I have been lurking on these forums for some time now, but I want to share my story.

I am a 41 y/o male father of 3, busy at home and work. I have had low back pain on and off for most of my life, but my first experience of severe pain was at age 30, with an intense spasm and pain after bending over to change my kid’s diaper. I could not walk or move for 1 month. I was diagnosed with a slipped disc without any imaging or a proper evaluation and eventually recovered. Over time, these intense spasms starting becoming more frequent, longer lasting, and the pain which ensued became more debilitating.

I am a physician, but trained in another area unrelated to the spine. I sought care from local experts at the academic center where I was in residency at the time. On pelvic xrays, the right ASIS was found to be lower than the left by 1.2 inches. Although direct measurements of tibial and femur lengths have not been performed, I have self-measured and confirmed this to be a true anatomic LLD, part tibial and part femur. I was told to shim my right-side shoes by 1.2 inches, do some stretching, and go along on my merry way.

I shimmed one pair of my work shoes and soon had worse pain and more frequent pain, so I went back to wearing regular shoes and ignored the problem for a few more years. A few times a year this pain would come back and I would self-medicate with NSAIDS, steroids, muscle relaxants, lyrica, and some good whiskey.

At age 35, I started having painful episodes while just sitting with my kids in my lap, or light movements. An initial lumbar spine MRI indicated an 8mm spondylolisthesis with pars fractures, severe L5/S1 bilateral foraminal stenosis, and some scoliosis. These spinal deformities are presumably secondary to the underlying anatomic leg length discrepancy and perhaps shit luck. I saw a few specialists, including a physical medicine/rehab specialist, a spine surgeon, and along the way a couple physical therapists, and a few great chiropractors. All offered a combination of either steroid injections, surgical intervention, or light modified exercises found in workout magazines for the elderly.

Nobody recommended strengthening my core and posterior chain, except for the chiropractors.

I worked through things, did some light PT, shimmed all my right-side shoes, starting with 1/8 inch and worked up to about ¾ inch on all of them over a few months. The slow approach to the shimming seemed to work better than the rapid approach. Apparently, the leg- length discrepancy is not to be fully corrected if caught this late in life, which was not part of the instruction I received earlier.

The spasms seemed to resolve, but the pain never really went away and the occasional severe bursts of pain continued every few months. I started reading about strength training for low back pain and came across something called stronglifts 5x5. I started lifting on my own at a commercial gym. I felt better pretty quickly, but had poor technique, and I thought I wasn’t doing enough “cardio”, so like a moron I added in running on the off days when I was not lifting.

Needless to say, due to poor form, lack of understanding an appropriate stress –recovery- adaptation cycle, and the pre-existing back issues I never it made it close to even a body weight squat (205 lbs). At the same time, the back pain starting returning in full force.

I was in a different part of the country now, and established care with a different group of surgeons, chiropractors, and physiatrists. I was chastised for squatting and deadlifting and “making a difficult situation worse”. I was instructed to go back to light modified exercises with resistance bands, swimming, and again surgical intervention or steroid injections. What has been suggested is an L5-S1 posterior laminectomy with fusion.

I happen to be a stubborn ass. I continued to ignore the advice of colleagues, my doctors, and my wife, who regularly calls me worse things than a stubborn ass.

Of all the people whose advice I ignored, the last person who I thought I would listen to was my mother-in-law, who heard about something called Starting Strength, and more importantly that there was a SSC coach in my area. I immediately called this man, Phil Meggers, who has made a significant impact in my life.

When you have a coach who understands spine biomechanics, the stress-recovery-adaptation cycle, and who can monitor your form and progress, you can make a difficult situation like mine better. I read Starting Strength, from front to back, and I started a classic linear progression. Phil watched my lifts, adjusted a great many things, and all lifts improved dramatically. We experimented with how much to shim my lifting shoes, and over the years have found 5/8 inch to be about right for squats, and one inch on deadlift shoes. Phil hosted a Starting Strength seminar a few years ago which I attended and I received valuable insight from Rip and his team. Rip called me “all sorts of fucked up”, which I took as a badge of honor, because he still taught me.

Fast forward a few years later, and I have brought my squat and deadlift up to double body weight, and can bench and press more than I ever could before. I can’t say the pain is completely gone, but is much more manageable, and I am much more resilient to injury. I still have occasional back spasms, and in Rip’s words there are still certain activities that “piss off my back”, which I avoid doing - cleans, snatches.

The last severe back injury I had was a few months ago, squatting 360 lbs, which was 80% of my squat one-rep max then. It just happened to be a day where I was not fully warmed up. The pain was bad enough that I repeated my low spine MRI. Amazingly, 5 years after true strength training my MRI had NOT changed. I have images if anyone is interested. My spondy is stable and the lateral foramens at L5/S1 still have “severe stenosis”. Before I started lifting with a coach, I would injure by back picking up my toddler or cleaning my house. Now my injuries occur under a heavy squat – and I recover much faster. I am working my way through it now and feel great.

My life is very different now. I rarely take pain medications. I am the strongest I have ever been. I plan to be stronger at 50 than at 40, and the only remnant from my pre-starting strength life is that I still drink good whiskey.

At some point in my life I will very likely require surgical intervention, but when I do my recovery will be swift and I’ll be back to lifting again. I am not saying this plan will work for everyone with spinal defects nor am I telling you to ignore the advice of the medical establishment. This is a reminder that you must be the seeker of your own truths. Thanks Rip, and a shout out to Phil Meggers, who has become a good friend and the best coach I know.