Lower Back injury, which exercises to use for rehab?

[BigJosh]

I am currently using Rippetoe's novice program as laid out in practical programming. Friday evening was my deadlift workout. I must have failed to recognize it was time for me to switch from making 15lbs jumps on the deadlift to making 10lbs jumps, because my working deadlift set felt extremely heavy. I was only able to get 2 complete reps, even though I really tried for the 3rd.
Saturday, i woke up with lower back stiffness and discomfort. This was clearly not the usual kind of soreness one could expect after heavy deads. I was stiff all day, but just kind of ignored it and thought it would go away.
Sunday, I was still stiff but thought I could workout through the discomfort. I did 4 warm up sets for my squats and it felt a little uncomfortable, but I thought I could manage. Upon starting my first working set, I realized the pain was anything but normal. Instead of stopping, I made the stupid choice to keep going. As I went down for my 4th rep and attempted to bring it back up my back cracked, and I dropped the weight to the safeties. I was in a lot of pain and stopped my workout.
By the time I got home i could barely walk or stand up straight. I spent the night in a lot of pain. Went to the doctor on monday, he said I had a lower lumbar strain.
Now on to the question: I want to begin starr's rehab protocol in a day or so. Should I use good mornings since the injury originally happened during deads or should I use full squats?
Sorry for the novel, thanks in advance for advice.

[confuzzl3don3]

Does your back hurt when doing squats? Figure out which of the exercises (PCs, squats, deads, bench, OH press) causes pain in your back. Your squats, deads, and PCs should probably be affected. I wouldn't turn to good mornings as a way of rehab, but rather follow the Starr rehab for the lifts that the injury prevents you from doing.

[Patrick L.]

The Starr rehab is for muscle belly tears only. Your problem as you describe it may not be one. I don't fuck around with back injuries...its a good way to hurt yourself permanently, or at least for an extended period of time. Hearing a "crack" in your back is not good. I would lay off completely for a few days and see how it feels...you may need to go see someone about it again.

[2big2fail]

Believe it or not I found walking to be a tremendous help for rehabbing a lower back. I discovered this by accidently about 10 years ago when I develped a herniated disc and a God awful case of sciatica. For me, going to the weight room was out of the question....the only thing I could manage to do was to walk for about 15 minutes. Quite frankly it was the only thing that made the pain go away..the pain meds didn't do a thing.

Seems to be a lot of medical evidence out there that backs this up.

[IlPrincipeBrutto]

Hi BigJosh,

I injured myself in a similar way to you, back in November, when trying to deadlift 275 pounds. I felt something ripping in my lower back, and could barely walk once I cooled off.

As a rehab exercise I used the squat, starting 3 days after the injury with just the bar.
I also did an awful lot of stretching for the lower back, like sitting on a chair and trying to get my head between the knees, or lying on my back and bringing one knee at a time to my chest.

For me it worked fine, although it took a long while to feel confident enough to deadlift again the same weight.

Whatever you use, let pain be your guide, and don't push it more than you need to.

IPB

[BigJosh]

Thanks everyone for the advice.

Confuzzl3don3- Indeed I will have to figure out which exercises are hurting it. Based on the fact that the injury was intially caused by the deadlift, i'm assuming it will hurt and since the squat "increased" the injury i am assuming it will hurt. Based on the injury and the lifts that caused it, it is also safe to assume OH Press and PC's are going to hurt as well.
The reason I bring up good mornings as a potential rehab exercises is because, they are recommended by starr in "the strongest shall survive" as the primary exercise to rehab a lower back injury. He doesn't recommend using the deadlift, although, he doesn't recommend not using it.
And he recommends the squat for quad and hip injuries, but not lower back injuries.
Thus the reason for my confusion.

Patrick- If the pain doesn't aleviate, I will definetly be seeing someone else soon. Back injuries are nothing to fuck around with.

2big2fail- Since you bring it up, I am actually currently finding walking is helping to stretch out some of the tightness in my posterior chain. Good advice there.

