T Nation

Herniated Disc

Greetings Gang,
I am 38 years old and have gotten back into the lifting groove for the past 10 months after a 3-1/2 year layoff. Thanks to T-mag and the things I have learned there about nutrition and lifting technique, I have been able to reclaim and surpass my former level of strength and size. Unfortunately, after getting jazzed about full squats and slower tempos, I herniated a lumbar disc during a set of squats. I think the biggest problem was that I took them too low, and my lower back, lumbar region, ‘rounded over’. Also, my hamstring flexibility is somewhat lacking, prevent my pelvis from maintaining the proper rotation in the bottom of the movement.
I read warnings about this in T-mag, but didn’t have a good enough mental picture to realize this was happening to me. Take a minute to turn sideways to a mirror without weight and check your form, or have a friend watch your lower back as you squat! Your lumbar region is supposed to maintain a curve inward toward your stomach. I think a special article on T-mag about this would be great with photos of lumbar region showing exactly what this ‘rounding over’ looks like. In the past, I squatted more than this with rare episodes of mild and temporary low back muscular pain (could have been cumulative damage, I guess). When the disc finally herniated, I was ‘only’ squatting 225 and feeling fine until I felt a couple of pops down in my lower back. The next morning, I knew for sure something bad happened!

Well, I consider myself lucky because my sciatic pain only lasted a few days and I am back to work, but I have some partial numbness in my right foot. The doc says most people recover well in 3-4 weeks without surgery. I think this is the classic L5/S1 nerve impingement “S1 radiculapathy”. I have no pain walking, stretching, bending over, etc, and can still work out, although I am choosing exercises that greatly limit spinal compression. I have read that walking is very good for this since the discs don’t have there own blood supply and walking helps pump nourishing spinal fluids into the discs.

I would like to hear from some of you who have gone through this already. I realize that every case is different. The doc told me that the fibrous ring of the disc would heal back up, the herniated center (‘jelly’) portion would eventually dissolve, and the disc probably would not herniate again. What has been your experience? How long did it take for the numbness to clear up? Were you ever able to squat again? How about picking up heavy dumbbells?
The doctor has not given me a specific list of therapeutic exercises, although I am familiar with the usual pelvic tilts and stretching. I picked up a set of inversion boots and feel that this decompression therapy has helped some. If any of you have been through therapy, I would appreciate some descriptions of the most helpful exercises you performed.
Thanks in advance for your advice.

You are part of the majority as far as healing goes. 60% of these cases get better without any medical treatment. Just take it real easy for a while and walk A LOT. It’s true walking is the best exercise for a herniated disk. It sounds like you have a good doctor.
Reading your story sounded very familiar. I had the same thing happen to me, only my original doctor was a moron. He told me I had pulled a muscle, so I just worked through the pain thinking, “it’s only a pulled muscle”. Well it got worse, and by the time I found a good doctor it was too late. My case had slipped into the 40% that require medical treatment. I dealt with the pain for about 4 months. I had one epidural steroid injection and it did nothing for me. My doc finally decided to perform a lepenectomy to remove the ruptured L5 because the sciatic nerve was beginning to scar, and I was not responding to any other form of treatment. Deep “ass to grass” squats are not worth the risk if you ask me. I will never go below parallel again, and in fact, it will be a while before I get the guts to squat again period.

If I were you, I would wait until you are completely healed before doing any back exercises. Better safe than sorry. I would not wish the pain of going through back surgery on my worst enemy. Hope this helps!

