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McKenzie Protocol


#1

I have a small central disc protrusion in my lower back with mild bilateral arthrosis, lowest vertebrate. My doctor prescribed this McKenzie protocol and said it might help to get the bulge back into vertebrate. Has anybody had this and done the McKenzie protocol? If so, what were the results?

Also, my doctor said no more Good Mornings, Romanian Deadlifts, Squats, or any other lift that requires me to bend over. Ugh... Is anybody that's experienced this still doing regular deadlifts or sumo deadlifts? What kind of lifts have you done to replace bent over pulls for read deltoids and rhomboids? Lastly, aside from leglifts how are you working your Ab's?

Thanks,

J


#2

I would say for now the doctor is probably right in that you should avoid exercises that place an excessive shearing force on the lumbar spine. McKenzie's have gotten great results with athletes with lumbar disc issues that I have worked with.

Before I answer the rest of your questions or give more advice, can you explain what your current/previous training protocol involved? Also, how do you normally work your Ab's?


#3

Current / Previous Training:
If you're familiar with CT's HP Mass Program that's what I've been doing.
a. Upper body days @ 87.5% 3RM sets vary by week / includes 1 lower body exercise @ 80% 3RM
- Core exercises: Overhead Shoulder Press, Incline Bench Press, Flat Bench Press
- Assistance exercises: Bent Over Rear Delt Rows, Bent Over Reverse Grip Rows, Shrugs 4s x 8r
b. Lower body days @ 80% 3RM sets vary by week / includes 1 lower body exercise @ 87.5% 3RM
- Core exercises: Back Squat, Deadlift (sometimes I would use a Sumo variation)
- Assistance Work: one day I would do Romanian Deadlifts, one day would be leg curls 4s x 8r
c. Neural Charge workouts, Push Press @60% 1RM, Hang Cleans @ 80% 1RM, Bench Press @ 60% 1RM, Medicine Ball Slams.

Cardio: Tread Mill walk at 4MPH with incline set to level 4, sometimes jog at 7MPH with incline at 1, occassional stair master.

Do you think that Sumo Dead Lifts or the more traditional variation place added stress on the lower lumbar spine? Just setting up in-front of a mirror it doesn't seem that it would but I haven't tried to do any yet.


#4

Sumo Deadlifts will place less stress on the lower back due to you being closer to the ground than during traditional deadlifts so you will generally have less of a forward lean. But the decreased stress on your low back gets placed instead on your adductors and it doesn't eliminate all of the stress from your low back.

You still didn't answer how you normally work your Ab's?

As for rhomboid/rear deltoid work, you can do cable work or incline bench reverse flys (basically lay face first into the incline bench and perform reverse flys). Those are just two off the top of my head.


#5

Crap, I did forget the Ab's. I use Kneeling Cable pulldowns, seated (on a lat pulldown machine) crunches, swiss ball crunches, and knee-ins.

I would really hate to stop deadlifting but if I have to for the health of my back I guess I will have to. I will try the Sumo Deadlift first and see how it goes.


#6

Just take a quick glace at all of the "abs" work you do - it is all flexion based. It isn't surprising that you ended up with a disc bulge. Lumbar flexion shouldn't be completely avoided, as you need a proper balance, but it shouldn't be a focus and, IMO, there are a lot of better options for targetting your "abs"/lumbar stabilizers. I would look at your abdominals as a part of your lumbar stabilizers, rather than a separate entity, and work them in that sense. Plank variations, Pallof Press variations, etc. would be great for you to start to perform for physique and injury correction/prevention.

Also, don't think of it as you will NEVER be able to squat/deadlift again. Just avoid excessive loading that can place you into a loaded position of spinal flexion for the time being. Once the disc issue settles/resolves and you strengthen the proper stabilizers and address mobility deficits, you should be able to return to deadlifts/squats.

I had a 5mm disc bulge that occurred around Aug 2010, didn't get it addressed until Oct 2010, had 2 shots in the series of epidural injections in Oct-Nov, and progressed through rehab/strengthening and now am back to squatting and light deadlifts (progressing slowly, probably could be progressing quicker, but would rather be smart about it for now).


#7

Did your leg go numb and stuff too? The initial pain was something I've never felt before; I can only classify the pain as amazing. LOL!

Thanks for the feedback. I've never lifted with a belt before but I'm thinking that I probably should now.


#8

Leg went numb/tingling into the foot. Sharp shooting pain from my buttocks down to my calf. Difficulting getting out of bed, into and out of my car, driving for long periods, finding a comfortable position in bed, etc.

