Various Back Injuries

[blooey]

Hi all,

I have two back injuries for which I am hoping to get some input. I believe they are simply muscle strains, but I was hoping that someone with more experience than me could give me a little feedback.

As a little background, I am a 25-year-old (almost 26) male who has been lifting weights for about 9 years, but I've only been lifting seriously (deadlifts, squats, cleans, etc.) for 4. I've been able to achieve a decent amount of strength for my size (I place somewhere between advanced and elite for the 165lb class on Rippletoe's strength standards at: http://www.crossfit.com/cf-journal/WLSTANDARDS.pdf), but lately I've been plagued by a few injuries that have kept me from doing a serious workout. They are detailed below.

Injury 1 (Mid-Back)

1. When did the pain begin?
Beginning of November.

2. What were you doing at the time? Or did the pain come on gradually over time?
I was doing jerks and had to drop the weight. As I was cleaning the weight back up, I felt a sudden twinge in my mid-back.

3. Where, anatomically, is the pain?
It is located on the right side of my back between my spine and my right scapula, but closer to my spine. Vertically, it is just about at the height of the pointy bit of my scapula.

4. What does the pain feel like? Sharp? Dull? Aching? Stabbing? Shooting?
When it hurts, it's sharp or stabbing. It definitely isn't dull and doesn't ache, and it doesn't spread to other parts of my body.

5. Is the pain constant, or intermittent, or only on certain motions?
I only feel pain when I do certain motions. At other times, I am "aware" of the injury in that my right side feels different from my left, but it doesn't hurt.

6. What motions make your pain worse?
I can trigger the pain by doing a front raise with a barbell. Also, putting down deadlifts hurts a lot. Strangely, picking up a heavy deadlift doesn't hurt very much. It also hurts a little to do any sort of horizontal rowing motion.

7. What, if anything, makes your pain better?
It pretty much hurts whenever I do the movements above.

8. Does your pain radiate to any other part of your body?
No.

9. What things could you do before, that you cannot do now because of your injury?
Deadlifts. Cleans. Any heavy horizontal pulling motions.

10. What is your main concern regarding the pain and its consequences?
Not being able to do my workout. This, combined with a sprained wrist from September, has kept me from doing a real workout for almost four months.

11. Have you ever injured that part of your body before? If so, how?
No.

12. Is your pain getting worse over time? And if so, how much worse over what time period?
It has stayed more or less the same. It might be a little better, but not enough to allow me to start working out seriously again.

Injury 2 (Lower Back)

1. When did the pain begin?
Last Saturday (December 13), but I injured the exact same spot in mid-September, so I guess the true injury started from there.

2. What were you doing at the time? Or did the pain come on gradually over time?
The first time (mid-September), I was doing front squats and had to dump the weight. As I dumped it, I felt a pain in my lower back. The second time (last Saturday), I had just finished a set of front squats and was walking around for a few minutes before the pain began. When I do front squats, I go hamstrings to calves.

3. Where, anatomically, is the pain?
On the lift side of my spine somewhere in the L4-L5 or L5-S1 (?) area. If I dig my knuckles past my spinal erectors on the left side of my spine, it hurts. It doesn't hurt if I do the same for the right side of my spine. The pain feels more like it's "on" my spine rather than "in" it, though it more or less sits right on it, if that makes any sense.

4. What does the pain feel like? Sharp? Dull? Aching? Stabbing? Shooting?
Sharp or stabbing. Not dull or aching. For the first day, the pain felt like it spread a little to the top part of my left glute, but it's gotten better since then.

5. Is the pain constant, or intermittent, or only on certain motions?
It was constant with any motion for the first day. It's gotten better since then and I can walk without pain, but I have to hobble a bit.

6. What motions make your pain worse?
Holding a heavy weight with my right (but not left) hand. Squats. Bending at the hip.

7. What, if anything, makes your pain better?
I did some very light (broomstick) RDLs and SLDLs which gave my back a good pump and allowed me to move around without pain for a little while.

