T Nation

L4/L5 and L5/S1 Disc Protrussion


#1

Hello, I'm wondering if there are any powerlifters/practitioners/any1 that have had any success rehabing/treating lumbosacral issues.

I'm pretty sure my L-SI is hypermobile, and my hips are rotated (Left Side is more Posterior and Right Side more anterior).

What Kind of started all my issues was a hard fall onto my PSIS (3yrs ago) and a miss grove in a squat (1.5yrs ago) on first rep of last set of 405 x 5 x 5. Felt a pop on left side and immediate pain. A chiro said my glute gave out and my sacraltubro ligament took the load and I strained it.

Up and till April 2015 I was still able to train pain free with regular visits to a chiro (L-Si adjustment and Glute ART) and very lengthy warmup before SQs/DLs.

After April 2015 I did Provincials and won @ 181 w/1422 Total and decided to take time off to get my injury under control (because I want to be able to lift when I'm 40 etc- currently 24)
-I got a MRI (October 2015) which revealed L5/S1 Protrusion on S1 nerve Root
-I got a PRP Nerve root Block (Janurary 2016) on the S1 nerve root to relieve pressure - which provide basically no relief - which I feel ruled out the S1 never root as the cause of pain.
-Between October 2015-Till now I've been doing McGill exercises (Bird Dogs, Side Planks, dead Bugs, Cat/camels) before every work and on off days of gym, as well as McKenzie / Williams protocols
-I took 3+ months off of squating and Deadlifting (since Jan 2016) and Haven't touched a heavy weight since April 2015.
-I just started DLing and Squating for about 2 months now - Doing Trap Bar DLs and Sumo to be easier on the lower back as well as alot of uni-lateral (rear foot elevated SQs) as well as front SQ/Safety Bar Squats.
-But even with these modifications I'm crippled the next day and these movements cause pain/discomfort and I can feel my L-SI really load up and doesn't feel good.

-Now I'm Starting to think I should lay off even trying to DL/SQ with the variations as I feel it loads up my joint and will stick to the leg press and uni-lateral work.
- My GF/training partner saying im Babying my back and of course its going to hurt getting back into SQ/DLing- but I feel if the movements (SQ/DL) didn't cause my pain before they shouldn't now as pain is an indicator of something not working right... I'm sure I'm babying my injury/ I'm overly hypersentive to any little ache/pain. Am I wrong or should I experience some discomfort
-As well Im going to start benching with my feet up to avoid pain when I have an arch (its a small to moderate arch)
-I also made modifications such as sitting on a swiss ball while on the computer etc.
-Currently Im doing McGill Exercises i stated above usually about twice a day (morning or pre workout and before bed) which is strengthening my core, but hasn't really resolved my L-SI /lumbosacral stiffness.
-I've done some research and What I'm Thinking is getting a Trochanter belt to help stabilize my pelvis and help the ligaments re-tighten to stabilize my L-side (they say to wear it 3-6 weeks- then do glute strengthening exercises)
-As well start rolling out my arches in my feet, TFL, Glutes more often.
-I also just got another MRI done 3 weeks ago and I find out results on the 12th.

My current Symptoms:
-Stiffness lumbosacral Area (when bending at hips)
-Pain in L-SI / Sacrum when I instate a hip hinge
-Pain/discomfort when Sitting
-I feel Tightness In a Ligament connecting to Sacrum through my L-Glute.
-I have muscle aching/throbing in my -L-Glute / TFL / tibialis anterior (usually when sitting)
-Erectors really tight (try to stretch them but too painful)
-Sometimes when I'm Walking get sharp pain L-SI/ Sacrum area because pelvis feel un-stable (especially when all the weight is on my Left Left in the gait cycle)
-Alot of sharp Pain in L-SI / Sacrum Area when I sneeze (Pretty sure its not sciatica - its stay local - doesn't go into glute- just feel pain in L-SI/Sacrum area)
-Even when benching with a small-moderate Arch creates a sharp pain in L-SI area and what also feels like the Facet joints jamming.