Just be smart about your progression. You didn't say how large the bulge was, but regardless you do not want to make it worse.


#9

The MRI refers to it specifically as a "small central disc protrusion" and it wasn't overly visible on the MRI unless you looked close. I'm still having issues sleeping and have found that keeping a pillow between my legs helps.


#10

Have the same damn problem man. Small bulge between L5 and S1 and another above that (cant remember the name)

Tingling/numbness/burning/pain in lower back, legs/calves and feet. Happened about a year ago. Been doing the rehab for a couple months now. sitting is really killing me though. Doing the mackenzie back extensions religiously but still cant set without lots of pain and numbness.

Havnt got the steroid injections yet.


#11

I am going through the same thing right now guys and it sucks. Some days are worse then others ans sitting and sleeping can be a real bitch. The McKenzie protocol works great especially after a long day in the car or at the computer.

Level Headed how much did you feel the injections helped you with your rehab progression I am considering having it done if my flare ups become more frequent.


#12

I had a 5mm disc bulge. I definitely hit a point where I wasn't able to go a day without significant symptoms - difficulty getting into and out of bed, difficulty sleeping, trouble getting into and out of my car, trouble walking longer distances (parking lot to work even).

Just had problems doing everyday life stuff. I didn't even consider any type of athletic or training activity and even some rehab based stuff due to pain at that point. After my first shot (sometime in October) things improved about 60%. Everyday life stuff got a lot easier, but still had lingering symptoms. Since the 2nd shot (sometime in Nov), it's be golden.

The ESI definitely helped me out with my situation and made rehab exercises and just life in general so much easier.


#13

All,

I found that sitting at my desk with the leg that I was having issues with up on top of my desk worked pretty well. Sleeping I've found that putting a pillow under my lower back and putting a pollow in-between my legs, I sleep on my side, helped a lot. Unfortunately I've spent way too much time on Lortab, LOL.

I started PT on Wed and the therapist has me doing the McKenzie exercises as well as doing some other core training. He did some pressure relief on my gluteus and hip, no smart-ass comments LOL, and I am feeling better. I'd say about half of the pain has gone away and now I only have some aching in my lower back as well as some numbness now just in the lower inside section of my shin and above my ankle. The core exercises are good and I'm kind of embarrassed that I never knew about them or tried them prior to this.


#14

I was wondering if any one uses acupuncture to manage there symptoms especially neural ones. I have a very good practitioner in my area and was wondering if you would think it would be worth my time and money?


#15

I did acupuncture for a little bit. It helped curb the symptoms very slightly and reduce the muscle spasm in my low back, but ultimately won't do anything to help heal the issue deep at the disc pathology. I did it for about 3 weeks before the practitioner and I felt that it wasn't going to be as beneficial as once hoped (at the time I was refusing to admit it was a disc pathology and was treating it as an SIJD w/ sciatica).

I think acupuncture has it's place for musculoskeletal, inflammation, and some small nerve irritation, but won't be of help to decreasing the size/bulge of the disc.


#16

Yeah, ulimately you should see an Orthopedist or a Neurologist and get your back checked. Then get into a good physical therapist.


#17

I've done the McKenzie exercises & found them to be extremely helpful. My back issues weren't as bad as yours, but a friend who's had back surgery did them on his doctor's orders & still does them 2 years later because they keep him feeling strong & loose.

My husband used acupuncture successfully after a back injury, bur it was just a part of a whole therapy system.


#18

Hey Jaynick, good to see that you are getting results. I am a physical therapist and I truly believe that Mckenzie method is the best for treating back pain conservatively especially when you work with someone who is a certified specialist. Keep doing your extension exercises bud and within 8-12 sessions you should be feeling a million times better.


#19

The only thing I don't like about doing them is that when I'm done I have discomfort right around the area that I'm guessing is the vertebrate with the protruding disc. I'm still doing them but that's a little annoying. I've been doing some of the core work my therapist has me doing at the gym and then coming home and doing those exercises, perhaps it's too much work.


#20

Hey Jaynick, yes the extensions can be difficult because your disc is essentially blocking your motion but as it reabsorbs centrally, you should improve. As for that tenderness, that is normal and is actually a good sign from a prognosis standpoint (if you were having sciatic pain at least).

The tenderness will persist for a little but as your ROM increases it should dissipate. If the therapist is doing mobilizations to your lower lumbar, this should also decrease the pain. Good luck.