Need help training someone with back issues

[Shaun Pang]

I'm currently training someone with back issues. His complaint is that when he wakes up in the morning, his back will be crooked - his spine is curved to the right when viewed posteriorly. He experiences pain when he climbs up the stairs quickly, jumps, walk briskly and sometimes randomly throughout the day.

On a few occasions, after a few hours of awakening, his spine straightens out and stays that way throughout the day. Usually, it stays curved. The worst part occurs when he wakes up in the morning (doesn't occur if he takes naps during the day). It also seems that his right erectors are slightly atrophic when compared to the left. Currently getting him stronger in general using barbells. All exercises are done pain free (once in a while he overextends on the press, which cause pain, understandably) and I'm getting him to spread the load evenly laterally (push his hips to the right slightly so that his spine is straight during deadlifts etc)


He has a scan done a few months back and this was the doctor's findings.

There is normal alignment. No spondylolisthesis is seen.

At L1-2 level, there is a mild diffuse disc bulging and marginal osteophytic bone ridging, mild decreased T2 weighted signal of the intervertebral disc suggestive of mild disc desiccation, and a superimposed small broad based focal left paracentral disc protrusion. There is a mild central spinal canal stenosis and no significant neuroforaminal stenosis at this level.

At L2-3 and L3-4 levels, there is diffuse decreased T2 weighted signal of the intervertebral disc suggestive of disc desiccation, mild diffuse disc bulging and marginal osteophyte bone ridging. There is mild central spinal canal stenosis at L3-4 level

At L4-5 level, there is diffuse disc desiccation, mild diffuse disc bulging and marginal osteophytic bone ridging, central annular fissuring and a superimposed broad based focal central disc protrusion. There is mild central spinal canal stenosis but no significant neuroforaminal stenosis at this level.

L5-S1 level, no significant abnormality is seen

The conus medullaris is of normal configaration and is at T12-L1 level. The bone marrow signal is within normal limits. No vertebral body compression fracture is noted.

Provisional diagnosis: chronic prolapsed intervertebral discs with degenerative disc disease for further mx.



Is there anything I should look out for/what other steps should i take/what should be avoided? Thank you for taking time out to help!

[Mac Ward]

How old is he?

Nothing abnormal. Keep it simple, slow steady weight increases with perfect form, solid rest, and nutrition.

[Shaun Pang]

He's 44 this year. Ok, great. Will do so. Thanks Mac.

[Shaun Pang]

Not sure if the previous reply went through. There seemed to be some issue after I hit submit reply.

He is 44 years old. Thanks Mac, will do so. Just curious, what are the likely causes of something like this?

[Mac Ward]

I have no idea.

But the readings look like most adults, I wish my back was that good. I would train him slowly, work LP, gain his confidence, and let the program work.

[Shaun Pang]

Will definitely do so. Thank you once again for the help.