shoes/socks on. Pain much better by the afternoon. Helped by massaging glutes/hips.

Squatted 400x5x5 on 24/12/13 without pain.

25/8/14
Flare up. No obvious incident in the gym. Just a hard run of training culminating in squatting 475x5x5. Saw a Chiropractor. Diagnosis: SI joint inflammation caused by accumulated microtrauma.

Squatted 420x5x5 easily on 15/9/14.

16/1/15
Flare up. Lost tightness at the bottom of a 2-second beltless pause squat for 390x6. Pain/stiffness when getting out of bed in the morning. Struggling to put shoes/socks on. Pain mostly gone by the end of the day. Helped by massaging glutes/hips.

Managed some light deadlifting (420x4) with absolutely no pain on 25/1/14.

Saw the Osteopath on 26/1/15. He did some dry needling to try to relax the erectors. If anything, that's just pissed it off more.

I'm sceptical about his advice. My pain is a dull ache at the base of my spine, matches all the SI joint symptoms, and it's generally relieved by training. I've taken my squat from 490 to 590 over this time period, and my deadlift has been up and down between 505-550 depending on how my back's been feeling.

Should I just spend the money on an MRI? If it does show an annular tear, what then?

I'm not going to do anymore beltless squatting.

Squatting, deadlifting, hanging from ab straps, and foam rolling my hips/glutes seems to help more than anything else does.

Thanks,

Will.

[Mark Rippetoe]

An "annular tear" in what?

[John Petrizzo]

An "annular tear" in what?

Rip, I think he is referring to the annular fibers of an intervertebral disc.

Will, I would stop seeing that Osteopath as his advice is off base and he does not seem to be helping you. When you first met with him did he evaluate you for SI joint dysfunction? It very well could be a disc issue, but regardless of the underlying cause, your best option will be continuing to train. As long as you maintain your form, and manage your volume appropriately, you should be fine. If you really want an accurate diagnosis, get the MRI, but ultimately I don't think it is going to change how you approach your treatment or training at this point.

I saw you tried to PM me, I just cleared my inbox so you should be good to send me a message if you want to.

[wk105]

Rip, I think he is referring to the annular fibers of an intervertebral disc.

That's what he said.

When you first met with him did he evaluate you for SI joint dysfunction?

No.

It very well could be a disc issue, but regardless of the underlying cause, your best option will be continuing to train. As long as you maintain your form, and manage your volume appropriately, you should be fine.

That's what I was thinking when he was going on at length about unilateral core exercises. Even a herniation, not just a tear, would benefit from training. And I'm not even convinced it is a tear anyway. I get an ache at my beltline, not sharp pains in my midback.

If you really want an accurate diagnosis, get the MRI, but ultimately I don't think it is going to change how you approach your treatment or training at this point.

I'll see if I can get one on the NHS. But I'm not going to pay for one privately because it's not going to change what I do.

Thanks for your advice.

[Will Morris]

Rip, I think he is referring to the annular fibers of an intervertebral disc.

Will, I would stop seeing that Osteopath as his advice is off base and he does not seem to be helping you. When you first met with him did he evaluate you for SI joint dysfunction? It very well could be a disc issue, but regardless of the underlying cause, your best option will be continuing to train. As long as you maintain your form, and manage your volume appropriately, you should be fine. If you really want an accurate diagnosis, get the MRI, but ultimately I don't think it is going to change how you approach your treatment or training at this point.

I saw you tried to PM me, I just cleared my inbox so you should be good to send me a message if you want to.

Not to mention, you are going to best manage an annular tear by repeated extension and by modifying your posture to avoid lumbar flexion. The squat and deadlift technique as described in the book are perfect for this. I use them both to manage patietns with annular tears on an almost daily basis.