Quad/hamstring injury, hurts during seated knee flexion/extension
A few months ago, I hurt my back doing god knows what. I was attempting to maintain my strength levels (425 SQ, 455 DL, 250 BP) as my baseball season was about to start and I was throwing/doing much more skill work in preparation for it. So I was squatting twice per week, once for volume and once for intensity with triples across, and doing some pulling/benching on those days too (along with chins and cleans).
I also was taking a lot of batting practice (5 times per week) and throwing baseballs 3-4 times per week as well. This is boring so I will skip any further mention of it.
At some point, the bottom part of my lumbar spine felt... bad. When I abducted my left or right arm and reached out, I would feel a pulling sensation accompanied by a sharp pain. It felt like a muscle pull. I let it go for awhile, squatting lighter weights without much trouble. But the pain persisted, so I rested for some time before seeing a chiropractor who didn't hate barbell training. I had very poor spinal flexion before pain set in (maybe 75 degrees), and after her adjustments, it was nearly back to normal. She initially feared spondylolisthesis, but after her adjustments, she advised me that she thought it was just basic joint dysfunction and not a stress fracture.
I went back for another adjustment, and they really did help a ton - this coming from a guy who has a natural fear of doctors, chiros, or really anyone in the medical profession.
I pitched in my first game with the symptoms mostly gone (I had resumed squatting and deadlifting shortly after; my chiro had no problems with this after the 2nd adjustment), and I felt fine. The next day, I had shooting pains in my right quad. Sometimes. It hurt very badly - sharp, truncated pains - in the morning and when I sat up after sitting for more than 15 minutes. It didn't hurt that much in the bottom position of an unweighted squat, and doing a bunch of them didn't really feel bad except for a slight twinge in the bottom part of the squat.
I could not find a specific movement pattern to reproduce the pain (outside of sitting for 15 minutes and then getting up) when I saw the chiro the next day. She did a spinal adjustment, which didn't help, and offered me a viscious IT band release massage, thinking that was the problem. Remembering your advice about how I should get one of these from someone I don't mind hating (but that it was worth doing), I agreed and found a solid metal pole to grab on to. I almost asked for a tongue depressor and cotton, knowing that it would be painful.
Painful is an interesting and woefully inadequate term for what this was. Agony is more applicable, I suppose. At any rate, it didn't help all that much, which worried me. She gave me some mobility drills which I dutifully did, and I took an extended rest (which I hated).
About three weeks later, it felt a little better, so I decided to resume squatting. I did some sets across at 135; the next day was fine. The day after the rest day, I squatted 225 for a few sets across. Slight twinge in the bottom position; but fine. And two days later, I did 275 for sets across. Again, slight twinge, no real problem.
Until the next day (yesterday). Now my leg feels like someone is plunging a sharp knife into my right upper quad and I have a slight dull backache in my lumbar spine area (this really isn't an acute problem, I am just mentioning it for completeness).
Foam rolling / rolling on a PVC pipe / rolling on a very hard softball doesn't do much aside from generally hurt without giving me any relief in the affected area.
I found out how to specifically reproduce the pain. I sit down, back erect, just like I am setting up for a leg extension (er, I don't know anything about them...). I can extend my left knee and raise my left leg without any issue. I cannot do this with my right knee past 35 degrees or so before I feel a shooting pain that originates right behind my right knee, up to my right glute area - generally on the far (distal?) side of the body parts involved. The further I try to extend the knee, the more the pain goes up towards my lumbar spine / glutes.
I'm at a loss for what to do / what the diagnosis is. I haven't yet been back to the chiro nor have I seen a doctor for the issue, which I probably should do. But I figured I'd get an opinion from you and the guys on the board first, because frankly, I'd like to get some opinions from people who push weight around and won't tell me to lay off for six months. If that's ultimately the diagnosis, I'll probably comply half-assedly, but I want it to be the last resort.
Thanks for reading this giant wall of text, and I hope I included all the necessary details.
It sounds like a disc, unfortunately, about L4-5. An MRI is in order.
Unfortunate. This is what I feared. I have no real experience with obtaining an MRI in an expedient fashion. I have a visit with the chiro on Monday evening and will tell her this story as well as your input. I have insurance; I suppose I have to go to a GP to get a referral? Aside from seeing the midwife/doctor for our upcoming son, I don't see doctors and haven't been to one in six years (where I just got a routine physical; nothing wrong). Anyway, I'm not expecting real answers here, but if you have input as to how I can force the MRI issue (I'm worried they will make me dance to get one), that'd be great.
Originally Posted by Mark Rippetoe
Thanks for all your help. I'll lay off the squats, deadlifts, farmer's walks, and KB swings. Guess that leaves me with chins/benches/rows. Sigh.
Washington may be one of the states that allow chiropractors to prescribe MRIs. At any rate, she'll know how to get it done.
Do you have HMO-style insurance, or POS? If the former, and the chiro is not allowed to refer you for an MRI, get your doctor to refer you to an ortho. HMOs will fight a GP on an MRI referral, but will be less likely to argue with a specialist.
Originally Posted by kyleb
If the latter, you have more control, but the cost of the scan will almost certainly be subject to your deductible.
Managed care plans (HMO, POS) generally require referrals to see specialists, but usually not a provider specialty of chiropractor. The chiro can certainly call in with clinical and a request an MRI. As long as they get an authorization (you may need an X-ray first) you will be good to go. And it would only be subject to a deductible if your plan has one.
Whose plan doesn't have a deductible?
Teachers and state employees mostly.
Originally Posted by Mark Rippetoe
FWIW, my medical plan doesn't have a deductible...