T Nation

Lifting with Fused Lumbar Spine?


#1

Hi all.

2 weeks ago I fell from a roof and crushed the L3 vertebrae. It's been fused to the L2 and L4 with metal rods and I'm thinking about the future. Do people return to lifting with these kind of injuries? How long does it take? One doctor said I couldn't lift anything for 6 months but he was mostly surprised that I could move at all.

What can I reasonably expect?


#2

Definitely listen to the surgeon in terms of coming back slowly. Let that fusion heal very well, because that will determine the rest of your prognosis. IF the surgery goes well and IF it heals completely, your long term prognosis could be quite good. The metal rods aren't supposed to be the only support long-term. Hypothetically, they keep it nice and stable, but eventually the vertebral bodies should fuse to each other. At that point, that segment should be as or nearly as strong as any other spinal segment...IF it heals well in the beginning.


#3

You have to be very careful, and lifts such as Deads are extremely hard to deal. I would wipe all of your PR's clear and don't let anything keep you down mentally to start. Last August, I ruptured a disc in my back and it took until december to start lifting LIGHT. I started with alot of back extensions and roman chair work to test it out, and have since adopted the 5/3/1.

I don't see any reason why you can't lift when given the clear. I would only suggest that you take your time and start light to build a solid foundation around your skeletal limitations. The screws/pins can only hold so much weight, I've seen titanium screws in you same surgury bent because of complete arrogance, and the DB is continuing to do the same.

Give yourself realistic one year(from surgery) goals. Work those numbers backwards with the 5/3/1 and check your starting numbers. Take the time off to learn perfect form, stay consistent and you'll have nothing but spite for what most Dr's say...most have no knowledge or training on the strength of will.


#4

PM StormTheBeach. He fucked up his back in the same area you did and he rehabbed it just fine and deadlifts over 800 lbs.

CS


#5

The problem with a fusion is that all of the pressure that would normally be dispersed amongst all of the vertebral joints evenly is applied to the joints directly above and below the fused vertebrae. So even if your back is feeling much better now, it's only a matter of time before the L1-L2 level and the L5-S1 level are herniated from heavy lifting. I'm a nerve conduction study technologist so I help with the diagnosis of spinal disorders everyday and, in my experience, patients that have spinal fusions are basically fucked if they don't play every one of their cards perfectly. I would definitely recommend lifting and keeping your lower back strong once you have recovered from the surgery but, in my opinion, competitive powerlifting is absolutely out of the question. If I were you, I would keep squatting and deadlifting with light weights and would compete as a bench specialist only in the future. Is it possible to squat and deadlift heavy after having a lumbar fusion? yes. Is it worth the risk? fuck no.


#6

A big thank you for the responses. It's a lot to take in right now and I realize my initial expectations have been too high. I have a history of doing too much too soon but this time the risk is not worth it.

In the short term lifting will be out of the question completely. Long term I'll skips deads completely and hopefully I can do some 20 rep squats and push those numbers.


#7

i wouldnt skip deads. Even light high rep deads will strengthen your lower back and teach it to build resistance to that type of stress.


#8

You're right. If I can handle 20 rep squats I could probably pull off 20 rep deads as well.


#9

I dont want to sound like a hater or anything, but dont give up on heavy squats and deads for ever. My opinion is to contact sone powerlifters who have dealt with spinal injuries. They can help you through the process. Now I also understand that not every one wants to be at risk again so you dont have to but if you really want to squat and dead send some messages. A few names that come to mind ted toalston he can be reached at the elitefts q and a. Stormthebeach you could pm him, and if you could find a way to contact loui simmons that might help too. I know that last suggestion sounds crazy but it is your lifting career we are talking about.


#10

yeah, that's a great idea.... if OP wants to wind up in a wheelchair with chronic pain in his low back, severe muscle atrophy and an addiction to pain meds.


#11

What would you say is the biggest thing I'm risking? Herniating the other discs? Damaging the vertebraes/metal in some way?

I really appreciate your input. I won't actually try for new 1RMs ever again but I'd like to understand the injury and rehabilitation better so any bit of information is valuable.


#12

Srry I miss wrote the last post basically I meant contact some powerlifters who have been through the same thing, they might be able to help you. Vincent dizenzo also has rruptured discs too.


#13

Thanks for your support. What I think Loftearmen means is that some spinal injuries are worse than others. I'd love to "only" have a ruptured disc. Those things can heal pretty good over time. Unfortunately I crushed the vertebrae and what's left of it is now secured with metal rods.

It's still good advice to talk to others with a similar injury though.


#14

if anything squats can put more flex and compressive loads on the spine depending on depth and style, where as deads you can remain in a straight back pretty easily if you focus on it.

