T8 compression fracture

[nkelman]

Hey Rip,

Age: 24
Weight: 90KG/200lbs

I have had mild pain in my mid back for at least a year. Pain also in ribs, and sometimes random heart pain. My back right now feels fine (apart from the morning when its around 3/10) , it's only when I sort of "hunch over" and make myself look like the hunchback of notredame that I get pain.

Got an Xray and this was what the report said (from the radiologist presumably?)

"THORACIC SPINE XRAY"

Increased mid thoracic kyphosis with more than 20% compression fracture of T8. No significant spondylosis and pedicles are intact.



The doctor (GP) then told me the fracture was healed, and Im now getting a DEXA scan to check for bone weakness. He told me, if the DEXA comes back negative for osteoporosis, then there is only pain meds he can offer me. If it comes back positive, he said I got alot more to worry about.

I'm assuming the fracture is from falling about 2m onto my back (onto concrete) a few years ago.

Since it flared up really bad a month or so ago, I have benched 300, pressed 200, and deadlifted 400 without ANY PAIN. Squats make it flare up bad so I have stopped.

What I'm worried about:

- Should I trust the Radiologist (or what ever wrote the report) ?

- The GP looked at my Xray through his fucking table side lamp, and said it had healed, should I trust him?

- Squats are making it flare up right now, I have tried hack squats, and goodmornings, and can do so without pain. Should I continue with these for a while, or do you think its my squat form thats triggering it? If I stand up without a bar and get myself into the rack position, I get back pain.


Thanks mate.

[Mark Rippetoe]

I'm sure the radiologist can see an old healed T8 compression fracture competently. The problem will not be osteoporosis for a young male barbell trainee. Is this the complete language of the radiology report?

[nkelman]

Yes that was the complete report. They xrayed my lumbar, but it was fine.

The report didnt say it had healed, the GP did.

[Mark Rippetoe]

If the injury was years ago, it has healed. In the absence of any other options, I personally would train through it.

[nkelman]

Thats good, because its deadlift day.

One more question, if it's healed, why is there still pain. My spine feels "loose" in the morning when I get out of bed, and I still get pain when I hunch over. I work as a Carpenter, and don't even notice it during the day, but I'm wondering if this slight pain is for life, or anything I can do to make it go away/lessen. The only information I can find on google, is from older people having this injury, and getting them to stand/walk is a good outcome.

Thanks Rip

[wal]

Listen mate if you have doubts about a medical report go and get another opinion from a specialist in sports injuries if needs be. If you get pain then that is a warning. Maybe your form is off, maybe your squatting too heavy. If you want to continue with training into your older years you need to take care of your back now. I know Rippetoe is a knowledgeable trainer but he can only do so much. It is no good asking him if you should trust a medical report. It is up to you to go and get the GP's opinion verified before you launch into a full blown training session.

[Mark Rippetoe]

Thats good, because its deadlift day.

One more question, if it's healed, why is there still pain. My spine feels "loose" in the morning when I get out of bed, and I still get pain when I hunch over. I work as a Carpenter, and don't even notice it during the day, but I'm wondering if this slight pain is for life, or anything I can do to make it go away/lessen. The only information I can find on google, is from older people having this injury, and getting them to stand/walk is a good outcome.

Thanks Rip

The pain is probably from the soft tissue - disc, ligaments, muscles - that are in an abnormal position due to the change in shape of the vertebral body after the fracture. But they cannot adapt if you dont train. The caveat is that you have to be aware of any change in the nature of the pain as you train, which would indicate that I was wrong in giving you this advice. I am wrong occasionally.

[wal]

Mark I know you like to help, you are generous with your time trying to advise these young trainees, they trust your advice without reservation. But some of them (not this guy) have egos bigger than their brains and will chew more they can swallow, will train through serious injury and cause long term medical problems that will pursue them into old age. My concern for you is you have taken on a hellish responsibility. To ask a trainee to train through pain with a potential spinal injury is not wise. If he has a compression injury he probably needs an MRI to verify what is wrong, an Xray and a casual glance by a GP is not good enough. I know the kid wants to train I would to if I was in his position. All he wants is someone (you in this case) to give the green light. I tend to these days take advice with caution even from MD,s. Your experience in sports injury appears rather extensive(probably better than most MD,s I seen)but I would suggest that this trainee go and get fully checked out before he starts lifting with heavy weights again.

[Mark Rippetoe]

It has certainly not been my experience that most people will go against doctors' advice and train like hell through an injury. It has been my experience that this is counter-intuitive for the vast majority of the species, and that unless a person is a pro athlete, aggressive rehab is just not done. The only thing that might make me reconsider my advice would be his comment in the OP that both you and I didn't catch:

and sometimes random heart pain

I don't believe he knows what this really is, but to cover my ass like you advise I'm going to recommend that he wait until he sees a cardiologist -- not his GP -- about this, and is sure that there is nothing wrong behind the sternum.

[wal]

That is why you are a pro, that is really good advice. I just look at this way if the kid were mine thats what I would tell him to do. Pity there are not more like you that take that much concern.