T Nation

Lower Back Pain, No Injury?


#1

Hi everyone,

Friend of mine has a problem with back pain for about 6 months. Pain is constantly there, with variations in intensity, getting worse after lifting objects from ground and explosive movements. He complains on severe pain after playing football.

He did CT scan few days ago, and results showed no injury.
Have you got any idea what the problem could be?
Nutrition issues are not out of question, either.


#2

Having had multiple back injuries over the years, including two severe ones, I could only advise trying a second medical opinion. Six months is a pretty long period to struggle with back pain, especially if it is severe.
Does stretching help at all?


#3

He says that stretching doesn't help him.. I believe he will look for second doctor's opinion..
Thanks for reply..


#4

What type of stretching and specific stretches is he doing? If he stretches correctly it will absolutely help him with pain.

The first thing that he needs to do is figure out the cause of his back pain, then he can start to actually address that cause. Since we have nothing more to go on than "his back hurts", there is really no way that any of us could hope to give you any kinds of educated guesses as to why he is having back pain and therefore can't really give you any ways to fix said back pain.

For instance, his back pain could be the result of:
-getting repeatedly tackled and twisted or slammed into the ground while playing football (you didn't mention what position he plays) and thus he may be bruised or even have injured

-poor form while lifting and thus using incorrect muscle groups and movement patterns

-tight hip flexors and lower back muscles (Anterior Pelvic Tilt/Lordosis/Lower Crossed Syndrome), thus placing his lumbar spine under excessive tension throughout his day and becoming aggravated from his additional lifting/sporting activities

-uneven leg length, thus tilting his pelvis laterally and placing his spine in a scoliotic curve (sideways curve)

-inactive hip extensors (Glutes primarily), thus causing him to attempt to lift things with his back

-weak legs, thus again causing him to compensated by lifting with his back

-tight hamstrings, thus preventing him from maintaining a neutral pelvis while squatting/hip hinging

Etc...etc...etc...

In short, without details we'd just be throwing crap at the wall and hoping that it sticks.


#5

Well, here is some more info, although he is going to have MRI.

Week off of training helps. He doesn't have sciatica symptoms (pain going down the leg), his lordotic part is normal.
Hamstrings and/or calves might be a bit tight - due to playing soccer. He recreationaly plays soccer (when i said football, i meant soccer).

He thinks that he might have injured himself while doing squats, either front squats or low-bar (powerlifting) backsquats while not keeping lower back arched.
Regarding flexibility, his form on olympic style backsquats is very good, but he loses his lower back arch when doing low-bar squats and lower back rounds a little bit.

I don't think he's doing fewer than 6-8 reps, ever; so having these things in mind, do you think he could have hurt himself squatting?


#6

The number of reps is irrelevant in regards to the potential for injury. People "throw their backs out" reaching across the bed to hit the snooze button or bending over to pick up a small item all the time. It has more to do with the biomechanics (and therefore leverage, load that is placed on specific tissues, and ability or inability of tissues to contract or lengthen accordingly) of the movement than the number of times you do it. Yes, very low reps often means that people have a difficult time maintaining correct biomechanical patterns, but fatigue can result in loss of proper mechanics just as easily. The lower rep sets do often involve heavier weights (and thus greater forces), but again, even if you are using moderate weights there is plenty of force to cause an injury if your mechanics are incorrect.

So, yes your friend may very well have strained one of his muscles while squatting. Since his MRI shows no injuries to his disks, it is likely that with some rest (or at least drastically reduce his intensity and then very slowly building back up only as he is able to maintain perfect form), good nutrition, fixing his mobility issues, and time he should be able to fix his problem.


#7

Thank you very much for replys...
Best regards


#8

Here is some update...

MRI showed L4-L5 disc herniation, dorsolateral with radicular compromitation in left side. Pain is located, doesn't go down the leg (and he says he feels better lately).

Do you have any advices on how he should train for recovery?

He's worried about being able to squat, sprint and deadlift again, about how long does it take for injury to calm and his back to strengthen for such activities. Any thoughts?