how to train with low back pain

[cun2x]

I have been feeling a burning sensation on my low back when I sit down for a prolonged period. My physiotherapist suspected that it's a disc bulge, and told me to do McKenzie press up every 2 hours, and give some TENS treatment.

Any advices on what I should do training wise? My routine currently is:

Day 1: squat, bench, rows
Day 2: squat, military press, chin up
Day 3: squat, bench, deadlift

I was thinking about substituting squat for lunges, rows for hammer machine rows, incline bench for military press. What do you guys think?

[Ian Kay]

First of all, get the disc taken care of. Go to the doctor and make sure it is/isn't a disc bulge.

As for exercises in the meantime or after treatment of the disc:

1. Stick with single-leg exercises. Forget about doing conventional deadlifts and squats for a while. If you execute the single-leg lifts properly, you'll reduce back stress quite a bit and may actually come back to the bigger lifts even stronger. Personally, I'd stick with split squats and maybe some moderate-height step-ups for a little while, to avoid the "jolt effect" of moving lunges. But I just like to be extra careful. It's up to you. (If by any chance you have a slideboard, then slideboard ham curls are pretty good for working the hams/glutes with no loading. Just use a controlled range of motion: don't tuck your heels all the way under you. Stop curling when your heels are directly under your hams, and squeeze those glutes to keep your hips up!)

2. When benching, either elevate your feet on steps or do floor presses. Either of these will reduce potential low-back arching.

3. Work on some classic "core-stability" exercises, in order to disperse the stress properly. Get all of your "abs" firing, and your glutes too. Side and regular planks, bird dogs, perhaps some supine bridges. Do these in short-holds and reps, not very long holds and certainly not weighted. Just get things firing and move to the next exercise.

4. I'd avoid overhead pressing altogether for now.

Hope this helps a bit.

[UConnJulie]

I totally agree with everything Ian said above ... with the additional recommendation to really work on your body mechanics ... learn to separate hip and lower back movements (so that your lower back is not moving every time you move your hips). Most back injuries are aggravated more by daily movements like bending over to brush your teeth and sitting in poor posture moreso than the lifting you are doing.

And just my opinion, but your program could use a little variety ... that's an awful lot of squatting which puts a large compressive force through your spine (ie BAD for disk problems) ...

[cun2x]

Thanks a lot for the advices. Single leg lifts are my friend for now. It's also time to activate my glutes and taking care of my posture.

I'm currently reading 7 steps to pain free living by Robin McKenzie (he really emphasize good postures in daily living) and also Ultimate Back Fitness and Performance to get my abs and lower back strong again. Hopefully that'll help!

[Lisa~]

Here's a related thread you might find interesting:

Upper body focused workout???

[tbrim20]

Originally Posted by UConnJulie

I totally agree with everything Ian said above ... with the additional recommendation to really work on your body mechanics ... learn to separate hip and lower back movements (so that your lower back is not moving every time you move your hips). Most back injuries are aggravated more by daily movements like bending over to brush your teeth and sitting in poor posture moreso than the lifting you are doing.

And just my opinion, but your program could use a little variety ... that's an awful lot of squatting which puts a large compressive force through your spine (ie BAD for disk problems) ...

I agree with UConnJulie. You program needs some work. It is very unbalanced.

You first need to diagnose the problem as the location of the bulge will have a large impact as to what exercises you should do and what you should avoid.

It sounds like you have some spinal stability issues here. This is most like due to many issues which would need a thorough assessment to figure out which apply. I'm guessing that you have a very weak or nonfunctional inner unit. Most likely you could have a sever lack abdominal function. You're probably not using your TVA correctly. You could have very weak transverso-spinal mulsculature(multifidi, etc). I'm going to take a guess and say that your posture probably needs some work.

#1 Stop doing all axial loading. Stop any exercise that causes pain as this is a clear sign that you are only making it worse.

#2 You are going to have to retrain your inner unit to stabilize your spine(TVA, Obliques, transverso-spinal musculature, etc).

#3 You are going to have to fix your posture as this could be the reason the injury occured.

#4 Learn proper lifting form. This will help you to not put your spine into faulty loading positions and minimize spinal compression. This is a must.

You really need to start from the ground up here. Planks are much too advanced of a core exercise for you to do. You are going to have to start back at square one with tummy vacuums, horse stance, and some lower abdominal exercises like forward ball roll.

I would strongly urge you to find a qualified practitioner that can teach you how to use your inner unit properly. The longer you aggravate the injury, the worse it will get.

There are guys who can squat and deadlift(all dynamic movements) excessive amounts of weight, yet they have back pain doing any stabilization like while brushing their teeth(Just as UConnJulie said). This is because they have a very strong outer unit(spinal erectors, rectus abdominus) and a very weak inner unit. Happens much more often than you would think.