Additionally If anyone can help me make plan/rehab strategy that would be great.
-Currently My Plan is
-still do my McGill Stuff as it is strengthening my core
-Self myofascial release on Glutes/TFL/Erectors/Hip flexors
-In the Gym on Leg day do alot of unilateral training (doing 2:1 Left to right ratio for sets)
-Avoid SQing/DLing and benching with arch (as these cause discomfort)
-Sitting on a Swiss ball
-sleeping with pillow between legs
-wear a trochanter belt 3-6wks
If anyone has any exercises I should add to my list that would be great.

As well Does anyone know of a good practitioner in Toronto who actually lifts that would be good to possible treat me. I'm trying to figure this out on my own as money is tight. I really want to get back to competing, but for now I just want to get out of daily pain.


#2

Just Received my new MRI results and they are:
-New small right paracentral disc protrusion L4-L5 not causing any nerve root impingement
-No significant change in the size of the small to moderate posterior diffuse disc protrusion L5-S1
-New posterior annular tear at this level. The disc is intimate with the descending left S1 nerve root similar to previous finding
-Facet Joint hypertrophy and neural foraminal narrowing

The Dr. Advice now is: lose 7lbs and to get leaner. As he said for every pound I lose its 7lb of pressure of the disc and it will open up neural foramen.
-so he want me to get down to 175 and Im currently 182 which will supposedly take off 49lb pressure from this injured area.
-He said to keep doing McGill exercises (planks, bird dogs, dead bugs etc)
-He also said to avoid squating and deadlifting and bench with my feet up which I knew he would say

What was depressing he said to never Squat or deadlift again. Am i Fucked for life? The results on MRI look and sound bad anyone ever make recovery from this?

For now I'll keep doing McGill Exercises, lose 7lbs like he said and get leaner, and avoid compressive/shear force loading on the body (SQ/DL's). I meet with him again at end of August.

If anyone has any advice it would be greatly appreciated.


#3

Find a way to do decopression. Lots of videos on youtube.
Sphinx position is one.
I hang off a GHR while holding a weight-Before/during/after workouts and flex the hamstrings some then relax to let it release.
Do lots of reverse hypers.
Look into piriformis stretching.
I have bulges at 2/3 and 3/4. I have degeneration at 4/5 and S/1.
Years ago I quit working lower body except machines... that was a big mistake as it only got weaker and hurt more.
Now at 50 years of age, today I did reverse hypers, paused box squat, rack pulls, tbar rows, and good mornings for lower body. I'm in less pain than I was at 35. My other lower body day will reverse hypers, deadlifts, speed squats, and GHR.
Regardless of whats wrong, healing comes from blood getting pumped in it, so you have to work it if you want it better.


#4

I posted this in reply to another member aswell.....
I'm 38 and now facing being medically retired from the FD with a back injury. I'm at 17yrs of professional service, 20yrs total, and currently a Captain. I have been lifting sine I was 17, wakeboard, snowboard, hunt, and fish. Father of a 6yo 4yo and 2yo. I starting dealing with low back pain a couple years ago. The Drs and I have tried everything! L5-S1 disc extruded, pushing on the nerve root, and now collapsed. Both the orthopedic and neuro surgeons say I need a TLIF Fusion that will effectively end my career and change my life as I have known it physically. That being said, I'll fight on. I'll continue to enjoy activity levels that 80% of the fucks in our population can't and wont do without being injured. You can too. I'm not gonna lie, Ive cried, but dont give up. I know this is a lifting forum and I've lifted hard my entire life. If you are injured at 2 levels you need to BE VERY CAREFUL. I never thought this would ever happen to me and I'm not giving up hope of getting better, but the reality is you only have one spine and there are not many options to fix it if it goes bad "especially at 2 levels". Your life will be forever changed. Stay as active and strong as possible if for some reason you start facing what I am, dont take the pills, and please listen to you backs fellas.. Good Luck!