Starr Rehab protocol good for old lower back injuries? (5 months)

[hippopotamus]

I searched the forums but could not find a similar thread. I'll pose my question as a general one, and then also give details about myself.

About 5 months ago I injured my lower back while deadlifting (poor form, rounded back) as part of the standard SS program. I had difficulty standing up from seated position, pain when leaning forward, etc. This type of injury appears to be fairly common on the forums, and the Starr rehab program seems to be a commonly prescribed and effective rehab protocol.

However, what I couldn't find is recommendations if the initial injury is older than just a few days. The Starr program is designed to be done only a few days after injury in order to prevent scar tissue, but in my case scar tissue has likely already built up since the injury was so long ago. Would the Starr method still be useful for someone several months post injury? Also, if the Starr method would be useful, would adding an erg component on low resistance be beneficial (initial pull is like a light deadlift, so it's like high rep, low weight deadlifts?) If there's no use to the Starr method for an old injury, what else should I do?



A little more about my situation:

I'm 30, male, 5'10, 175lb, novice lifter.

My pain/stiffness is in the lower back, slightly biased to the right, no pain down the leg. After the initial injury the pain (2-4 out of 10) would subside within 3-5 days but an uncomfortable stiffness and a baseline pain (0-1) would linger and this hasn't improved. Within the first ~2 months, I went through 3-4 cycles of re-injury after returning to lifting prematurely or erg-ing at resistance level 10, with the same recovery pattern (pain subsides within 2-3 days, with lingering stiffness). Several provocative motions can cause a pinch (2-4 out of 10) (eg. hyperlordosis, or standing up, leaning back or back and to the right). There is a slow, uncomfortable stretch in my lower back when I bend over to touch my toes or do a "child's pose" yoga, especially in the morning. PT gave general core exercises and stretches but I saw no improvement, though I only stuck with it for about 4 weeks. Chiro (~ 5 sessions) gave only temporary relief (~30-60 minutes post session) so I stopped going. Heat and advil give temporary relief, though I rarely take advil. MRI shows very slight bulging disc at L4/L5, which the rehab MD isn't concerned about, and facet joint deterioration on the left (asymptomatic) side.

I haven't done any compound lifts for 3-4 months, though I have been active with competitively dragonboat paddling for the last 3 months. 100% effort on my left side (opposite to the stiffness) is perfectly fine and injury free, but right side is prone to reinjury, so I've avoided this for several months. But I know there does exist a muscle imbalance and part of the reason for doing Starting Strength was to even things out.

[Mark Rippetoe]

Starr developed the rehab after precisely this situation occurred with his back. Try it.

[hippopotamus]

Thanks for the encouragement. I am definitely encouraging it. A common theme comes up from searching for the method, which is that it's appropriate only for muscle belly tears and not joint injuries. What are the tell-tale signs of a muscle belly tear as opposed to a joint injury?

[hippopotamus]

For example, you easily diagnosed this injury as a facet joint issue not a muscle belly tear. But there are a lot of similar problems in my case to this one:

http://startingstrength.com/resource...?t=8701&page=1

Just trying to figure out what guidelines one can use to differentiate between a muscle belly and joint issue.

Thanks again. I really appreciate your help

[Subsistence]

I thought the star protocol was for muscle belly injuries, and low back injuries were usually spinal?

[Mark Rippetoe]

Just trying to figure out what guidelines one can use to differentiate between a muscle belly and joint issue.

Muscle belly tears bleed, and therefore show a bruise.