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Herniated disc 1 year ago but still no relief

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  • Herniated disc 1 year ago but still no relief

    I had been strength training since 2014 and in Nov 2018 I herniated my L4/L5 during a conventional deadlift set. I remember the exact moment when it happened (felt some movement in the low back).

    Saw 20 different health care providers (PTs, Chiro, RMT etc) since then. Most misdiagnosed my problem and prescribed stretches, clam shells etc. Paid for an MRI and confirmed the herniation. Then saw two professionals: Stuart McGill Certified Professional and Stuart McGill Certified Master Clinician. They both prescribed walking and the big 3. Pretty much whatever is in the back mechanic book.
    Not much relief.

    Started doing Mckenzie pushups and they seem to provide some very short term relief. Also, can't sit without a lumbar support (otherwise, get the burning pain right away) so I carry one everywhere.

    In terms of training, as suggested by the McGill professionals, I haven't been doing anything for lower body except walking. No spinal compression (no OHP either which sucks because it was favorite lift). Only train bench press, pullups and dips.

    I finally got to see a pain management specialist and have had 2 cortisone steroid shots in the spine. No relief at all. In fact, the 2nd shot (which was a week ago) has made matters worse.

    I'm 35 and don't want to get surgery. My pain is at a 2-4 (on a scale of 1-10) 24 hours a day and I get some sciatic pain (in the left leg/hip) but I can still perform most daily tasks.

    I recently discovered Barbell Medicine and have been in information consumption mode. In Episode 72, Dr. Baraki mentioned that herniated discs can take 2 months to 30 months to heal so I'm still hopeful.

    Should I avoid the spinal hygiene/big 3 stuff and just start incorporating some sort of a squat and hip hinge back into my training? (finding a load that I can tolerate, find a pain free ROM etc).
    And should I continue walking? (I get short term relief from pain while walking).

  • #2
    Hi there,

    I'm sorry to hear about your journey. It is a common one and I'm sure can be very frustrating. With that said, I'm glad to hear you are learning from our content and remain hopeful/optimistic about the future, as you should be.

    We don't believe "spinal hygiene" is a thing, nor do we think there is anything uniquely beneficial about the "big 3" compared to any other form of exercise that an individual can tolerate and adhere to, particularly when combined with appropriate education on the topic. I would strongly encourage you to read this article as a starting point:

    I would also strongly encourage you to continue walking and remaining generally active, trying to live your life as "normally" as possible. We would also agree with incorporating some form of squatting / hinging into your exercise -- an initial approach could look like something outlined in that article if you are trying to work through this process yourself, which is great!

    Alternatively, if you are interested in more structured / explicit prescription and guidance, we also have resources available (e.g., back pain template/consult bundle, as well as rehab consults and coaching with our staff).
    IG / YT


    • #3
      Thank you, Dr. Baraki. Really appreciate the response. I'll certainly look into the back pain template. Is it pertinent to someone with chronic pain for over a year?

      I did some goblet squats and single leg RDLs but unfortunately, the pain got worse the next day. It wasn't just DOMS. Seems like all the muscles got extremely tight. The Sciatica got worse too. One thing I noticed is that the movements themselves were not painful. Should I 'power through'?

      Lastly, what's your opinion on the Mckenzie press up? The McGill folks advised against it but in my case, they certainly help with the pain (more than the big 3 ever did).


      • #4
        I'm sorry to hear about your back and your experience with clinicians thus far. The main thing you need to look for at this point is where to start. Continuing with your walking program is fine, but if you are on a program now that feels stagnant, it is likely time to change some variables. You are perfectly fine to do press ups if they provide relief. At this point there really are not bad movements, and starting to add in some variability can be beneficial. Often what happens in situations like this is you have an issue, see a clinician, clinician tells you to stop doing "x," you stop doing "x" but get no relief, see another clinician, get another "x" and so on and so forth until there's not really much you feel comfortable doing.

        To your most recent post, maybe we need to start with just a body weight squat and hip hinge. Once you get to where you tolerate that, we can add some weight. There are also other exercises with which to work such as lunges, leg press, and even machine work if need be. The ultimate goal is to get you feeling better and back to training. This comes from starting to chain together small wins. It sucks man and I'm sorry you've been going through it, but there is a lot you can work on to get yourself over the hump.


