T Nation

Left Glute/Low Back/Hip Injury (1+ Year)


#1

In October 2014, I had been running 5x10 squats and deadlifts in my workout for 8 weeks and felt my lower back was taking too much of a beating (no real pain; just felt like it needed a break), so I ended the workout 4 weeks early to start a different program using lighter weight. Immediately as I ascended into my third rep on a warmup set of squats, I felt something slip/shift in my low back and had to rack the weight right away. The pain was localized to my left low back area. Besides a 6 week period of relief from early March to mid May 2015, I am still dealing with the injury and cannot work out without possibility aggravating the injury further.

I have seen two chiropractors, an acupuncturist/sports medicine doctor, a sports medicine doctor, a physician, and a self-proclaimed "healer" all of which I have learned something from but none of which have cured me of my issue. I haven't gotten a correct/confident diagnosis from any of these people about what is truly causing me this pain. I am going to list everything about my injury as well as some of my body's irregularities that I think may be contributing to my problem to see if any of you guys can help me figure out what's going on with me and/or how I can begin to fix it:

The first chiropractor did some deep tissue work on both piriformii and my electro-stim on my left low back. I didn't have a single bit of relief from his treatment. He had me get an x-ray and found that I have very mild genetic hip dysplasia in both hips. After many visits, he told me that he thought I should look elsewhere for help since he "couldn't get rid of the inflammation". He also had me get an MRI (of which I had to request of him many times) and found that there was a 5mm central disc protrusion at L5-S1 indenting the anterior thecal sac. I had the MRI in late December 2014. I could not squat down or row without pain.

Once I was home in Queens, NY for winter break, I found an acupuncturist/sports medicine doctor in Manhattan. She tried to perform some acupuncture on my hands which was extremely uncomfortable to the point that we had to stop because I was close to vomiting. She blamed this on my "very high pain tolerance" and that the pain alone is usually enough for a patient to realize something is wrong. She also had a deep tissue massage therapist work on me, as well. I saw her only two times and stopped making appointments when I realized her methods werenâ??t working at all.

When I got back to school in the Philadelphia area (Villanova University), I made an appointment with the school's sports medicine doctor. I read him my MRI and x-ray results. He said it was good news that the herniation wasnâ??t touching the nerve. He also mentioned that I will probably never be able to squat or deadlift again and then wrote me a prescription for physical therapy.

I had about 12-18 visits to a physical therapist over a span of 4-6 weeks. The therapist discovered I had a "significant" anterior pelvic tilt and a gluteal imbalance where my left glute would not fire the way my right one did (hamstring would fire first). I did a lot of piriformis, calf, hip flexor, glute medius, hamstring, core, and IT band work with her. She also would readjust my hips and perform deep tissue work on me. I felt like the methods she was using on me were not geared toward an athletic/weight lifting injury. They seemed too "therapeutic" for the lack of a better term and more geared toward older people. I wasnâ??t feeling any relief from her work until she mentioned that I try "slump sliders", or sciatic nerve flossing techniques.

I got back home for Easter break and started to aggressively perform sliders. Whenever I had a second, I would do this for each leg for about 10-40 repetitions. A couple of days later, I made an appointment to visit a "healer" who was a bodybuilder that claimed he has a gift which my 280+ pound bodybuilder cousin attested to. I only saw him once at that point and was already feeling much better from the slump sliders prior to seeing him. He performed work on me for about 20 minutes, noting that the pain "originated in my left lower trap". I was supposed to follow up with him once more, but he wasn't free again until I would be back at school.

That day, I felt 100x better than I had in a while. A few days and a few slump sliders later, almost all pain and tightness was gone. I was able to do EVERYTHING that I had done pre-injury with very minimal tightness. 6 weeks later (and I admit that very little stretching/slump sliding was done in that period), I started to get pains in my left low back/glute again after doing a lot of sitting related to a showing and funeral. The pain was not as bad as it used to be and I was able to (and still can) squat down and row with minimal pain.

To make a long story short, I have seen another chiropractor, a regular doctor, and the same healer between May and now. The chiropractor saw me about 12-15 times this summer and did not provide me any significant relief. He found that there is a ball of tense tissue he referred to as a spasm in the area where the pain is. The regular doctor barely checked me out, said he thinks I have muscle tear, and told me to take 6 weeks off. I have seen the healer a couple of times and cannot rationalize paying him out of pocket every time I see him when I haven't any relief from his methods, either. I'm pretty sure that it was the slump sliders and not his treatment that helped me in March. I started to aggressively roll on a lax ball and foam roller for my hip flexors, piriformii, and IT bands followed up with static stretching, but haven't gotten much more than temporary relief from all of that. The healer mentioned that I'm one of the most flexible people he's ever worked with.

