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Lumbar Facet Irritation


#1

Hi friends!

Lumbar facet irritation has been happening to me for the past 5 years, with about 2-3 episodes a year. Although lately it feel like it occurs more frequently. It usually occurs after either deadlifting, squatting or a intense soccer game. Sometimes it occurs from simple things such as standing up of a chair!

The pain is intense, causing muscle spasm, my torso contorts, my glutes, hammies and abdominals tighten up like rocks. Initially I can hardly walk for about 2-3 days, and it takes about a week for the pain to subside, and another week or 2 for full recovery. My chiro says its due to my "sticky" L1-L2 joints, and also tight SI joints. I also have some considerable anterior pelvic tilt and my pelvis is 10mm higher on the right side. Ive always had tight hammies and glutes.

Question is; is there anything I can do to prevent this? Core exercises? Pilates? Should I give up on deadlifts and squats?

Someone help! This sux!

ouch


#2

Bumpity bump.

Seriously, this is meant to be a common problem. Someone please help. BBB? Can you hear me? Ive spent the whole weekend in pain!

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#3

Although I can't give advice for helping to speed the recovery process, what I can suggest is that you look at the symptoms you have and address them once the pain has subsided. You say you have APT and tight hamstrings and glutes, which in itself is almost contradictory- APT is usually caused when the hip flexors are strong, and the hams/glutes are weak; you may be mistaking tightness for weakness. Address the APT by increasing strength of the glutes/hams and mobilizing/stretching the hip flexors (whole load of articles worth checking out on this particular site on how to do so.) Once you decrease the excessive curvature of your lumbar spine, it should help ease the irritation of the facet joints. Increasing core strength and stability will also be of benefit, but don't take this to means 100's of crunches and sit-ups; again, read around some of the articles on how to properly train the core.
You say your right hip is higher: have you been diagnosed with any sort of anatomical leg-length discrepancy? If not, it could be a functional issue- if so, work on balancing the strength of each leg (unilateral exercises,) stretch all areas of the hip, and work on mobility (guess what- more articles on all this.) All this said, be sensible in your initial recovery- give the pain time to subside, ice and rest. No sense pursuing things too soon and potentially making them worse.


#4

Thanks Mr Watermelon.

You see what pisses me off, is that I have been stretching my hip flexors every day, and I have been activating my glutes everyday. I was doing all I can and I was feeling pretty dam good, and yet I still get this stupid injury. I almost see it as I had pushed myself just a little bit too much and BANG! Almost like its just bad luck. FML.

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#5

Is it possible I have disc damage? The chiro says he doesnt think so, but should I be asking for a referral to a neurosurgeon?

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#6

It could be that stretching the hip flexors will only get you so far- you could try looking into receiving some professional soft tissue work (like an ART practitioner) to ease up the tightness. Also, as I mentioned before, your APT is more than likely caused by a muscular imbalance around the hips; whereas you say you stretch your hip flexors/ activate your glutes every day, until you can bring the strength of one up to par with the other, the problem will likely persist. Really focusing on working the glutes and hamstrings over the long-run should hopefully help balance things out- these things take TIME!! Your core could also be the weak-link here, so don't forget about it; a large portion of your core works in conjunction with the activity of the glutes, so increasing strength/stability should hopefully help get your glutes also working more efficiently.

To touch on your last point there, too: injuries happen. You say you may have pushed yourself too hard, and maybe you did. The only thing you can do when these things happen is to give the injury the time it needs to heal, learn from the experience, and commit to training smarter in the future.


#7

Based off of your previous posts/injuries, I'd definitely lean towards a linkage between your previous chronic adductor injury and this lumbar injury. Likely you have some significant imbalance at the lumbosacral and hip region. Without a physical evaluation, it would be very difficult for somebody to give you a solid diagnosis over the internet. Advice can be well meaning and maybe help with over all health, longevity, etc, BUT it may not directly help with the recovery of the specific injuries you have going.

Did your chiro state why he feels you have a "sticky" L1-L2? Also, a 10mm discrepancy in pelvic height is quite large IMO. Has the chiro and or healthcare practitioner you have seen given you any reason as to why they feel it is so uneven? Do you list/lean to one side when standing? Any chance of static posture photos?

Do you have any radiating symptoms/pain into the lower extremity? It is possible that you have some disc degeneration occurring, especially considering your past adductor issues. Assuming the chiro is correct that there is something wrong around the L1-L2 level, the referral patterns match. At the T12-L1 level, referral patterns are at the inguinal region and medial thigh and L1-L2 level referral patterns are at the anterior/medial thigh. Not saying you for sure have disc involvement, just saying that there is a correlation and crossover between symptoms of you lumbar issues and adductor issues. Whether that correlation is from disc involvement or some sort of musculoskeletal issue could only safely be determined with a hands on evaluation and other testing.