8. Does your pain radiate to any other part of your body?
Initially to the top of my left glute, but not any more.

9. What things could you do before, that you cannot do now because of your injury?
Almost everything really. Lower back pain sucks.

10. What is your main concern regarding the pain and its consequences?
As above. I'm worried that I won't be able to train, and that depresses me. I can still do pushups and pullups, but that's about it.

11. Have you ever injured that part of your body before? If so, how?
Yes, in September (detailed in point 1). I believe it may be the same injury that just never quite healed.

12. Is your pain getting worse over time? And if so, how much worse over what time period?
It was getting better (movement without pain unless I dug around with my knuckles) until I re-injured it.

Before these two, I also sprained my wrist doing cleans (elbow hit my knee at the catch, mid September) and had a few problems with my left hip that I managed to cure (maybe) with mobility drills (pain since June, no pain since November). These are the only injuries I've ever had that have made me modify my workout or behavior. I've had minor aches before, but usually just push past them.

Sorry for the long post, and thanks for your help! Let me know if there is any more information I can provide that would be useful.

P.S. Actually, when reading my responses to the question above, I kind of feel like a moron because I get the feeling that the injuries are caused/re-caused by jumping into training a little too early, but I'd still be interested in what other people have to say anyway. Thanks!

[UConnJulie]

They both sound muscular, but could also be articular (ie the facet joints).

In the mid-back one, any pain upon taking a deep breath? How about with isolated thoracic spine rotation (both directions)?

In the lower back, how does it feel to lie on your stomach and rest, propped up on your elbows? What about pushing all the way up onto your hands (but letting your pelvis rest on the ground)? Now bring your butt back to your heels and your chest to the ground. Any pain with that?

[blooey]

Hi Julie. Thanks for the reply (and beautiful kids, by the way).

I'm not sure what an isolated thoracic spine rotation is, but I can twist my upper body in either direction without my mid-back hurting. My lower back hurts a bit if I twist to face right.

The lower back movements were more clear to me. I was able to perform them all without pain. The pain is still there (I tested that by doing some deep squats), but not when I perform those specific movements.

[UConnJulie]

Do you have a foam roller?

What kind of lower body flexibility exercises do you do?

Any history of shoulder problems/pain?

[blooey]

Do you have a foam roller?
No, but my gym does, and I use it after every workout, though I'm not nearly as diligent with rolling as I am with my workout. When I do use the foam roller (probably 3 times a week, on average...I train 4 times a week), I typically start with my calves, hamstrings, glutes, lower back, mid/upper back, then move to my quads, hip flexors, and inner/outer thigh. I don't foam roll my upper body much (lats occasionally).

What kind of lower body flexibility exercises do you do?
I didn't start doing any real mobility or flexibility work until about July of this year. I started then because of the hip problem I mentioned in my first post. I also don't do a whole lot of static stretching.

On workout days, my warmup is below (please forgive my descriptions...I don't know if the names are entirely accurate). I don't always do things in order, but this is how I usually progress.
+ Ankle mobility drills (where I put my foot close to a wall and bring my knee to the wall)
+ Leg swings (front-back and side-to-side)
+ Lunges (front and side)
+ Over-under drills (Set the bar in the power rack to about mid-thigh, then step over it. Set the bar slightly higher, and slide under it.). These are from side to side.
+ Hurdle drills (Set the bar in the power rack and pretend I'm doing hurdles, without the running bit)
+ Bird dogs (Get on the ground on your hands and knees, then swing my leg around like a dog peeing. I also do the one where you only leave one hand and knee on the ground.)
+ Overhead squats (45lb bar)
+ Sots Press (45lbs - Put the bar across your back in squat position, then lower yourself into an overhead squat while keeping the bar the same distance from the ground).
+ Hip circles
The whole thing takes me 5-15 minutes depending on how many reps I do of each.

On non-workout days, I do the above, but use a broomstick instead of the bar. As with foam rolling, I'm not 100% on these, but I probably average 2 times a week (because the other four days I'm working out).

