Inflexible hamstrings due to herniated disk

[Will Morris]

Thank you so much for the detailed explanation. I always appreciate when someone takes to the time to provide not only useful advice but does so in a polite and professional manner. I would rather be told that I am wrong by someone who knows more than I do, than to continue to think I am right when I may not be.

I never realized that I had a serious neck injury until long after it happened. My guess is that it happened when I was a linebacker. At various times, something would cause intense pain for several days and the pain would go away. The only time I had a massage, I was incapacitated for several days. I was only of those people who only went to see a doctor for flu shots and a physical every few years. Since my neck never hurt when I went for a physical, the issues with my neck went undiagnosed for a very long time.

After a discussion with a family member, who is an orthopedic surgeon, I went to see a local provider. He recommended an MRI and referred me to a neurologist. The neurologist recommended never lifting weights over my head and I decided to quit squatting. The injury is high enough on the cervical spine that I later found that I could low bar squat and I can overhead press as long as I don't perform some contorted move trying to get one more rep. Obviously, I need to be very careful with this and a visit to a neurologist is now an annual event, like flu shots and a physical.

You are clearly quite thorough with your screening of new clients and IIRC you are also quite strong I am quite thorough with my patients but the second half of this statement is not correct. I certainly train often, but there are far more people who are stronger than I than people I surpass in strength.. If I ever need PT again, I hope I can find someone as capable.Finding a Physical Therapist who graduated from Baylor University and spent time as a military PT is a good screening test for a solid, competent PT. The military health system allows PTs to act as physician-extenders, so military PTs have to be competent enough to order radiology, labs, medications, etc. This increased practice privileges forces the PTs to take on more responsibility from a patient care standpoint and you are forced to become very good at knowing what is, and what is not, something you should be treating.

Do the terms "transverse ligament" or "alar ligament" sound familiar to you?

[Delaying_the_inevitable]

One last point. The physical therapist that my daughter saw in college was more significantly more expensive than the orthopedists or neurologists that treated me. Also, the therapist was out-of-network and the physicians were in-network. Obviously, the PT lasts longer than the specialist visits, so the physician still charged more per hour. I am sure that there were other nearby therapists that were less highly recommended but still excellent, but as a parent of a D1 athlete who was trying to finish a career without surgery we went with the recommendations of other athletes.

I found that a single visit to a specialist was relatively cost effective and a follow-up call with someone that could tell me what to do own my own worked quite well. Others will have a different cost comparison and need more assistance with after injury care than I did.

Do the terms "transverse ligament" or "alar ligament" sound familiar to you?

Yes. Neck injury was C2-C3, so if my extremely limited understanding of anatomy is correct, those ligaments are in the same area. I was in an accident that resulted in a lumbar compression fracture and probably caused the cervical spine issue become more acute. Except for the neck issue, I might made it through college with no injuries. Same with my older and more athletic sibling who made it to roughly 40 before even a minor injury.

Thank you for the suggestions on selecting a physical therapist.

[David Brinkmann]

Ok then. From tomorrow on he'll do rack pulls with slowly increasing rom. Thanks, both of you. He's definitely excited to lift some actual weight.

[Delaying_the_inevitable]

Ok then. From tomorrow on he'll do rack pulls with slowly increasing rom. Thanks, both of you. He's definitely excited to lift some actual weight.

How did the first two weeks go?

The following is similar to something that I mentioned earlier as a alternative to a rack pull. The lift could begin near the lockout position for the first rep and the bar could be lowered to suitably high pins instead of the floor. Later, the pins could be moved lower.


"... set up hooks on a squat rack or set up blocks that would put the bar a couple of inches below lockout. .... Unrack the bar, take a tiny step forward with your deadlift stance, and do a controlled eccentric rep while trying to keep your spine extended as your #1 priority. If you have partners, you can do these in a power rack instead. Pick the bar up off the safety pins, have your partners pull the safety out, and then perform the eccentric rep."

[Will Morris]

How is this different from a slow RDL? An RDL does not require partners to assist.

[Delaying_the_inevitable]

The starting point is different. I thought the OP was his training partner, but there is no need for assistance as long as the pins remain in place during the lift. The only reason one would need a partner or partners would be if the lift began at the pins, instead of the hooks, and the pins were moved after the bar was lifted.

When I was recovering from an injury, I preferred starting near the lockout using the hooks and lowering the bar from there to the floor. If things felt fine, I completed the set. If something felt wrong I could let the bar down rapidly inside the rack.

[David Brinkmann]

Well. He did the rack pulls once with 50 kg. So the weight was pretty light. But the following week he was complaining about back pain and didn't even want to add weight to his squats, because he was afraid of having another injury. He's now increasing his squat again, but still very cautious about every little pain. Since then he only wanted to do back extensions without weight, no rack pulls. We'll have to see, if he wants to do actual back work again at some point. I'm doing what I can. Don't want him to quit squatting/training because of his pain.

[Delaying_the_inevitable]

Since the lifter can barely touch the top of his knees, any deadlift variation will need to start well above the floor. With that limitation, rack pulls would seem to be a reasonable choice. Although RDLs obviously couldn't begin at the floor, they could be initiated from the hooks on a rack or some other raised surface. It shouldn't matter whether one lowers the bar to pins or a place determined by the lifters flexibility. Some people may be more comfortable with rack pulls than a lift that requires a walkout with a loaded bar. Although I have used the hooks to quickly load a bar during warm-ups or initiate a deadlift following an injury, I have never consider walking out something close to my max.

[stef]

Although RDLs obviously couldn't begin at the floor, they could be initiated from the hooks on a rack or some other raised surface.

Lucky, since that's how they're done.

[Dillon Spencer]

Well. He did the rack pulls once with 50 kg. So the weight was pretty light. But the following week he was complaining about back pain and didn't even want to add weight to his squats, because he was afraid of having another injury. He's now increasing his squat again, but still very cautious about every little pain. Since then he only wanted to do back extensions without weight, no rack pulls. We'll have to see, if he wants to do actual back work again at some point. I'm doing what I can. Don't want him to quit squatting/training because of his pain.

I have nothing of any medical or therapeutic value to offer to here, but I've been following this thread with interest and something came to mind after your most recent post. From this article:

And finally, situps and back extensions may be the worst thing you can do for your painful back. Think about it: your discs are old and beat up, thinner and less flexible – does it sound like a good idea to wiggle them around and grind them against their poorly-separated adjacent bones?

Your friend is afraid to perform an exercise that will strengthen his back in a position of rigid, anatomically normal extension because it involves added weight, but is perfectly happy to wiggle his already damaged spine through flexion and extension because it doesn't involve added weight. I get that you don't want to discourage him from training, but I think he needs as much help getting his mind right as his back right. Have you had him do any reading around here, or are you just hoping he'll take your word for everything? Referring him to some of the many articles about back pain and back strength might be helpful, if you haven't done so already.