Max. Load on a Herniated disc?

[Funk]

Bill, other PTs, Biomechanists, Exercise Phys. Nuts:
I was diagnosed with a herniated disc (L4-L5) with a 5-6mm bulge in the right posterior direction about a year and a half ago. I have full mobility now, but am still extremely careful with any extreme rotation and do my best to avoid lumbar flexion at all costs. My questions is, despite whatever I may have the strength to perform olympic lifts, overhead exercises, etc.; is there an amount of weight I should try to use as a max. load to help keep my disc safe and not cause further damage? Let me know if you need more info. on the injury or anything- Thanks in advance.

-Funk

[Bill Hartman]

Everything will be individualized. Discs are actually good with respect to compression. There are strength athletes that compete at the highest levels with histories of herniated discs. You need to ask yourself if it is worth it.

That said. Have you completed a full progression of rehab to restore normal motor patterns (bracing activities included) and progressive return to reasonably high levels of activity?

If so, you may be able to start progressing back to "normal" activities.

NEVER allow the spine to flex under load. Start light and progress in range of motion and load. Keep tabs on any symptoms and act accordingly.

Keep in mind that there are many substitutions for heavy lifts that reduce spine loads such as belt squats, split squats, step-ups, etc. Also note that seemingly "easy" exercise can increase spinal loads dramatically such as a reverse hyperextension, hyperextension, and sit-ups.

Good Luck.

Bill

[Funk]

Bill, I went through a progressive rehab stint with physical therapy which was cut when insurance stopped paying for it. I have a lot of xpeience training peole with disabilities and used a lot of that experience to progress on my own as well as talking to my old professors. I have full ROM, mobility (as far as I can tell, I don't really extert rotationally but I can go past 90 degrees of spinal rotation left and right). In the past week I've taught 10 1-hour spin classes, completed 3 resistant workouts, been on a stepmill twice for 20 minutes, and worked with about 9-10 hours in the weight room with teams. All that activity didn't bother my back at all, so I'm able to live pretty "normal". I mostly just add loading into my workouts at a much slower pace than I'd like to so that I can monitor the symptoms. The biggest concern I had was whether the disc would be at a greater risk of being damaged by the compressive loading at and beyond a certain amount of weight. Thanks Bill!