What I do is a bit of a mishmash of things I've read on T-Nation over the years. I sometimes feel that if I were to do all of the stretches/mobility work that the coaches recommend, that would be all that I have time for. I used one of the articles as a base (I believe it was Mike Boyle's mobility article, but I can't recall the exact exercises right now) and added additional movements that I felt would help me.

Any history of shoulder problems/pain?
I've never had enough shoulder pain to really notice it, though my shoulder has felt "achey" before, usually after I make a mistake in the gym. For example, I once got too ambitious with flat dumbbell benching and ended up bouncing the last few reps. My left shoulder ached for a few days after that, but not enough to change my workout (I don't do much pressing anyway).

[UConnJulie]

To fix the current complaints start with more focused foam rolling on the sore spots. To get into the lower back use a tennis ball or lacrosse ball instead of the roller. If it is too painful, do it up against a door or wall. The ball might work better in the mid/upper back too.

I'd also add in some static stretching after your workouts or on alternate days or something. Hamstrings. Quads. Hip flexors. Calves. Glutes/piriformis. Pectorals.

Those should alleviate your pain. When you start back at it, make sure you are doing stuff to get the lower traps and rhomboids working again ... like face pulls, YTWLs, etc.

[blooey]

Thanks for your advice. Unfortunately, I'm visiting my brother, who doesn't have any tennis balls, but I'm sure I can scrounge around for some. I will be adding stretching to my routine, since it seems that lack of flexibility is a problem with me (especially on my left side).

If I may ask, I know what a face pull is, but what is a YTWL?

Thanks again for your help!

[UConnJulie]

You can get a sleeve of tennis balls for $5 at any Wal-Mart.

If you do a search here, there are lots of posts on YTWLs ...

[blooey]

Interesting. Sometimes it seems so easy to get an answer from someone who knows that I forget to search myself (which I usually do).

And yeah, tennis balls are cheap but I hate spending money. I suppose that spending money to stay healthy is one of the things i should spend money on, though.

Thanks again for your help.

[UConnJulie]

Dude, it's less than $5. You probably spend more than that on a latte!!

[blooey]

That's true, but I actually don't buy lattes because I consider them a waste of money. I even avoid buying beers as much as I can until I feel an excess of social pressure. I'm really cheap . I also have tennis balls at home, just not at my brother's apartment (came here before I started the threat).

But I do get your point .

[CoQ10]

Julie -

You asked the OP if he had a history of shoulder problems. Is there a link between chronic shoulder issues and lower back pain? I've been struggling with the former for quite some time now and am starting to have lower back issues as well.

Thanks,
C10

PS - Hope you're well, OP. I know firsthand how debilitating a lower back injury can be!

[UConnJulie]

Everything is connected!! But yes, if your scapular stabilizers aren't functioning well, then you likely have hip issues as well, which correlate pretty strongly to lower back stuff.

[blooey]

I just wanted to follow up briefly on the above injuries (I hate it when I try to help someone and they never respond, so...). Now, four months out, I'm pretty much pain free with respect to the injuries I referenced above. I've managed to mess myself up in other ways, of course, me being me, but the new "injuries" aren't things I'm terribly worried about. For example, I was trying to do some flags last weekend and ended up holding onto the bars for a bit too long while I failed, twisting my shoulders slightly. Oops. It feels better now, though, so yay. I am still young and, once again, invincible.

For the record, I started doing the full Ian King stretching routine (there was a T-Nation article about it, but I forget the exact link) after every workout and foam rolling after the lower body ones. This is in addition to the mobility drills I do as warmups. On off days, I also use a tennis ball to roll any muscles on my back/legs that feel tight. I admit to being less than disciplined about doing YTWLs, but I'm sure I'll be better about it in the future since I'm trying to bring up my bench.

And yes, I did end up getting some tennis balls after all. My wallet weeps. My gym has foam rollers, so I just roll there.

So thanks! I guess what I should have done was fairly obvious, but it's nice to think that I'm special, just like everyone else .