        • #5
          Thank you, Derek. The encouragement and guidance is much appreciated.

          I will start with body weight squat and hinge.

          Besides the Mckenzie press up, is there anything else I can do to stop the disc from pinching the nerve? I've tried the nerve flossing method but it didn't help.


          • #6
            Not that I am an expert on the subject to the same level as the Doctors here - I have merely read through a lot of the content these guys have put out or promoted. I "herniated a disc" (there is some evidence that it has been herniated for much longer) last February during a squat and I still am dealing with symptoms. In fact, only the last month or so things have started to get significantly better. I made a lot of mistakes in managing this, such as very inappropriate loading shortly after as things seemed like they were improving, and just letting it defeat me in a way. It is very hard to manage over such a long period of time and can be exhausting and frustrating.

            But, I HIGHLY recommend Austin's most recent article (linked above; What do). I wish i had it earlier, even though that information was there; it just never really clicked before. Read it religiously, re-read it again and again, truly try to understand it and understand the article (and Embrace the Process). There is no time limit or estimation how long it can take - but that is part of the process. For me, the hardest part to wrap my head around seemed to be finding an entry point - they mention you may have to get creative and it is true! I thought "well i seem to be able to tolerate empty barbell squats mostly, i should therefore be able to tolerate something like a split squat - just in case ill also do it with less range of motion too". Turns out - it was split squats and perhaps dumbbell overhead press were making symptoms worse for me for months (things i thought would not at all be contributing to increased symptoms).

            There was a lot I had to do, such as un-marrying myself from the main movements (knowing it would only be temporary; and in fact may not be necessary for everyone) - manage expectations (chaining those small wins in the gym to build up confidence). Also, it really helped to practice mindfulness, understanding that a lot of my expectations were actually contributing to my symptoms - such as getting up from bed and how i moved was like bracing for pain. Suddenly I was able to sit during a meal, or for prolonged times at work - and drive without much pain. I was able to box squat, then pin squat (focusing on improving range of motion under little load rather than just trying to pump up the weight on just the box).

            Now, I am back to squats to about parallel and am consciously trying to slow my pace in terms of load increase. Trying to take it from the point of view of a big picture. I am also currently working on getting my body comfortable with forward flexion of the spine since that seems to increase symptoms. An example of how one can do this is rather than beating yourself up mentally on how you just wish you can deadlift again, maybe focus on training something you did less of or not at all before. I was doing rack pulls for a while, and now am moving towards a trap bar deadlift (never really programmed those) and maybe the sumo deadlift (also never programmed). Missing something has been reframed into an opportunity and I am able to continue training. And hey, maybe if the load is tolerable and appropriate, time to emphasize a little more on getting that bench up? There are a lot of options out there. Maybe there is more that you can still do vs what you cannot still do (for now).

            This is obviously easier said than done but try it - it may seem like you tried everything but try to re-frame things for yourself. Perhaps even try to be somewhat scientific about things - only modifying say 1 exercise a week and record it so you can isolate what may or may not be working for you (increasing symptoms or not). Understand too - that what may work at one point may not work later on. We are adaptive, and pain is complex. I also highly recommend one of BBM's latest videos on YouTube (at an army base?) where Jordan talks about pain - comparing it to hunger. It is a lot to take in, but chew it, think about it, and maybe try things again if need be (hopefully with a new mindset).

            (my results may be anecdotal, but the processes behind it and discussed here are backed by evidence)

            Also - mandatory Canadian apology for the rant there, eh.

            TLDR: Implant Austin's last article into your brain, maybe consider tattooing it somewhere you can read it all the time. And what Derek said.
            Last edited by azeemqwerty; 12-18-2019, 02:57 AM.


            • #7
              I’ve been dealing with this for over 2 years man and I know it sucks. My symptoms are probably a 6/10 on average.I get burning and tingling in lower back and down both of my legs. I am dropped out of school for a little while until this issue is under control because I can’t sit for 5 minutes or stand for long without symptoms. I train some stuff in the gym to work all my muscles but I can’t do a lot of things. I hope you make some progress with your issue. Have you improved at all?