T Nation

Back injury....

On thursday morning, I did some moderately heavy deadlifts and squats. Used excellent form, everythig went smoothly. Went home fine, no problems. Woke up friday morning with a stiff lower back and a twinge in the lower right side of the back. Not really too bad. Saturday, I woke up and it hurt more. Everytime I do much movement with my right leg, or get out of bed, it’s a painful twinge. The twinge is actually lower in the lower back, sort of right where the bone starts near your ass. It feels like it’s under that first bone, and on the right side of the spine.

Whats the deal with this? Anyone have any suggestions? It’s Monday morning now, and I still have it. I massage it a bit myself, and it loosens up my back a bit, but the twinge stays. Thanks .

Could be your siatica (sp?). That pain usually radiates from the lower back. You probably need to strengthen your lower back too. Not too many people pay any attention to those little muscles, but a strong lower back muscle can prevent all kinds of discomfort.

It’s your SI joint you’ve strained. Happens to me once in a while when I overtrain lower back. Give it a few days, but don’t stretch it. Ice will help. Heat will not. I’m usually fine in 2-3 days. Never stopped me squatting, but DLing was painful.

Thanks guys. This thing sucks, I hope it goes away soon. It’s been 5 days and it’s still killing.

Mike,dont’ hope it goes away.get your butt to your doctor.self diagnosis is never a good idea,believe me I know.I feel for ya man.hope you feel better soon.

Is the pain near the “dimple” at the top of the buttock? Lie on your back and cross your right leg over the left, with the right knee bent 90 degrees and the ankle just above the left knee. Let the right knee drop to the floor so your legs form a “4”. No have someone push down on the right knee and the left hip bone. Does this reproduce some of the back pain. Try this with your legs reveresed. Also lie on your back and have someone push down on both hip bones and then push them together. Does pushing down reproduce pain and pushing together relieve it? If so, you may have an ilio-sacral or sacro-iliac dysfunction. See an osteopathic physician, a chiropractor or a phsyical therapist familiar with osteopathic manipulative therapy to diagnose and treat this. Without an hands-on eval there can be no definitive diagnosis, but the SI/IS joint is a possibility that fits your description but which most people are not familiar with. Let me know what you find.

The pain is near that dimple, and is deep to the surface. I’ve just tried the “4” position and had no pain. Actually, the pain has lessened since yesterday morning. It feels a bit stiff, but not much pain, only an occasional twinge. It seems to be getting better. Thanks for the tips guys.

I had a similar problem. I would feel the pain down in my calves. I went to a chiropractor and he said my back was out of alignment. He kept working on my back for a month telling me it was looking better. I got tired of him and went to my doctor. The doctor said I probably had an inflammed disc and it was hitting a nerve and that is why I would feel discomfort all the way down my leg. He gave me some meds for the inflammation and in a week the pain was gone. I gave it two more weeks with no pain and began working my back and legs(lightweight). No problems since. The funny thing was when I told the Doc I went to the chiropractor the first thing he said was “Did he say your back was out of alignment”

I’m glad it’s better now. It does sound like an IS/SI joint problem; these frequently clear up on their own. Still, I’d recommend having someone treat it the next time it flares up and having them show you how to treat it yourself (and self-treatment is possible in less severe cases).

My reasoning is this: The joint is held together by ligaments and the roughness of the articular surfaces of the sacrum and ilia. If the joint stays out of position for long, there may be a permanent elongation of the ligaments which will lead to long-term instability of the joint. Secondly, as the joint moves outside the anatomically-correct positions (it is designed to move only about one degree, which is so small that some back surgeons with allopathic, i.e. “MD” training rather than osteopathic training, will tell you that the joint does not move!), there is the possibility of eroding the articular surfaces. As these surfaces get smoother from grinding in the incorrect position, the joint becomes less stable.

No, I don’t know of any studies or data to support my contention, but it makes anatomical sense and I’ve run it past other PTs who agreed. Anecdotally, I’ve seen two people with chronic IS/SI joint instability and their situations seemed to fit my hypothesis. Basically, I had a patient who could not even roll over in bed without this joint making an audible pop–and the guy was literally bedfast due to back pain. Getting onto a bedside commode was torture. An extreme case but it was unforgettable. The other guy, whom I’ve known personally for over 20 years, had a sports injury to the joint about 20 years ago. When he was injured, he just spent about six weeks letting the joint heal up on its own and has had IS/SI episodes at least a couple of times per year ever since. I strongly suspect that had he had treatment at the time of the injury, he would have been healed up in a couple of weeks and had fewer if any subsequent problems.

As for chiropractors...oy vey. There was an "expose" of sorts in a consumer mag a few years ago about how chiropractors pad their practices. Basically, joint mobilization like chiropractors and DO's perform (to "pop" the joint) is ideal for certain acute injuries, but this three times a week for months stuff verges on fraud from what I can tell. (A Rand study chiropractors are fond of citing indicates that chiropractic is the most effective treatment yada yada yada. What the chiroprators don't tell you is that this is for *acute* orthopedic injuries--i.e. like during the first couple of weeks at most. After that acute phase--for certain problems--you need something else. And some chiropractors apparently honestly believe they can cure cancer with chiropractic!!!! No, I'm not making that up!!! They've turned an insight into a mania! And then some of these losers, in my state, attempted to give chiropractors the exclusive right to treat the spine, thereby putting many physical therapists out of business, physical therapists who have spent years of extra training in many different schools of thought on back treatment and who each have literally hundreds of satisfied patients! And, some of these chiropracors advertise that they perform "physical therapy" in their ads, i.e. they give hot packs and massages! (As you can imagine, there were some legal moves to end this use of the term "physical therapy").

Do I hate all chiropractors? No. Some I’m sure would be worth entrusting with my life. (A DO whom I respect makes quiet referrals to some chiropractors he respects, so I know such chiropractors exist.) But the field is inclined to overreaching (e.g. curing cancer and literally every other ailment through manipulative therapy) and is populated with some incredibly unscrupulous folks due to a lack of self-policing. (In fairness, the medical profession needs to police itself better, but it is still better than the chiropractic field.)

Okay, okay. Breath slowly and deeply. Imagine a verdent forrest…Maybe I need to go do a few squats!