I have bad discs and deep squats are far worse than anything hahah. I do lots of box squats to parrallel, especially front squats to the box are awesome, lots of sumo deads for heavy and lots of light conventional pulls for lower back/core. Seems to balance pretty well for my current problems and ive been able to push some moderate weight again, and im 2 years after my last spasm just about where they were like yeah you lost all the fluid in ur discs u need to chill.

Anyways, dont forget single leg work and core work. If you prioritize these over power lifts i guarentee you feel better and make more progresson the power lifts. I usually do like 1 power lift and 2-3 single legg and 2-3 core each session for lower body. That way its never to much or idk it just feels right man.


#15

There are several things that you're risking if you abuse that fusion. Probably the most obvious one would be herniating the discs above and below but also breaking the hardware off of your spine is certainly another issue. Both of these would require another surgery to repair and once you get that second surgery you're boned because you will likely never get the relief you are looking for.

When this happens people have a tendency to keep going back and getting more operations in an effort to fix a problem that isn't fixable and eventually they end up being chronic pain patients (usually from a radiculopathy and a complex regional pain syndrome) and on disability. I know it probably seems like a big stretch to say that all of those things are going to happen to you and I'm not saying that they absolutely will happen if you push your weights too hard; however, it does happen frequently and it happens to athletic, motivated people like powerlifters too.

Just be careful man. The doctors are usually overly conservative with what they say you can and can't do so if you follow their instructions and maintain a positive and proactive attitude towards your recovery then you'll recover to the best of your body's ability.


#16

Good advice on the psychological obstacles he is likely to face.

Here are a couple of phrases that may assist:

Don't let the perfect be the enemy of the good.

The man who moved a mountain started with the smallest stones.

Also, when I was a child one of my Rabbis in elementary school taught me a lesson that originally came from Rabbi Akivah. I was about ten years old when I learned this lesson, at least in part. Imagine that you are at the base of an old dried up waterfall, with a massive boulder at its base. Now imagine that there is still a small drop of water falling from the top of the waterfall and impacting on the massive boulder. Now imagine that the small drop of water has been dripping for so long as to have eroded a hole deep into the boulder.

Clearly, the waterfall has been dripping this drop of water for a very long time. The question I was asked was, "Did the first drop of water do anything to the boulder?". Being a young kid, I answered no, but the truth is of course the first drop of water had an impact on the stone, however imperceptible. Had the first drop had no impact of erosion on the boulder, then neither would the second drop, the millionth drop, or the billionth drop. The lesson? That all long processes start with small steps. J.Rex needs to remember this.


#17

Thanks for the warnings. It puts things in perspective.


#18

[quote]Loftearmen wrote:
The problem with a fusion is that all of the pressure that would normally be dispersed amongst all of the vertebral joints evenly is applied to the joints directly above and below the fused vertebrae. So even if your back is feeling much better now, it’s only a matter of time before the L1-L2 level and the L5-S1 level are herniated from heavy lifting. I’m a nerve conduction study technologist so I help with the diagnosis of spinal disorders everyday and, in my experience, patients that have spinal fusions are basically fucked if they don’t play every one of their cards perfectly. I would definitely recommend lifting and keeping your lower back strong once you have recovered from the surgery but, in my opinion, competitive powerlifting is absolutely out of the question. If I were you, I would keep squatting and deadlifting with light weights and would compete as a bench specialist only in the future. Is it possible to squat and deadlift heavy after having a lumbar fusion? yes. Is it worth the risk? fuck no.[/quote]

Glad to find someone who works in the field and has real world knowledge on the matter.

My girlfriend has taken an interest in training and I would like to help her get started. She also had a lower back surgery. I cannot name which vertebrae were fused but this surgery occurred when she was very young and has healed over 20 years.

The training program I would like to put her on is a full body program like SS to get the basic lifts down. I ran this program myself and know the weights get heavy very fast and was wondering what you would recommend as a limit on the weights.

She’s a chick and obviously won’t be able to lift enormous weights anytime soon, but I’m concerned and want to be careful about this.


#19

Hi all, OK so after 12 years out of any real work out of training due to fear after spinal fusion to L4 & L5 I have now made a decision to start getting back into shape. I am not fat and if anything slightly skinny and I would love to build my arms, shoulders and core muscles in my body like abs and back to help me.

The problem is fear and it seems no one knows the best way to start, can anyone help me out and advise on the best method to start after such a long time out. Thanks everyone and good to meet you, Ash


#20

[quote]AshleyFlyHalf wrote:
Hi all, OK so after 12 years out of any real work out of training due to fear after spinal fusion to L4 & L5 I have now made a decision to start getting back into shape. I am not fat and if anything slightly skinny and I would love to build my arms, shoulders and core muscles in my body like abs and back to help me.

The problem is fear and it seems no one knows the best way to start, can anyone help me out and advise on the best method to start after such a long time out. Thanks everyone and good to meet you, Ash[/quote]

I would run starting strength and start with just the bar on all of the lifts.