Some other things that might be linked to the issue:

I fractured my left ankle many years ago and have badly sprained my right ankle multiple times. I've read that this can lead to the glutes "turning off" and APT.

Picture of my ankkles: http://s3.postimg.org/85eyttjjn/ankles.jpg

Pictures of my APT: http://s3.postimg.org/629lj9q2b/Full_Size_Render.jpg http://s3.postimg.org/7g18ekpbn/Full_Size_Render_1.jpg

My left leg is always a bit bigger/more defined than my right. I'm thinking this may be since the left glute doesn't fire as well and therefore that quad takes a bigger load. This is what my legs used to look like a few years ago: http://s3.postimg.org/hfw4uh0kz/IMG_6093.png

My left lower trap often gets a really nasty knot that I have to massage away with my fingers in order to make it hurt less.

I thought that the pain was induced just from sitting too long, but I realized that whenever I'm forced to take a break from lifting at all, the pain subsides a decent amount. However, when the pain is bad, sitting makes it much worse. It doesn't hurt when I work out, but often will after I leave the gym. I have had a lot of trouble figuring out what the exercises are that aggravate it.

I have taken this past week off from lifting and have been stretching/foam rolling my hip flexors as well as doing slump sliders as often as possible. The pain/tightness has subsided a bit but is certainly still there. I do feel that the slump sliders are helping, but I often have moments where I think that whatever I am doing is helping only to be in pain in the next few days.

Sorry for the long post. I just wanted to get all of that information out there. Any insight or advice would be more than appreciated. Also, any doctor/physical therapy/acupuncturist recommendations in either the Philadelphia/NYC area (Philadelphia preferred since I am at school more than at home) would also be appreciated. If you think you could help me out but need more information from me, feel free to ask and I would be more than happy to give it to you. If you've gotten this far, thanks so much for taking the time to read this.


#2

Hey DV526,

Just read through your post. I respect that you have written out everything so thoughtfully.

I noticed I share some of the same issues as you and will be following this thread as well as my own to shed some light on these symptoms.

I too have visited a bunch of doctors and have discovered I have an anterior pelvic tilt as well as a glute imbalance and knots in the lower left traps. Not saying it’s the same thing at all but just wanted you to know you’re not in it alone and good on ya for asking for advice before it progresses any further.

Keep us updated as you try new treatments.


#3

Thank you for the response, TDHBB. I have been doing my research for about as long as I have been injured and haven’t came across anything that even remotely mirrors my issues(s), so to know I’m not entirely alone is comforting (though I hope you feel better ASAP). I have been holding off writing this post for a long time now because I knew how much I was going to have to put into it, but I can’t take the discomfort and narrow training any longer.

I’m not sure if you have the low back/glute issues, but I have been doing sciatic nerve flossing techniques whenever I’m not in class and have been finding them to keep me comfortable for a longer time the more I continue to do them. This morning I did them for each leg over and over again throughout the entire time I ate breakfast and felt a ton of relief. I’ve been sitting at a chair for a little at school now and though I feel tightness in the area, it’s noticeably much more relaxed and tolerable. I’m thinking that if I continue with this and can get the pain to subside, I’ll then work on the gluteal imbalance and ankles first and then focus more on the APT. I found some articles by Bret Contreras on his website that deal with gluteal imbalance and APT and while the methods are similar, fixing an imbalance requires more volume for the improperly-functioning glute. I think it would make sense to put most of my effort toward that first.

As for the lower trap knots, I really have no idea what’s causing it. I was told by the healer that the right side of my body was too tight and has caused my left to compensate for quite some time now. I don’t know if that is truly the case, but I’m hoping that achieving balance in the other areas might work to help the trap issue, as well.


#4

Funny to see TDHBB here, as while I was reading your post I immediately thought back to his case and was going to suggest you check out his thread.

Is your pain located in the SI joint area? (picture for reference: bodiempowerment.com/wp-content/uploads/2014/11/22567767_s-arrow.jpg)

I would suggest you find a Postural Restoration Institute Certified physical therapist (a directory can be found on their website) to help you with this problem. What you are describing sounds very much like a presentation of the Left AIC pattern as discussed in some detail on my responses to TDHBB’s post. It may seem like an odd coincidence that you two would have the same pattern, but the Left AIC is EXTREMELY common, as it is rooted in natural and normal asymmetries found in every human body. In active populations – like the kinds of people who read T-Nation – this pattern can get out of hand and cause a variety of orthopedic issues. You need to address the underlying pattern in order to treat the symptoms.


#5

Thanks for the response. I have located a therapist in NJ and am thinking about having an assessment in the near future.