T Nation

Long-Term Leg Weakness, Now Sciatica


#1

About 5 years back I hurt my left lower back - got varying accounts of what actually got injured. It was a partially torn ligament at most, somewhere between the SI joint and L4. I've mostly rehabbed it, but do aggravate it from time to time when my form breaks down or I go too deep on squats, etc.

Over the past few years I have noticed: small and weak left quad, weak left hip flexor (I can't judge size), small and weak left oblique. [Also weak on the left leg in abduction. Not sure about hams/glutes as that is hard to tell]

About a week or 2 ago I developed some major sciatica symptoms - my entire left leg is weak, pain from my left low back (and sideways across the left back) to my left knee, tingling from my left leg to my left foot.

I'm just wonder if the quad/hip flexor/oblique issues could be somehow related to the sciatica? I'm sure the sciatica will go away, but I'm more concerned with my noticeably weak left oblique/hip flexor as I wonder if it contributes to my reaggravating my back injury every so often.


#2

More than likely you had a disc bulge issue. Whenever numbness/tingling extends below your knee and especially into your foot/toes, you are more concerned with a disc bulge rather than just standard sciatica. If anything, a disc bulge could be a contributing reason behind having a weakness along the left side of your body.

It sounds like with the incident that occurred 5 years ago, you saw several physicians. Did you ever get an MRI done? Any follow up visits since then? I would recommend going back to get another evaluation as the symptoms are returning and a possible disc issue may have worsened.


#3

Thanks for the response!

At the time of the initial injury, i had an MRI, X-rays, went to a couple docs and multiple PTs/ARTs. Everything looked good in the MRI and X-rays then at least. One doc said I partial ligament tear, the other docs didn't think even that. I had definite pain in the left lower back/across the hip which took a couple months to go away that initial time.

It's funny you said toes even though I didn't mention toes - I actually do feel tingling through to my toes too.

If it is a disc bulge, what could be done about it, and how will it affect my future lifting?


#4

Depends on the severity of the budge and whether you take a surgical or conservative approach. Some bulges can be handled with rehab and treatment, while others would require surgery. It will ultimately come down to what you and your physician decide upon after you get another MRI.


#5

Since I have had bad experiences with physicians and such, I will try the self-rehab approach for now. If that doesn't work out then I guess seeing a doctor will be the only way to go, though I'm not sure what they'd do for me other than take my money and 1) recommend surgery, 2) recommend cortisone, 3) recommend I stop lifting heavy weights, or 4) recommend a terrible PT. 1, 3, and 4 are possible solutions, but their being recommended by any of the doctors I've dealt with won't mean much to me anyway, unless I've already found that I am out of alternative solutions.

From what I've been reading in searching the threads around here, as well as my own limited knowledge, I probably need to:
-let it rest
-put more emphasis on glutes/multifetus activation
-do more work on proprioception with feeling a neutral spine
-cat/camels
-focus on form even more
-(On top of the the foamrolling, stretching, mobility, ab work I already do).

Let me know if this doesn't make sense or is simply a course of action that is not suited for addressing my issues.

Thanks again for your input.


#6

I am personally not a fan of cat/camels, as both exercises encourage extension/flexion of the lumbar spine. I would make any ab work that you focus on be exercises that do not encourage movement and/or shearing forces to the lumbar spine. Read up on Stuart McGill - tons of great information on the low back. Exercises for the lumbar spine, IMO, should work towards stabilization of the lumbar spine. Planks and variations of planks, bird dogs, ab wheel/swiss ball roll outs, anti-rotation palloff presses, and overhead/anti-extension palloff presses area all good exercises.

You can try the "rehab myself" approach, but with the fact that you have ongoing weakness in your extremity and the symptoms have worsened, I would highly recommend seeing a physician regarding it. Especially since your last imaging (X-ray and MRI) was 5 years ago, I would recommend getting new imagining since you have re-injured it. If you were unhappy with the results from your former physician, do some research and find a qualified one. Find one that has experience and/or works with a professional team or athletes and may have a better understanding of your active lifestyle. Ultimately it is your decision, but with the situation that you have described, those are my suggestions.


#7

I thought cat/camels might be good for "nerve flossing", but I don't know much about that honestly. I guess that's not too important if I have a disc bulge and am better off sticking with spine stabilization exercises like you described and like I had already read about. Thanks!

I just hesitate to go to the docs because I have spent thousands of dollars (and countless hours) I cant afford to spend on docs, PTs and ARTs that have given me 0 or marginal benefits for the couple injuries I've had over the years. The idea of going through that again is not attractive.

Finding a doctor that works with professional athletes (and hopefully knows quality PTs) is a great idea. I'm thinking a doctor that works with football players might be best, as their sport is very physical and a doctor can't just tell a football player to "stop lifting heavy weights" and bad rehab will be quickly exposed. I live in LA, so no NFL teams (damn you Al Davis!), but I could call around USC/UCLA's athletic departments and hope they share.

I hope you don't feel like I'm asking you to spoonfeed me, but you have any other ideas on how I might track down quality doctors?

Thanks again for posting.


#8

Googles is a person's best friend. Here are the two athletic training/sports medicine websites for USC and UCLA since those were the two schools you listed.

USC - http://www.usctrojans.com/ot/usc-athletic-medicine.html

UCLA - http://www.uclabruins.com/departments/rehab-center.html

LA Lakers team physician is STEPHEN J. LOMBARDO, M.D., who works out of this clinic in LA http://www.kerlanjobe.com/home/


#9

:P. Thanks, I am all set!