T Nation

Core Training for a Herniated Disc?


#1

17 y/o athlete here. Been dealing with what I recently found out to be a herniated L5-S1 disc for 14 months. Huge bummer, and even though I can squat and deadlift pain free, I ceased all heavy lifting upon finding out to attempt to start over after I strengthen my core.

My squat was at 355lbs for 4 when I stopped.
Dealift was at around 405 lbs.

I need help to strengthen my core significantly before I resume squats. Any suggestions?


#2

Since no one has chimed in,
If you have been cleared to lift weights:
Compression is your enemy. Find a way to decompress the low back every workout. Realize that if you continue to lift heavy, the disc may move out further and pinch the nerve. I have canal stenosis now and it sucks.
As far as core goes, I do a lot of ab wheel work, QL exercises, various low back exercises, including GHR, reverse hypers, hypers, and a lot of glute work. Most will tell you to stay away from twisting movements, but I do woodchops with no problems. I do not recommend side bends.


#3

Here is a Back Expert talking about training the mid section. He shows in a science nerd way what’s going on in your back, with a visual aid. Then shows his favorite moves.

Here is a big strong lifter talking about training after injuries. At 41 minutes in, they start talking about the herniated disk. Stan talks about using Dr. McGill’s approach. He stresses training stability and endurance over movement.


#4

Thanks for the advice. I listened to some of it. Might get the book. But should I continue or stop lifting heavy? I was planning on stopping for awhile anyway before I even found out about the disc because I play basketball, and lifting heavy, well, what I did has been detrimental to my speed and on court performance. Even though I could squat 405lbs deep, my body had become to slow to use all of the force the right way. I had planned to continue lifting again after like six months, or in March.
I’m a basketball player before anything.


#5

I highly recommend you find a PT credentialed in MDT (Mechanical Diagnosis and Therapy). I like Dr. McGill, he has some good stuff but I think he misses the mark a tad (though he is bt far one of the best ones out there and generally does get it…he’s got tons of good research, papers, and studies). That said I am a PT with an HNP (herniated nucleus pulposus) and was deadlifitng in the 400’s too (injury at 19 y/o - best strength in my mid 20’s). Honestly sitting in class and reaching to put my shoes on, or into my backpack hurt me more often that lifting ever did. If your tall (I am 6’3) and since you like basketball I am guessing you’re probably tall than that means (I am guessing here) your sitting posture is less than optimal.

Form becomes crucial (maintain that lordosis in your spine). Also look for a book called “treat your own back” by Robin McKenzie. I have seen simple changes in posture and range of motion help more people that any complex core strengthening ever did (myself included…in fact my own back pain led me to the post graduate certifications I got because traditional PT wasn’t cutting it). Don’t get me wrong, strengthening is important. However, people think they have core or back weakness and that hurt their back. If you smashed your hand with a hammer, and it hurt, how do you think your hand strength would test out? Not great probably, but it’s because the pain caused the weakness (called neurological inhibition), the weakness didn’t cause the pain. A lot of studies on core strength in people with LBP are done in people with LBP and that makes them flawed already. There was actually a study done where they looked at healthy people working in a factory. They tested their LB strength and a year later looked to see who had the most back injuries. The “strong group” had more injuries that the “weak” group. Point is, it’s not all about strength. Listen to McGill’s stuff too because I lot of people make themselves worse doing core strengthening (either choosing the wrong exercises - or using the wrong muscles from choosing exercises above their current strength level).


#6

I’m 6’1" and yea I do believe my posture can improve. I don’t get sciatica often, and activity soothes my pain. I also have flat feet (arch is completely gone’ and I have a weird knee problem where my right knee feels pain when I squat deep.


#7

Start with the “Treat your own back book” by McKenzie - it is deceptively simple, but works fantastic.I can’t tell you how many people give that shocked look after like "what just happened, how is my pain so much less (or motion so much better). It’s like $10 on Amazon. Invest in a lumbar roll for sitting. Learn more about spinal mechanics (ie. what flexion and extension is) and avoid exercises that load you in flexion (like crunches and sit ups). As for exercises, if it doesn’t hurt you, and your not losing lumbar motion or having pain during or after I’d say do whatever you like. If it hurts, or your worse afterwards you might need some more input from someone that can actually work with you. That’s my suggestion.