IlPrincipeBrutto- That is the kind of insight i need. It makes since to me, that the squat could potentially be benefical for rehabing a lower back injury as opposed to targeting the lower back directly. And it seemed to work for you.

Once again, thank you very much for your advice.

[cervicornis]

Back injuries are hard to diagnose accurately and the pain is a highly individual thing. If this is your first experience with back pain, you're probably best off using rest and ibuprofen for a few days.

I like to use light warm-up sets to help determine if my back will benefit from work or more rest. If you feel better as you warm-up, continue on and then based on how everything feels, you can decide if you want to do the program or just stick with some conservative weights. If you feel progressively worse as you warm-up, best to call it a day.

Rushing out to the doctor at the first sign of back pain is a waste of time IMO. It sucks, but you might need to learn through experience how your back reacts to different stimuli. Then you will be able to fine-tune your activity and recovery to keep the pain at a manageable level.

[BigJosh]

Back injuries are hard to diagnose accurately and the pain is a highly individual thing. If this is your first experience with back pain, you're probably best off using rest and ibuprofen for a few days.

I like to use light warm-up sets to help determine if my back will benefit from work or more rest. If you feel better as you warm-up, continue on and then based on how everything feels, you can decide if you want to do the program or just stick with some conservative weights. If you feel progressively worse as you warm-up, best to call it a day.

Rushing out to the doctor at the first sign of back pain is a waste of time IMO. It sucks, but you might need to learn through experience how your back reacts to different stimuli. Then you will be able to fine-tune your activity and recovery to keep the pain at a manageable level.

It is hard to diagnose back pain, i agree with that.
However, I disagree that rushing to the doctor is a waste of time. As I was lying on the floor writhing in pain sunday night, I didn't know what I had done to myself. Going to the doctor allowed me to verify that it was a soft tissue injury. Also he was able to prescribe me methylprednisolone, to reduce inflammation and promote healing and pain killers and muscle relaxers so that I am able to stretch my posterior chain (which includes my lower back) to promote healing and avoid a repeated compensation for my injury (a limp, if you will) so that I can heal correctly. So, i have to respectfully disagree with your opinion. However, I do appreciate your feedback.

Really though, my question is not how to warm up or stop if there is pain. Just as my question is not whether or not I should have gone to the doctor.
My question is what exercise(s) should I use as part of Starr's injury protocol, given the nature and causes of my injury.

[cervicornis]

With regard to doctors, I'd like to add the following. I take a fairly pessimistic view on the value of a doctor's diagnosis and recommendation when it comes to the subject of back pain. Especially for active folks like us who might be willing to accept the trade-offs of such activity.

I was diagnosed (via MRI) with a partially-herniated disc when I was 17 (tennis injury) and the recommendation was to quit playing tennis. So I quit the sport in the middle of my senior year, despite the fact that I enjoyed it and was competitive.

Fast forward a few years and once I was in college, I got into new sports, all of which would aggravate my back on occasion. Again, the doctors I would visit suggested I switch to different activities like walking, yoga, and other silly bullshit. One orthopaedist actually recommended a rather complicated surgery at the age of 28.

I'm 35 now, and I haven't been to a doctor for my back in 7 years. I've been training BJJ for about 4 years and started SS about 6 months ago. Back pain is sometimes a daily issue, and then I might be fine for months. Bottom line, I love these sports and I want to train, and I'll be damned if some pain is going to stop me. Over time, you learn what you can get away with and you do your best to avoid it.

One of my buddies who started SS with me felt a few twinges of back pain and decided it wasn't worth it, and it just pisses me off, I suppose. I still kick myself for quitting tennis and all those years where I pussy-footed around and did nothing in fear of my damn back. Fuck that.

[cervicornis]

I hear ya, Josh. I'm not anti-doctor at all (I'm married to one). In this case, you got some nice meds and hopefully everything works out beautifully. My rant may be a bit off topic, but I thought this was a good opportunity to share my experience. It's a slippery slope from where you are now to finding yourself lying in a tube while giant magnets click away, and the next thing you know you'll be posing on a mat while some hairy chick does the downward dog 6" from your face.