  • Jason
 I am 36 years old.  I had a double lamenectomy in 1994 after rupturing l-4/l-5 and l-5/s-1.  (Career ending on the job injury.)  I started lifting weights and getting into bodybuilding during the rehab. My doctor told me to get in the gym, but not to work legs or anything that might compress my lower back or risk re-injury.  He said if I made it 5 years without a re-injury, I'd be as healthy as possible.  <P>
 I knew that not working legs was restricting my growth but I was so scared of re-injury, I stuck to the doctor's advice.  4 years, 360 days later I was back in the operating room.  Seems I somehow re-injured the l-4/l-5 disc.  Prior to this surgery I was feeling fine and enjoyed any activity I chose.      Last year I had a sudden onset of lower back pain, followed by a severe aching in my entire left leg, followed by "drop foot".  My doctor, a neurologist that works with Washington Redskin players, told me he believes that the fact that my legs did not grow like my upper body created a muscular imbalance and contributed to the re-injury, since we could not determine what else would have caused it. (I went from 6-2, 185 lbs. to 6-2, 215 with the same body fat levels.)<P>
 He told me I would be as good as I can get in a year.  Well, it's been a year and I still have "drop foot" (cannot curl my toes up or move my foot side to side.)  When I walk bare foot my left foot kinda flops on the floor like a swim fin.
 I have started doing hack squats, legs curls, and leg extensions.  I figure if not working legs still lead to injury, maybe working them will reduced the risk.  I am also addicted to my lifting belt, and devoured Paul Chek's articles.<P>
 I also suggest that you take it slow.  If you can find a Med-Ex brand, lower back machine at a physical therapist, use the shit out of it.  I used one in California after the first surgery and my lower back strength shot through the roof.  Haven't found one in Virginia yet. 
 Best wishes.

I had a Herniated Disc between the S1/L5, about 4 years ago from playing basketball. Mine required surgery, the pain was so bad i coulndt even sleep. To this day i still have no feeling in parts of my foot since the nerve got damaged so bad. This is what got me into working out.
I think squatting and deadlifting was important into getting my strength back. I started off doing light wieght, like 135lbs (or less), but with doing reps with 10 seconds down. Or maybe doing some 10x10 squats forcing me use light weight. It was a slow recovery process and now can do 315 for a few reps with no problems. My deadlift is also 405 for a few reps. Not bad considering i had a disc removed. I made hard work with light weights and it paid off.
Also used various swiss ball exercises, lots of walking, and lots of research. Its something you will have to live with the rest of your life. All my technics and back awareness is second hand nature for me now, causing me to live a pain free life. Your already in the right direction reading here, i have no doubts that you will be fine too.

Thanks for all the comments so far. So far, inversion therapy with boots, stretching, and using lumbar supports have helped be become more consious of the proper lumbar curve. The sciatic pain is all but gone. I have been able to train legs with one-legged squats and bike riding (just got a suspension mountain bike!).
I still have some slight numbness in my right foot, and a little weakness flexing it and the toes upward.
I can still train abs comfortably and have started doing hyperextensions with body weight (misnomer since I stop at horizontal position).
I am trying to keep the supporting musculature strengthened to support my spine.
I would appreciate any advice on a time frame before even attempting light squats again. Fe, your post was very encouraging for future ability. I would like to at least squat my body weight for training in the years ahead.

Hey FE, I also appreciate the encouragement your rehab results have given me. I can’t wait to start squatting again. I guess I am on the right track. So much for listening to the doctors.

There are some areas that might benfit fromART inyour condition. It won’t heal the disc, but if there are any areas of myofascial restriction, it would help. I would check you hip external rotators(piriformis, gluteus medis), the long dorsal sacral ligament, the sacrotuberous ligament, and the hamstrings. Also in the lower back look for problems in the multifidi, rotatores, and the quadratus lumborum. It was interesting that you mentioned a lack of hamstring flexibility. The stress will come out someplace if the sacral ligaments have adhesions.
The rest of the advice is good. Keep up the walking.

I began working out about 3 weeks after surgery. Started out slow using mostly machines for 1 month. Slowing working my way to dumbbells. I would say it was around 3 months after surgery I started to squat. I remember using quarters the first time. But even before I attempted squatting I did lunges with dumbbells.
My Doctor was great with working with me. I told him what I was doing at the gym, and he liked the idea a lot, encouraging me. I turned out great, but keep in mind I was around 22 yrs old at the time. Being 38 you may take a little longer to recover, everyone’s body is different.

Its good that you are walking. I walked about 2 miles every day for much of the summer months ( I had surgery in June). I did a bit of Paul Chek research, reading articles and listening to audio interviews. http://www.paulchekseminars.com
Its time to prioritize your back for a while, its something you have to live with forever. Approached right and taken care of properly, you wont have to deal with it forever.
Once again good luck.