#8

Thanks prof Watermelon and associate LevelHead. Your advice is greatly appreciated.

Watermelon; I think once I return to normal health, I will give deadlifts and squats a break for awhile until I build up this core of mine and get my pelvis into balance. Does anyone reccommend any training programs for core development? Im considering looking into the gymnastic side of things... L-sits and stuff. Maybe I should be proficient in those before I start deadlifting again. I want tio build strong glutes and hammies, although everytime I do try to do that I eventually do this back injury to myself. I might be going to heavy too fast?

LevelHead: the day I injured the back was also the same day that I thought to myself "I think my groins 99% improved". I have also never had back pains and groin issues at the same time. Although I dont know if that gives you any more idea if my discs are involved. The chiro did not give me a reason for my "sticky" joints, he said it may be a longterm thing and symptoms may only be surfacing now. And I do lean to one side, and the chiro reckons its due to my tilted pelvis. No pains in the lower extremity.

Thanks again for you help.

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#9

These 2 articles may be of use to you;

http://www.T-Nation.com/free_online_article/sports_body_training_performance/dispelling_the_glute_myth

http://www.T-Nation.com/free_online_article/most_recent/break_up_those_hips_and_fix_that_squat

Despite all that I've said, please bear in mind that I have no qualifications, and my advice is only based off a very general knowledge of the musculoskeletal system and conditions such as APT. I would suggest hanging about to hear additional input such as that of the quality of Levelheaded's post.


#10

I think it is a wise idea to not rush back into weighted deadlifts/squats. Slow progressions will be best. IMO you are looking way to advanced for your exercise selection with core development. I really feel you need so go to somebody who will give you a full functional assessment and has an excellent grasp of muscle synergistics, biomechanics, etc. to determine exactly where your limitations and weaknesses are. The more advanced exercises may seem more demanding, but you are likely not activating the proper musculature and patterns due to your body likely not being able to handle the increased difficulty of the exercises. This will only lead to further imbalance and injury.

Also, if you tend to injure your back every time you try to build strong glutes/hams, going "too heavy too fast" may be part of the reason but there are several things to consider:
1) Do you have the proper muscle activation from the prime movers to perform those lifts at that load? If the hamstrings and more importantly the glutes are not activating properly, the lumbar spine musculature will take on the added load.
2) Do you have the proper muscle activation from the secondary stabilizer musculature? If the lumbar spine stabilizers cannot support the lumbar spine properly and you are performing lifts like deadlifts and squats, than regardless of gluteal/hamstring activity, the lumbar spine won't be able to sustain and support the load, resulting in injury.
3) Do you have the needed mobility at the hips, ankles, Tspine, etc to safely perform the lifts? Lack of mobility at one place (ie: the hips) will be counterbalanced by increased mobility at another joint that likely shouldn't take on that mobility during that motion (ie: Lumbar spine).
4) Are you choosing the best exercises for the goals you want with the current abilities of your body? Squats and deads are great, but if your lumbar spine can't handle those shearing loads, you may be better suited to perform other hip dominant exercises (hip thrusters, single leg variations, etc).

Any chance of static postural photos? Or better yet, dynamic video of exercise technique?


#11

Watermelon; Thanks for your help. I have now studied those articles in detail.

LevelHead; Im not too sure where I can find someone to give me an assesment. Im sick of seeking proffesional help, and only looking at blank faces when I start talking deadlifts and squats. I need to ask someone who is in the "game". I am not sure on how activated I am, but I suppose thats why I need to seek help. I had been working on my mobility in the pasr 3 months like never before and had actually felt very mobile. I think I do have alot of work before I squat or deadlift again, but how am I going to know I am ready again.

I dont have any static photos and there is no point of taking pics now as back is in pain and my muscles have tightened and I look like the leaning tower of Pisa. I do have a video of the last set of deadlifts I had done. I know its not perfect technique, with my hips rising too fast. This was the second week of deadlifts and my last set was the heaviest at 100kg. I felt fine after doing these, it was only in the afternoon after I stood up of a chair that I felt the pain.

So ot has been 4 days, and while there is some improvement I am still in pain and still have to move arounf like an 90 year old. This is really starting to piss me off...

Thanks again for your help.

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#12

Bumpity bump.

Just a quick update friends; back is slowly improving, still probably 10 days away before I restart training. I will review the literature, and I plan to publish my new approach in this thread.

Feel free to post your own individual back problems, and how you overcame them in this thread.

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