Degenerating disc question

[Brad Davis]

Rip,

I think I've read all of the threads on this subject around here, but have a new one. 39 year old male.

I just went to an orthopedic surgeon for some moderate "weird" mid/lower back pain and (while I was at it) chronic neck pain that's been there since I was about 18.

The back pain is not a big deal. However, I have a congenital fusion at C3-C4 and the C5-C6 disc is mildly degenerated. He said the cause was most likely one or a combo of the 4 concussions that I had in HS sports. I have minor tingling on the inside of my upper arm and on my thumb and some fingers on the left side. Left grip is weaker than right, but both are pretty strong. Have noticed over the years that heavy shrugs cause more chronic spasms in my neck, but I had no idea they were disc related. I also noticed some "weird" trap and neck muscle spasm-like pain on a set of about 300 deadlift a month or two ago. He said I'm done with deadlift, squats, presses, and anything else that loads up the traps. I'm looking for a second opinion to discuss options. Not giving up that easily.

My question for the moment is whether bench and pullups should affect this area. I can't think of a reason why they would, but I figured it was worth asking. I'd like to continue my progressions on those because I'm actually getting decently strong on bench and weighted pullups. I'm going to hold off on the squat and deadlift until I get a second opinion and then decide from there.

While I'm at it, I'll ask another one. I read that you had a fusion at 43 and it worked out ok. Any idea if a fusion would be feasible at C5-C6 if C3-C4 are already fused? Also, if you have general ideas for a good direction to go, I'd appreciate it. I think you're going to recommend a neurosurgeon, but I already have the appt with the ortho that our Div. 1 football team uses. Not opposed to a 3rd opinion--this is my athletic life I'm dealing with, LOL.

Thanks in advance.
DBD

[Mark Rippetoe]

If he said this: He said I'm done with deadlift, squats, presses, and anything else that loads up the traps., then he basically said you were through training, because you can't use barbells without using your traps. Thank all the gods he is a fool. This injury is reminiscent of my own situation, arising over the course of decades and finally culminating in a fusion at C6-7. I have had absolutely no trouble with it since the surgery, having had 4-6 "cricks" in my neck per year for the 20 years previous. You would have 2 fused segments if they fused it; many people have 3.

But here's the deal: everybody your age has some mild degeneration in some disc somewhere, and nobody is going to operate on this diagnosis anyway, not without debilitating pain. Which you don't have yet. You'll know when you do, and when it is time, get it fixed without hesitation. Until then, chiropractic can probably manage it. Have you tried that yet?

[Ryan Long]

Brad,

It sounds like your condition is a little more serious than mine, but I also have disc dessication from C3 to C6 and bone spurs pressing on my spinal cord at each level. The neurosurgeon told me I should be careful with my grappling as that will speed up further disc degeneration and bony changes in my neck, but that I was not at risk of acute grave injury as a result of either my weightlifting or fighting.

I can't shrug or I'll immediately cause neck pain (neck spasms and alignment issues) but for some reason the shrug at the end of a SNA or CLN doesn't bother me. I've managed to develop a decent pull without the use of shrugs in isolation. If I do the standard bodybuilder isolation movements I'll usually cause an neck problem right away as well.

I use a home cervical traction device that seems to alleviate alot of the arm pain. http://www.dme-direct.com/saunders-c...nit-home-trac/ My insurance paid $700 for it but you can pick one up off of ebay from $200. This model works a lot better than the cheap over the door models, may be worth looking in to.

[Brad Davis]

Thank you very much for your reply, Rip.

If he said this: He said I'm done with deadlift, squats, presses, and anything else that loads up the traps., then he basically said you were through training, because you can't use barbells without using your traps. Thank all the gods he is a fool....

Until then, chiropractic can probably manage it. Have you tried that yet?

Yeah, "you're done with training" was the bottom line message. He asked me 2-3 times "Just how strong do you think you need to be?" I came out of there without a lot of basic facts because most of the visit was the MD trying to reason with me about the wisdom of my athletic preferences.

I have not tried chiropractic treatment yet. I've never used one before, so now's the time to get started. Until the ortho visit, I didn't know I needed any treatment for my neck because I have gotten used to the spasms, etc. for 20+ years. I asked him about that pain because I was curious and was there anyway.

