Lower Back Injury MRI Results

[reckless]

Hi Mark,
just wanted you input on rehab / training with my condition.
I injured my lower back while squatting during 1st week of january...bad form since i think i tried to extend my back too much...anyways heard a pop and dropped the weight and had difficulty in standing up, sitting down for too long and all forward and backward bending.
Took pain killers and only got a mild relief after that got soft-tissue release, manipulation, joint mobilization. These restored range of motion but i started getting numbness / tingling on my right side (side of glutes, groin, calves, big toe and heel) and tightness on my right glute and lower back which wont go away.
.
So the doc asked me to get my MRI which showed this:

Transitional vertebra is seen at the lumbosacral junction with sacralized L5 vertebra.

Disc desiccation in the form of loss of normal T2weighted hyperintense signal of nucleus is seen at L2-3 and L4-5 levels

Posterocentral disc protrusions with posterior annular tear are seen at L2-3 and L4-5 levels causing indentation upon the thecal sac and mild narrowing of bilateral lateral spinal recess. Mild central canal stenosis is seen.


I started deadlifting very light weights and have made it 65 kg X 8. Now i'm afraid to add weight. my best before this episode was 130 kg x 3. the PT has asked to avoid extension based exercises since tear is posterior.

so can i continue deadlifting or will it hinder recovery and how slowly should i increase weight, also which execises to avoid

Thank you for your help.

[reckless]

anyone?

[Nate9]

You can keep going trough your lp, people with back problems do and get better while getting stronger, plenty of articles and threads about this topic on the website. You might want to avoid back extensions and situps, basically all the stuff that requires you to move your back around.

[Jstrause]

What was the pain response (during the lift and after) when you were deadlifting?

Personally, I think if your PT is basing "treatments" and recommending changes to training purely on MRI findings then he is misguided.

Also, if you developed radicular symptoms after this PT manipulated/STM/mobilized you, it may be a good idea to stop going to this PT.

[reckless]

thanks for the reply Nate9 and Jstrause.

You can keep going trough your lp, people with back problems do and get better while getting stronger, plenty of articles and threads about this topic on the website. You might want to avoid back extensions and situps, basically all the stuff that requires you to move your back around.

thanks...will avoid back extensions and situps

What was the pain response (during the lift and after) when you were deadlifting?

Personally, I think if your PT is basing "treatments" and recommending changes to training purely on MRI findings then he is misguided.

Also, if you developed radicular symptoms after this PT manipulated/STM/mobilized you, it may be a good idea to stop going to this PT.

thanks for the reply...i usually don't get pain after deadlift (maybe because weight i'm using is light) only sharp tightness on the right side of lower back...even when pain occurs after deadlift (2 out of 10 times.) its a very dull one

However, what bothers me is that deadlift doesn't make the tingling and numbness go away(sometimes increases them slightly) ...in fact this tingling and numbness on my right side is so random i haven't been able to associate its increase or decrease with anything (neither the PT could figure out)...except for when i do an anterior pelvic tilt i can feel it immediately in my groin area upto the outer right side of my balls. also cant walk for long as the right leg and foot start getting affected and i start somewhat limping.

i consulted another PT and this one is saying i need to stop lifting weights till these radiating symptoms go away and can only do core stability exercises and all..the doc says the same....but i dont want to stop lifting....my rehab with deadlift was going on fine till the onset of these radicular symptoms and now i'm confused.

[GammaFlat]

Hi Mark,
I started deadlifting very light weights and have made it 65 kg X 8. Now i'm afraid to add weight. my best before this episode was 130 kg x 3. the PT has asked to avoid extension based exercises since tear is posterior.

so can i continue deadlifting or will it hinder recovery and how slowly should i increase weight, also which execises to avoid

Thank you for your help.

I'm surprised the PT thought about the issue as much as he/she did. After meniscal tear knee surgery, the most my PT wanted me to do was absolutely unweighted range of motion "moves" for months. I told him I wanted to squat. The look on his face was as if I'd killed his pet. Emotional, offended, hurt and mouth agape. I am not a doctor nor professional in the field of medicine or rehabilitation. My comments should not be construed as advice. I only pass along my thoughts as what I might do and what my experiences have been.

First of all, I'm fearful of an MRI on my back because I think my report might look like yours. Any time I tweak my back, I find that squats with the 45lb bar are the very first thing to do. I avoid acute pain but as soon as I can do the bar without acute pain, I am on it. Add weight slowly.

This morning I could not navigate stairs normally due to bad ankle sprain and knee problems (recent meniscus repair). (I chronicle my ankle sprain with an attempt at levity in another thread). I got in the cage with just the bar today and pulled off 5 reps with no acute pain. I added 50 (2 25's) then replaced the 25's with 45's. 5 reps with each. I decided to leave good enough alone for today. I don't count this as a workout and feel like I could do that daily or even multiple times per day. I am now navigating stairs. I feel like I must sound like an idiot because I almost don't believe it myself (every time I'm recovering). The advice on this site (Bill Starr Injury Protocol) for recovering from injuries is borderline magic. Don't get me wrong, my knee and ankle are still not perfect but they are far more usable with less pain.

[Jstrause]

In my experience (I am also a PT) most people tend to respond better to lumbar extension movements (deadlifting) with these types of issues. If you are able to deadlift without drastically increasing the symptoms then I see no reason for you to stop with your LP. If you told me you finished a set of 5 and walked away with a drop foot, then I would be concerned. I would just make sure you are extra vigalent about your form to avoid any lumbar flexion throughout the pull or other lifts - maybe a form check from a SSC would be beneficial?

As far as the PT and the doc recommending "core strengthening", this is just the default recommendation when they do not know what to do about your problem. They are just hoping you take a few weeks of doing absolutely nothing (glute squeezes, transverse abdominus exercises, clamshells etc.) and you just get better on your own. This is why most PT is worthless and it has the reputation that it does.

There was an excellent podcast episode about a year ago that spoke to a military member who went through something similar and rehabbed with barbell exercises. Might be a good listen to give you some more info and reassurance.

[Meshuggah]

I highly recommend the McGill Big 3

[Jstrause]

I know you posted that as a joke, however, if you walk in to the majority of outpatient PT offices this is exactly what you will see.

[Meshuggah]

No joke at all. You must be uneducated about Dr. Stuart McGill.