Training with cervical disc herniation

[Tim W]

Takes some getting used to, but I have my guys with new disc replacements hold a nerf ball under their chin when they squat to keep their head in the right place. Works beautifully.

Surgeon cleared me to lift again, limited only be pain. Had my first session back today. Last time I trained was 8/27/18, so around 2.5 month layoff. Was on a 4-day upper/lower split at the time, and had gotten to the following singles (5 across) before disc ruptured:
SQ 355, BP 205, OP 150, DL 395

Began a simple vanilla LP. Alternate BP, OP. No cleans - pulling every session to start, then twice a week when it gets hard.

Squats: Tucked a tennis ball under chin to maintain neutral C-spine. Worked up to 185x5x3. Felt somewhat tough because I'm detrained, but form and barspeed looked good on video. I wanted to be conservative at first, to minimize DOMS. Gonna take a few 10# jumps, then 5#, then drop to a midweek light slot eventually.
Bench: Was indescribably awful. Did 45x5x2, then 70x5, then 95x3, then 115x0. Got 105x2 but my right tricep (disc was at C6/7) was shaking. I know my chest and left arm could have done more. Settled on 85x5x3 but it was VERY hard. Surgeon told me this might take several months to come back fully. Very depressed.
Deadlift: Worked up to 255x5. Could have pulled more. Grip was limiting more than back, and legs were not fresh. Going to take a few #20 jumps, then #10, then #5, then pull only twice a week, with rows or chins on the off day.
Press: We will see on Friday.

A few questions to the forum.
1. Should I work on getting chest strength back with flyes (band, DB, or TRX) while limited by tricep recovery, or just stick to bench, and let everything come back together? Are there ways to get that tricep firing better? More light reps, isolation, else?
2. I feel like I may run through round 2 novice LP much faster on the lower body than on the presses. How do I program when that happens?
3. Grip is limiting my pulls now. Strap up and keep adding weight, or let it progress more slowly while grip comes back?
4. Good substitute for midweek deadlift slot? I am 43 and not really sure I can learn to clean at my age/athletic ability. Plus, scared to be slamming a bar into front rack position right next to a surgical site. Rows? Chins? If I chin or row, any value to adding in a 4th session on weekend so i can train those movements more than once a week?

Thanks everyone for the support and advice. It felt great to get back under the bar, but discouraging to see how much strength I lost. At least now I know my weights - the not knowing was almost worse than the reality.

[Tim W]

The tennis ball trick was great Will! Felt awkward, but really got me to not overexaggerate the "look down" cue.

[Will Morris]

A few questions to the forum.
1. Should I work on getting chest strength back with flyes (band, DB, or TRX) while limited by tricep recovery, or just stick to bench, and let everything come back together? Are there ways to get that tricep firing better? More light reps, isolation, else? As heavy as you can possibly do, but keep the sets to 2s and 3s.
2. I feel like I may run through round 2 novice LP much faster on the lower body than on the presses. How do I program when that happens? This is all going to be dependent on how much return you get and how fast.
3. Grip is limiting my pulls now. Strap up and keep adding weight, or let it progress more slowly while grip comes back? Do your warm-ups with a regular grip and go as long as you can. When grip gives before legs and back, switch to straps. Keep trying to push the last manageable weight up during your warm-ups. Increase every week, if possible.
4. Good substitute for midweek deadlift slot? I am 43 and not really sure I can learn to clean at my age/athletic ability. Plus, scared to be slamming a bar into front rack position right next to a surgical site. Rows? Chins? If I chin or row, any value to adding in a 4th session on weekend so i can train those movements more than once a week? I'd favor a strict barbell row with the back rigid and locked in extension, pulling from a dead stop each rep. I'd probably consider maintaining the tennis ball / nerf ball biofeedback system when doing these to keep you from going into the neck bobbing thing that a lot of us do as the weights get heavy.

but discouraging to see how much strength I lost. After I had Tommy John Surgery (and the resulting ulnar nerve injury during surgery) I went immediately from a 315# bench press for a single to unable to do an empty bar bench press 2 weeks out of surgery. I had to start on a smith machine to just have my right arm go along for the ride. I couldn't fully extend my elbow, so that limited triceps activation and my right triceps lagged behind significantly. I remember calling Rip and asking for his advice, and he told me to just stay the course and a bunch of isolation exercises wouldn't be helpful. At 8 weeks post-op, I was able to bench press 315 for a single with my valgus block elbow brace on. The next day, I got rid of the brace and went back down to 235-245, and started working up from there. Threes were manageable, but I had real problems with 5s because my tricep would fail. I stayed the course and today I was able to bench 345 for a double but could have hit it for a third rep. Stay the course. The more you force the body to return to normal, the better it will.

