Hyperextension back injury?

[tkinsley]

OK, I'm stumped. DH DLs with a hyperextended lumbar spine--no rounding at all. He has a recurrent focal pain with heavy DLs. No radiation, no nerve symptoms. When severe, it can last up to two weeks and interferes with sleeping due to pain. No prior trauma other than this. He saw an ART practitioner in Houston who was convinced it was from excessive back rounding--he doesn't round his back in the slightest. Chest is up, shoulders back, tight lifting.

Anyhooo... he tweaked it again today with a lighter DL--if it helps, he doesn't lift from his legs at all to start, he is all back.

Any thoughts on this?

Thanks, all.

Tina

[kuri]

Does he have a normal amount of lumbar lordosis? Or his is low back "flatter"?

I ask because I (and siblings) have less and run into problems with prolonged hyperextension, especially if loaded.

[UConnJulie]

Could be facet joint dysfunction (local joint strain) or could be localized muscle strain (especially if he is lifting with his back first) ... or honestly still could be discogenic, just a mild bulge instead of herniation.

What in general makes it feel better? (sitting versus standing versus lying down; knees to chest stretch versus prone on elbows or press up?)

How's his flexibility? (ie 90 degree SLR, heel to butt in prone?)

[tkinsley]

Originally Posted by kuri

Does he have a normal amount of lumbar lordosis? Or his is low back "flatter"?

I ask because I (and siblings) have less and run into problems with prolonged hyperextension, especially if loaded.

Looks pretty normal to my eye.... he REALLY hyperextends though.

[tkinsley]

Originally Posted by UConnJulie

Could be facet joint dysfunction (local joint strain) or could be localized muscle strain (especially if he is lifting with his back first) ... or honestly still could be discogenic, just a mild bulge instead of herniation.

What in general makes it feel better? (sitting versus standing versus lying down; knees to chest stretch versus prone on elbows or press up?)

How's his flexibility? (ie 90 degree SLR, heel to butt in prone?)

I think standing better than sitting better than lying down. I'll ask about the other stuff. His chiro/ART evaluation was underwhelming--they pooh-poohed even the possibility of a hyperextension etiology--despite the fact that he told them (and demonstrated) that he doesn't round at all, they were "sure" that was probably the problem (even w/o evidence to support it). Grr.

[UConnJulie]

Annoying ... there ARE hyperextension etiology ... for example any type of spondylolisthesis ... and I have even seen confirmed disks (via MRI) get worse with extension and better with flexion. That's why it is so important to treat the individual symptoms with feedback as opposed to the diagnosis -- two instances of the same injury often respond differently to the same treatment!

Has he had any films done?

[tkinsley]

Originally Posted by UConnJulie

Annoying ... there ARE hyperextension etiology ... for example any type of spondylolisthesis ... and I have even seen confirmed disks (via MRI) get worse with extension and better with flexion. That's why it is so important to treat the individual symptoms with feedback as opposed to the diagnosis -- two instances of the same injury often respond differently to the same treatment!

Has he had any films done?

Nope. Not yet.

Here's his response:

What in general makes it feel better? (sitting versus standing versus lying down; knees to chest stretch versus prone on elbows or press up?) Standing vs sitting. Lying versus standing; Knees to chest versus prone on elbows or press up makes no difference in comfort.

How's his flexibility? (ie 90 degree SLR, heel to butt in prone?)
Yes and yes, Flexibility is great.

Thanks Julie.

[UConnJulie]

Sounds like a localized facet joint strain as they are more likely to be non-specific ... is he in Houston?

[tkinsley]

He works offshore in Houston, so pretty much yes.

[UConnJulie]

There's an Ann Maree Williams listed in Houston who should be good ... I can't find contact info for her though ... I'll do some checking around and see what I can find ...

But, if it is provoked by hyperextension, it should get better with flexion exercises (like Williams Flexion Exercises ... knees to chest, ham stretching, hip flexor stretching, crunches) and abdominal strengthening.

[tkinsley]

Thanks for the help, Julie. I bought him the Stuart McGill book on low back stuff--he figured out what it is and is doing whatever corrective exercises McGill recommends. Apparently they work; he deadlifted with no pain at all this week.

I am SUCH a good wife.

[UConnJulie]

Awesome! (I wish I had a wife like you!!! )
I told Matt NO CHOCOLATE for Valentine's Day ... maybe he'll get the hint and view my wishlist at Perform Better!!!