I know you don't have a crystal ball, but I'm wondering if you have an idea in mind of what "success" looks like in this scenario. For example, is un-degeneration (LOL) something that you've seen happen when someone has a mildly degenerated disc? Is it more likely that chiro treatment will help me keep training, with flare ups for a few years, and then someday it'll stop working, get worse, and need a fusion?

Can you see any biomechanical reason that bench press would load the C5-C6 disc? Barring, of course, pressing my head into the bench as discouraged in SS:BBT, of course--I don't do that. I use the recommended form.

Thanks Ryan.

...I was not at risk of acute grave injury as a result of either my weightlifting or fighting.

Funny term. I hope you don't mind if I steal it, LOL.

I can't shrug or I'll immediately cause neck pain (neck spasms and alignment issues) but for some reason the shrug at the end of a SNA or CLN doesn't bother me.

This brings up a question for Rip, and you too, if you care to comment. I've wondered if the discs are more affected by sustained loading or explosive loading. Some materials, wood for example, are much stronger against short duration forces, as compared to sustained loads. If discs are less susceptible to short duration peak forces, then perhaps olifting would be a good training shift.

I use a home cervical traction device that seems to alleviate alot of the arm pain. http://www.dme-direct.com/saunders-c...nit-home-trac/ My insurance paid $700 for it but you can pick one up off of ebay from $200. This model works a lot better than the cheap over the door models, may be worth looking in to.

Thanks for that info. Definitely will look into it and have been researching this subject. I didn't know what traction was until very recently when I started reading about this sort of thing.

Good luck with your lifting and your grappling, by the way. I used to really enjoy judo and jiu-jitsu classes back in my mid-20s. Great fun.

DBD

[Mark Rippetoe]

I'm wondering if you have an idea in mind of what "success" looks like in this scenario. For example, is un-degeneration (LOL) something that you've seen happen when someone has a mildly degenerated disc? Is it more likely that chiro treatment will help me keep training, with flare ups for a few years, and then someday it'll stop working, get worse, and need a fusion?

They don't heal, not that I know of. And you're right, it is likely that chiropractic will work for several years, and then you'll need the fusion. I don't think that cleans and snatches would be a better choice here, irrespective of the "strength of materials" question, because in explosive exercises it is harder to control your position with the movement happening so fast, and a situation like this is sensitive to position problems. If you find that you keep tweaking it with cleans and snatches, you may have to quit doing them.

[Brad Davis]

Thanks again, Rip.

What about the bench press question?

[Mark Rippetoe]

Can you see any biomechanical reason that bench press would load the C5-C6 disc? Barring, of course, pressing my head into the bench as discouraged in SS:BBT, of course--I don't do that. I use the recommended form.

Strictly speaking, C5-6 is not in the kinetic chain of the bench press, so there is a way to bench without hurting it. Just don't use your neck as a brace.

[Brad Davis]

Thanks again. Now as I sort this stuff out, I have at least one of the major lifts that I can do without thinking about this crap. Stinks getting old, but it's better than the "dying young" option...

[Steve Hill]

I don't think that cleans and snatches would be a better choice here, irrespective of the "strength of materials" question, because in explosive exercises it is harder to control your position with the movement happening so fast,

Which is why (as anybody who paid attention to the Shane Hamman interview could tell you) it's REAL important to be REAL strong.

Life loads us unexpectedly, and asymmetrically.

[Ryan Long]

Brad,

I'm not sure about the answer to your question about the duration of forces and disc response, but I generally don't experience much/any neck pain during strength training. When I used to do the boneheaded beach lifting routines I often had neck pain, seems that the higher rep sets and focus on upperbody work caused me more trouble. I really have to be careful about neck position when I deadlift and CLN/SNA or I jack my neck. Some people like to use a lot of head movement when they SNA, I don't. I don't even really try to pull with my traps at the top but see that it happens when I review the video of my lifts. Rip's recommendations on neck position have been key for me. I've competed in WL a few times and trained in it for a couple of years with no problem, I'm not training to compete in a PL meet next month and haven't hurt myself yet, and I'm pulling some almost respectable weights.

As far as 'healing' the discs, I'm not sure if its really possible. My PT, who used to do chiropractic adjustments on my neck when it was really bad, was a big proponent of traction because he said the it allowed the discs to "reinflate" with the surrounding CSF. Sound hokey to me, but it also seemed to help. At the very least traction reduces pressure on some of the impinged nerves and reduces some inflammation. If you can get your insurance to cover a good traction device (not the over the door type) I think it is worth it. Hell, might be worth paying out of pocket too.

Good luck.