How to diagnose a muscle belly injury?

[GavinL]

I want to make sure I diagnose my injury correctly before I do the rehab in the Sticky.

I have pain in my left-side lumbar back just above the glute. It's on one side so I don't think it involves my spine, but sometimes I can feel the through the hamstring or further up the back (such as after sitting for long periods of time) so I wonder if maybe a nerve got damaged or something.

I felt it happen after I tried to put down the weight after a heavy Power Clean, versus just dumping it (no bumpers.. foolish, I know). I got the weight down and felt a strain and within a minute, I was stiff as a board and called it a day. The next day I could barely get out of bed.

Ice helps a lot, contrast showers too (but I do only cold for the first 2-3 days, then cycle cold/hot). In the mornings it's hard to move, but once I get warmed up, the pain fades considerable and ROM is back to normal, but I feel the strain at extreme ranges, such an an ATG squat.

So I figured it was a muscle issue and I had intended to rehab it starting with Back Extensions and BW Squats. The more reps I did, the better it felt such as 25 reps, 3 sets, but after I cool down it tightens up worse than before and the next morning is even worse, so that's where I am confused.

- Do nothing? Sometimes staying off an injury lets it heal, but I hope that's not the answer. There has to be a better, faster way. I'm 21 and quite fond of things healing quickly but this back issue is stubborn.

- Or restart that same rehab protocol? Is the stiffness and pain to be expected or does it mean I am doing it wrong? I don't want to dig the hole deeper before I climb out of it and time away from Squats, Deads, Cleans, Snatch, Rows, and everything else worth doing is killing me.


Lastly, since I am limited in the gym as lifts, I have been focusing on Bench, Press, Pull-ups/Chins, and grip training; they are progressing at a strong pace too. Do I need to discontinue all of this to let my body focus on the back injury or may I continue working these since they cause me no back pain?

[Mark Rippetoe]

This a classic example of a job for a Chiropractor. It is not a muscle belly tear, but rather a facet joint or an intervertebral ligament injury. It is very common, you will have it again, and you'd better get used to the idea that you 1.) don't go to the doctor (MD-type) every time you tweak your back, and 2.) you are going to train through and around it, which you're doing well now. Traction is very helpful for these things, so get some ab straps that you hang from in the rack and learn to use them. Reverse hypers are usually good for this injury, along with back extensions, and the pain you're having now after it goes away when you train it will be helped with traction and will subside very soon as the thing starts to heal. This is an unfortunate part of training for some people, myself certainly, and you'll have to learn to cope. A chiropractor can help, if you can find a good one. I know one here that thinks that "the gravity is pulling back and to the left today", so he wouldn't work out well.

It might also behoove you to figure out what might have predisposed you to this injury. It's very often hamstring flexibility.

[GavinL]

Do you think the rehab in the sticky is the right way to go for this or am I aggravating it?

I have started it and it feels like it's helping, but the next morning I feel rigid and somewhat locked up until I get moving. I do think it's improving, but I guess I'll know for sure in about 2 weeks.

It's so hard to find a MD or even PT with a solid understanding of S&C training and I have just about stopped trying. I do see a chiro and he's trying different things, but it's once a week. The relief is great, but by the end of the same day, I'm back to where I was.

My hamstring flexibility is average, where I am beyond average in the other areas so I see that as a possible imbalance and I'm working on it. It does cause a little rounding at the bottom of a true ATG squat (hams touching calves) and I relax at the bottom a little, but I was working on that before I stopped lifting to devote to the rehab.

I'm using Back Ext as my rehab tool. Should I do the same protocol with Rev. Hypers too or pick one? Do I need to cut down on volume if I do both? I'm the type of personality to overdo it than vise versa, so it's hard not training like a madman even for a few days, hence the injuries.

I took a few days off of everything and then started the rehab.

Day 1 - Back Ext: (BW)*25*3
Day 2 - Back Ext: (BW+5)*25*3
Day 3 - Back Ext: (BW)*10, (BW+10)*25*3

If I am to add in Rev Hypers, what should day 4,5,etc look like? Or just figure it out and do what makes it feel better?

I wish I could do more volume of rehab and fix myself faster, so if that's an option..

[rmscott_75077]

I have exactly the same symptoms. It happend to me on Sunday. I went to the Chiropractor on Monday. I still have the issue, didn't seem to help, but I plan to go back to the chiropractor on Monday. I went to one that specializes in sports.

I'm pretty sure mine is related to hamstring flexibility. I did body weight squats then the bar on Thursday (3 sets of 25) it seemed to feel fine until about 1 or 2 hours after working out.

[GavinL]

Monday is my chiro day of the week. I talked about the stiffness in the morning after only light back work and he says it sounds like inflammation building up since the body doesn't move much if at all during sleep, whereas during the day I'm moving and fluids are getting drained. It makes sense and explains why I feel so much better after I get moving.

He thinks I am doing too much and causing more inflammation, and I am adding a lot of weight quickly on an exercise like Back Ext.. I suppose 25-45# *25*3 might not be the smartest progression. How do you know what weight is the right weight to work? I feel better and better (though fatigue may set in) but it's the next day that gets me.

Day 4 - Back Ext: (BW)*10, (BW+15)*25*3; Rev Hypers: BW*25*3
Day 5 - Back Ext: (BW)*10, (BW+20)*25*3; Rev Hypers: BW*25*3

Today is Day 6 and I'm contemplating adding 5 lbs (25# now) and continuing the course--getting all reps is definately not an issue, but I'm worried how to tell if I am truly doing too much. Rehab pain sucks, but I am no pussy.

This way, I can do my 2 weeks of rehab as proscribed and then make my judgements more valuable at the end, but if I am infact using too much weight, I am wasting a lot of time.

On the bright side, I think I will add back in my other lifting that doesn't stress the low back, so hey--I can do something.

I'm also looking into traction.

[Mark Rippetoe]

Hanging in the rack is very good for these problems. Get some armpit straps that the physiquers use for knee-ups and hang a couple of minutes between your sets of back extensions.