30% Compression of L3

[bimbem]

My 35 year old brother, 5'6" 165lb, is recovering from a 30% compression of his L3 that took place 2 months ago and has asked me to help him train now that his Dr. has "cleared" him for physical activity and the ongoing pain is diminished. He is fit but does not have barbell training experience. Any advice on how to manage his training given his injury.

[Mark Rippetoe]

More about the injury.

[bimbem]

It made him say ouch!

The detail I am aware of but forgot to include is that the compression is uneven such that the front portion of the disk is thinner than the back portion. No apparent nerve damage. He is walking without assistance.

[bimbem]

Here are the docs notes from the x-ray.


INDICATION: Evaluate for kyphosis. S/p 15 foot fall sustaining L3 compression fracture. CT scan L-spine outside facility 7/8/2023 revealed findings FINDINGS: Scoliosis-compression and anterior wedging of L3, flattening of lumbar lordosis. No significant scoliosis. 12 pairs thoracic ribs. Scoliosis technique which limits detail to reduce dose. Lumbar spine-5 lumbar vertebral bodies. Acute 30% compression and anterior wedging of L3, flattening of normal lordosis. No definite disc space narrowing. No evidence of spondylolisthesis.

[Mark Rippetoe]

This is a compression fracture, most likely healed by now. Start light, progress the usual exercises slowly.

[bimbem]

Thank you Mark!

[Will Morris]

Thank you Mark!

You might see that his back looks marginally different when getting into position compared to the model, and more importantly, him falling into flexion on a squat is most likely not going to feel good.