See text in bold in the quoted text.

[Tim W]

Thanks Will.
So advise bench/press programmed with 5 sets of triples, or 8 doubles? Any preference? I assume the idea is to go as heavy as i can manage, to recruit maximal amount of koror units to “wake up” the sluggish tricep. Am i on the right track with that idea? Add weight per session as in standard LP?

[Will Morris]

Thanks Will.
So advise bench/press programmed with 5 sets of triples, or 8 doubles? Any preference? I assume the idea is to go as heavy as i can manage, to recruit maximal amount of koror units to “wake up” the sluggish tricep. Am i on the right track with that idea? Add weight per session as in standard LP?

You can't trained a compromised motor unit to exhaustion, or weird, bad things happen. In your situation, I'd probably start with 7-7-8 doubles, if, that allows you to lift more than a triple. Add weight as fast as that arm will let you.

[Tim W]

Thanks Will.
I was able to press 95 for 8 doubles. They were doable but was really grinding to get right elbow to extend. Interestingly could only do 100x2x8 on bench. I would have expected bench to be a much higher # relative to press, but I guess the similarity in loads is because the rate limiting issue is tricep weakness, not chest or shoulder.

From your experience with cervical radiculopathy with weakness, how quickly should I get expect this to recover? Hopefully it’s not permanent. Also when do i transition back to fives? Was thinking once the loads match my prior 5x5 volume day loads, and then start adding reps each session.

[Will Morris]

Thanks Will.
I was able to press 95 for 8 doubles. They were doable but was really grinding to get right elbow to extend. Interestingly could only do 100x2x8 on bench. I would have expected bench to be a much higher # relative to press, but I guess the similarity in loads is because the rate limiting issue is tricep weakness, not chest or shoulder.

From your experience with cervical radiculopathy with weakness, how quickly should I get expect this to recover? Hopefully it’s not permanent. Also when do i transition back to fives? Was thinking once the loads match my prior 5x5 volume day loads, and then start adding reps each session.

Well, I think if you look at the innervation of the pec and lat as both having a substantial C7 input, that may help resolve the conundrum as far as a mismatched press to bench ratio. I'd expect the tricep to be fairly limiting in the press as well, but the chest and lat deinnervation, to whatever degree it has occured, will impact the bench a lot more than the press.

It took me about 4 months post-op to get most of my strength back, however, my grip has still lagged behind. My right grip is only about 40% of my left after the ulnar nerve injury.

Over the next month or two, a repeat EMG would provide some good data as to the amount of reinnervation that is occuring.

[Joel Chapman]

Good luck with your continued recovery. Please update this thread occasionally, I am very interested. I am getting a cervical fusion next month and I am already lookin forward to making progress towards recovery.

[Tim W]

Good luck with your continued recovery. Please update this thread occasionally, I am very interested. I am getting a cervical fusion next month and I am already lookin forward to making progress towards recovery.

Will do Joel.
Squats and pulls have progressed well. I am clearly detrained from the nearly 3 months off, but they feel fine and I am taking large jumps in weight.
Presses are another story. I was herniated at C6/7, so primarily have weak triceps, although lat and pec affected too based on shared innervation. I can only bench doubles at half the weight I was doing for top set of 5 prior to injury.

On advice of Will Morris I am going as heavy as i can handle for multiple (8) sets of two. So still keeping volume in that 15 range. I assume the idea is to activate the highest % of motor units and not be limited by fatigue. I am adding 2.5 per OP session and 5 per BP session. The reps are hard but doable. It’s like my tricep just doesn’t want to fire. Surgeon told me this could take several months.

I have just become at peace with the reality that my two plate bench will know be many months away!

[Will Morris]

Will do Joel.
Squats and pulls have progressed well. I am clearly detrained from the nearly 3 months off, but they feel fine and I am taking large jumps in weight.
Presses are another story. I was herniated at C6/7, so primarily have weak triceps, although lat and pec affected too based on shared innervation. I can only bench doubles at half the weight I was doing for top set of 5 prior to injury.

On advice of Will Morris I am going as heavy as i can handle for multiple (8) sets of two. So still keeping volume in that 15 range. I assume the idea is to activate the highest % of motor units and not be limited by fatigue. I am adding 2.5 per OP session and 5 per BP session. The reps are hard but doable. It’s like my tricep just doesn’t want to fire. Surgeon told me this could take several months.

I have just become at peace with the reality that my two plate bench will know be many months away!

While you are lifting really light (comparatively to before the injury), you can lift virtually everyday and still go up in weight. That may help coax your triceps into waking up.